St. Jude's Elder Care II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced annual inspection visit on 11/20/2025 and was greeted by Caregiver Melinda Nofuente. LPA Ramirez identified herself and explained the purpose of the visit. The facility is located on a residential street and is a single-story dwelling. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Physical Plant and Environment safety: Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to residents, were observed to be inaccessible to residents. LPA Ramirez observed carbon monoxide detectors and smoke alarms in hallways. LPA Ramirez inspected four (4) resident rooms. All resident bedrooms contained required furniture, linens and lighting. Water temperatures in all grooming and bathing areas were measured to be with 105 – 120 degrees F. LPA Ramirez observed grab bars near toilets and inside shower. LPA Ramirez observed no-slip coating in showers. LPA Ramirez observed seated shower chairs in bathrooms. Food Service: LPA Ramirez observed sufficient supply of nonperishables for one week and perishable foods for a minimum of two days in the facility kitchen area. Soaps, detergents, and cleaning compounds were observed to be stored away from food supplies. Freezers and refrigerators were observed to be clean and within temperatures of 0-degree F (-17.7 degree C), and refrigerators with maximum temperature of 40-degree F. (4 degree C). see 809-C Planned Activities: LPA Ramirez observed board games, magazines, and other activities for residents. Residents Rights-Information: LPA Ramirez observed the following postings in common areas throughout the facility: Complaint Poster (PUB 475), personal rights, and nondiscrimination notice. LPA Ramirez observed facility land line. Disaster Preparedness: The facility has the Emergency Disaster Plan (LIC610D/9 pages) in place. Last documented emergency drills were conducted on 10/01/2025 and 11/01/2025. LPA Ramirez observed facility sketches with exits and emergency exits routes throughout various locations of the facility. LPA Ramirez observed emergency food supply located in garage. Residents with Special Needs: No large bodies of water were observed LPA Ramirez observed signs posted indicating “No smoking - Oxygen in Use” in various locations of the facility. LPA Ramirez observed several oxygen tanks in garage secured in stands. Knives, sharps or other items that could pose a danger to residents with dementia, were observed to be inaccessible. Auditory devices were observed to be in working order. During inspection, LPA Ramirez observed that R1 and R6 share a room. During record review of R6's resident records, LPA Ramirez did not observe a statement signed by R6's indicating their acknowledgment that their roommate intends to receive hospice care in the facility and their voluntary agreement to grant access to the shared living space to hospice caregivers and others. Health Related Services/Incidental Medical Services: The medications are centrally stored in the medication closet and in bubble packs and/or original containers. During the inspection of kitchen area, two (2) of R1's medications were observed stored adjacent to perishable food items, posing a potential risk to resident safety and highlighting a deficiency in medication storage protocols. During inspection of additional perishable foods located in accessible and unlocked garage, one (1) of R2's discontinued medication and R7's discontinued medication were observed stored adjacent to perishable food items, posing a potential risk to resident safety and highlighting a deficiency in medication destruction protocols. Staff interviews and records reviewed revealed R7’s services were terminated in 2024. Staff interviews revealed that R2 was removed from hospice on 10/15/2025, and the medication observed in garage fridge was discontinued by their doctor. LPA Ramirez observed Centrally Stored Medication and Destruction Record for six (6) out of the six (6) residents in care. The facility provides incidental medical services. Staffing: Administrator Certificate for Judy Ragno with an expiration date of 11/09/2027. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. see 809-c Personnel Records Training: Staff files are maintained at the facility. LPA Ramirez observed required annual training, CPR and First Aid for two (2) out of the two (2) personnel record reviewed. LPA Ramirez observed TB testing results, Health screening, fingerprint clearance and job application for three (3) out of the three (3) personnel record reviewed. Infection Control: Staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has an Infection Control Plan in place. Operational Requirements: The fire clearance is approved for five (5) non ambulatory residents and one (1) bedridden resident over the age of 59 years old. This facility may retain no more than six (6) hospice residents. There was one (1) resident on hospice during time of inspection. Resident Records/Incident Reports: LPA reviewed resident records for six (6) residents in care. Resident records are maintained at the facility. Admission Agreement, Physician's Report (including T.B and Ambulatory Status), Consent for Medical Treatment, Preplacement Appraisal Information, Resident Pre-Appraisal, Care Plan/Appraisal/Needs and Services Plan, Resident Rights were observed. Three (3) deficiencies were observed and cited during this annual inspection. Exit interview was conducted with Administrator Judy Ragno via telephone. A copy of this report, 809-D and appeals rights was provided via email due to printer out of ink.the state’s words, verbatim · CDSS document, Nov 20, 2025

Type of visit: Case Management - Other

The purpose of this report addresses a deficiency that was cited on 08/13/2024. On this day facility was cited for CCR 87412(g) it was appealed and dismissed by department. LPA Gutierrez met with Caregiver Melinda Nofuente and Administrator was notified by phone. A copy of this report was left with Caregiver.the state’s words, verbatim · CDSS document, Oct 22, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced Annual Required Visit at 8:00 AM. LPA was met by Caregiver Melinda Nofuente and explained the purpose of the visit. Administrator Judith Ragano arrived shortly. Facility is licensed to serve residents over 60 years and over. Approved for five (5) non-ambulatory, and one (1) bedridden resident. The facility is located in a residential area. The home consists of (4) resident bedrooms, (2) bathrooms, kitchen, dining room, living room, visitor/office room, laundry room, a shaded patio in the backyard, and an attached garage. LPA toured the facility and observed the following: Each client bedroom has the required furniture and bedding. There is extra clean linen and towels in a hallway closet. Smoke detectors were observed in each room and throughout the facility and are properly operating. There is 1 carbon monoxide in the hallway and is properly operating. The facility has one (1) fully charged fire extinguishers which is kept in the laundry room. At 8:17 AM LPA observed a bottle of Comet cleaner accessible to clients in bathroom #1 under sink. Caregiver removed and locked comet cleaner with other cleaning supplies in laundry room. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. Sharps are locked and placed in cabinet in kitchen. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between 96.2-116 not in the required range of 105-120 degrees F. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction. The garage is clean and has extra supplies. SEE LIC 809C Five (5) Staff files were reviewed and included Criminal clearance record, CPR/training, and health screening with TB. Administrator did not keep personnel files at facility deficiency cited. Five (5) Client files were reviewed and included physicians report, TB clearance. Fire/earthquake drill was conducted on August 3rd, 2024. Infectious control plan was reviewed. The medications are centrally stored and locked in a cabinet in dining area. The facility uses the Medication Administration Record (MAR) log to document medications given. LPA reviewed medications for all clients, and they are being administered as prescribed by the physician. Deficiencies have been noted on LIC 809D under Title 22 Regulations. Exit interview was conducted and a copy of this report, LIC 809D and appeal rights were provided to Melinda Nofuente.the state’s words, verbatim · CDSS document, Aug 13, 2024

Allegation investigated: Staff inappropriately touching resident. Staff hit resident.

Licensing Program Analyst (LPA) V. Maldonado made an unannouced complaint visit at the facility for the purpose of investigating the above-mentioned alleagtions. LPA Maldonado met with Administrator Judy Ragano, and explained the purpose for the visit. During today's visit, LPA Maldonado obtained a copy of the resident and staff roster, an incident report dated: 8/16/23 regarding Resident#1 (R1), and a copy of the following documents for R1: Facesheet, Physician's Report, and Pre-Placement Appraisal. LPA also conducted interviews with Residents#1-6 (R1-R6) and Staff#2-4 (S2-S4). LPA was unable to interview Staff#1 (S1) due to S1 no longer working at the facility. The investigation revealed the following: (Report continued on LIC9099-C...) Unsubstantiated Regarding allegation: Staff inappropriately touching resident. It is alleged that on 8/14/23, a S1 pinched R1's buttocks and was "pushing" themselves onto R1 from behind. Per staff interviews conducted, (2) of (3) staff denied the allegation. (1) of (3) staff interviewed could not corroborate the allegation. S2 stated that an internal investigation was conducted by S2 and nothing was found indicating the allegation to be true. S1 was let go of their position and is no longer working here, regardless of the findings of the facility's internal investigation. Per resident interviews, (5) of (6) residents could not corroborate the allegation. R1 denied the allegation and stated S1 did not make R1 feel uncomfortable or touch R1 inappropriately. This allegation was unsubstantiated. Regarding allegation: Staff hit resident. It is alleged that on 8/14/23, S1 pinched and slapped R1's face. Per staff interviews, (2) of (3) staff denied the allegation. (1) of (3) staff interviewed could not corroborate the allegation. Staff stated they are professional and receive training in treating residents with dignity and respect. Per interviews conducted with residents, (5) of (6) residents could not corroborate the allegation. R1 denied the allegation and stated S1 never hit R1. This allegation is Unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Per California Code of Regulations, Title 22, and Health and Safety Code, no deficiencies were observed or cited during today's visit. An exit interview was conducted and copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 29, 2024 · control 28-AS-20230816170212

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alberto Lopez conducted the required annual inspection. LPA arrived unannounced and met with DSP Melinda Nofuente and Administrator Judy Ragano showed up a short time later and assisted with the inspection today. The facility is licensed for 6 residents ages 60 and over. The fire clearance is approved for Six (6) non- ambulatory residents. Currently there are 6 residents at the facility. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: 1. Infection Control. The facility staff are using appropriate hand hygiene and wearing gloves while assisting the clients. Staff are cleaning and disinfecting each shift for high touched surface area. Facility has sufficient PPE supplies and has an Infection Control Plan. 2. Physical Plant and Environmental. The facility is a single story house and located around the residential neighborhood area. The facility includes living room, dining area, kitchen, four clients bedrooms, two bathrooms, and an attached garage with laundry area. LPA inspected the carbon monoxide detector and is working probably. The smoke detectors are in each room and common area, and they are working well. LPA tested the hot water temperature in two bathrooms and kitchen, and they were tested between 112.4 -117.9 degrees F. which is within the Title 22 regulation. All the sharp knives and utensils are locked in the kitchen cabinet. All the cleaning supplies and chemicals are locked in the laundry room. The facility has sufficient personal hygiene products for clients to use. All clients rooms are not completely furnished with chairs and have required beddings. All the bathrooms are clean, sanitized, and operational. The exit and passageway are is safe and clear of obstructions. There is a broken wooden gate, ramp that needs repair or replacement and debris on one side of home that needs to be addressed. 3. Operational Requirements. The facility maintained a fire clearance approved by the fire department which 4 may be non-ambulatory. Currently All the clients in the facility are non-ambulatory. The facility also has shaded area with table and chairs for client to utilize for outdoor activity. The last fire/disaster drill was conducted on 10/04/23. (Continue on 809C) 4. Staffing: The facility has sufficient staffing, and the night supervision staff did receive planned emergency training. 5. Personnel Record-Training: All the staff files are maintained in the facility. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. The administrator Judy Ragano’s certificate will be expired on 11/09/2023. All the direct care staff received Medication Management Training. The first aid training certificates for staff is current. 6. Resident Records-Incident Reports: Resident files are maintained at the facility and have the following documents in their files - Admission Agreements, Identification & Emergency Information, current Physician's Report, Pre-admission appraisal/Appraisal Needs & Services Plan. 7. Resident Rights-Information: The Complaint, ombudsman and CCLD poster and Residents personal rights are posted by the main entry. Visiting hours were posted at facility. 8. Planned Activities: Facility has sufficient space to accommodate indoor and outdoor activities. There are sufficient supplies and equipment to meet resident's physical capability. 9. Food Service: The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. The food is properly stored in the refrigerator (clean, labeled and well maintained). Pesticides and cleaning supplies are kept away from the food preparation areas. Kitchen is kept clean and free from rodents. 10. Incidental Medical & Dental: The medications are centrally stored in original containers. During the visit today, LPA reviewed 6 residents' medication files and all medications are administered according to Doctor’s orders. 11. Disaster Preparedness: The facility has an Emergency Disaster and Mass Casualty Plan containing emergency evacuation, storage and preservation of medications, The facility conducts emergency drill on a quarterly basis for all staff and residents. Facility needs to update emergency disaster plan. 12. Residents with Special Health Needs: No residents have prohibited health conditions. Deficiencies observed during today’s visit. See (809D) technical advisory was provided. An exit interview was held. A copy of this report, 809D, technical advisory notes, and appeal rights were provided.the state’s words, verbatim · CDSS document, Oct 6, 2023

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.