Touch of Serenity Senior Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by staff and explained the nature of the visit. Juan Reyes, Administrator, arrived shortly after and met with LPA. There are four (4) residents at the facility and there are no residents receiving hospice services currently. LPA began the tour of the inside and outside of the facility. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. There is a minimum of one week of non-perishables foods and two days of perishables foods available. There is additional food storage in a spare refrigerator and freezer located in the garage. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage cabinet located in the kitchen. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA inspected the facility bathrooms and LPA measured the hot water temperature which measured 109 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. LPA observed that toxic chemicals, cleaning solutions and disinfectants are stored in the garage. The facility has an available clean supply of linens. LPA inspected residents’ bedrooms which had sufficient lighting to ensure safety and comfort. All bedrooms observed to have all required components. Storage space is provided for residents in their bedroom. Smoke detectors/carbon monoxide detectors were tested and found to be operational. LPA toured the outside of the facility and observed outdoor passageways are Continued on LIC809-C free of obstructions. LPA observed there are shaded seating areas for residents’ enjoyment in the backyard of the facility. LPA observed a fire extinguisher with service date of January 20, 2026, charged and mounted in the kitchen. Fire drills are conducted every three months, LPA verified fire drill logs are kept and last drill was conducted April 2, 2026. LPA began reviewing records. LPA reviewed three resident records. All the required documentation was present and reviewed in the residents’ files. LPA reviewed two employee records. All employees present have a criminal record clearance and are associated with the facility. LPA observed records reviewed have a current First Aid certificate. Based on the observations made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator, and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jul 14, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator (AD) Juan Reyes and discussed the purpose of the visit. The facility currently has five residents in care. The facility is a one-story home with five resident bedrooms, one staff room, three bathrooms, kitchen, living room, dining room, and detached two car garage. The facility appears clean, safe and sanitary. LPA observed the kitchen to be clean and free of vermin. LPA observed the sharps to be locked under the kitchen sink. LPA observed the centrally stored medication to be locked in a kitchen cabinet. LPA observed a fire extinguisher in the kitchen charged and with a service date of December 12, 2024. LPA observed a seven day non-perishable and two day perishable food supply on hand. LPA observed the resident restrooms to have soap, grab bars, and non-slip mats. LPA tested the water temperature to be between 109.5-109.9 degrees Fahrenheit. LPA observed the staff room to have a lock and made inaccessible to residents in care. LPA observed the toxins and chemicals to be in the locked garage making them inaccessible to residents in care. LPA observed the emergency food and water supply in the facility. LPA observed a shaded seating are in the backyard for resident use. LPA observed no obstructions in the backyard. LPA and AD tested the fire alarm and carbon monoxide detector, and they were found to be operational. LPA reviewed staff files and no discrepancies were observed. LPA reviewed resident files and no discrepancies were observed. LPA reviewed resident medication and no discrepancies were observed. LPA observed the last fire drill to be conducted on June 8, 2025. Based on today’s observations no deficiencies are being noted per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Juan Reyes and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jul 10, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose of conducting the health and safety case management visit to follow up on the death regarding Resident #1 (R1). LPA was greeted and granted entry after stating the purpose to Caregivers Javier Tamayo and Paloma Alonza. Administrator (Admin) Juan Reyes arrived shortly after. On October 29, 2024, the Department received the death report of R1. Administrator to forward a copy of the Coroner's Report and Death Certificate once obtained. LPA toured the facility with Administrator Juan Reyes. Facility was observed to be clean, sanitary, and in good repair. Facility maintains sufficient 2-day supply of perishable and a 7-day supply of non-perishable food. Toxins, medications, and sharps were secured and inaccessible to the residents. The certificate of liability insurance remains current. No health and safety violations were observed during the tour. LPA reviewed and took photographs of R1's pertinent documentation. Admin to forward copies of the following records to LPA via email by end of today's business day: Resident Roster, Death Report, Identification and Emergency Information, Physician's Report, Discharge Summary, Preplacement Appraisal Information, Assessment Form, Needs and Services Plan and Mortuary Information. Based on the review of the Guardian Employee Roster dated October 30, 2024, S1 and S2 were not associated to the facility at the time of inspection. Admin to submit a copy of S1's and S2's identification cards along with the completed Criminal Background Clearance Transfer Request Forms (LIC9182) by October 31, 2024. Based on today's visit, a deficiency is being cited, and an immediate civil penalty is being assessed. An exit interview was conducted with Administrator Juan Reyes, and a copy of this report including the LIC809-D, LIC421BG, LIC811s, and the appeal rights were provided at exit.the state’s words, verbatim · CDSS document, Oct 30, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Oct 31, 2024

87355 Crmininal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code... shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance... This requirement was not met as evidenced by: Based on observations, interviews, and record review, S1 and S2 were not associated at the time of inspection which poses an immediate Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Oct 30, 2024

Plan of correction: Adminstrator stated that a copy of the identification cards and LIC9182s will be submitted in addition to an Acknowledgement of Understanding of the said regulation to LPA via email by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the required 1-Year annual using the CARE Inspection Tool. LPA met with Administrator Juan Reyes and stated the purpose of the visit. There are five resident bedrooms and four resident bathrooms and with one staff bedroom. The laundry room was located in the attached two-car garage. LPA observed the facility to be clean and sanitary. All rooms were inspected and appropriately furnished. Beds and bedding supplies were in good condition, adequate lighting was provided, sufficient storage space for each residents' personal belongings were observed. Bathrooms were found to be in compliance, clean, and operational. The water temperature measured at 110.8, 111.0, 110.6, and 111.0 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food available. LPA toured the exterior of the facility. LPA observed the outdoor passageway free of obstructions. The two exit gates were self-closing and self-latching. LPA observed sufficient seating and shading. The fire extinguisher was mounted, charged, and serviced on December 1, 2023. The auditory devices and smoke/carbon monoxide detectors were tested and operational. LPA observed the emergency disaster supplies including food/water in the garage. Emergency evacuation drills are being conducted quarterly. LPA observed the required 'See Something, Say Something' (PUB475) poster in the correct size. LPA conducted an audit of five residents' files and two personnel files. No discrepancies were noted. Staff and resident interviews were conducted. Medications were audited for five residents. No discrepancies noted. Based on the observations made during today's visit, no deficiency is being cited today. An exit interview was conducted with Caregiver Iris Bernal, and a copy of this report was provided at the end of the visit.the state’s words, verbatim · CDSS document, Jul 11, 2024