Pleasant Hill Villa Home Care

On 09/21/2023 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregiver, Myra Ecaruan and explained the purpose of the visit. Acting Administrator, Joy Dela Cueva, arrived shortly after. Joy's Administrator Certificate# 6016749740 Expires 06/25/2024. The facility’s fire clearance was approved for 6 non-ambulatory. LPA toured facility with Joy 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 106.3 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 were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 06/11/2023. Emergency Disaster Plan was last posted on 09/10/23. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 09/10/23. 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 Continued.... LPA reviewed 4 residents records. LPA reviewed 7 staff records and 0 of 7 have current first aid training and associated to the facility. THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 11:24AM, LPA observed knives, scissors and matches unlocked in kitchen drawer. At 11:39 AM, LPA observed ladder, wood planks, garbage can located outside in the backyard At 11:43 AM, LPA observed screen door, more wood, broken wooded fence located behind storage shed in the backyard. At 11:45 AM, LPA observed wood planks in the front yard. At 11:48AM, LPA observed metal bed frames, walker, headboard, white door and dried up paint bucket located outside in front of the garage. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 09/28/2023: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate 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. Exit interview conducted. Appeal Rights and a copy of this report provided.

On 8/31/2022 at 1:30PM, Licensing Program Analysts (LPAs) G. Luk and J. Sampair arrived unannounced to conduct a health and safety check as a result of a priority 1 complaint. LPAs met with Licensee, Gliceria Magat. Administrator, Christina Elazegui arrived an hour later. LPA toured facility including but not limited to the bedrooms, bathrooms, common area, kitchen, garage and outdoor area. Facility temperature was maintained at 76.6 degrees F. Hot water temperature was measured at 108 degrees F in kitchen sink. 7-day of non-perishable and 2-day of perishable food supplies were sufficient. Resident's medications were kept locked in the cabinet. Smoke and Carbon monoxide detectors observe. First-aid kit was complete. Fire extinguisher was observed to be full and last serviced on 6/29/2022. There are no accessible bodies of water observed. At 1:00PM, LPAs observed a bottle of furniture polish stored next to can goods in the garage storage. Licensee removed the furniture polish during inspection. At 1:03PM, LPAs observed unlocked garage door which had cleaning supplies and laundry detergent accessible. Cabinet under the sink was unlocked with cleaning supplies. LPAs also observed unlocked scissors in the drawer. Staff locked up disinfectant, cleaning supplies, and knives during inspection. At 1:05PM, LPAs observed air vent on the ceiling by the garage door and hallway bathroom appears to be loose and may be falling down. Ceiling vent in the hallway by the front door has cobwebs. Room #3 toilet seat is missing and floor of shower was dirty. Gate latch in the deck area is in disrepair and until to self-close. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights was provided.

Licensing Program Analyst (LPA) James Sampair conducted an infection control annual inspection and explained the purpose of the visit with Administrators Gliceria Magat and Maria Christina Elazegui. LPA observed all staff wearing face masks during the visit. Maria Christina Elazegui is the designated Infection control leader. LPA discussed the mitigation plan with them, as well as their current COVID-19 infection control practices. They have conducted staff training on infection prevention, symptoms, transmission, as well as the proper donning and doffing of PPE. All of the staff and residents were fully vaccinated. LPA inspected the facility inside and outside. LPA observed screening station located near the front entrance with a digital visitor's log, hand sanitizer, face masks, and a no-touch temperature probe. Routine symptom screening (+/-) temperature and symptom check is done at entry for all staff, residents, and visitors. LPA observed COVID-19 signs posted in common areas to promote hand washing, cough/sneeze etiquette and physical distancing. Facility documents daily temperatures and COVID-19 symptom checks for staff and residents. Pathways were observed to be free of obstruction and fire hazards. There were sufficient food and water supplies in the kitchen refrigerators/freezers. Emergency paper and PPE supplies were observed. Facility room temperature was maintained at a comfortable temperature and the water temperature was in the acceptable range. A certified administrator is on site at all times to oversee proper business operation and compliance with COVID-19 infection control practices. Fire extinguishers were observed fully charged and last inspected in June 2021 and the Smoke and Carbon monoxide detectors were fully operational. LPA observed two citations that have been written up on the LIC809-D for 1 Type A and 1 Type B deficiencies that were both corrected before the LPA left the facility. Exit interview conducted and a copy of this report and copies of the Appeal Rights were provided.