Reliez Valley Care Home

On 12/09/2025 at 09:45 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Required Annual Inspection. Upon entry, the LPA stated the purpose of the visit to Caregivers Pablo Larosa and Anna Guillermo. During the inspection, the LPA spoke over the phone several times with the Licensee / Administrator Leah MacDonald. The LPA toured the facility including but not limited to residents’ rooms, bathrooms, kitchen, common areas and the backyard. The LPA observed adequate lighting for the comfort and safety of residents in all rooms. Inside and outside areas are free of obstruction and no bodies of water. The temperature in the living room was measured at 70.5 degrees Fahrenheit. The hot water temperature was measured at 128.8 degrees Fahrenheit, which was far above the safe range of 105 to 120 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and slip-resistant mats. There is more than the minimum of a one-week supply of nonperishable food and 2 days of perishable food. Centrally stored medications, sharps, and toxic cleaners are inaccessible to residents in care. The LPA observed the required postings in the facility, including the Residential Care Facility for the Elderly Complaint Poster, Ombudsman and Personal Rights posters, and the Theft and Loss Policy. Smoke detectors and carbon monoxide detectors were tested and found to be in operating condition. The fire extinguisher was fully charged and replaced within one year on 7/2/2025. The Emergency Disaster Plan was last reviewed on 11/01/2025. Emergency, disaster, and fire drills are conducted quarterly; the most recent drill was conducted on 11/01/2025. First aid kit was observed to be complete. Liability insurance certificate expires on 1/17/2026. Continued on LIC 809-C . . . 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 . . . Continued from LIC 809 The LPA reviewed 4 resident records and 5 staff records. 2 Type A and 1 Type B citations were issued during the inspection. Exit interview conducted and a copy of this report provided.

On 12/05/2024 at 9:25 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregivers, Marilyn Magalued and Joanna Magalong and explained the purpose of the visit. Marilyn phoned the Licensee/Administrator, Leah MacDonald to inform. The facility’s fire clearance was approved for capacity of six (6) all non-ambulatory residents. Hospice waiver approved for two (2) residents. Administrator Certificate # 7004457740 expires 05/11/2024. LPA toured facility with Joanna including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of five (5) total bedrooms which four (4) bedrooms are occupied by the residents and one (1) bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 76 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 129.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 03/01/2024. Emergency Disaster Plan was last posted in 2023. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 10/01/2024. LIC809-C Continued... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LIC809-C (Page 2) LPA reviewed four (4) residents records. LPA reviewed four (4) staff records and four (4) of four (4) have current first aid training and associated to the facility. THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 12:15pm, LPA observed the hot water temp. was measuring 129.2 in shared bathrooms. At 12:31pm, LPA observed range stove located outside in the side backyard. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 12/12/2024: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Exit interview conducted. Appeal Rights and a copy of this report provided.

On 11/30/2023 at 9:45 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregivers, Dominador Lampano and Nina Alapar and explained the purpose of the visit. Nina phoned the Administrator, Leah MacDonald and advised. Leah arrived approximately 30 minutes later. Administrator's Certificate# 6015445740 Expires 05/11/2024. The facility’s fire clearance was approved for six (6) capacity in which all may be non-ambulatory with a hospice waiver for two (2). LPA toured facility with Nina including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms which 5 bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 73 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 113 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. LIC809-C Continued... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LIC 809 Continued... Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 03/06/2023. Emergency Disaster Plan was last posted on 11/2023. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 10/01/2023. LPA reviewed 5 residents records. LPA reviewed 4 staff records and 3 of 4 have current first aid training and associated to the facility. THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 10:11 AM LPA observed a bottle of Clorox Bleach unlocked under the kitchen sink cabinet. At 10:45 AM LPA observed Resident #5 in a full rail hospital bed At 12:30 PM LPA observed during file review no doctor's orders for full rail hospital bed for Resident #5 At 1:30 PM LPA observed during file review that Staff #4 was missing Health Screening and TB Test. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 12/07/2023: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Exit interview conducted. Appeal Rights and a copy of this report provided.

On 2/14/2023 at 11:10AM, Licensing Program Analysts (LPAs) L. Alexander and G. Luk conducted an unannounced to conduct a case management visit. LPAs met with Administrator, Leah MacDonald. While LPAs was at the facility for another visit, the following deficiency was observed. At 10:45AM, LPAs observed front door had a door chain latch located near the top of the door. Staff informed LPAs that door chain latch was put on to prevent residents from leaving. The following deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiency by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.

This is an amendment to an original report dated 01/17/23. On 01/17/2023 at 2:50PM, Licensing Program Analysts (LPAs) L. Alexander and C. Fowler arrived unannounced to conduct a POC visit. LPAs met with Leah MacDonald Administrator and explained the purpose of the visit. Facility has the following deficiencies that was not cleared and deficiencies were issued on 11/30/2022 from California Code of Regulations, Title 22 : LPAs observed the following deficiencies during today's POC visit: At 2:50pm - LPAs observed S2 was not associated to facility. At 2:56pm - LPAs observed vitamins located in created bedroom with the door unlocked. Exit interview conducted. A copy of this report and appeal rights provided.

This is an amendment to an original Annual Report (809) dated 11/30/22. On 11/30/22 at 2:40 PM, Licensing Program Analysts (LPAs) L. Alexander and C. Fowler arrived unannounced to conduct an Infection Control Inspection. LPAs was greeted by, Caregiver, Maria Christina Velasquez, and explained the purpose of the visit. Leah MacDonald, arrived approximately at 3:32 PM. Upon entry, LPA's temperature was not checked. LPAs observed screening station that contained hand sanitizer, masks and COVID signage. LPAs toured facility including but not limited to common areas, bathrooms, bedrooms, kitchen, garage and backyard. LPAs observed cough etiquette and physical distancing posted in the common areas. All hand washing stations were equipped with soap, paper towel, and hand washing posters. During record review, LPAs observed visitors log and temperature logs for residents or staff. LPAs observed facility has a copy of Mitigation Plan on file. The following deficiencies were observed during the visit: -At 2:42 PM, LPAs observed S2 was not associated to facility. -At 2:43 PM, LPAs observed a pair of scissors laying on kitchen counter top. -At 2:44 PM, LPAs observed keys in top kitchen cabinet that contained medication. Continue to LIC809-C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 -At 3:16 PM, LPAs observed a created bedroom in the garage. -At 3:20 PM, LPAs observed a created bedroom out of the dining room connected to the kitchen The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations. Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. A copy of this report and appeal rights provided