Walnut Home Care

Allegation investigated: Staff does not allow resident visitation.

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced complaint visit on 05/13/2026 to deliver findings related to the above allegation. LPA met with Administrator Richard and Josie Rabena and explained the purpose of the visit. The investigation included a review of the client roster, R1’s face sheet, visitation policy, and visitation log. LPA conducted interviews with two (3) staff members (S1-S3), two (2) witnesses (W1-W2), and three (3) residents (R1-R3). (Continued on LIC 9099C) Unsubstantiated Allegation: Staff does not allow resident visitation. It is alleged that the facility does not allow R1 visitation. During an interview with R1, it was communicated that R1 did not want visitation from one particular visitor and did not express concerns regarding the facility preventing visitors. During staff interviews, it was disclosed that there were concerns regarding that visitor; however, staff stated they were honoring R1’s request not to see the visitor. During witness W1’s interview, concerns were also reported regarding the visitor. During LPA’s visit, it was observed that other residents had visitors present, who disclosed they visit the facility frequently without concern. LPA also observed the facility’s visitation log, which documented several visitors, including after-hours visitation. Co-Administrator explained that the facility works with each resident regarding visitation arrangements based on their individual preferences and needs. Based on the investigation conducted, which included interviews with staff, witnesses, and residents, as well as a review of relevant records, there was insufficient evidence to support the reported allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was held, and a copy of this report was provided.the state’s words, verbatim · CDSS document, May 14, 2026 · control 28-AS-20260508162044

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA met with Gabriel Abrera, Caregiver and Richard Rabena Jr., Administrator and explained the purpose of the visit. The facility is approved for (5) non ambulatory and (1) bedridden resident age 60 and up. Rooms #1 & 2 approved for staff and licensee, all other rooms are for residents. Room #7 is approved for bedridden, and approved for (2) hospice waivers. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were maintained. Bathroom has hygiene items such as hand soap and toilet paper. The Administrator/licensee has not been reviewing and updating the use of infection control procedures at least annually in the facility. Operational Requirements: The facility accepts and retains residents with dementia. The plan of operation includes training for staff who provide dementia special care.Facility maintains liability insurance in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate which expires on 06/16/2026. Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood which consists of (5) resident bedrooms, (2) staff bedrooms, (3) bathrooms, living room, dining room, kitchen, and attached garage with an office area. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, linen, light, chair and sufficient closet space. There are no cameras in the facility. Smoke alarms and carbon monoxide were tested and operable. The facility has a carbon monoxide detector in the hallway. The facility does not have working signal systems in exit points. There are (2) fire extinguishers in the facility which was last serviced on 08/15/2025. Backyard was inspected and has a shaded area and sitting area. There are no swimming pool or bodies of water on the premises. The hot water temperature reading measured within the required 105 - 120 degrees Fahrenheit. Hot water readings were 110.6 deg F in bathroom #1, 117.5 deg F in bathroom #2 and 115.6 deg in bathroom #3. ****REPORT CONTINUED ON LIC809-C***** Staffing: A total of (6) caregivers including the Administrator provide care and supervision to the residents. There are sufficient staff to meet resident needs. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have the required training and associated to the facility. Personnel Records-Training: Staff files are maintained at the facility and were reviewed for criminal background clearance and training. Personnel records have health/TB screenings. Administrator's certificate is valid, expires on 07/27/2027. Staff have current CPR & first aid certificates. Administrator's first aid/CPR training expired on 11/01/2025. Resident Rights-Information: Resident personal rights are posted. Visiting policy is posted at a location that is visible and accessible to residents and families. Facility provides internet services to all residents and have access to the facility phone. Planned Activities: Information regarding Dementia is part of training for direct care staff and is included in the Plan of Operation. The facility provides sufficient space to accommodate both indoor and outdoor activities. Food Service: The kitchen was inspected and sufficient food supplies of 2 day perishable and a week of non-perishable are observed. Pesticides and cleaning supplies are kept away from the food preparation areas. Incidental Medical Services: Residents medications were reviewed to confirm medication is given as prescribed and is documented properly. The facility uses the Medication Administration Record (MAR) log to document medications given. Medications were stored in a locked cabinet and inaccessible to residents. Medications are administered as prescribed. Resident Records-Incident Reports: All (6) resident files were reviewed containing admission agreements, Physician's Report, Medical/Functional assessments, Needs and Services Plans, TB clearance, Personal rights, Medical Consent, Medication Records. Disaster Preparedness: The facility has a complete Emergency Disaster and Mass Casualty Plan containing emergency evacuation. The facility conducts fire drill on a quarterly basis. Last fire drill was conducted on November 10, 2025. Medications of one resident needing refrigeration are stored in the refrigerator in the garage that were not in a separate container and not clearly labeled 'medication'. Residents with SHN: Currently, there are no residents under hospice care. (5) of (6) residents with 1/2 bed rail did not have a written order from their physicians in the resident's record. There are no hospice residents and there is (1) bedridden resident. Deficiencies cited, Technical violation and Technical Assistance issued. Exit interview and a copy of this report was provided to the Administrator, Richard Rabena.the state’s words, verbatim · CDSS document, Nov 13, 2025

The state marks this report as 8 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection on 10/10/24. LPA met with the administrator, Richard Rabena, and explained the reason for the visit. The facility is licensed to serve 6 residents ages 60 and over, of which 5 may be non-ambulatory and 1 bedridden. Room #7 is approved for the bedridden resident. There is a hospice waiver approved for 2 residents. LPA inspected the facility using the CARE tool and observed the following. The single story facility consists of 5 resident bedrooms, 2 Staff rooms, living/dining room, family room, kitchen, 2 bathrooms, and the attached garage. Staff room #1 has a private bathroom. The backyard has a shaded area for resident use. The hot water temperature was measured between the required range of 105-120 degrees F. There are no swimming pool or bodies of water on the premises. The facility has a carbon monoxide detector located in the hallway. Sufficient food supplies of 2 day perishable and a week of non-perishable are observed. Facility has sufficient space to provide indoor and outdoor activities to residents. Facility accepts and retains residents with dementia. Staff are ensuring that incontinence residents are changed often and the facility remains free of odor from incontinence. There are currently no residents with prohibited or restricted health conditions. No residents are using oxygen equipment. Medications are centrally stored and locked in the hallway cabinet. LPA reviewed 4 resident files and medications. Resident #4 did not have the annual medical assessment on file. Medications are being administered as prescribed. LPA reviewed 3 personnel files. The files have the required forms and health assessment with TB test results. Annual training are being provided to staff. Administrator's certificate expires on 7/27/25. The Emergency Disaster Plan is reviewed annually and has the emergency procedures indicated. A deficiency is issued on the LIC809D form. An exit interview was held and a copy of this report along with appeal rights was given to the administrator.the state’s words, verbatim · CDSS document, Oct 10, 2024

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit to finish the annual inspection. LPA met with licensee/administrator, Richard Rabena, and explained the reason for the visit. During the visit today, LPA completed the remainder of the inspection and the following were reviewed: Staffing: The facility has sufficient staffing to meet the needs of the residents. All staff members have current CPR & First Aid certificates. Per the licensee, there is backup staffing if needed. Personnel Records-Training: LPA reviewed 3 Staff files. The administrator's (Richard Rabena) certificate expires on 7/27/25. Staff have fingerprint clearance and associated to the facility. Staff files have the required documents such as personnel record, health screening with TB results, employee rights form, and in-service training. Staff also have appropriate dementia care training. Resident Records-Incident Reports: LPA reviewed 6 resident files that are maintained at the facility. The files contain the admission agreement, medical assessment with TB results, consent forms, property valuable form, preappraisal form, and personal rights form. The physician's report for Resident #3 diagnosed with dementia is not current. Resident Rights-Information: Information for appropriate reporting agencies are posted at the facility. Residents' rights are respected and implemented by staff. Planned Activities: Facility has sufficient space to provide indoor and outdoor activities to accommodate residents who are physically handicapped. Incidental Medical and Dental: LPA reviewed 6 resident medications and there were no discrepancies observed. Residents with Special Health Needs: Facility accepts and retains residents with dementia. Staff are ensuring that incontinence residents are changed often and the facility remains free of odor from incontinence. There are no residents currently with prohibited or restricted health conditions. No residents are using oxygen equipment. A deficiency is issued on the LIC809D. An exit interview was held. A copy of this report along with appeal rights are given to Mr. Rabena.the state’s words, verbatim · CDSS document, Dec 5, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection. LPA met with licensee, Richard Rabena, and explained the purpose of the visit. The facility is licensed for a capacity of 6 residents ages 60 and over, of which 5 may be non-ambulatory and one bedridden. Room #7 is approved for bedridden. Room #1 & 2 approved for staff and licensee. All the other rooms are for residents. There is a hospice waiver approved for 2 residents. LPA conducted the inspection using the Compliance and Regulatory Enforcement (CARE) Tools. The following were observed: Infection Control: The facility has submitted an Infection Control Plan. Staff are continuing to clean and disinfect the home. They are using appropriate hand hygiene and wearing gloves while assisting residents. Operational Requirements: The facility has a dementia care plan to accept or retain residents with dementia. There are no residents utilizing oxygen at this time. Physical Plant & Environment Safety: The facility consists of 5 resident rooms, 2 Staff rooms, a living room, dining room, family room, kitchen, one common bathroom, and attached garage. There is a shared bathroom between rooms #6 and #7. Staff room #1 has a private bathroom. The backyard has a shaded area for resident use. The hot water temperature was measured between the required range of 105-120 degrees F. There are no swimming pool or bodies of water on the premises. The facility has a carbon monoxide detector located in the hallway near the kitchen. Food Service: There are sufficient food supplies of 2-day perishable and a week of non-perishable items. The food are properly stored in the refrigerator. Disaster Preparedness: The facility has an Emergency Disaster Plan posted with contact numbers and at least 2 relocation sites. Emergency procedures are indicated on the form. Due to time constraint, LPA will return another day to complete the remainder of the domains. There are no deficiencies observed during the visit today. An exit interview was held and a copy of this report was given to the licensee.the state’s words, verbatim · CDSS document, Nov 30, 2023