Ward Residential Care Home IV

We haven’t transcribed this report yet. The complete document is on the state’s site.

Type of visit: POC

At approximately 11:00 AM Licensing Program Analyst (LPA) arrived unannounced and made inspection of garage refrigerator, which was observed to be clean and well organized with food out of original commercial packaged dated with the date they were placed in new bags or Tupperware. Deficiency cleared. Report reviewed with licensee.the state’s words, verbatim · CDSS document, Oct 28, 2025

Type of visit: Case Management - Annual Continuation

At approximately 11:00 AM Licensing Program Analyst (LPA) Stevenson arrived unannounced to CONTINUE a required 1-year annual inspection and was greeted by co-licensee Eugene Poquiz. Licensee Alicia Poquiz arrived at approximately 11:45 AM to assist with today's continued inspection. At approximately 11:10 AM the garage refrigerator was observed to be clean and organized and yard had been picked up to further reduce tripping hazards with elderly residents present. At approximately 11:15 AM five (5) staff files were reviewed and five (5) of (5) files had required documents including health screening, TB testing, criminal clearance and 1st Aid/CPR training. At approximately 12:10 PM, six (6) of six (6) resident files were observed to have all required documentation per title 22 regulation. At 1:25 PM LPA observed medicines to be centrally stored and locked and medicine records to be accurate. During today's inspection hospice nursing arrived to initiate hospice services for resident (R2) and licensee was advised to submit to licensing notification of initiation of hospice services and a list of required elements to submit was provided to licensee. Technical violation and/or advisories cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report was reviewed with Licensee, Alicia Poquiz and Appeal rights were given.the state’s words, verbatim · CDSS document, Oct 28, 2025

The state marks this report as 11 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

At approximately 1:35 PM Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to BEGIN a required 1-year inspection of this licensed senior care facility. LPA was greeted by one live-in caregiver and another caregiver who are both associated to the facility via Guardian. The live-in caregiver called the Licensee, Alicia Poquiz who arrived at approximately 2:15 PM. The Facility has fire clearance for six (6) residents and approved for 5 non-ambulatory residents and one (1) bedridden resident in room #5. Room #1 is approved for two (2) ambulatory residents only. Room five (5) and room six (6) ADU (back yard shed) are for staff use only. The facility is a two story home and the second level of the home is not used by residents and there is a gate at the bottom of the stairs to prevent residents going up the stairs. The facility currently provides care for six (6) residents. LPA toured the building and grounds which was found to need a deep cleaning, licensee was advised to remove trash and broken appliances in the backyard and to be mindful to reduce trip hazards at all times. (Technical violation issued). In addition a number of light bulbs in the living room were missing and licensee was advised to replace the bulbs with residents with potential vision issues. Facility was a comfortable temperature, with all exits free from obstruction. All required postings were observed. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Licensee and I observed leaking fluids of possible juice and meat in a garage refrigerator and licensee advised to perform a deep cleaning and inspect food for quality (type B citation issued) Outside ADU was noted to be locked and contained only staff items inside, a separate large shed contained hardware and supplies. Continued on LIC809C Continue from LIC809 There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Toxins are stored in a locked cabinets and Sharps and other kitchen supplies that could pose danger were found secured in the kitchen cabinet. A locking cleaning supply closet was noted to be open with staff present and licensee was advised to ensure that cleaning supplies were secured and locked at all times. (technical violation issued) There was a supply of hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Water temperature measured between 105 and 120F as required by regulation. Smoke detectors and carbon monoxide detectors were present, inspected and found to be in working order. Fire extinguisher was charged with proof of service in June of 2024. Facility has a central fire alarm system that was tested by outside party on 11/17/2024 LPA request copies of Deed and updated Liability insurance,LIC500 and LIC9020 and LIC308 (Designation of facility responsibility; if changes) to be submitted to CCL by 11/23/2025 **LPA will return at a future un-announced date to complete inspection including facility files and medication administration review. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report was reviewed with Licensee, Alicia Poquiz and Appeal rights were given.the state’s words, verbatim · CDSS document, Oct 23, 2025

The state marks this report as 11 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) Araceli Canela made an unannounced annual required 1 year inspection of this licensed senior care facility. LPA was greeted by two caregivers and Licensee, Alicia Poquiz arrived shortly after. The facility is a two story home and the second level of the home is not used by residents and there is a gate at the bottom of the stairs to prevent residents going up the stairs. The facility currently provides care for six (6) residents. LPA toured the building and grounds which was found to be clean, at a comfortable temperature, with all exits free from obstruction. All required postings were observed. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Toxins are stored in a locked cabinets and Sharps and other kitchen supplies that could pose danger were found secured in the kitchen cabinet. There was a supply of hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Water temperature measured at 107 degrees and within the required regulation. One out of one fire extinguisher was inspected and charged. Smoke detectors and carbon monoxide detectors were present, inspected and found to be in working order. Fire extinguisher was charged with proof of service 1/17/2024. Resident files were reviewed (6) and were all found to be complete and organized. Staff files were reviewed and have current health screening, fingerprint clearance, proof of training. Medications are locked in cabinet in the living room. Continued on LIC809C Licensee/Administrator to submit the current following documents by 1/15/2025: · LIC 308 Designation of Facility Responsibility · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan · LIC 9020 Register of Facility Residents Infection Control Plan of Operation (If changes) Copy of Liability Insurance No citations issued during todays visit.the state’s words, verbatim · CDSS document, Dec 23, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Araceli Canela conducted a pre-licensing inspection and was greeted by Licensee, Alicia Poquiz and Administrator, Annabelle Antonio. This pre-licensing inspection is being conducted as an initial facility application. Fire Clearance has been approved on 10/19/2023 for 4 non-ambulatory, of which 1 can be bedridden, and 2 Ambulatory residents, for a total capacity of 6. There are currently 0 residents in care. LPA conducted a tour and inspection of the indoor and outdoor portions of the facility. The home is a two story home and the second floor is off limits and not used by residents, stairs are gated and prevent access to the second floor. The down stairs . Fire extinguisher was charged and current. Smoke detectors and carbon monoxide detectors were present and all functional. Exits were observed to be unobstructed. Hot water measured 115.0 degrees in faucets used by residents which falls within regulation between 105 & 120 degrees F. There was an ample supply of linens, dishes and cooking supplies. There was a sufficient hygiene products available for residents. LPA observed adequate food supply per facility capacity. Facility was found to be a comfortable temperature of 70 degrees F. Toxins were observed to be secured and locked under kitchen sink. In addition, all knives and other sharp items were found to be in a locked location in the kitchen. Medications will be centrally stored in a locked cabinet in living room with medication records and files. Facility also has blank templates for incoming resident and staff records, all contained in a secured location. Required postings such as Rights to resident councils, client's rights and Complaint Poster are posted at the main entrance of the facility. Component III orientation was conducted with the Licensee Applicant. The pre-licensing evaluation has been completed and there are no corrections needed. This report was reviewed with applicant and an electronic copy was provided. Signatures on file.the state’s words, verbatim · CDSS document, Dec 1, 2023