Pleasant Hill Villa Home Care 2

On 04/16/2025 at 7:00 PM Licensing Program Analyst (LPA) L. Alexander conducted an unannounced Case Management visit while conducting a Pre-Licensing visit for a Change of Ownership. LPA met with Administrator, Joy Dela Cueva and explained the purpose of the visit. LPA called Licensee, Gliceria "Glecy" Magat to discuss the modified rooms in the detached garage. While LPA toured the facility with the facility sketch LPA observed that the detached garage had three (3) separate rooms that included hardwood floors, a desk, a desk chair, chairs, a twin bed and other items located in this space. LPA phoned the Licensee, "Glecy", that stated this space was modified for an office for the new licensee. Glecy stated that the garage was already modified with the 3 rooms prior to her becoming the licensee of the facility. LPA reviewed a copy of current facility sketch that only illustrates the detached garage as a "garage" and not an office or another type of room. LPA observed a refrigerated freezer that included food for the residents. Technical Violation is being issued during visit. Exit interview conducted and a copy of this report was provided.

On 01/03/2025 at 12:15 PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregiver, Leonora Gabatino and explained the purpose of the visit. Leonora phoned the Administrator, Joy Dela Cueva to inform. The administrator arrived shortly after. The facility’s fire clearance was approved for capacity six (6) non-ambulatory. Hospice waiver approved for three (3) residents. Administrator certificate #7004869740 expires 06/25/2026. LPA toured facility with Leonora including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of seven (7) total bedrooms which six (6) 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 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 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 08/21/2024. Emergency Disaster Plan was last posted on 01/30/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 12/10/2024. 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 six (6) residents records. LPA reviewed eight (8) staff records and 8 of 8 have current first aid training and associated to the facility. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 01/10/2025: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization Updated LIC 500 Personnel Report LIC 610E Emergency Disaster Plan - Reviewed Liability Insurance Current Administrator’s Certificate - Reviewed No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.