Green Valley Care Home

On 1/30/2026 at 10:50AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct a case management visit to deliver an immediate exclusion letter. LPA met with Administrator, Marjorie Osia and explained the purpose of the visit. During visit, LPA hand delivered the immediate exclusion letter for S1 to Administrator, Marjorie Osia. Administrator states that S1 is not currently employed at the facility and will be immediately removed from the facilities Guardian Roster. No deficiencies are being cited on this date.

On 9/10/2025 at 1:30PM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Marjorie Osia and explained the purpose of the visit. The facility’s fire clearance was approved for 6 non-ambulatory of which 1 may be bedridden. LPA toured facility with Marjorie Osia including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 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 105.6 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 detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 2/9/2025. Emergency Disaster Plan was last posted on 7/20/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 6/10/2025. At 2:00pm, LPA reviewed 5 residents records. At 2:15pm, LPA reviewed 3 staff records and 3 of 3 have current first aid training and associated to the facility. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 9/20/2024 at 1:30PM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Marjorie Osia and explained the purpose of the visit. The facility’s fire clearance was approved for 6 non-ambulatory of which 1 may be bedridden. LPA toured facility with Marjorie Osia including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 75 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 106.1 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 detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 2/9/2024. Emergency Disaster Plan was last posted on 7/02/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 9/01/2024. At 2:30pm, LPA reviewed 5 residents records. At 2:50pm, LPA reviewed 4 staff records and 4 of 4 have current first aid training and associated to the facility. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

During an interview with S2 and S3 on 4/3/22, S2 and S3 both denied of not remembering the incident. However, based on record review of R1's incident report, it indicates that a staff was assisting R1 in the bathroom when R1 during the incident. Allegation: Staff did not seek medical attention to resident in a timely manner. Based on interview with S1 and record review on 4/3/23, S3 assessed R1 and asked if R1 was in pain. R1 did not express of any pain so an ice pack was applied. When S1 arrived 10-15 minutes later, R1 expressed of pain so 9-1-1 was called. Allegation: Staff did not communicate with authorized representative of changes of resident's health status. LPA interviewed 3 staff and 3 of 3 staff stated that S1 is informed when there is a change in a resident's health condition, then S1 will then notify family. LPA discovered during an interview with S1 that S1 will text or call R1's responsible party to keep R1's responsible party updated. LPA observed a history of communication between S1 and resident's responsible party via text and progress notes. Allegation: Staff did not ensure resident was utilizing medical devices. However, interview with 2 staff revealed that staff assisted R1 with the hearing aid. However, R1 removes hearing aid. S1 stated staff will observe hearing aid on the chest or pillow, and staff will store hearing aid in the container to avoid misplacing it. Based on information obtained, facility was not assisting resident with nebulizer. However, there is no doctor's order for nebulizer. Allegation: Staff provided confidential information to an unauthorized person. Based on information obtained, facility staff disclosed of R1's passing over the phone with R1's family member. However, interview with S1 revealed that R1's family member contacted facility to notify staff about visiting R1, so staff disclosed to R1's family member of R1's passing. REPORT CONTINUES ON 9099C 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 Allegation: Staff did not safe guard resident's personal belongings. Based on information obtained, R1 was missing a hat. However, LPA reviewed R1's LIC 621 and did not observe the hat is listed to be entrusted to the facility. Allegation: Facility's door is in disrepair. Based on information obtained, a chair was being used to close the door. However, based on observation and interview with S1 on 4/3/2023, the door in room #2 is a French door. S1 stated the facility was instructed by the local fire department to remove the latch on top and bottom of the right door in case of an emergency. On 4/3/23, S1 demonstrated to LPA that left door of the French door latches to the right door when the lock is turned to the right. Allegation: Facility do not follow covid protocols. However, LPA interviewed 2 residents and 2 of 2 residents stated they observe staff wears their face coverings. 3 of 3 staff denied allegation. Although the allegation may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED . Exit interview conducted and a copy of this report provided to Administrator 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 It was alleged facility did not provide resident with notification of rent increases. However, on 10/11/22, LPA obtained a copy of rate increase notification dated January 15, 2021. This agency has investigated the complaint alleging facility did not provide a refund to authorized representatives and facility did not provide resident with notification of rent increases. . We have found that the complaint was UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. Exit interview conducted and a copy of this report provided to Administrator.

On 10/18/2021 at 11:50 AM, Licensing Program Analyst (LPA) L. Francisco arrived unannounced to conduct Infection Control Inspection. Administrator, Marjorie Osia later arrived at 12:03pm and LPA explained the purpose of the visit. During the Infection Control Inspection, LPA toured facility including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and backyard. Facility has a sufficient 2-day perishable and one week non-perishable food supply. 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 30-day supply of PPEs maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff. No deficiencies cited during visit. Exit interview conducted with Administrator. Due to technical difficulties, LPA provided a copy of report via email.

On 10/18/2021 starting at 1:10 PM, Licensing Program Analyst (LPA) L. Francisco conducted a Case Management concurrently with Infection Control Inspection to discuss information obtained regarding bedridden room (Room #2). LPA met with Administrator, Marjorie Osia and explained the purpose of the visit. Although room #2 was approved for bedridden, it was determined by Fire Inspector during an inspection completed on 10/12/2021, that room #2 does not meet Fire Code requirements for bedridden. LPA reviewed resident's (R1) physician report and LPA observed R1 is not bedridden. LPA advised Administrator to not accept bedridden residents in room #2 until further guidance. LPA requested to submit a copy of updated floor plan to CCL by 10/22/2021. No deficiencies cited during visit. Exit interview conducted with Administrator. Due to technical difficulties, LPA provided a copy of report via email.