Villa Victoria Care Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA identified herself and was granted entry by Fe Oca, caregiver. LPA discussed the purpose of the visit with licensee Victoria Labrador According to the facility’s license, the facility serves six (6) elderly residents, all of whom may be non-ambulatory at any given time on the facility's premises. During today’s inspection, the facility’s current census is four (4) residents living at the facility. There were 4 residents present at the facility site during the inspection. LPA inspected the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. The facility maintained extra linens and towels. Hygiene supplies were present and stored. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and activities. The facility’s ambient internal temperature was comfortable and compliant, at 77 degrees(º) Fahrenheit (F). Hot water temperature at taps accessible to residents was also compliant. There were at least 2 days of perishable food, and at least 7 days of non-perishable food present. A food cabinet had a locking mechanism, which LPA addressed during the visit; nonetheless, there was food on the dining table that was accessible to residents. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] Cooking, dining equipment, and utensils were present, and all were safely stored. There were no toxic chemicals or poisons accessible to residents. Medications were properly labeled, as required, and stored in a locked cabinet, which LPA inspected. The facility-maintained medication logs, which LPA reviewed. No pools or bodies of water on the premises. Per licensee Labrador, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and the facility telephone were all working. Fire extinguishers were present (01) and serviced within the last 12 months. The first aid kit was complete and readily accessible. LPA reviewed staff and resident records. The LPA's visit did not raise any licensing concerns. The files that LPA reviewed contained the required documents. Confidential records were stored in a locked area. Required licensing postings were observed in a visible area of the facility. There were no deficiencies cited during today's annual inspection. An exit interview was conducted with licensee Victoria Labrador, to whom a copy of this report, along with the Licensee/Appeal Rights (LIC9058 03/22), were provided at the conclusion of the visit. The signature below confirms the documents were received. LPA obtained a current Designation of Administrative Responsibility (LIC 308), Personnel Report (LIC 500), and Emergency Disaster Plan (LIC610-E) during the visit.the state’s words, verbatim · CDSS document, Mar 26, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA Lopez identified herself, was granted entry by caregiver Fe Oca. LPA discussed the purpose of the visit with caregiver Oca and licensee Victoria Labrador later arrived and joined the visit. According to the facility’s license, there may be a maximum of six (6) residents all of whom may be non-ambulatory in at any given time at the facility site. During today’s inspection, the facility’s current census is 5 residents living at the facility. There were 5 residents present at the facility site during the inspection. LPA, accompanied by caregiver Oca, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary and in good repair. Pathways were free of obstruction and slip hazards. Resident’s bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and activities. The facility’s ambient internal temperature was comfortable and compliant, at 70 degrees Fahrenheit (F). Hot water temperature at taps accessible to residents were also compliant: sink in restroom #1 delivered hot water at 117 degrees F; sink in restroom #2 delivered hot water at 114.4 degrees F; and sink in restroom in #3 delivered hot water at 116.8 degrees F. The temperature at taps not accessible to residents and is only used by staff read as follows: kitchen sink delivered hot water at 126 degrees F. The facility did not have a caution sign posted. There was at least 2 days of perishable food, and at least 7 days non-perishable food present. Cooking, dining equipment and utensils were present, and all safely stored. There were no toxic chemicals or poisons accessible to residents. There were chemicals under the kitchen sink and sharps that were in an unlocked drawer, but there was a door barrier that prevented resident access to the area. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] Medications were properly labeled, as required, and stored in a locked cabinet. One resident’s medications were placed in a labeled container but according to staff and licensee that specific medication container, with medications, is not used by the facility. The medication container is given and used solely by the resident when they leave the facility for a few days, and the medication is taken with them. LPA inspected the medication cabinet. The facility-maintained medication logs which LPA reviewed. No pools or bodies of water on the premises. Per caregiver Oca, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present (01) and serviced within the last 12 months. First aid kit was complete and readily accessible. LPA interviewed staff and resident, and reviewed staff and resident records. During today’s visit there were 5 residents on the facility premise. LPA interviews did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in a locked area. Required licensing postings were observed in a visible area of the facility. There was a deficiency observed and cited during today's annual inspection, and may be found on the LIC809-D page of this report. There were also technical advisories and technical violations provided to the facility at the conclusion of the visit. LPA informed Licensee Labrador of the new Department updates effective January 1, 2025, for the senior care regulations. LPA provided licensee with the Department flyer and demonstrated how and where to find the regulation updates. LPA informed Licensee Labroador the facility's Plan of Operations will need to be updated. An exit interview was conducted with licensee Victoria Labrador to whom a copy of this report along with the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. The signature below confirms the documents were received. Licensee Labrador submitted a current Designation of Administrative Responsibility LIC 308 and Personnel Report LIC 500, to the licensing office January 2025. LPA requested am updated copy of their Emergency Disaster Plan LIC 610-E, within 10 business days. Forms are available at www.ccld.ca.gov.the state’s words, verbatim · CDSS document, Mar 17, 2025

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: POC

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced case management visit for a Plan of Correction clearance. LPA Lopez identified herself and was allowed entry by caregiver Lydia Cortez. LPA met with Licensee Victoria Labrador and discussed the purpose of the visit. On 02/14/24, the facility was issued two deficiencies regarding the Administrator Certification and two residents who did not have their updated Physician’s Report (LIC602). During today’s visit, LPA observed that the Administrator had their Certificate on file. LPA also observed that the two residents who needed their LIC602 updated had their updated LIC602 located in their facility file. As such, the deficiencies have been corrected and are deemed cleared. No deficiencies were observed during today's visit. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Licensee Victoria Labrador at the conclusion of the visit. The signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Apr 24, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA Lopez identified herself, was granted entry by caregiver RosaFe Dela Cruz. LPA discussed the purpose of the visit with Licensee Victoria Labrador. According to the facility’s license, there may be a maximum of six (6) residents all of whom may be non-ambulatory in at any given time at the facility site. During today’s inspection, the facility’s current census is 5 residents living at the facility. There were 5 residents present at the facility site during the inspection. LPA, accompanied by caregiver Dela Cruz, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary and in good repair. Pathways were free of obstruction and slip hazards. Resident’s bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as some Personal Protective Equipment (PPE). The facility needed additional PPE supplies. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and activities. The facility’s ambient internal temperature was comfortable and compliant, at 70 degrees Fahrenheit (F). Hot water temperature at taps accessible to clients were also compliant: kitchen sink delivered hot water at 119.8 degrees F; sink in restroom #1 delivered hot water at 102.7 degrees F; sink in restroom #2 delivered hot water at 119.1 degrees F. There was at least 2 days of perishable food, and at least 7 days non-perishable food present. Cooking/dining equipment and utensils were present, and all safely stored. There were no toxic chemicals/poisons accessible to residents. Medications were properly labeled, as required, and stored in a locked cabinet. LPA inspected the medication room and found that medications were properly labeled and stored. The facility maintained medication logs which LPA reviewed. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] No pools or bodies of water on the facility premises. Per licensee Victoria Labrador, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present (01) and serviced within the last 12 months. First aid kit(s) were complete and readily accessible. LPA interviewed staff and residents, and reviewed staff and resident records. During today’s visit there were 5 residents on the facility premise. LPA interviews did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in a locked area. Required licensing postings were observed in a visible area of the facility. There were deficiencies observed and cited during today's annual inspection and may be reviewed on the last page of this report. An exit interview was conducted with Licensee Victoria Labrador to whom a copy of this report along with the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. The signature below confirms the documents were received. LPA requested Licensee Labrador to submit a current Designation of Administrative Responsibility LIC 308, Emergency Disaster Plan LIC 610-E, and Residential Infection Control Plan LIC 9282 (6/23), to the licensing office within 10 business days. Forms are available at www.ccld.ca.gov. A current Personnel Report LIC 500 form was provided to the LPA during the visit.the state’s words, verbatim · CDSS document, Feb 14, 2024

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced required annual inspection and in conjunction conducted this case management visit at the facility. LPA Lopez identified herself and was granted entry by caregiver Rosafe Dela Cruz. LPA stated the purpose of the visit and reviewed the basic elements of the visit with licensee Victoria Labrador. During today’s visit, LPA provided the Licensee consultation and provided additional information regarding the Department’s website, Changes to Administrator Certification Training Requirements (PIN 23-14-CCLD), Criminal Background Clearance Transfer Request (LIC9182) and Criminal Record Exemption Transfer Request (LIC 9188) Form Updates (PIN 23-08-CCLD), Residential Care Facilities for the Elderly Reference Guide to Administrator, Staff, and Volunteer Training Requirements (PIN 23-16-ASC), and Revised Infection Control Regulations and Permanent Adoption (PIN 23-12-ASC). No deficiencies were observed or cited during this case management visit. An exit interview was conducted with Licensee Labrador and a copy of this report, and Licensee/Appeal Rights (LIC 9058 3/22) were provided to the Licensee at the conclusion of the visit. The signature below confirms the documents were received.the state’s words, verbatim · CDSS document, Feb 14, 2024