St Matthews Home for the Elderly

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced required annual visit using the Compliance and Regulatory Enforcement (CARE) Tool. LPA was greeted by Reinalyn Martin, Caregiver explained the reason for the visit. Silvia Castro, Administrator arrived shortly thereafter. The facility is licensed to serve residents ages sixty (60) and older. The approved capacity is six (6) non-ambulatory residents and one (1) bedridden only. This facility may retain no more than two (2) hospice residents. There were two (2) residents under hospice care during inspection. Facility Tour & Observations Personal Rights postings (LIC 613C and Ombudsman), Complaint Poster (PUB 475), and nondiscrimination notice were observed in a common area. Residents had access to personal space, privacy, and adequate storage. No firearms/weapons were present. Physical Plant The facility is located in a residential area and consists of a one-story home containing four (4) resident bedrooms, three (3) restrooms which one is private restroom, kitchen, dining/living room area, garage/laundry area, front yard, and backyard. LPA observed four (4) resident bedrooms, all containing the required furnishings including beds, mattresses, linens, dressers, chairs, and adequate lighting. Cleaning supplies and toxic substances were observed locked and inaccessible to residents in the kitchen, garage, and under a bathroom sink. Bathrooms were clean and equipped with required grab bars near showers and toilets, as well as non-skid mats. Hot water measured within the required range of 105°F–120°F. Extra linens and towels were available in a hallway cabinet. Smoke and carbon monoxide detectors were tested and observed to be functional. Several fire extinguishers were observed throughout the facility. No bodies of water were present on the premises. The backyard provided shaded seating for residents. Passageways and exits were observed to be clear and unobstructed. (continued on 809C) Food Service Refrigerators/freezers were maintained at proper temperatures (refrigerators maximum of 40 degrees °F and freezer 0-degree °C) with sufficient supply of 2-day perishable and 7 days non-perishable food. Fresh produce, proteins, and dry goods were stocked. Knives and were observed in a locked kitchen cabinet. Health-Related Services & Records Four (4) resident files were reviewed and contained current required documents including Admission Agreements, Pre-Placement Appraisals, Consents, Needs and Services Plans, Physician’s Reports with TB and ambulatory status, and Personal Rights acknowledgments. During record review, it was observed that R4 did not have a physician’s order for bed rails. Threer (3) residents’ medications were reviewed and observed to be centrally stored in a locked closet near the front entrance. Centrally Stored Medication and Destruction Records were observed to be current. Disaster Preparedness Last fire/earthquake drill was conducted on March 06, 2026, with logs available. LIC 610D. Emergency supplies (water, food, flashlights, batteries, first aid) were observed in the garage. Infection Control Plan was updated. Personnel Records & Training Three (3) staff files were reviewed and included criminal record clearances, CPR/First Aid, required training and TB screenings. Administrator Certificate for Silvia Castro was valid through October 14, 2026.. Insurance Liability insurance was in compliance with an expiration date of June 26, 2026. An exit interview was conducted with Silvia Castro, Administrator. During the inspection, deficiencies were observed and cited on the attached LIC 809D/809C in accordance with Title 22, Division 6 regulations. A copy of this report, LIC 809D/809C, and appeal rights will be provided.the state’s words, verbatim · CDSS document, May 7, 2026

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: POC

Licensing Program Analyst (LPA) Gabriela Castro conducted a Case Management visit to follow up on the Plan of Correction (POC) for outstanding annual licensing fees for St. Matthew Home for the Elderly, Facility #198602197. Per Community Care Licensing (CCL) records, the facility’s last annual fee payment was received on 07/23/2023. LPA attempted to meet with the Licensee; however, the Licensee and Administrator were contacted via telephone and informed in detail of the purpose of the visit. During today’s visit, LPA reviewed the facility’s payment history and observed that past-due annual licensing fees in the amount of $1,484.00 have not been paid. In addition, the Licensee has failed to submit the required Plan of Correction (POC) to the Department by the due date of 12/25/25. Due to continued non-compliance, an immediate civil penalty in the amount of $100 per day is hereby assessed for the period of 12/26/25 through 12/29/25, and will continue to accrue until the violation is corrected. Refer to LIC 421 FC. An exit interview was conducted. Copies of the report, LIC 421 FC, and Appeal Rights were provided to the Lead Caregiver.the state’s words, verbatim · CDSS document, Dec 30, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Gabriela Castro conducted a Case Management visit to follow up on outstanding annual licensing fees for St. Matthew Home for the Elderly, Facility #198602197. Per CCL records, the facility’s last payment was received on 07/23/2023. LPA has made multiple attempts to contact the Licensee to confirm payment status. On 09/26/2025, LPA emailed the Licensee and attempted to call the phone number listed on the facility profile; however, the number was found to be non-working. LPA has continued to request an updated, working facility phone number. On 10/01/2025 and 10/30/2025, LPA made further attempts to contact other partner facilities under the same Licensee in an effort to obtain updated contact information. Messages were left requesting a return call. On 11/25/2025, Licensing Program Manager (LPM) contacted the Licensee directly and spoke with them regarding the outstanding annual fees and the facility’s non-working phone number. A letter was generated and sent to the Licensee documenting the requirement to resolve both issues. On 12/11/2025, LPA sent a text message to the Licensee requesting an update on the outstanding fees and again requested an updated facility phone number. As of today’s visit, record review indicated that the facility’s licensing fees remain unpaid, and the facility telephone number has not been updated. Licensing Program Analyst provided the facility’s assigned PIN to facility payment of past due annual fees. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed are indicated on the LIC809D page. Exit interview held and a copy of the report along with appeal rights were provided.the state’s words, verbatim · CDSS document, Dec 23, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87156(a)(F) · Plan of correction due date: Dec 25, 2025

87156(a) An applicant or licensee shall be charged fees as specified in Health and Safety Code section 1569.185. (F) A late fee that represents an additional 50 percent of the established annual fee when any licensee fails to pay the annual licensing fee on or before the due date as indicated by postmark on the payment. This requirement is not met as evidenced by: Based on record review, Licensee has failed to submit the required facility annual fees, resulting in noncompliance.the state’s words, verbatim · CDSS document, Dec 23, 2025

Plan of correction: Licensee will submit the required facility annual fees to the Department by 12/25/25. Licensee will ensure all future annual fees are paid by the required due date to maintain compliance.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met Caregiver Reinalyn Martin at approximately 12:22 PM and explained reason for visit. Administrator Silvia Castro was notified by telephone. This facility is a Residential Care for Elderly (RCFE) to serve residents for age 60 and above. The facility is approved for 1 bedridden and 6 non-ambulatory. The facility may retain two (2) hospice residents. LPA Gutierrez observed two (2) bedridden residents at time of visit. Immediate civil penalty was assessed. Facility has a Dementia Care program. The Facility is a single-story building in a residential area with four (4) resident bedrooms, three (3) shared bathrooms, kitchen, dining room, living room, den/tv room, front yard, backyard and attached car garage. All resident bedrooms were toured. Each bedroom has a bed, linen, dresser, and lighting. Smoke detectors/carbon monoxide detectors were observed in each room and throughout facility. The facility has one (1) fire extinguisher that is fully charged in kitchen. Cleaning supplies and toxic substances are inaccessible locked in garage. 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 resident bathrooms have the required grabs bars and non-skid mats. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The common areas include the living room and dining area are clean and have the required furniture. The facility does not have a swimming pool or large body of water. There is a shaded seating area for the residents in back yard. Passageways and exits are free of obstruction. Three (3) staff files were reviewed and included Criminal clearance record, and health screening with TB, and CPR/First Aid certificates. Three (3) out of six (6) resident files were reviewed and included physicians report, TB clearance, and appraisal needs and service plans. R1 did not have admission agreement, consent forms ,appraisal needs and service, and identification and emergency form. R4 was missing TB test. R5 missing completed physicians form and order for bedrails. Last fire/earthquake drill was conducted in March of 2025. Infectious control plan was reviewed. (1) resident was interviewed. Resident medications were reviewed, and no discrepancies found. Medications are centrally stored and locked MAR log is used. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC809Ds. Exit interview held and a copy of the report along with appeal rights were provided.the state’s words, verbatim · CDSS document, May 23, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Annual Required Visit on 04/15/2024. LPA was met by Licensee Terry Mcgee and explained the purpose of the visit. Facility is licensed to residents 60 years old and above. The facility is approved for 1 bedridden and 6 non-ambulatory. The facility may retain two (2) hospice residents. LPA requested and obtained a copy of Personnel Report (LIC 500), Resident Roster (LIC 9020) and copy of liability insurance. LPA OBSERVATIONS: The Facility is a single-story building in a residential area with four (4) resident bedrooms, three (3) shared bathrooms, kitchen, dining room, living room, den/tv room, front yard, backyard and attached car garage. Front Yard: Was clean and well maintained. No hazards were observed. Kitchen: LPA observed kitchen to be clean and appliances appeared to be in working order. LPA observed sufficient 2 days of perishables and 7-day supply on non-perishables. Dining Room/Living room/Den/TV room: Dining room was observed to be clean and contained table and 5 chairs. Living room area has plenty of seating for residents and guests. Den/Tv room was observed to be clean and contained plenty of seating. Linen Closet: Contained plenty linens, towels, and hygiene products. Resident Rooms 1 - 4: All contained the required furnishings, linens and were observed to be clean. See 809-C Bathrooms 1-3: Resident bathroom# 1 was observed to be clean and contained soap and paper towels. Signs promoting hand washing were observed. Grab bars were observed near toilet and shower. Water temperature in this bathroom were measured to be within the required 105 – 120 degrees F. Shared resident bathroom #2 water temperature was measured to be within the required 105 – 120 degrees F. Grab bars were observed near toilet and shower. Resident bathroom #3 only has a toilet and sink. Water temperature in this bathroom was measured within the required 105-120 degrees F. Centrally Stored Medications: LPA’s observed hallway closet located near entry to be locked and inaccessible to residents. Attached Garage: LPA observed extra bedding supplies, cleaning products and hygiene products. Garage was locked and inaccessible to residents. Backyard: Clean and free from hazards. LPA observed plenty of seating and shaded area. LPA observed carbon monoxide in hallways. Smoke detector is hard wired and tested during visit. LPA observed auditory sensors on front door and sliding door. Administrator certificate was observed for Deborah Davis with an expiration date of 01/15/2025. No deficiencies are being cited. Exit interview was conducted with Licensee Terry Mcgee and a copy of this report was provided via email due to printer problems.the state’s words, verbatim · CDSS document, Apr 15, 2024