Spyglass Senior Villa I

On this day, July 2, 2025, at 4:35 pm, Licensing Program Analyst (LPA) Delmundo arrived unannounced to deliver the amended LIC9099 Complaint Investigation Report dated 11/17/2023. LPA was granted entry by Jeffrey Santos, staff. LPA met with Rhonette Santos, co-administrator, and informed the reason for visit. Exit interview conducted and copies of this report and amended report provided.

On 05/21/2025 at 1:10PM, Licensing Program Analysts (LPA) T. Syess-Gibson conducted an unannounced 1-Year Required inspection. LPA met with Rhonette Santos, Administrator and explained the purpose of the visit. The Administrator currently holds a certificate (#7027774740) that expires on 03/20/2026. The facility’s fire clearance was approved for six (6) 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 three (3) bathrooms. LPA did not observe any bodies of water. 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 120.1 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and no skid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 10/08/2024. Emergency Disaster Plan was last posted on 04/08/2025. 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 LPA reviewed five (5) resident records and four (4) staff records, and they were current and complete. LPA also reviewed a sample of medication. LPA requested the following documents to be submitted to CCLD by 05/28/2025 : LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan No deficiencies cited during visit. Exit interview conducted and a copy of this report provided to Rhonette Santos.

On 9/06/23 at 12:00 p.m., Licensing Program Analyst (LPA) Greg Clark arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Rhonette Santos, Back-up Administrator and explained the purpose of the visit. The facility’s fire clearance was approved for 6 clients of which 6 may be non-ambulatory. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 6 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 72 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 112.3 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable 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 10/13/22. First aid kit was observed to be complete. Fire drill was last conducted on 6/1/23. At 12:15 p.m., LPA reviewed 5 residents records. At 1:00 p.m., LPA reviewed 5 staff records and 5 of 5 have current first aid training and associated to the facility. At 1:45 p.m., LPA reviewed a sample of resident’s medications. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 9/13/23: LIC 610E Emergency Disaster Plan No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 6/06/2021 at 2:30PM Licensing Program Analyst (LPA) Leslie Ibo arrived unannounced to conduct an annual required inspection. LPA met with house manager Rhonette Santos and informed the purpose of visit. Administrator Rakhee Sharma arrived at the facility around 3:15PM. Facility has census of 5. LPA toured the facility inside and out including but not limited to common areas, resident rooms, bathrooms, kitchen and patio. Facility has enough supplies of PPEs, paper supplies and hygiene supplies. Medications are centrally stored in a locked area that is inaccessible to clients and refilled every 30 days. Water temperature was observed to be at 107.5 degreen Fahrenheit. Facility has a sufficient 2-day perishable and one-week non-perishable food supply. Visitors policy is posted on the front entrance. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Facility staff were observed to be wearing proper PPE. Facility has a mitigation plan and maintains record of routine screening for residents and staff. No deficiency cited during the visit. Exit interview conducted. Appeal Rights and copy of this report provided.

On 6/15/2021 at 10AM Licensing Program Analyst (LPA) Leslie Ibo arrived unannounced to conduct an annual required inspection. LPA met with house manager Rhonette Santos and informed the purpose of visit. Administrator Rakhee Sharma was not available during the visit, LPA spoke to Administrator to let her know Rhonette will receive the report today. Facility has census of 6. LPA toured the facility inside and out including but not limited to common areas, resident rooms, bathrooms, kitchen and patio. Facility has enough supplies of PPEs, paper supplies and hygiene supplies. Medications are centrally stored in a locked area that is inaccessible to clients and refilled every 30 days. Facility has a sufficient 2-day perishable and one week non-perishable food supply. Visitors policy is posted on the front entrance. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Facility staff were observed to be wearing proper PPE. Facility has a mitigation plan and maintains record of routine screening for residents and staff. No deficiency cited during the visit. Exit interview conducted. Appeal Rights and copy of this report provided.