Routine inspection·March 11, 2026

Licensing Program Analyst (LPA), Cuadra arrived unannounced to conduct a Required -1 Year visit, and met with staff. Licensee, Michelle Jangar arrived later and disclosed that Administrator Renato Yamat is no longer working at the facility. According to the Licensee, there was a notification submitted to the Department via email to report the change of Administrator. LPA/staff toured the facility common areas, hallways, residents rooms, kitchen and bathrooms observed had sufficient lighting. Residents rooms are furnished per regulation. The facility was a comfortable temperature. Passageways were free of obstructions. Facility has a sufficient supply of cleaners, hygiene items and paper products. A call button is located in each bathroom, LPA tested the call system in resident's rooms and staff response time was under three minutes. A tour and inspection of the kitchen area were found to be clean and sanitary. The kitchen was observed to have a sufficient supply of perishable and non-perishable food. Prepared and left over foods were covered and labeled. The facility has emergency supplies, including food and water to meet requirements of the 72-hour shelter in place. The shed in the back yard is for storage of equipment only. Resident and staff files are located and locked in cabinet. All medications were all locked and inaccessible to residents in care. Required postings were observed. Annual fees are current. No activities were conducted during LPA's visit (technical violation issued). LPA had a conversation with the Licensee about the importance of activities. There were eight garbage cans located in bathrooms and resident's rooms do not have a lid/cover (technical violation issued). Continued on LIC809C... Continued from LIC809... At approximately 9:45am Shared bathroom between room#5 and 6 shower head is leaking. There was a bucket full of water holding water coming off from shower head. At approximate 10:00am LPA/Licensee observed hot water measured 130.6 and 129.6 degrees which is not within regulation between 105 and 120 degrees F at faucets used by residents in care. At approximately at 10:15am LPA/Licensee observed fire extinguishers were observed to be last charged on 2/2025. Facility's smoke and carbon monoxide detectors were operational. Bathrooms have non-skid surfaces and grab bars at the toilet and shower areas. Exit doors have auditory alarms to alert staff. The last fire drill was conducted 01/20/26. - At 10:30 AM, LPA conducted a file review of three staff and five residents. LPA observed three out of six staff individuals (I1, I2 & I3) were fingerprint cleared, but their fingerprints have not been transferred and associated to the facility. LPA informed Licensee that staff (I1, I2 & I3) are not associated to facility and should never be working and providing care to residents prior to a criminal record clearance transfer. Civil penalties are being assessed in the amount of $100 per person per day for a total amount of $1500 for allowing a person to work, reside or volunteer in the facility without a fingerprint clearance transfer and association. Three out of three staff (S1, S2 & S3) do not have a health screening form on file including their TB test. Two out of three staff (S2 & S3) do not have current 1st aid or CPR certificates updated. One out of three staff (S3) have not completed all required training hours. There are residents receiving hospice care services within the approved hospice waiver. However, based on deficiencies found during today's visit, Licensee was informed that a review of current hospice waiver of six residents will be reviewed. All residents' care plans are updated. Medical assessments are current and included a description of any known behavioral expression. Continued on LIC809C... Continued from LIC809C...At approximately 11:00am, LPA/Licensee reviewed the facility approved fire clearance dated 11/30/2020 by the Vallejo Fire Department for six non-ambulatory residents of which one may be bedridden in bedroom #2 only. Resident R3 is occupying room #2 which is the only room approved as bedridden room. However, during records review two other residents (R1 & R2) out five residents have a bedridden status and are occupying room #3 and room #6 respectively, which are not cleared by the Fire Department as bedridden rooms. Licensee is operating outside the limitation of the license by accepting a bedridden resident in a non-ambulatory room. LPA/Licensee discussed the issue with R1 and R2 to provide the option to submit a request to the Fire Marshall to assess bedrooms to grant fire clearance. According to the Licensee, R1 and R2 are not bedridden and they will obtain an updated physician's report (LIC602). During the visit, LPA spoke with R1 and R2 who expressed that they are not fully bedridden and they are in agreement to obtain an updated medical assessment. Five out of five residents (R1, R2, R3, R4 & R5) does not have half bed rails order on file. However, it appears like R5 does not need bed rails. Licensee Michelle Jangar, administrator certificate 7002269740 expires on 10/25/2027. Medications and medication records were reviewed. Documentation Needed for Change of Administrator: - LIC 200 indicating change of administrator. - LIC 501 Personnel Record. - LIC 500 Personnel Report (indicating amount of hours to be spent at the facility). - LIC 308 Designation of facility responsibility. - LIC 503 Health Screening Report. - Copy of Administrator's certificate. - Detailed employment/education history. Licensee agrees to submit updates of the following documents by not later than 3/25/26: Copy of liability Insurance, emergency disaster plan (LIC610E). Deficiencies are cited from the California Code of Regulations (CCRs), Title 22, and the Health and Safety Code. ***Civil penalties in the amount of $1500.00 is being assessed due to staff not being associated to facility. Appeal Rights Given. Exit interview conducted with Licensee and copy of this report was given.