Non-compliance follow-up·July 30, 2025

At approximately 2:30 PM, Licensing Program Analyst (LPA) Julie Florio arrived at facility unannounced, to conduct a quarterly Legal/Non-Compliance visit. LPA was greeted at the door by caregiver, Benjamin Filomeno. Administrator, Madonna Grace Martinez was contacted via telephone and arrived at approximately 2:45 PM. LPA toured the building and found it to be clean and orderly. Food was plentiful and stored in a safe manner. At approximately 3:00 PM, LPA reviewed 3 of 3 resident files. LPA observed 3 of 3 residents did not have completed re-appraisals/care plans or consents for emergency medical treatment on file. Additionally, 1 of 3 residents, (R1) did not have proof of negative TB results on file. Administrator agrees to complete these documents and submit them to the Department upon completion in order to bring the facility into compliance. At approximately 3:30 PM, LPA reviewed 3 staff files. 3 of 3 files contained proof of current First Aid/CPR certification. 3 of 3 staff files did not contain evidence of completed annual training of health screening as required by Title 22 regulation. Administrator agrees to complete these documents and submit them to the Department upon completion in order to bring the facility into compliance. LPA was presented with proof of current administrator Certificate for Madonna Grace Martinez #7020245740 expires on 6/20/2027. Continued on LIC809C... Continued from LIC809... LPA will return to regional office to discuss with licensing program manager and may return to issue citations and possible civil penalties at a later date. Updated copies of the following documents shall be submitted to CCL within 30 days of this visit : LIC 308 Designated Responsible Party LIC 500 Personnel Summary No citations issued during today's visit. Exit interview conducted with Administrator whose signature on form confirms receipt of documents.