The Estate Home 2

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 8:45 A.M. LPA was greeted by caregiver, Felicidad “Fely” Cacal who contacted the administrator by telephone. At 9:16 A.M., Administrator, Estrella (Lillian) Alarcon, arrived at the facility, LPA explained the reason for the visit. LPA is conducting the required annual visit for The Estate Home #1 and The Estate Home #2 simultaneously. Entrance interview conducted. Beginning at 9:50 A.M., the LPA, along with administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and facility is in compliance with Title 22 Regulations. This facility doesn’t have a staff room; facility will provide 24/7 care. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. The following was observed: OUTDOOR SPACE: The backyard is shared between this facility and another related facility. The shared yard has a covered outdoor area equipped with furniture for residents’ use. The facility does have a fountain, but it was observed to be empty at the time of the visit. COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed the required postings in the common area. The facility maintained a comfortable temperature of 76 degrees. Facility provides sufficient space to accommodate both indoor and outdoor activities. LPA observed a working phone available for residents use whenever needed. Continued on LiC 809-C Continued from LIC 809 KITCHEN: Kitchen appliances appeared to be in operable condition. All knives and cleaning supplies were observed to be locked and properly stored at the time of the visit. At 9:55 A.M. hot water temperature measured 119.5 degrees Fahrenheit. Medication was observed locked in a kitchen cabinet. Hardwired combination smoke and carbon monoxide detectors were tested at 12:40 A.M. and were functional at the time of the visit. Fire extinguishers were observed to be fully charged and purchased on 11/06/2025. BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are two (2) total bedrooms. One bedroom is designated as a shared room, and the other is a private room. At the time of the visit, both bedrooms were being utilized for single occupancy. RESTROOMS: The LPA observed two (2) restrooms in the facility, both of which are designated for resident use. Resident restrooms are clean and sanitary and in operating condition with grab bars and slip-resistant surfaces. Water temperature was measured in shared resident restrooms and measured within the required range. RECORD REVIEW: At 11:15 A.M. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. Two (2) resident records were reviewed and were observed to be complete and contained all required documents. Four (4) staff files reviewed were complete and contained all required documents. Continued on LIC 809-C Continued from LIC 809-C MEDICATION REVIEW: At 11:40 A.M. medication reviewed started. Medications reviewed for two (two) residents were observed to be maintained and administered in compliance with regulation at the time of the visit. EMERGENCY DISASTER PLAN: During today’s visit, the LPA reviewed the facility’s infection control plan. The facility’s policies and procedures as it pertains to emergency disaster plan are adequate, complete, and updated annually, as required. Emergency food and water supplies were observed stored in a closet designated for extra food provisions. During today’s visit LPA obtained a copy of the facility’s personnel record LIC 500, resident roster, and copy of current liability insurance. Emergency disaster drills are conducted quarterly, with the last drill documented on 10/12/2025. No citations issued today. Exit interview conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Nov 7, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 12:20 P.M. LPA met with Licensee/Administrator Estrella (Lillian) Alarcon. Entrance interview conducted. Beginning at 12:30 P.M., the LPA, along with Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. This facility doesn’t have a staff room, facility will provide 24/7 care. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. The following was observed: OUTDOOR SPACE: The backyard is shared between this facility and another related facility. The shared yard has a covered outdoor area equipped with furniture for resident use. The facility does have a fountain, but it was observed to be empty at the time of the visit. KITCHEN: Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Emergency food and water supply are stored in the garage of another facility sharing the same outdoor property. All knives and cleaning supplies were observed to be locked and properly stored at the time of the visit. At 12:34 P.M. hot water temperature measured 119.0 degrees Fahrenheit. Medication was observed locked in a kitchen cabinet. All cleaning supplies were observed locked and inaccessible under the kitchen sink. Hardwired combination smoke and carbon monoxide detectors were tested at 03:03 P.M. and were functional at the time of the visit. Fire extinguishers were observed to be fully charged and purchased on 08/12/2024. Continued on LIC 809-C Continued from LIC 809 COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed the required postings in the common area. The facility maintained a comfortable temperature of 76 degrees. LPA observed cameras throughout the common areas only. Facility provides sufficient space to accommodate both indoor and outdoor activities. LPA observed a working phone available for residents use whenever needed. BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are 2 (two) total bedrooms; one is a shared bedroom and the other is a private bedroom. RESTROOMS: The LPA observed 2 (two) restrooms in the facility, both of which are designated for resident use. Resident restrooms are clean and sanitary and in operating condition with grab bars and non-skid surfaces. Water temperature was measured in shared resident restrooms and measured within the required range. LPA observed a camera inside the master restroom. Licensee stated that staff use that “Baby monitor” to check on residents during the nighttime. LPA explained that per regulation, individual privacy shall be provided in all toilet, bath and shower areas. Licensee removed camera from the master restroom during today’s visit. RECORD REVIEW: At 2:04 P.M. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. LPA reviewed three (3) resident records. All records were complete and contained all required documents. Four (4) staff files reviewed were complete and contained all required documents. Continued on LIC 809-C Continued from LIC 809-C INTERVIEWS: Throughout the visit, LPA interviewed 2 (two) staffs and 2 (two) residents. MEDICATION REVIEW: At 3:50 P.M. medication reviewed started for all 3 (three) residents.Medications reviewed were observed to be maintained and administered in compliance with regulation. LPA observed licensee preparing medication containers for two (2) days in advance. LPA remined licensee that regulation states each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. Technical advice issued. Licensee agreed to use medication organizer only for the current day. During today’s visit LPA obtained a copy of the facility’s personnel record LIC 500, resident roster, and copy of current liability insurance. Emergency disaster drills are conducted quarterly, with the last drill documented on 09/16/2024. Pursuant to Title 22 of the CA Code of Regulations, the following deficiency was cited (refer to LIC 809-D): Exit interview conducted and copy of the report was issued and appeal rights provided. Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Oct 28, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 10:28AM. LPA met with Licensee/Administrator Estrella (Lillian) Alarcon. Entrance interview conducted. Beginning at 10:53AM, the LPA, along with Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: Hardwired combination smoke and carbon monoxide detectors were tested at 02:34PM and were functional at the time of the visit. Fire extinguishers were observed to be fully charged and purchased on 07/17/2023. OUTDOOR SPACE: The backyard is shared between this facility and another related facility. The shared yard has a covered outdoor area equipped with furniture for resident use. The facility does have a fountain, but it was observed to be empty at the time of the visit. KITCHEN: Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Emergency food and water supply are stored in the garage of another facility sharing the same outdoor property. All knives and cleaning supplies were observed to be locked and properly stored at the time of the visit. COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed the required postings in the common area. Report Continued on LIC 809-C BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are 2 (two) total bedrooms; one is a shared bedroom and the other is a private bedroom. RESTROOMS: The LPA observed 2 (two) restrooms in the facility, both of which are designated for resident use. Resident restrooms are clean and sanitary and in operating condition with grab bars and non-skid surfaces. Water temperature was measured in shared resident restroom and measured within the required range. RECORD REVIEW: Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. 1 (one) resident record reviewed was complete and contained all required documents. 4 (four) staff files reviewed were complete and contained all required documents. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today’s visit, the LPA reviewed the facility’s infection control plan. The facility’s policies and procedures as it pertains to infection control are adequate. LPA also reviewed the facility's emergency disaster plan, which was observed to be complete and updated annually, as required. Emergency drills are conducted monthly, with the last drill documented on 10/06/2023. INTERVIEWS: Throughout the visit, LPA interviewed 2 (two) staff and 1 (one) resident. MEDICATION REVIEW: Medications for 1 (one) resident was observed. Medications reviewed were observed to be maintained and administered in compliance with regulation. During today's visit, LPA gathered the following items: LIC 500 A copy of the facility's liability insurance No deficiencies cited. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Nov 1, 2023