Villa Board and Care Home
RCFE · Memory Care
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 help with daily living activities such as bathing, dressing, and medication management. An RCFE with a Memory Care designation is additionally required by California Title 22 (§87705 and §87706) to provide specialized staff training in dementia care, individualized care plans for residents with cognitive impairment, and appropriate supervision protocols — requirements that go beyond a standard RCFE license.
831 Coral Dr. · Rodeo, 94572
Quick facts
Quality snapshot
Updated April 25, 2026Compared to 182 California RCFE memory care 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
Severity18thWeighted citations per bed
Repeats100thRepeat deficiencies as share of total
Frequency4thDeficiencies 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
Villa Board and Care Home scores C−. Better than 41% of comparable California RESIDENTIAL CARE ELDERLY facilities. Severity: bottom 18%. Repeats: top 0%. Frequency: bottom 4%.
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_memory_care / small beds (182 facilities).
Citation severity over time
↑ worseningWeighted severity score per month · 24 months
Weighted score (24mo)
40
Last citation
Feb 26
Finding distribution
26 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.Rules this facility has been cited for are shown first.
What dementia-care training must staff complete?Cited Mar 202222 CCR §87705 / HSC §1569.625
Because this facility markets dementia or Alzheimer's care, state law mandates higher training standards:
- 12 hours initial dementia training — 6 hours before a staff member works independently with residents, 6 more within the first 4 weeks.
- 8 hours annual dementia in-service — required every year thereafter.
- Administrator CE — the administrator must include 8 hours of dementia-specific continuing education in every 2-year recertification cycle.
Training must cover individualized care plans, behavioral expressions, appropriate supervision, and the facility's dementia care philosophy.
Ask on tour: Ask how dementia training records are kept — families may request documentation.
What must this facility report to the state — and how fast?Cited Mar 202222 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 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.
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
- 071440415
- License type
- RESIDENTIAL CARE ELDERLY
- License status
- LICENSED
- License expires
- Not yet indexed
- Licensed beds
- 6
- Operator
- Villa, Daniel D.
Inspections & citations
8
reports on file
41
total deficiencies
10
Type A (actual harm)
1
dementia-care citations
InspectionMarch 16, 2026No deficiencies
Plain-language summary
On March 16, 2026, inspectors conducted a follow-up visit after an annual inspection in February found deficiencies that the facility was supposed to correct by March 11. The facility failed to submit its correction plan by the deadline, and six deficiencies remain unresolved, resulting in civil penalties of $3,600.
View full inspector notes
On 03/16/2026 at 3:15PM, Licensing Program Analyst (LPA) Carol Fowler arrived unannounced to conduct a Plan of Correction (POC) visit. LPA met with Daniel Villa, Administrator and explained the purpose of the visit. On 02/25/2026, LPA conducted an Annual Inspection visit in which deficiencies were cited. The POC due date was 03/11/2026. Administrator failed to submit the POC by the due date and this is why LPA came to make a POC visit. Deficiencies not cleared: 87303(a) = $100.00/day x 6 days (3/11/2026 to 3/16/2026) = $600.00 87204(a) = $100.00/day x 6 days (3/11/2026 to 3/16/2026) = $600.00 87308(c) = $100.00/day x 6 days (3/11/2026 to 3/16/2026) = $600.00 HSC 1569.618 (c)(3) = $100.00/day x 6 days (3/11/2026 to 3/16/2026) = $600.00 87412(c)(2) = $100.00/day x 6 days (3/11/2026 to 3/16/2026) = $600.00 87307(d)(4) = $100.00/day x 6 days (3/11/2026 to 3/16/2026) = $600.00 Civil Penalties in the total amount of $3600.00 is assessed today for failure to meet POC date for deficiencies. Exit interview conducted. A copy of this report, appeal rights provided and LIC421FC provided.
Other visitFebruary 25, 2026Type A7 deficiencies
Plain-language summary
On February 25, 2026, an unannounced routine inspection found multiple deficiencies at the facility: a lifted hallway floor, mold in a bathroom shower, unlocked medications in a bedroom and refrigerator, a fire extinguisher without proper documentation, a non-resident living in the facility, and clutter in the yard including inoperable vehicles and equipment. The facility was also missing required staff files and administrative documentation. The facility must submit corrections by March 5, 2026.
View full inspector notes
On 2/25/2026 at 9:50 AM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Daniel Villa, Administrator and explained the purpose of the visit. The Administrator currently holds a certificate (#7010385740) that expires 2/7/2027. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of three (3) bedrooms not currently occupied by residents, and two (2) bathrooms. No bodies of water observed. A comfortable temperature is maintained at 67 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of residents. The hot water temperature in the residents’ shared bathroom was measured at 109.6.4 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was not tagged. Emergency Disaster Plan was posted and updated. First aid kit was observed to be complete. LPA reviewed two (2) staff files which were incomplete. 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 CONTINUE FROM LIC809C LPAs requested the following documents to be submitted to CCLD by 3/5/2026. · LIC 308 Designation of Administrative Responsibility · LIC 309 Administrative Organization · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan (9 pages) · Liability Insurance Infection Control Plan LPA observed the following deficiencies: At 10:50am, LPA observed the floor in the hallway lifting. At 10:45am, LPA observed a staff members son living at the facility sleeping in the living room. At 10:50am, LPA observed a fire extinguisher without a tag or receipt. At 10:55am, LPA observed 2nd bathroom shower with mold at the top of the shower. At 10:53am, LPA observed S2 medication setting in room on night stand unlocked. At 11:00 am, LPA observed the door leading to the garage has black smug marks all over. At 11:05am LPA observed located on the side and back yard a commode, 3 ladders, 3 gas cans, trash, rake, 2 lawn mowers, broken table, wood planks, broken chairs, overgrown trees, wheelbarrow, dolly's, gulf club, 2 mattresses van, motor home and black small car all vehicles are not operable. 2 shovels, storage unit unlocked. 11:10am LPA observed clutters in the open porch area. 11:15am LPA observed unlocked medication in the 2nd refrigerator. The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, 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 this report and appeal rights provided
Regulation
(f) All waste shall be located, stored, and disposed of in a manner that will not transmit communicable diseases or odors, pose a risk to health and safety, or provide a breeding place or food source for insects or rodents. (2) Syringes and needles are disposed of in accordance with the California Code of Regulations, Title 8, Section 5193 concern…
Inspector finding
Based on observation, the licensee did not comply with the section cited above by having trash in a trash bad on the side of the house and having syringes located in an unlocked cabinet in the kitchen which poses an immediate health and safety risk to persons in care. POC Due Date: 02/26/2026 Plan of Correction 1 2 3 4 Administrator agreed to remove trash and put the sharps container in the locked cabinet and provide photos of the corrections to the department by the POC date.
Regulation
(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
Inspector finding
Based on observation, the licensee did not comply with the section cited above by having a commode, 3 ladders, 3 gas cans,rake, 2 lawn mowers, broken table, wood planks, broken chairs, overgrown trees, wheelbarrow, dolly's, gulf club, 2 mattresses van, motor home and black small car all vehicles are not operable. 2 shovels, storage unit unlocked. which poses a potential health and risk to persons in care. POC Due Date: 03/11/2026 Plan of Correction 1 2 3 4 Administrator agreed to remove all i…
Regulation
(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity…
Inspector finding
Based on observation and interview, the licensee did not comply with the section cited above by having a staff member living at the facility sleeping in the living room which poses a potential health and safety risk to persons in care. POC Due Date: 03/11/2026 Plan of Correction 1 2 3 4 Administrator agreed to move staff members son to a room or out of the facility by the POC date.
Regulation
(c) General storage space shall be maintained for equipment and supplies as necessary to ensure that space used to meet other requirements of these regulations is not also used for storage.
Inspector finding
Based on observation, the licensee did not comply with the section cited above by not maintaining space in the garage and having clutters which poses a potential health and safety risk to persons in care. POC Due Date: 03/11/2026 Plan of Correction 1 2 3 4 Administrator agreed to have all clutters removed from the garage to be able to use the space for general storage space. Administrator also agrees to submit a photo of all the clutter removed from the garage by the 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 during record review, the licensee did not comply with the section cited above by not being CPR or first aid certified and not having any staff that has a current CPR or first aid certificate which poses a potential health and safety risk to persons in care. POC Due Date: 03/11/2026 Plan of Correction 1 2 3 4 Administrator agreed to get CPR and first aid certified as well as have staff CPR and first aid trained by the POC date and submit copies of the certificate to the de…
Regulation
(c) Licensees shall maintain in the personnel records verification of required staff training and orientation. (2) Documentation of staff training shall include:
Inspector finding
Based on observation, interview and record review, the licensee did not comply with the section cited above by not having staff complete required staff trainings which poses a potential health and safety or risk to persons in care. POC Due Date: 03/11/2026 Plan of Correction 1 2 3 4 Administrator agreed to hire a CCLD approved vendor to conduct staff required trainings and submit copies of staff certificate of compleation.
Regulation
(4) Stairways, inclines, ramps and open porches and areas of potential hazard to residents with poor balance or eyesight shall be made inaccessible to residents unless equipped with sturdy hand railings and unless well-lighted.
Inspector finding
Based on observation, the licensee did not comply with the section cited above by having an open porch area with clutters which poses a potential health and safety risk to persons in care. POC Due Date: 03/11/2026 Plan of Correction 1 2 3 4 Administrator agreed to clear the open porch area and submit photos to the department by the POC date.
InspectionJanuary 23, 2025Type B4 deficiencies
Inspector: Carol Fowler
Plain-language summary
On January 23, 2025, inspectors conducted a routine annual inspection and found several deficiencies: clutter in the kitchen, living room, and backyard; a fire extinguisher without proper documentation; an incomplete first aid kit; and at least one staff member lacking current CPR certification. The facility's smoke detectors, carbon monoxide detectors, grab bars, and emergency plan were in order, and the home is approved to care for up to six non-ambulatory residents.
View full inspector notes
On 1/23/2025 at 2:25 PM, Licensing Program Analysts (LPAs) Carol Fowler and David Doidge conducted an unannounced 1-Year Required inspection. LPAs met with Daniel Villa and explained the purpose of the visit. The Administrator currently holds a certificate (#6035480740) waiting on renewal. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPAs toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of three (3) bedrooms not currently occupied by residents, and two (2) bathrooms. No bodies of water observed. A comfortable temperature is maintained at 73 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of residents. The hot water temperature in the residents’ shared bathroom was measured at 114.4 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was not tagged. Emergency Disaster Plan was posted and updated 1/23/25. First aid kit was observed to be incomplete. LPAs reviewed two (2) staff files which were all complete. 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 CONTINUE FROM LIC809C LPAs requested the following documents to be submitted to CCLD by 1/25/2024. · LIC 308 Designation of Administrative Responsibility · LIC 309 Administrative Organization · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan (9 pages) · Liability Insurance Infection Control Plan LPA observed the following deficiencies: · At 2:45pm, LPA observed clutter such as bags of clothes, bedding under kitchen table and living room. · At 2:50pm, LPA observed clutter in the back yard air fryer, rice cooker, wood planks, 3 ladders, bedrails, 2 ice chests, fruit picker, wheelchairs, 4 shovels, 2 lamps and an electric saw. · At 3:00pm, LPA observed a fire extinguisher without a tag or receipt. · At 3:06pm, LPA observed staff not CPR certified. The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, 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 this report and appeal rights provided
Regulation
(c) General storage space shall be maintained for equipment and supplies as necessary to ensure that space used to meet other requirements of these regulations is not also used for storage.
Inspector finding
Based on observation, the licensee did not comply with the section cited above by having clutters under the kitchen table, in the living room, entry way and back yard such as boxes of clothing, bedding, air fryer, rice cooker, wood planks, 3 ladders, bedrails, 2 ice chests, fruit picker, wheelchairs, 4 shovels, 2 lamps and an electric saw which poses a potential health and safety risk to persons in care. POC Due Date: 02/24/2025 Plan of Correction 1 2 3 4 Administrator agreed to remove all clu…
Regulation
All facilities shall have telephone service on the premises. Facilities with a capacity of sixteen (16) or more persons shall be listed in the telephone directory under the name of the facility.
Inspector finding
Based on observation and interview, the licensee did not comply with the section cited above by not having a landline phone which poses a potential health and safety risk to persons in care. POC Due Date: 02/06/2025 Plan of Correction 1 2 3 4 Administrator agreed to get telephone service at the facility and submit the phone number to the Department by the 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 and record review, the licensee did not comply with the section cited above by having Administrator and staff CPR certificates expired which poses a potential health and safety risk to persons in care. POC Due Date: 02/07/2025 Plan of Correction 1 2 3 4 Administrator agreed to update CPR training for all staff and submit a copy to the Department by the POC date
Regulation
87208((A) Building(s) to be occupied, including a floor plan that describes the capacities of the buildings for the uses intended...7)Sketches, showing dimensions, of the following:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by staff/family sleeping in the garage in a makeshift bedroom being used for accommodation. Which poses a potential health and safety risk to residents. POC Due Date: 02/14/2025 Plan of Correction 1 2 3 4 Administrator agreed not to allow staff/family to sleep in the garage. Facility will submit a written addendum to their operating plan describing how the garage will be utilized as intended to CCLD by POC date.
Other visitJanuary 17, 2024Type A15 deficiencies
Inspector: Carol Fowler
Plain-language summary
On January 17, 2024, state licensing conducted a routine one-year inspection and found multiple safety and health violations: hazardous chemicals and medications stored unsecurely and accessible to residents, an expired fire extinguisher, hot water above safe temperature, cleaning supplies scattered throughout the facility, a broken shower, broken closet doors, pest webs and dust throughout common areas, an unauthorized person living in the garage, tools and flammable materials stored in living spaces, incomplete staff and resident records, no emergency disaster plan, and all staff CPR and first aid certifications expired. The facility was also operating beyond its approved capacity for non-ambulatory residents and the administrator's certificate had expired.
View full inspector notes
On 1/17/2024 at 9:30AM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Daniel Villa and explained the purpose of the visit. The Administrator currently holds a certificate (#6035480740) that expired on 2/7/2023. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of three (3) bedrooms occupied by residents, and two (2) bathrooms. 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 128.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 03/2/2022. Emergency Disaster Plan was not posted or provided. First aid kit was observed to be incomplete. LPA reviewed Administrator and two (2) staff files which were all incomplete. 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 CONTINUE FROM LIC 809 LPA observed the following deficiencies: · At 10:00am, LPA observed scissors on the kitchen counter. · At 10:05am, LPA observed bar cleaner, stove cleaner, stone cleaner in unlocked cabinet underneath kitchen sink. · At 10:10am, LPA observed staff medications (insulin)in the refrigerator, razor blade in a unlocked drawer. · At 10:13am, LPA observed the dishwasher door held together with rope. · At 10:17am, LPA observed febreze underneath unlocked cabinet underneath bathroom sink and in the hallway on a cabinet and in 2nd bathroom. · At 10:22am, LPA observed hot water temperature at 128.5 degrees F. · At 10:28am, LPA observed not enough meat in 1st or 2nd freezer. · At 10:35am, LPA observed fire extinguisher was expired. · At 10:40am, LPA observed spider webs over the kitchen sink, on the walls in the living room, hanging from the ceiling, dusty furniture, spills running down the wall at the entry in the living room. · At 10:47am, LPA observed closet doors off track. · At 10:50am, LPA observed bathroom shower knob broken and needs to be cleaned. · At 11:00am, LPA observed a man living in the garage. · At 11:15am, LPA observed paint, weight bench with weights, tire, bike parts, tire, box, wood planks, lawn mower, 2 ladders, shovel, butain fuel, 2 dollies, unlocked shed, fruit picker, black plastic bags, and a small makeshift building in the back and side yard. 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 CONTINUE FROM LIC809 · At 11:20am, LPA observed unlocked medication multi vitamin, vitamin E, D3 and used syringes in small extended room off of the dining area. · At 11:29am, LPA observed a mini chainsaw, large saw, 2 cans of bernzomatic, and 2 cans of propane located in the dining area. · At 11:50am · At 11:00am, LPA observed staff and resident files incomplete, facility has no disaster plan. · At 12:05pm, LPA observed a ll staff CPR/FIRST AID has expired. LPA requested the following documents to be submitted to CCLD by 1/25/2024. · Resident Roster · LIC 308 Designation of Administrative Responsibility · LIC 309 Administrative Organization · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan (9 pages) · Liability Insurance Infection Control Plan The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, 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 this report and appeal rights provided
Regulation
Fire Safety - All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic.
Inspector finding
This requirement was not met as evidenced by expired fire extinguisher which poses a potential health & safety risk to residents in care. POC Due Date: 01/24/2024 Plan of Correction 1 2 3 4 Administrator agreed to provide CCLD with a copy of purchase receipt for new fire extinguisher or service tag from fire extinguisher. Administrator also agreed to have fire extinguisher inspected annually for fire safety compliance.
Regulation
(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degre…
Inspector finding
Based on observation, the licensee did not comply with the section cited above by having the hot water temperature at 128.5 which poses an immediate health and safety risk to persons in care. POC Due Date: 01/18/2024 Plan of Correction 1 2 3 4 Administrator agreed to lower hot water heather, do a video of water being checked and submit to CCLD by POC date.
Regulation
(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.
Inspector finding
Based on observation, the licensee did not comply with the section cited above by having bar cleaner, stone cleaner, razor blade, mini saw, large saw, bernzomatic, propane, febreze air freshener, vitamins, syeringe, insulin, unlocked and assessable which poses an immediate health and safety risk to persons in care. POC Due Date: 01/18/2024 Plan of Correction 1 2 3 4 Administrator agreed to lock all items and make them in assessable to residents in care and submit photos to CCLD by POC date. Cl…
Regulation
The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
Inspector finding
Based on observation, the licensee did not comply with the section cited above having a broken dish washer, spider webs on the walls in the living room, the living room window, and hanging from the ceiling, brown drippings coming down the wall in the living room, tables with dust, closet doors in bedroom #3 off track paperwork on dining table boxes on the floor in the passage way which poses a potential health and safety risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 …
Regulation
(e) Water supplies and plumbing fixtures shall be maintained as follows: (6) Toilet, handwashing and bathing facilities shall be maintained in operating condition. Additional equipment shall be provided in facilities accommodating physically handicapped and/or nonambulatory residents, based on the residents' needs.
Inspector finding
Based on observation, the licensee did not comply with the section cited above by having a broken knob in the 2nd bather shower, floor of the 2nd bathroom shower has stains, hair in the drain which poses a potential health and safety risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 Administrator agreed to fix broken knob in shower #2 and clean the stains and hair from the shower. and submit photos to CCLD by POC date.
Regulation
(f) Solid waste shall be stored and disposed of as follows: (2) Syringes and needles are disposed of in accordance with the California Code of Regulations, Title 8, Section 5193 concerning bloodborne pathogens.
Inspector finding
Based on observation, the licensee did not comply with the section cited above by having syringe needles in a container in the small room next to the dining area which poses a potential health and safety risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 Administrator agreed to get rid of syringes and read and understand regulation and submit self certification to CCLD by POC date.
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 by having 2 large boxes in the door ways which poses a potential health and safety risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 Administrator agreed to move 2 large boxes out of the passageway and submit photos 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 by not renewing Administrator and staff CPR or First Aid certification which poses a potential health and safety risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 Administrator agreed to get CPR/First Aid renewed and send a copy of updated CPR/First Aid to CCLD via email by POC date.
Regulation
(d) The licensee shall maintain documentation that an administrator has met the certification requirements specified in Section 87406, Administrator Certification Requirements or the recertification requirements in Section 87407, Administrator Recertification Requirements.
Inspector finding
Based on observation, interview and record review, the licensee did not comply with the section cited above by not having the Administrator continuing education or recertification documents which poses a potential health and safety risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 Administrator agreed to provide CCLD a copy of Administrator recertification document via email by POC date.
Regulation
(a) All residential care facilities for the elderly shall provide training to direct care staff on postural supports, restricted conditions or health services, and hospice care as a component of the training requirements specified in Section 1569.625. The training shall include all of the following:
Inspector finding
Based on interview and record review, the licensee did not comply with the section cited above by not providing staff training which poses a potential health and safety risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 Administrator agreed to read understand regulation, provide staff with training's and send a copy of self certification and training documents to CCLD by POC date.
Regulation
(d) The licensee shall provide initial and ongoing training for all members of its staff to ensure that residents’ rights are fully respected and implemented.
Inspector finding
Based on interview and record review, the licensee did not comply with the section cited above by not providing staff with ongoing training which poses a potential health and safety or risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 Administrator agreed to read understand regulation, provide staff with training's and send a copy of self certification and training documents to CCLD by POC date.
Regulation
(b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects.
Inspector finding
Based on observation, the licensee did not comply with the section cited above by having spider webs with a spider in the kitchen sink area which poses a potential health and safety risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 Administrator agreed to clean and remove spider and spider web from the kitchen sink area and send photo to CCLD via email by POC date.
Regulation
(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following:
Inspector finding
Based on record review, the licensee did not comply with the section cited above not having a copy of the facilities emergency and disaster plan posted or on file which poses a potential health and safety risk to persons in care. POC Due Date: 01/31/2024 Plan of Correction 1 2 3 4 Administrator agreed to provide CCLD a copy of the facilities emergency and disaster plan via email by the POC date.
Regulation
(1) Supplies of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days shall be maintained on the premises.
Inspector finding
This requirement is not met as evidenced by: Deficient Practice Statement 1 2 3 4 Based on observation, the licensee did not comply with the section cited above in having 7-day non-perishable which poses a potential health and safety risk to persons in care. POC Due Date: 01/24/2024 Plan of Correction 1 2 3 4 Administrator agreed to purchase food (meat)and submit receipts and photos of food to CCLD by POC date.
Inspector finding
87208((A) Building(s) to be occupied, including a floor plan that describes the capacities of the buildings for the uses intended...7)Sketches, showing dimensions, of the following: This requirement was not met as evidence by: Deficient Practice Statement 1 2 3 4 Based on LPAs observation licensee did not comply with the section cited above by staff/family sleeping in the garage in a makeshift bedroom being used for accommodation. Which poses a potential health and safety risk to residents. PO…
Other visitApril 14, 2022Type A1 deficiency
Inspector: Carol Fowler
Plain-language summary
An informal conference was held on April 14, 2022 to discuss violations found during a routine annual inspection on February 17, 2022. The facility accepted a bedridden resident with a restricted health condition without obtaining required state approval first, and staff training and care planning documents were incomplete. The facility was given until April 18, 2022 to submit an exemption request, family letter, and care plan, and a civil penalty was issued for the administrator's failure to follow these requirements.
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An Informal Conference was held on 4/14/2022 at 2:00pm, via remote. The informal conference process was explained to the Administrator. The Administrator was also informed that this Informal Conference is part of the administrative action process and that further citations will result in a formal Non-Compliance Plan, and may lead to a referral to the Department's Legal Division for a possible Administrative action. Present during the meeting were Licensing Program Manager (LPM) Jeremy Fong, LPM Harpreet Humpal, Licensing Program Analyst (LPA) Carol Fowler, LPA Laura Hall, Administrator Daniel Villa. The purpose of today's Informal Conference was to discuss the recent deficiency at the Administrators facility from a annual visit 2/17/2022. LPM J. Fong, LPM H. Humpal, LPA C. Fowler and LPA L. Hall discussed the following issue: -Accepting a bedridden resident with a restricted condition without an exception. -Staff training for a resident with a restricted condition. -Incomplete resident file. -Providing a care plan for the resident. During the meeting, the licensee agree to submit proof of the following by April 18, 2022: - A formal letter requesting an exemption. - A letter from the residents family. -A care plan. The following deficiency was issued for administrators qualifications (see LIC 809D) administrator failed to submit an exception request for the resident with a restricted health condition before accepting resident into the facility. (cont 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 Civil Penalty continues as the licensee has failed to submit requested documents Exit interview conducted and a copy of this report provided.
Regulation
(a) All facilities shall have a qualified and currently certified administrator...freedom from other responsibilities and shall be on the premises a sufficient number of hours ... there shall be coverage... (d) The administrator shall have the ...Sections 87405(d)(1) through (7). .... This requirement was not met as evidence by:
Inspector finding
Based on LPA's observation licensee did not comply with the section cited ablove which poses and immediate helath and safety risk to clients.
InspectionMarch 30, 2022No deficiencies
Inspector: Carol Fowler
Plain-language summary
On March 30, 2022, inspectors returned to verify that two previous violations had been corrected: a bathroom ceiling repair and removal of staff sleeping quarters from a garage. Both of those issues were fixed and cleared. However, the facility had not yet submitted required documentation for another violation, so the state continued assessing daily penalties until the paperwork was provided.
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On 03/30/2022 at 2:55pm, Licensing Program Analysts (LPAs) C. Fowler and L. Hall arrived unannounced to conduct a proof of correction (POC) visit for the deficiencies cited on 3/22/2022.. LPAs met with Administrator, Daniel Villa and explained the purpose of the visit. On today's date LPA observed ceiling had been repaired in the bathroom for CCR 87303(a) and garage no longer occupied staff using it as a sleeping room 87208(a)(7). These two (2) deficiency are cleared. Administrator did not submit POC for 87621(b)(1)(B). A civil penalty has been assessed from 3/22/2022 to 3/30/2022 at $100 x 9 = $900. LPAs printed out regulations 87621 and 87616 for Administrator to review and submit correct documents. Plan and proof of correction was discussed with Administrator. Civil Penalties will continue to be assessed daily until corrected. No deficiencies are being cited on this date. Exit interview conducted and a copy of this report provided.
Other visitMarch 22, 2022Type A5 deficiencies
Inspector: Carol Fowler
Plain-language summary
This was a follow-up visit on March 22, 2022 to check whether the facility had corrected problems found during an earlier inspection. The facility had not submitted proof of corrections by the deadline, so the state issued a $500 civil penalty and extended the deadline to March 15, 2022 for most items, though two specific deficiencies were not extended and one was re-cited for continued non-compliance.
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On 03/22/2022 at 1:20 pm, Licensing Program Analysts (LPAs) C. Fowler and L. Hall arrived unannounced to conduct a POC visit. LPAs met with Administrator, Daniel Villa and explained the purpose of the visit. Upon arrival LPAs had not received any POCs from Administrator. Administrator requested for extension on 3/11/2022 submission of POC for deficiencies cited from annual inspection date 3/03/2022. The POC due dates were 3/11/2022 with the exception of section #87705(f)(1) with the due date of 3/5/2022. The proof of corrections for deficiencies section #87705(f)(1) and 87211(a)(1) were cleared during POC visit. Administrator requested extension due to a fall. LPA C. Fowler extended the request until 3/15/2022 with the exception of sections 87621(b)(1)(B) and 87606(f)(1). On this same day, LPA C. Fowler discussed with Administrator the above and informed him that LPA C. Fowler will recite. An immediate Civil penalty of $500 was issued today. Deficiency section 87606(f)(1) is re-cited--refer to LIC809D. Failure to submit proof of correction by plan of correction due date may result in civil penalty. Plan and proof of correction was discussed with Administrator. Exit interview conducted. Appeal Rights and copy of this report provided.
Regulation
87606(f)(1) (f) To accept or retain a bedridden person, a facility shall ensure the following: (1) The facility's Plan of Operation includes a statement of how the facility intends to meet the overall health, safety and care needs of bedridden persons. This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by accepting a bedridden resident with restricted health condition without fire clearance in room #1. Which poses an immediate health and safety risk to clients.
Regulation
87621(b) In addition to Section 87611 the licensees shall be responsible... (1) Ensuring that ostomy care is provided by an appropriately...(B)There shall be written documentation by an appropriately skilled professional outlining...instruction...facility staff who have been instructed. This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by accepting a bedridden resident with restricted health condition without fire clearance in room #1. Which poses an immediate health and safety risk to clients.
Regulation
87506(b) Each resident’s record shall contain at least the following ...(17)Documents and information required...(A)Section 87457, Pre-Admission Appraisal;(B)Section 87459, Functional Capabilities;(C) Section 87461, Mental Condition; (D)Section 87462, Social Factors This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by missing required documentation in residents files, Pre-placement Appraisal Needs and Services Plan, Identification and Emergency Information, Consent for Medical Treatment and Residents Rights. Which poses a potential health and safety risk to residents.
Regulation
87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by not providing a grab bar in the bathtub. having a hole in the ceiling from an upstairs bathroom leak in the shared bathroom. Using a screwdriver to operate the shower faucet in bedroom #1. Which poses a potential health and safety risk to residents.
Regulation
87208((A) Building(s) to be occupied, including a floor plan that describes the capacities of the buildings for the uses intended...7)Sketches, showing dimensions, of the following: This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by staff sleeping in the garage in a makeshift bedroom being used for accommodation. Which poses a potential health and safety risk to residents.
InspectionMarch 4, 2022Type A9 deficiencies
Inspector: Carol Fowler
Plain-language summary
During a follow-up visit on March 4, 2022, inspectors found multiple safety hazards at the facility: unlocked scissors and tools left accessible, dangerous items in an unsecured shed and garage, a hole in the ceiling, missing grab bar in a bathtub with water at unsafe temperature, a screwdriver left in a shower as an operating tool, and an unlocked garage being used as staff sleeping quarters. A resident with restricted health conditions was in a room without proper fire clearance, and required admission documents were missing from a resident's file. The facility was cited for these violations and given a deadline to correct them.
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On 3/4/2022 at 10:15 am Licensing Program Analyst (LPA) C. Fowler arrived unannounced to deliver the findings from the Infection Control Inspection conducted on 3/1/2022 LPA met with Administrator, Daniel Villa and explained the purpose of the visit. LPAs observed the following deficiencies; -At 2:40pm LPAs observed facility dose not have a Mitigation Plan. -At 2:49pm LPAs observed unlocked scissors on desk in office/dining room. -At 2:50pm LPAs observed rakes, shovel, paint, tree trimmer, 3 ladders, lawn mower and unlocked shed in back yard. -At 2:59pm LPA's observed a hole in the ceiling, no grab bar in bathtub, in shared bathroom, water temperature 129.5 degrees F. -At 3:04pm LPAs observed bedridden resident with restricted health condition without fire clearance in room #1. -At 3:05pm LPAs observed a screw driver in the shower to operate the shower faucet in bedroom #1. -At 3:11pm LPAs observed garage door unlocked. In the garage there was a staff sleeping in a makeshift bedroom being used for accommodation. 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 -At 3:16 pm during record review LPAs observed R1 file was missing Preplacement Appraisal Needs and Services Plan, Identification and Emergency Information, Consent for Medical Treatment and Residents Rights. 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.
Regulation
87303 (e) Water...shall be maintained as follows:(2) Faucets used by residents for personal care...Hot water temperature controls shall be maintained... temperature of not less than 105 degree F (41 degree C) and not more than 120 degree...This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by maintaining water temperature between 105 degree F and 120 degree F which poses an immediate health and safety risk to residents.
Regulation
(f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s)..This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by not maintaining a safe environment with unlocked rakes, shovel, paint, tree trimmer, 3 ladders, lawn mower and unlocked shed located in the back yard. which poses an immediate health and safety risk to residents.
Regulation
87621(b) In addition to Section 87611 the licensees shall be responsible... (1) Ensuring that ostomy care is provided by an appropriately...(B)There shall be written documentation by an appropriately skilled professional outlining...instruction...facility staff who have been instructed. This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by accepting a resident with a restricted health condition. Which poses an immediate health and safety risk to clients.
Regulation
87606(f)(1) (f) To accept or retain a bedridden person, a facility shall ensure the following: (1) The facility's Plan of Operation includes a statement of how the facility intends to meet the overall health, safety and care needs of bedridden persons. This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by accepting a bedridden resident with restricted health condition without fire clearance in room #1. Which poses an immediate health and safety risk to clients.
Regulation
87211 (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, ... (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence,,, This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by not having a Mitigation Plan LIC 808. Which poses a potential health and safety risk to residents.
Regulation
87506(b) Each resident’s record shall contain at least the following ...(17)Documents and information required...(A)Section 87457, Pre-Admission Appraisal;(B)Section 87459, Functional Capabilities;(C) Section 87461, Mental Condition; (D)Section 87462, Social Factors This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by missing required documentation in residents files, Pre-placement Appraisal Needs and Services Plan, Identification and Emergency Information, Consent for Medical Treatment and Residents Rights. Which poses a potential health and safety risk to residents.
Regulation
87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by not providing a grab bar in the bathtub. having a hole in the ceiling from an upstairs bathroom leak in the shared bathroom. Using a screwdriver to operate the shower faucet in bedroom #1. Which poses a potential health and safety risk to residents.
Regulation
87208((A) Building(s) to be occupied, including a floor plan that describes the capacities of the buildings for the uses intended...7)Sketches, showing dimensions, of the following: This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by staff sleeping in the garage in a makeshift bedroom being used for accommodation. Which poses a potential health and safety risk to residents.
Regulation
87212 Emergency Disaster Plan (a) Each facility shall have a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available. This requirement was not met as evidence by:
Inspector finding
Based on LPAs observation licensee did not comply with the section cited above by not having an Emergency Disaster Plan. Which poses a potential health and safety risk to residents. which poses a potential health and safety risk to residents.
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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