St Jules Care Villa

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nune Margaryan conducted an annual required visit. LPA met with Administrator Maria Quiogue and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. The physical plant was inspected along with medications, food supply, and residents and staff records. The facility is licensed to serve 6 residents over 60 years old of which 4 may be non-ambulatory, with a Hospice Waiver approved for 3. The facility currently has 4 residents. Currently 2 residents on hospice. The facility is a single story structure located in a residential neighborhood. It consists of the following: 3 resident bedrooms ( one is shared), 1 staff room, 2 bathrooms, kitchen, dining room, living room, laundry area, attached garage. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the residents located in the backyard. LPA toured the facility. All indoor and outdoor passageways were free of obstruction. The kitchen was inspected. LPA observed all kitchen equipment to be clean and in working condition. LPA observed sufficient supply of perishable and non-perishable foods. Sharps, cleaning supplies are locked and inaccessible to residents. Smoke / Carbon monoxide detectors were in compliance and operational. There are 2 fire extinguishers ( in the kitchen and in the hallway) which are fully charged. The common areas (dining room, living room) are clean and were properly furnished. Covered Fireplace observed in the living room. Resident rooms were sanitary and had the required furniture and furnishings. Oxygen tank was observed in share bedroom and "No Smoking - Oxygen in Use" sign was posted outside resident room doors. LPA observed medications are centrally stored and locked in the dining room. Laundry are was observed in the garage. Garage door was locked at the time of visit. Extra freezer was observed in the garage. There are extra clean linen and towels in garage cabinet. Continue 809C The resident bathrooms are clean and operational w/grab bars and non-skid surface/mats in place. The hot water temperature was tested and maintained within the required range of 105-120*F. The first aid kit was observed and found to be in compliance with the Title 22 Regulations. LPA reviewed 2 residents and 3 staff files. LPA observed staff maintained a criminal record clearance and are associated to the facility. LPA reviewed residents' medications. Medications are documented properly and stored appropriately. Deficiency was noted on LIC 809D. Exit interview was conducted. Copy of this report and appeal rights were provided to Maria Quiogue.the state’s words, verbatim · CDSS document, Oct 17, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA was met by Caregiver Alan Punsalan at approximately 9:00 AM and explained reason for visit. House manager Maria Quiogue arrived shortly. Facility is licensed to serve six (6) residents over 60 years old four (4) can be non-ambulatory. Hospice waiver approved for Three (3). The facility is in a residential area, and it is a one-story family home. A tour of the single-story facility included the living room, kitchen, dining room, three (3) client bedrooms, one (1) staff room, 2 bathrooms, front yard, backyard, attached garage. LPA toured the facility and observed the following: Each resident’s bedroom has the required furniture and bedding. R1 did not have physician orders for bed rail deficiency cited. There is extra clean linen and towels in garage cabinet. Smoke / carbon monoxide detectors were observed in each room and throughout the facility and are properly operating. The facility has two (2) fully charged fire extinguishers which is kept in kitchen and hallway. Cleaning supplies and toxic substances are inaccessible locked in cupboards in kitchen. 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. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. Bathrooms had required grab bars and nonskid mats. 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. Garage has an extra freezer and supplies. SEE LIC 809C Three (3) Staff files were reviewed. Administrator did not have file at facility deficiency cited. Two (2) resident files were reviewed and were missing physicians report, consent forms, personal rights LIC 613, and appraisal needs and service. Fire/earthquake drill was not conducted deficiency cited. Infectious control plan was not available. The medications are centrally stored and locked in a cabinet in dining room. LPA reviewed medications for all residents, 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 Maria Quiogue.the state’s words, verbatim · CDSS document, Dec 17, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced Required One (1) year - Inspection to this facility and met with staff Richard "Rika" Fernando, who assisted with facility tour. At approximately 11:00AM LPA met with Administrator Fernan David to assist with the visit. The facility is licensed to serve 6 (six) ambulatory residents ages 60 and over of which (4) may be non-ambulatory. Facility is approved to for (3) residents on hospice, currently the facility has (0) residents currently on Hospice Plan. LPA Calderon and "Rika" toured and inspected the facility. Facility is a single story home, physical plant includes: (3) resident bedrooms and (1) staff bedroom, and (2) bathrooms, kitchen, dining, laundry area (located in the garage), an attached garage and backyard. The bathrooms are clean and operational with grab bars and non-skid surface/mats in place. The hot water temperature was tested throughout the facility and maintained within the required range of 105-120*F. The common areas dining room and living room were clean and properly furnished, no obstructions in pathways/ hallways. Resident rooms are clean and were observed with appropriate bedding/ linen and furniture. Two (2) residents: Resident #1 and #3 were observed using a hospital bed and 1/2 rails, no physician report was provided, deficiency cited. Resident #2 sleeps in recliner due to personal choice. The kitchen was observed for the ability to prepare and serve food. Kitchen appliances are clean and were operating at the time of the visit. Sharps are locked in the kitchen and are inaccessible to residents. LPA observed a sufficient supply of perishables and non-perishables. Cleaning supplies and toxins are locked and are inaccessible to residents. Temperature maintained at the house was maintained comfortable during the visit. (Continuation LIC 809-C...) The fire extinguishers observed to be fully charged. Smoke/carbon monoxide detectors were observed to be fully operational. Administrator was unable to provide documentation on Fire Drill to LPA, deficiency noted. LPA reviewed training's, Administrator was unable to provide training in-services, deficiencies were cited. LPA reviewed resident files, Resident #1, #2 and #3 did not have Appraisal Needs and Service Plan in resident's file during review, deficiency cited. LPA was unable to review staff files, Administrator informed LPA staff files weren't present during facility visit (missing training and personnel records), deficiencies cited. LPA used staff roster LIC500 and verified staff clearance on Facility Personnel Report Summary, all staff were cleared and associated. Medication was reviewed at 2:15pm, Resident #1 , Resident #2 and Resident #3 did not have a list of centrally stored medications. LPA toured backyard and ramps, pathways and were safe and was observed clean/ no bodies of water were observed and shaded area is provided. Liability Insurance was not provided to LPA, deficiency cited. LPA conducted interview with resident #2 and did (2) attempt interviews. Administrator Certification submitted certification renewal documentation's in a timely manner, Administrator is waiting for certification with CCLD- Administrator Certification Section. Per California Code of Regulations, Title 22, deficiencies were observed during the visit and LPA issued citations. LPA Calderon provided copies of LIC809, LIC809-C, (5) 809-D pages and Appeal Rights. Exit interview conducted and a copy of the report was provided.the state’s words, verbatim · CDSS document, Dec 14, 2023

The state marks this report as 15 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.