Vilma's Home

Type of visit: Required - 1 Year

On 11/13/2025 at approximately 09:30AM, Licensing Program Analyst (LPA) Ali Deniz arrived unannounced to conduct 1-Year Required visit of this licensed Residential Care Facility for The Elderly (RCFE). LPA was greeted by Administrator, Jethro Nicolas. Facility has an approved fire clearance and capacity for 4 non-ambulatory residents. Facility has an approved hospice waiver for 2 individuals. Upon arrival, LPA was informed that there were 4 Residents in care and 3 staff members on-site. At approximately 10:30AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 11:05AM, LPA and Administrator toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Staff were in the process of cleaning up kitchen at the time of this inspection. Toxins are stored in a locked housekeeping closet in the laundry room and in the garage. Water temperature measured 106.6 degrees F and 108.4 degrees F which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Fire Extinguishers found to be last charged on 02/07/2025 at the time of visit. Carbon Monoxide and smoke detectors were present and in order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure in a cabinet closet next to the kitchen. LPA explained importance of having a signal system always in order. Administrator agreed that the facility will make sure all the exit doors has alarm in place and order all the time. Continued on LIC809-C... Continued from LIC809... At approximately 11:55PM, LPA reviewed 3 resident records and found 3 of 3 residents have current care plans, signed admission agreements, and physician's report on file. Medication records are thorough and contained physician's orders for each resident. At approximately 12:05PM, LPA reviewed 4 staff records. 4 of 4 records did contain documentation of completed training records as required. Evidence of current first aid and CPR training were current. LPA was presented with proof of current CPR & 1st Aid certification. Administrator Certificate is for Nicolas Jethro #7033214740 expires 07/19/2026. LPA reviewed the facility emergency disaster plan. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducted and documented a disaster drill on 09/04/2025. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by due date of 11/30/2025: LIC 308 Designation of Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan (If Changed) LIC 9020 Register of Facility Client’s/Resident’s Copy/Proof of Updated Certificate of Liability Insurance No deficiencies were observed in the areas inspected, No citations were issued during today’s visit. Exit interview conducted. Copy of report provided to Licensee. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Nov 13, 2025

Type of visit: Required - 1 Year

12/05/2024, Licensing Program Analyst (LPA) Loera conducted an unannounced Annual Required – 1 yr. inspection visit for this facility. Facility has an emergency disaster plan as required. Facility has an infection control plan as required. There are currently four (4) residents in care. Facility approved/cleared for four (4) non-ambulatory, and hospice waiver for two (2). At approximately 12:30pm, LPA and Administrator toured the building and grounds. The facility was found to be at a comfortable temperature. LPA observed a 2 day supply of perishable and 7 day supply of non-perishable food. Refrigerated food was found to be stored in a safe manner being labeled. Medications were found to be centrally stored. All rooms were equipped with lighting, night stand, and chest of drawers. All rooms were in good repair. Extra hygiene products and linens were available for residents in care. LPA observed a daily schedule of activities. Water temperature in sinks accessible to residents in care were measured at 115.1 and 111.3 degrees F which is within the range of 105 to 120 degrees F. Fire extinguishers were last inspected 02/2024. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Toxins, sharps and other items that could pose threat if available to residents were located in the garage, locked drawer in kitchen, under the kitchen sink and were found to be secured. Facility has extra PPE located in the garage. Facility conducts monthly emergency disaster drills. LPA conducted spot medication count and found all prescription medication to be properly recorded on the Centrally Stored Medication Record. LPA conducted a review of four (4) resident records. All records had the required documentation. LPA conducted review of four (4) staff records/training. Upon a review of staff records, LPA found all staff to have required annual and initial training as well as current 1st Aid & CPR certification on file. No deficiencies cited during today's inspection. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC309- Administrative Organization Copy of Updated Liability Insurance Exit interview conducted with Administrator and a copy of this report was provided.the state’s words, verbatim · CDSS document, Dec 5, 2024