Traditions at Stacey Lee

Type of visit: POC

On today's date Licensing Program Analyst (LPA) William Vanegas conducted an unannounced visit for the purposes of conducting a plan of correction visit. Upon arrival LPA was greeted and granted entry to the facility by facility staff. LPA explained the purpose of the visit and Administrator was notified via telephone. LPA toured the facility and observed the following deficiency was corrected. All fire extinguishers were up to date and fully charged. No additional deficiency were observed at the time of this visit. LPA conducted an exit interview with Caregiver Rosalina Baltazar and a copy of this report and deficiency cleared letter was provided to the facility.the state’s words, verbatim · CDSS document, Apr 29, 2026

Type of visit: Required - 1 Year

On today's date Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual inspection. Upon arrival LPA was greeted and granted entry into the facility by facility staff. LPA explained the purpose of the visit and Administrator (AD) was notified via telephone. Administrator arrived shortly after to assist with the inspect. LPA accompanied with AD conducted a tour of the facility and observed the following. The facility is a one storied home with six bedrooms, one of which is a staff bedroom. The facility has five bathrooms one of which is for staff and guest use, and an attached three car garage. LPA observed the kitchen area to be clean and free of any mildew and debris. LPA observed there to be an electric stove, microwave, refrigerator, and a dishwasher. All appeared to be in good repair and tested operational. LPA observed a two day supply of perishable food and a seven day supply of non-perishable food. LPA observed all resident rooms to be clean and free of any hazards and debris. LPA observed rooms to be large enough to walk about freely and to have all required furnishings such as a bed, clean linens in good repair; meaning no strains or tares, a chest of drawers, a reading lamp, and enough storage space to store personal belongings. LPA observed all resident restrooms to be clean and free of any mildew and debris, restrooms had all required furnishings such as grab bars, slip resistant floor matts, and a shower chair. Hot water temperature tested between 114.3 and 117.7 degrees Fahrenheit. CONTINUED ON LIC809C LPA observed all smoke detectors and carbon monoxide detectors to be in good repair and tested operational. LPA observed fire extinguishers to be fully charged, however they are passed due for the annual fire inspection. A deficiency was issued on today's date. LPA observed first aid kit to have all required items including adhesive tape, scissors, tweezers, a thermometer, and a first aid manual. LPA reviewed six resident files and two staff files. One out of six resident files was missing some of the required documents a deficiency was issued on today's date. LPA observed all required postings to be posted by the main entrance however the see something say something (PUB475) sign was in the wrong dimensions. A technical violation was issued on today's date. LPA toured the outside of the facility and observed the outside areas to be clean and free of any hazards and obstructions along the emergency exit routes. Side doors were self latching and unlocked. LPA obsereved there to be a fully fenced pool in the backyard with the fence measuring at 5ft and the gaps in between the fence measuring at 4 inches. LPA observed the pool gate to be pushing outward and being unlocked. LPA reviewed medications accompanied by AD and observed all medications to be documented correctly. Per LPA review all medications are being administered per physicians orders. Based on observations made during today's inspection deficiencies will be issued per title 22 chapter 8 division 6 of the California Code of Regulations. An exit interview was conducted with AD and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Apr 16, 2026

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) William Vanegas conducted an unannounced inspection for the purposes of conducting an annual inspection. Upon arrival LPA Vanegas was greeted and granted entry to the facility by Care Giver Ernesto Esguerra, and explained the nature of the inspection. LPA Vanegas set up equipment and began a tour of the facility and observed the following. This is a one storied home with six bedrooms; five of which are resident rooms, and one of which is a staff room. There are five bathrooms two of which are private bathrooms, and three of which are shared bathrooms. There is a two car attached garage as well. There is a large backyard, with a fully fenced pool with the fence measuring at 4ft 9in. The gaps between the fence rails are 5in apart, and the pool door swings away from the pool and not into it, and the pool gate is locked. LPA Vanegas observed kitchen area to be clean and free of any mildew and debris. LPA Vanegas observed a refrigerator, electric stove, dishwasher, microwave, washer and dryer all to be in good repair and in working condition. LPA Vanegas observed a seven day supply of non perishable food and a two day supply of perishable food. LPA Vanegas observed all resident bathrooms to be clean and free of any mildew and debris, water faucets and toilets tested operational. Bathrooms have all required furnishings such as a shower chair, grab bars, and slip resistant matts. Bathroom water temperature tested between 117.5 and 123.3 degrees. CONTINUED ON LIC809C LPA Vanegas observed the outside of the facility to have a large backyard, with a shaded sitting area, and a pool. Backyard is large enough to participate in outdoor activities upon resident request. LPA Vanegas observed the backyard to be clean and free of any obstructions along the exit routes of the facility. LPA Vanegas observed all resident rooms to have the required furnishings such as a chest drawer, a bed, clean linens in good repair; meaning no strains or tears, a lamp, and enough storage space to store personal belongings. The rooms are large enough to walk about freely, and no obstructions are blocking entry ways. LPA Vanegas observed all fire extinguishers to be fully charged, and up to date. LPA Vanegas observed all smoke and carbon monoxide detectors to be in good repair, and operational. LPA Vanegas observed first aid kit to have all required items such as bandages, adhesive tape, scissors, tweezers, and a thermometer. LPA Vanegas reviewed two staff files, and six resident files. One of two staff files contained all documents however one was missing pertinent information. All resident files were missing required documents and a deficiency was issued. LPA Vanegas reviewed medication administration log, and observed all medication to be documented correctly and administered to residents in care per physicians orders. Based on today's observations during the inspection deficiencies will be issued per title 22 chapter 8 division 6 of the California Code of Regulations. An exit interview was completed with Administrator Lordele De Los Reyes and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, May 20, 2025

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: POC

On December 17, 2024, at 8:00am, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced POC visit to follow up on deficiencies cited in forms LIC809D on June 14, 2024. LPA was greeted and granted entry into the facility by Caregiver (CG) Maricel Neuman. LPA spoke with Administrator (AD) Lordele De Los Reyes over the phone and explained the purpose of the visit. AD De Los Reyes said that CG Neuman can sign on her behalf for the report. LPA Kim and CG Neuman toured the physical plant and made the following observations. Deficiency cited under Title 22 Regulation Health and Safety Code (HSC) 1569.618(a) pertaining to Notifying the Department of Social Services of Facility Manager being designated has been cleared. LPA Kim observed the LIC 308. Deficiency cited under Title 22 Regulation HSC 1569.625(b)(2) pertaining to Staff Training has been cleared. During the visit, LPA observed the facility had completed all the necessary training for staff. Deficiency cited under Title 22 Regulation HSC 1569.695(c) pertaining to Emergency Drill log has been cleared. During the visit, LPA observed the Emergency Drill was last conducted on November 4, 2024. Deficiency cited under Title 22 Regulation California Code of Regulations (CCR) 87303(a) pertaining to a Facility being clean, safe, sanitary, and being in good repair has been cleared. During the visit, LPA Kim observed the backyard next to the air conditioner has been cleaned and cleared. Licensee has been advised to maintain all items especially those that were previously deficient in the facility in accordance with Title 22 Regulations. An exit interview was conducted, and a copy of this report and two POC Clearance letters were provided to Caregiver Maricel Neuman.the state’s words, verbatim · CDSS document, Dec 17, 2024

Type of visit: Required - 1 Year

On June 14, 2024 at 8:20am, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Caregiver Maricel Neumann and explained the purpose of the visit. The facility is licensed to operate for six (6) non-ambulatory of which one may be bedridden and have a hospice waiver for four (4) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, one (1) staff bedroom, five (5) bathrooms, swimming pool, living room, dining room, kitchen, attached 3-car garage, and an outside covered patio area. LPA Kim toured indoor and outdoor of the physical plant with Caregiver Neumann. There are no obstructions on the premises. Swimming pool is enclosed by a fence that is found to be within Title 22 regulations. The swimming pool fence is self-closing and self-latching. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, Resident Room 5, and Staff Room 1. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 113.0 degrees and 115.3 degrees F. A comfortable temperature of 74 degrees F was maintained in the facility. The facility has two (2) fire extinguishers that are charged and they were all serviced on August 4, 2023. Smoke detectors and carbon monoxide detectors were operable. A working telephone (714-602-7673) remains available. Evaluation Report Continues on LIC 809-C LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, water, and supplies are stored in the garage. First Aid Kit contained all the necessary elements. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). LPA conducted an audit of resident files (R1-R6), staff files (S1-S3. and medication and medication administration review were in order and complete. LPA Kim conducted resident interviews and staff interviews. Deficiencies were cited during this inspection visit according to the California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted, and a copy of this report was provided to Caregiver Maricel Neuman.the state’s words, verbatim · CDSS document, Jun 14, 2024

The state marks this report as 6 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.