Va & C Homes / San Paco Circle

Type of visit: Required - 1 Year

On today's date Licensing Program Analyst (LPA) William Vanegas conducted an unannounced visit for the purposes of completing an annual inspection. Upon arrival LPA was greeted and granted entry into the facility. LPA explained the purpose of the visit and Administrator (AD) Augustine Au was notified via telephone. Shortly after AD arrived to assist with the annual inspection. LPA began a tour of the facility and observed the following. Administrator Augustine Au has a valid administrator certificate valid from January 29, 2025 through July 28, 2027. The facility is a one storied home with five bedrooms all of which are utilized for residents in care. The facility is also equipped with two full bathrooms that are both shared for the facility, additionally there is a detached two car garage. LPA observed the kitchen area to be clean and free of any mildew and debris. LPA observed kitchen area to have a gas stove, microwave, dishwasher, and refrigerator. All appeared to be in good repair and tested operational. LPA observed there to be a two day supply of perishable food and a seven day supply of non-perishable food along with a sufficient amount of emergency water on hand. LPA observed all resident rooms to be large enough to walk about freely and to be clean, free of debris and mildew, and of any obstructions and hazards. LPA observed all resident rooms to have all required furnishings such as a chair, a bed, clean linens in good repair; meaning no strains or tares, a chest of drawers, and enough storage space to store personal belongings. LPA observed all restrooms to be clean and free of any mildew and debris, LPA observed toilets and faucets to be operational. LPA observed restrooms to have all required furnishings such as slip resistant floor matts, and grab bars. Hot water temperature tested between 106.1 and 107.3 degrees Fahrenheit. CONTINUED ON LIC809-C LPA observed all smoke detectors and carbon monoxide detectors to be in good repair and tested operational. LPA observed all fire extinguishers to be fully charged, and up to date. LPA observed first aid kit to have all required items such as adhesive tape, scissors, tweezers, bandages, a thermometer, and a first aid manual. LPA conducted a tour of the outside of the facility and observed the following. The front yard has an outdoor shaded sitting area. The backyard was observed to be large enough to participate in outdoor activities upon resident request. LPA observed for there to be no debris or hazards along the exit routes. LPA observed the side doors to be self latching and unlocked. LPA reviewed four resident files and two staff files. All files (staff and resident) had all required documents. Staff training was up to date and documented correctly. LPA reviewed medications with AD, and all medications were documented correctly, and per LPA review all medications are being administered per Physicians orders. LPA reviewed P&I with AD. Per LPA review all balances were documented correctly and matched the cash on hand value. Based on observations and record review made during today's inspection no deficiencies will be issued per title 22 chapter 8 division 6. An exit interview was conducted and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Apr 22, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA Haley was greeted and granted entry by staff and explained the reason for the visit. The facility was empty and closed upon LPA’s arrival. Administrator Maxine (Maxima) Kniazeff was contacted via telephone and the reason for the visit was explained. Staff arrived to the facility about 30 minutes later to grant access to the facility. During the inspection, all resident bedrooms and bathrooms were inspected. All resident bedrooms had the necessary elements and were in compliance with regulation guidelines. Both resident bathrooms were clean and organized. Hot water temperatures were measured in the range of 105.6 degrees Fahrenheit and 106.8 degrees Fahrenheit. No hazardous items were observed in the resident bathrooms, and all grab bars were tightly secured to the wall. Resident medications, and P&I funds are locked in the cabinets in the facility office area. A first aid kit with all the required elements was locked in the cabinet office area. An emergency food and water supply was observed in a closet next to the front door. In the kitchen, knives and sharp objects are kept locked in a drawer near the sink. Hazardous cleaning materials are kept locked under the sink. A perishable food supply that meets regulation requirements was observed in the refrigerator. A non-perishable food supply that meets regulation requirements was observed in the cabinets. Continued on LIC809C The garage was organized and free of clutter. There was a refrigerator, and some exercise equipment observed. The backyard was clean, organized, and walkways were free of obstruction. The side exit gate is self-closing and self-latching. Smoke detectors, and carbon monoxide detectors tested operational. A fully charged fire extinguisher was observed mounted on the wall in the kitchen. Emergency evacuation drills are conducted monthly and the last emergency drill was conducted March 8, 2025 for all staff on each shift. No deficiencies are being cited as a result of today’s visit. An exit interview conducted, and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Apr 23, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Jerome Haley and Edward Kim conducted an unannounced visit for the purpose of conducting a required one year annual inspection. LPAs Haley and Kim were greeted and granted entry by staff and explained the reason for the visit. Staff contacted Administrator Maxine (Maxima) Kniazeff who arrived a short time later and was present for the remainder of the of the visit. During the inspection, all resident bedrooms and bathrooms were inspected. All resident bedrooms had the necessary elements and were in compliance with regulation guidelines. Both resident bathrooms were clean and organized. Hot water temperatures were measured in the range of 111.3 degrees Fahrenheit and 111.2 degrees Fahrenheit. No hazardous items were observed in the resident bathrooms, and all grab bars were tightly secured to the wall. Resident medications, and P&I funds were locked in the cabinets in the facility office area. A first aid kit with all the required elements was locked in the cabinets as well. LPAs observed an emergency food supply, emergency water supply, and an emergency disaster kit in the closet near the front door. In the kitchen, knives and sharp objects are kept locked in a drawer near the sink. Hazardous cleaning materials are kept locked under the sink. A perishable food supply that meets regulation requirements was observed in the refrigerator. A non-perishable food supply that meets regulation requirements was observed in the cabinets. The garage was organized and free of clutter. There was a refrigerator in the garage with an additional supply of non-perishable food items, and several boxes of adult briefs were observed in the garage. There were also miscellaneous facility items being stored in the garage. The backyard was clean, organized, and walkways were free of obstruction. The side exit gate is self-closing and self-latching. Continued on LIC809C Smoke detectors, and carbon monoxide detectors tested operational. A fully charged fire extinguisher was observed mounted on the wall in the kitchen. An emergency evacuation drill was conducted April 1, 2024 and evacuation drills are conducted monthly for all staff on each shift. Deficiencies are being cited as a result of today’s visit. An exit interview conducted, and a copy of this report and appeal rights were provided to Administrator Maxine Kniazeff.the state’s words, verbatim · CDSS document, Apr 3, 2024

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Staff #1 (S1) Lorna Awang and discussed the purpose of the inspection. Administrator (AD) Maxine Kniazeff arrived during the inspection. LPA reviewed Infection Control requirements. At about 9:15AM, LPA toured the facility with S1. S1 left the facility and LPA continued the inspection with AD. LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: this is a one-story home. Facility is a 5-bedroom, 2-bathroom, one-story house with detached garage that is being used for storage. LPA observed 1 staff and 0 residents present at the facility. Resident Bedrooms: the 5 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: there are no staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 115 degrees F in the common client bathroom and 117 in the private client bathroom. LPA inspected all rooms in the facility. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested, including the wired smoke detectors/carbon monoxide detectors. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the kitchen. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. LPA discussed licensing fees with AD. At about 10:15AM, LPA reviewed 4 resident files and 4 staff files, interviewed 1 staff, inspected medications for 4 residents, and inspected resident money and ledgers for 4 residents. CONTINUED. During the inspection, LPA and AD observed the following. Per Physician’s Report dated 02/09/23, Resident #1 (R1) is non-ambulatory but the facility does not have a fire clearance for non-ambulatory residents. Per staff files, S1, S2, S3, and S4 did not complete the 40-hour initial or 20-hour annual training. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Immediate civil penalties are being assessed. See LIC421IM. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, Oct 24, 2023

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.