Serene Care Winchester
RCFE
A Residential Care Facility for the Elderly (RCFE) is a non-medical residential care home licensed by California CDSS under Health & Safety Code §1560. Residents receive assistance with daily living activities such as bathing, dressing, meals, and medication management in a home-like setting. RCFEs are not hospitals or skilled nursing facilities — they do not provide round-the-clock medical care.
4984 Winchester Dr · Oakley, 94561
Quick facts
Quality snapshot
Updated April 25, 2026Compared to 214 California RCFE facilities of similar size, over the last 36 months.
Source: California Department of Social Services, Community Care Licensing Division. View raw inspection records →
Quality grade· click to show how this was calculated
Severity13thWeighted citations per bed
Repeats100thRepeat deficiencies as share of total
Frequency9thDeficiencies per inspection
Tick mark at 50% = peer median · higher percentile = better facility
Quality grade· click to show how this was calculated
Weighted citations per bed
Repeat deficiencies as share of total
Deficiencies per inspection
Tick mark at 50% = peer median · higher percentile = better facility
Serene Care Winchester scores C−. Better than 41% of comparable California RESIDENTIAL CARE ELDERLY facilities. Severity: bottom 13%. Repeats: top 0%. Frequency: bottom 9%.
Each metric is converted to a 0–100 percentile within the peer set (higher = better). The composite grade averages all four. Peer set: CA / rcfe_general / small beds (214 facilities).
Citation severity over time
↑ worseningWeighted severity score per month · 24 months
Weighted score (24mo)
51
Last citation
Feb 26
Finding distribution
12 total · 36 monthsScope × Severity (CMS A–L)
The rules that apply to this facility
California Title 22 requirements for this facility, with the specific regulation and a suggested question for each.
What training are all staff required to complete?22 CCR §87411
All direct-care staff must complete:
- 10 hours initial training within the first four weeks of employment.
- 4 hours annual in-service every year thereafter.
- Administrator certificate from a CDSS-approved program — 80 hours for first-time, 40 hours renewal every 2 years.
Ask on tour: Ask when the last staff training was completed and how it's tracked.
How many staff must be on duty overnight?22 CCR §87415
Based on 6 licensed beds:
One qualified staff member must be on call and physically on premises at all times overnight.
Violation pattern to watch for:A facility that documents a staff member as "on call" but with that person physically off-site — when the law requires on-premises presence — is in violation of this section.
Ask on tour: Ask the facility to walk you through their overnight staffing plan and confirm whether on-call staff are on premises or off-site.
What health conditions can this facility legally accept or refuse?22 CCR §87612–87615
Restricted — allowed with physician order + care plan
- Supplemental oxygen
- Insulin and injectable medications
- Indwelling or intermittent catheters
- Colostomy / ileostomy
- Stage 1 and Stage 2 pressure injuries
- Wound care (non-complex)
- Incontinence
- Contractures
Prohibited — facility must refuse or discharge
- Stage 3 or Stage 4 pressure injuries
- Feeding tubes (PEG, NG, or J-tube)
- Tracheostomies
- Active MRSA or communicable infections requiring isolation
- 24-hour skilled nursing needs
- Total ADL dependence with inability to communicate needs
A hospice waiver (HSC §1569.73) can allow continued care for residents on hospice who would otherwise fall into a prohibited category.
Ask on tour: Ask whether your loved one's specific care needs are restricted or prohibited, and what the facility's process is if needs change after admission.
What must this facility report to the state — and how fast?22 CCR §87211 / WIC §15630
- ImmediateElopement, fire, epidemic outbreak, or poisoningImmediately
- 2 hoursAbuse with serious bodily injury2-hour phone report + 2-hour written report — to the California Department of Social Services (CDSS), Adult Protective Services, and law enforcement
- 24 hrsAbuse without serious bodily injuryWithin 24 hours
- Next dayDeath of a residentPhone by next working day; written within 7 days
- Next dayInjury requiring medical treatment beyond first aidPhone by next working day; written within 7 days
- WrittenBankruptcy, foreclosure, eviction, or utility shutoff noticeWritten notice to CDSS and residents — $100/day penalty (max $2,000) for failure
Your enforcement lever:Incidents that aren't reported on time are themselves a separate violation. If you believe a reportable event wasn't filed, you can submit a complaint directly to the California Department of Social Services (CDSS).
How does CDSS enforce these rules?22 CCR §87755–87777 / HSC §1569.58
- 1Notice of DeficiencyWritten citation with a correction deadline. Facility must submit a Plan of Correction.
- 2Civil PenaltyStarts at $50/day for non-serious; $150/day for serious deficiencies — immediately, with no grace period. Repeats escalate to $150 first day + $50/day, then $1,000 first day + $100/day.
- 3Suspension of AdmissionsFacility cannot accept new residents until violations are corrected.
- 4Temporary Suspension or RevocationEmergency suspension for imminent danger; full revocation after administrative hearing.
- 5Exclusion OrderAdministrator and operator can be barred from all CDSS-licensed facilities — not just this one.
See how these rules have been applied to this specific facility:
View state inspection record and citationsState records
California Dept. of Social Services · Community Care Licensing- License number
- 079200804
- License type
- RESIDENTIAL CARE ELDERLY
- License status
- LICENSED
- License expires
- Not yet indexed
- Licensed beds
- 6
- Operator
- Lilyrose Llc
Inspections & citations
3
reports on file
12
total deficiencies
4
Type A (actual harm)
InspectionFebruary 5, 2026Type A5 deficiencies
Plain-language summary
On February 5, 2026, a routine unannounced inspection found several deficiencies: a chair was blocking an exit door in one bedroom, the facility lacked proper fire clearance for a bedridden resident, two residents receiving hospice care did not have hospice care plans on file, four staff members were not first aid certified, medication records were incomplete for two residents, and the back yard contained clutter including a mop bucket, chairs, and other items. The facility was assessed a $500 civil penalty and required to submit corrections by February 12, 2026. The administrator's certificate expires March 6, 2026.
View full inspector notes
On 2/5/2026 at 9:50am, Licensing Program Analyst (LPA) L. Hall conducted an unannounced annual required inspection. LPA met with Caregiver, Josephine Ambagan, and explained the purpose of the visit. Licensee, Jennifer Rances, arrived at 10:27am. Administrator holds a certificate #7033979740 expires 3/6/2026. The fire clearance is approved for two (2) ambulatory and four (4) non-ambulatory residents. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms and two (2) bathrooms. One (1) bedroom occupied by staff. No bodies of water observed. A comfortable temperature is maintained at 74 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 113.4 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors/ carbon monoxide were in operating condition during visit. Emergency disaster plan last reviewed 12/23/2025. Fire extinguisher was last purchased 12/27/2025. First aid kit was observed to be complete. Fire drill was last conducted on 01/09/2026. Continued on LIC809. 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 LIC809. LPA reviewed five (5) staff and five (5) resident records. LPA also reviewed a sample of the medications. LPA requested the following documents to be submitted to CCLD by 02/12/2026 . LIC308 Designation of Administrative Responsibility LIC610E Emergency Disaster Plan (last page) Liability Insurance LIC500 (Personnel report) Administrator certificate LPA observed the following deficiencies: At 10:03am, LPA observed a chair blocking the exit door in bedroom #3. At 10:05am, LPA observed a sink, 3 chairs, 2 trash cans, a mop bucket, and remnants of commodes in back yard. At 10:25am, LPA observed during record review R1 is bedridden and facility does not have a bedridden fire clearance. At 11:05am, LPA observed during record review there was not a hospice care plan for R3 and R4. At 11:15am, LPA observed S1, S3, S4, and S5 are not first aid certified. At 11:44am, LPA observed during record review the medication administrator record (MAR) was not filled out for R1 and R2. Continued on LIC809C. 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 LIC809C. *An immediate one-time civil penalty for $500.00 will be assessed on today's date for 87202(a)* Deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of the LIC421M, appeal rights, and this report provided.
Regulation
(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fi…
Inspector finding
Based on observation and record review, the licensee did not comply with the section cited above in having a bedridden resident residing at facility and a chair blocking the exit in bedroom #3 which poses an immediate health and safety risk to persons in care. POC Due Date: 02/06/2026 Plan of Correction 1 2 3 4 Licensee agreed to submit documentation for an updated fire clearance for R1 or relocate R1, and move the chair from blocking the exit in bedroom #3. Licensee will submit documentation …
Regulation
(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction.
Inspector finding
Based on observation, the licensee did not comply with the section cited above in having items in back yard which poses a potential safety or personal rights risk to persons in care. POC Due Date: 02/12/2026 Plan of Correction 1 2 3 4 Licensee agreed to have all items removed and submit photo to CCLD by POC date.
Regulation
(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staf…
Inspector finding
Based on observation, interview, and record review, the licensee did not comply with the section cited above in having staff first aid certified which poses a potential health and safety risk to persons in care. POC Due Date: 02/12/2026 Plan of Correction 1 2 3 4 Licensee agreed to obtain first aid certification for all staff and submit certificates to CCLD by POC date.
Regulation
(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are…
Inspector finding
Based on observation and record review, the licensee did not comply with the section cited above in documenting dosage taken which poses a potential health and personal rights risk to persons in care. POC Due Date: 02/12/2026 Plan of Correction 1 2 3 4 Licensee agreed to update MAR for R1 and R2 and submit a copy to CCLD by POC date.
Regulation
(b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include the following:
Inspector finding
Based on observation and record review, the licensee did not comply with the section cited above in having a hospice care plan for R3 and R4 which poses a potential health and safety risk to persons in care. POC Due Date: 02/12/2026 Plan of Correction 1 2 3 4 Licensee agreed to obtain a hospice care plan for R3 and R4, and submit a copy to CCLD by POC date.
InspectionFebruary 12, 2025Type A5 deficiencies
Inspector: Tonica Syess-Gibson
Plain-language summary
During a routine annual inspection on February 12, 2025, inspectors found several deficiencies: cleaning supplies and medications were stored in unlocked locations where residents could access them, a required safety poster was not posted, personnel records were not available for review, and all four residents' files were missing required pre-admission assessments. The facility was assessed a $250 civil penalty for the unlocked medication storage, which was a repeat violation. The inspector also noted that the facility's physical conditions—temperature, lighting, grab bars, smoke detectors, and fire safety equipment—met standards.
View full inspector notes
On 02/12/2025 at 9:53AM, Licensing Program Analyst (LPA) T. Syess-Gibson arrived unannounced to conduct Required 1 Year Annual inspection. LPA met with Caregiver, Joy Ballares and explained the purpose of the visit. Administrator, Ronan Rances arrived at 10:28AM. The facility’s fire clearance was approved for four (4) non-ambulatory and two (2) ambulatory residents. Hospice waiver approved for four (4) residents. LPA toured facility with caregiver, Joy Ballares including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of six (6) total bedrooms, one (1) bedroom vacant and one (1) bedroom occupied by staff and two (2) bathrooms. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 68 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 119.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7-day supply of nonperishable and 2 days of perishable foods. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was purchased on 01/10/2025. First aid kit was observed to be complete. Fire drill last conducted on 02/05/2025. Emergency disaster plan updated 05/05/2024. Continue on LIC809C 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 LIC809. One (1) staff file reviewed during visit; all other staff files were not available for review during visit. LPA reviewed all four (4) resident records. LPA requested the following documents to be submitted to CCLD by 02/19/2025 LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (last page) Liability Insurance LPA observed the following deficiencies: At 10:59AM, LPA observed facility didn’t have Pub 475 poster posted. At 11:02AM, LPA observed unlocked garage with Arm & Hammer laundry detergent, Clorox bleach, Tide laundry detergent pods, Ensuno fabric softener, Xtra laundry detergent,Comet, bleach, All-purpose cleaner with bleach, Simple green all-purpose cleaner and Finish powerball dishwasher tabs. At 11:14AM, LPA observed unlocked kitchen cabinet with medications. Civil penalty of $250 is being assessed for repeat violation . At 12:12PM, LPA observed record review no personnel records were at the facility for review. At 12:30PM, LPA observed record review all four(4) residents were missing Pre- Admission Appraisal. Deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted and a copy of this report, LIC421FC and appeal rights provided.
Regulation
(c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. (2) Information on the appropriate reporting agency in case of a complaint or emergency, including procedures for filing confidential complaints, shall be posted as follows: (…
Inspector finding
Based on observation, the licensee did not comply with the section cited above in not having he Residential Care Facility for the Elderly (RCFE) Complaint Poster posted which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/19/2025 Plan of Correction 1 2 3 4 Adinistrator agreed to purchase and post the PUB 475 poster and send CCLD a photo email by POC date.
Regulation
(c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of their individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations.
Inspector finding
Based on observation and record review, the licensee did not comply with the section cited above in not having a Pre-Admission Appraisal for residents which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/19/2025 Plan of Correction 1 2 3 4 Administrator agreed to place a preadmission Appraisal in each of the residents' file and send a self certifying email of completion to CCLD by POC date.
Regulation
87309 Storage Space and Access (a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage.
Inspector finding
Based on observation,the licensee did not comply with the section cited above in having Clorox bleach, Tide laundry detergent pods, Ensueo fabric softner,comet, Simple Green all purpose cleaner and Finish dishwasher powerball tabs which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 02/13/2025 Plan of Correction 1 2 3 4 Administrator agreed to purchase a cabinet and place all disinfectants, cleaning solutions and posionous substance in ti with a loc…
Regulation
87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: 92) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.
Inspector finding
Based on observation, the licensee did not comply with the section cited above in having centrally stored medications in an unlocked kitchen cabinet which poses an immediate health and safety risk to persons in care. POC Due Date: 02/13/2025 Plan of Correction 1 2 3 4 Administrator immediately locked kitchen cabinter with medicatons. Deficiency cleared during visit. Civil penalty of $250 is being assessed for repeat violation.
Regulation
87412 Personnel Records (f) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements:
Inspector finding
Based on observation and record review, the licensee did not comply with the section cited above in not having Personnel Records available to licensing to inspect, audit, and copy upon demand during normal business hours. which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/19/2025 Plan of Correction 1 2 3 4 Administrator agreed to bring personnel records to facility and send a self certifying email to CCLD by POC date.
InspectionFebruary 21, 2024Type A2 deficiencies
Inspector: Carol Fowler
Plain-language summary
During a routine annual inspection on April 26, 2026, inspectors found the facility clean and safe with proper exits, grab bars, secure storage of chemicals, and adequate supplies, but identified three issues: a ripped screen in a shared bathroom, unlocked medication in a kitchen cabinet, and incomplete resident and staff records. The facility must submit corrections to the state by February 28, 2024, though this deadline has already passed. The administrator's certificate was current at the time of inspection.
View full inspector notes
At approximately 4:15PM, Licensing Program Analysts (LPAs) Carol Fowler and Tonica Syess-Gibson arrived unannounced to conduct a Required 1 Year annual inspection and met with Caregivers, Thelma Hababag and Renato Hababag. Ronan Rances, Administrator arrived at 4:59PM. Facility has an approved fire clearance for 2 ambulatory and 4 non-ambulatory residents for a total capacity of 6 residents. LPAs conducted a tour of the facility and observed the following: the facility was clean and at a comfortable temperature 73 degrees with all exits free from obstruction. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. Toxins were secure and not accessible to residents. There is a sufficient supply of hygiene products, paper products, and linens available for resident use. LPAs reviewed 5 resident records which were incomplete. LPAs reviewed three (3) staff records which S2 and S3 were incomplete . LPAs reviewed three staff files. Administrator's Certificate #6025731740 was current with an expiration date of 03/06/2024. The facility last fire and evacuation drill was conducted on 01/05/2024. Facility's fire extinguishers were last inspected 01/09/2024. Emergency Disaster Plan updated on 01/08/2024 Smoke detectors and carbon monoxide detectors were tested and operational. The amount of fresh and non-perishable foods are within regulation. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit. Continued on LIC809C. 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 LIC809. LPA requested the following documents to be submitted to CCLD by 2/28/2024. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (last page) Liability Insurance LPAs interviewed one (1) resident. LPAs observed the following deficiencies: At 4:47pm, LPAs observed screen in shared bathroom was ripped. At 4:59pm, LPAs observed unlocked medication in kitchen cabinet. 5:24pm, LPAs observed record review two (2) out of three (3) files reviewed were incomplete. Deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted and a copy of this report and appeal rights provided.
Regulation
87465(h)(2) 87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication
Inspector finding
Based on observation, the licensee did not comply with the section cited above in not having medication locked which poses an immediate health and safety risk to persons in care. POC Due Date: 02/22/2024 Plan of Correction 1 2 3 4 Administrator agreed to locked centrally stored medication and conduct in service with staff about pre pouring and having medication locked. DEFICIENCY CLEARED DURING VISIT
Regulation
87412 Personnel Records (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:
Inspector finding
Based on record review, the licensee did not comply with the section cited above in not having staff personnel records complete with health screening, personnel record (LIC501) which poses a potential health and safety risk to persons in care. POC Due Date: 02/28/2024 Plan of Correction 1 2 3 4 Administrator agreed to complete staff personnel files and submit an sample and check list to CCLD by POC date.
Federal summary
CMS Care CompareNot a CMS-certified facility
California RCFEs (residential care facilities for the elderly) are licensed by the state, not by CMS. CMS data only applies to skilled nursing facilities or to CCRCs that operate a licensed SNF wing.
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