Sunset Garden II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alviso arrived unannounced to conduct a Required -1 Year inspection, on 2/24/26 at approximately 9:45am, and met with caregivers Dina Camilon and Estelita Cabardo. Staff contacted Administrator Eden Relota, and notified them the LPA was at the facility. The Administrator arrived to meet with the LPA for the annual inspection. Facility has an approved dementia plan of operation. There is an approved hospice waiver for two (2) residents. The facility has a required infection control plan. The facility has a required emergency and disaster plan. Per file review, last fire drills were completed on 1/20/26, Fire drill, and 12/10/25, Earthquake drill. Licensee is completing fire/evacuation/emergency drills quarterly as required. Fire clearance is approved for four (4) non-ambulatory, of which one(1) may be bedridden. There were three (3) residents in care at the facility. Two (2) fire extinguishers were serviced and tagged as required. Facility has a carbon monoxide detector that was working properly during the inspection. The smoke alarms are hard wired, and worked appropriately during the inspection check. LPA reviewed three (3) resident files, including medication records and medication storage. LPA reviewed three (3) staff files. All staff have criminal record clearance as required. LPA reviewed staff training. Staff had required first aid and CPR certification. Hot water was measured at 117.5 degrees Fahrenheit. All exits were clear and free of obstructions. All exits had auditory alarms on the doors; All alarms were working properly during the inspection. Continued on LIC809C... LPA observed a sufficient supply of food, including fruits, meats, vegetables, grains, dairy, drinks, and other food items for residents' in care. Sufficient furnishings for resident use. Sufficient supply of linens, paper products, cleaners/disinfectants, and personal protective equipment (PPE) supplies. All resident rooms, bathrooms, and common areas had sufficient lighting for residents' use. The home was observed to be at a comfortable temperature. The home was observed to be clean and orderly. The backyard deck has a ramp that leads out the fire exit gate. The fire exit gate opened freely with no obstructions, as required. LPA is requesting the following documents be updated and submitted by 3/24/26: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610-Emergency Disaster Plan (9 pgs)- if updated, submit copy- No changes, submit copy of last page (signed/dated) Copy of Current Liability Insurance Infection Control Plan- if any updates submit a copy- If no changes, submit copy of last page (signed/dated) Roster of Residents Copy of current Administrator Certificate There were no deficiencies cited during today's inspection. Exit interview was conducted with Administrator Eden Relota.the state’s words, verbatim · CDSS document, Feb 24, 2026

Type of visit: Case Management - Annual Continuation

Licensing Program Analysts (LPAs) Alviso and Contreras conducted a continued annual inspection, on 3/3/25 at approximately 2:25pm, and met with Administrator Eden Relota. There are four clients in care. Facility has an approved dementia plan of operation. There is an approved hospice waiver for two (2) residents. The facility has a required infection control plan. The facility has a required emergency and disaster plan. Licensee is completing fire/evacuation/emergency drills quarterly as required. Fire clearance is approved for four (4) non-ambulatory, of which one(1) may be bedridden. There were four (4) residents in care at the facility. Two (2) fire extinguishers were serviced and tagged as required. All exits were clear and free of obstructions. All exits had auditory alarms on the doors; All alarms were working properly during the inspection. Facility has a carbon monoxide detector that was working properly during the inspection. LPA reviewed four (4) resident files, including medication storage and medication records. LPAs reviewed four (4) staff files. All staff have required, criminal record clearance, first aid certification, and CPR certification LPA is requesting the following documents be updated and submitted by 4/03/25. LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E-Emergency Disaster Plan (ensure to review and update as needed/required) Infection Control Plan (ensure to review and update as needed/required) Continued on LIC809C.... Copy of LIC400 Handling of Client Cash Resources (include copy of surety bond if handling cash) Copy of Current Liability Insurance Resident Roster Copy of current Administrator Certificate. The following deficiencies were observed: Per LPA's file reviews staff, 2, 3, and 4 lacked required medication training. This deficiency will be cited, HSC 1569.69(a)(2) (2) Medication Training- In facilities licensed to provide care for 15 or fewer persons, the employee shall complete 10 hours of initial training. This training shall consist of 6 hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and 4 hours of other training or instruction, as described in subdivision (f), which shall be completed within the first two weeks of employment, see LIC809D Per LPA's file reviews staff, 2, 3, and 4 lacked required annual training. This deficiency will be cited, HSC 1569.625(b)(2) Annual Required Training-In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training, see LIC809D Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator/Licensee Eden Relota. Appeal Rights provided to the Administrator.the state’s words, verbatim · CDSS document, Mar 3, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Alviso and Contreras arrived unannounced to conduct a Required -1 Year inspection, on 2/18/25 at approximately 2:55pm, and met with caregivers Dina Camilon and Estelita Cabardo. Staff contacted Administrator Eden Relota, and notified them the LPAs were at the facility. The Administrator arrived to meet with the LPAs. Facility has an approved dementia plan of operation. There is an approved hospice waiver for two (2) residents. The facility has a required infection control plan. The facility has a required emergency and disaster plan. Per file review, last fire drill was completed on 12/5/23. Licensee is completing fire/evacuation/emergency drills quarterly as required. Fire clearance is approved for four (4) non-ambulatory, of which one(1) may be bedridden. There were four (4) residents in care at the facility. Two (2) fire extinguishers were serviced and tagged as required. All exits were clear and free of obstructions. All exits had auditory alarms on the doors; All alarms were working properly during the inspection. Facility has a carbon monoxide detector that was working properly during the inspection. LPA reviewed four (4) resident files, including medication storage and medication records. LPAs toured the facility. Hot water was checked at 107. degrees Fahrenheit. All smoke alarms were in place and working properly. Sufficient food supply. All medications were locked up and inaccessible to residents in care. All disinfectants/cleaners were locked up and inaccessible to residents in care. LPAs will return at a later date to continue the annual inspection.the state’s words, verbatim · CDSS document, Feb 18, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst(LPA) Alviso arrived unannounced to conduct a Required -1 Year inspection and met with caregiver Marife Davis. There were two other caregivers at the facility, Robert White, and Estelita Cabardo. Robert contacted Administrator Eden Relota, and notified them the LPA was at the facility. The Administrator arrived to meet with the LPA. Facility has an approved dementia plan of operation. There is an approved hospice waiver for two (2) residents. The facility has a required infection control plan. The facility has a required emergency and disaster plan. Per file review, last fire drill was completed on 12/5/23. Licensee is completing fire/evacuation/emergency drills quarterly as required. Fire clearance is approved for four (4) non-ambulatory, of which one(1) may be bedridden. There were four (4) residents in care at the facility; One (1) resident currently on hospice care. LPA reviewed four (4) resident files. All files were complete. LPA reviewed four (4) staff files. All staff have criminal record clearance as required. All staff have annual training. All staff have required First Aid & CPR certification. LPA toured the facility with the Administrator. All exits were unobstructed. Fire extinguisher was serviced and tagged as required- expires 5/9/24. Carbon monoxide detector was working properly during the inspection. All smoke alarms were working when checked during the inspection. All bathroom(s) had grab bars, and non-slip mat/flooring for bathing as needed. All postings were up and visible to all as required. Facility has a sufficient supply of personal protective equipment(PPE). Sufficient food supply, perishables and non-perishables. Continued on LIC809C... Cleaners/toxins were observed to be locked up and inaccessible to residents in care. Facility was at a comfortable temperature during the inspection. LPA observed the facility to be clean and orderly.LPA requested Licensee to update the following documents by 2/11/2024. LIC 308 Designated LIC 500 Personnel Summary-all staff names/titles-days/hours working LIC 610E Emergency Disaster Plan- update as needed-submit copy-if not updated-submit copy of review page signed/dated. Infection Control Plan- update as needed-submit copy-if not updated-submit copy of review page signed/dated. LIC 9020 Register of Facility Client’s/Resident’s. Copy of Administrator Certificate Copy of Certificate of Liability Insurance Copy of LIC400 Handling of Client Cash Resources, include copy of surety bond.if handling cash LPA observed the following deficiencies: LPA observed a plastic container in the refrigerator with medications unlocked, accessible to residents, and to any others in the facility that don't handle medications. Cited, Incidental Medical and Dental Care Services Section 87465(h)(2) - Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication, see LIC809D. The following deficiency(s) was/were cited from California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with the Administrator. Appeal Rights provided to the Licensee/Administrator.the state’s words, verbatim · CDSS document, Jan 11, 2024