Non-compliance follow-up·April 13, 2026

Licensing Program Analyst (LPA) Star Stevenson arrived unannounced at approximately 11:00 AM to conduct a required Non-Compliance Case (NCC) management inspection related to an office meeting held in Santa Rosa on 10/29/2024 the outcome of which resulted in the facility being placed on two year non-compliance plan of quarterly visits. LPA met with caregiver Ronald Lazaro who has Designation of Facility Responsibility (RP). RP called licensee Imelda Padama, who arrived at approximately 11:15 AM but then had to leave for a family commitment. At the time of the initial office visit on 10/29/2024 the following concerns were raised to the licensee including: 1. Fire Clearance/Live-in Staff: Staff shall not sleep or reside in un-permitted/uncleared rooms or facility communal areas, LPA Karina Canela cited for the same deficiency 07/10/2023 after numerous discussions regarding the same issue on 04/19/2023, 01/25/2023, 06/28/2022, 06/02/2022, 05/23/2022. 2. Staffing: Staff must be sufficient in numbers to provide adequate care and supervision to residents in care. 3. Staff Training: Staff must complete initial training hours prior to working independently with residents. 4. Staff Medication Administration Training: Staff shall complete initial training hours prior to working independently with residents. 5. Personnel Records: Staff records shall be complete with required documentation. 6. Residnet Records: Client records shall be complete with required documentation. Continued on LIC809C Continued from LIC809 7. Administrator Qualifications and Duties: The administrator shall be present a sufficient number of hours to ensure facility is operating within compliance; typically 20 hours a week. 8. First Aid Requirements: The administrator shall ensure that all staff have proof of current First Aid. 9. Buildings and grounds: The shed in backyard and storage room in the garage on a prior visit were both observed unlocked with chemicals inside, as well as chemicals and a bottle of alcohol in an unlocked cabinet in the laundry room. Facility is a Residential Care Facility for the Elderly (RCFE) with a Hospice waiver for two(2), an approved dementia plan and fire clearance for six (6) residents of which five (5) can be non-ambulatory and one (1) bedridden in room #4 only , when not on hospice care . Facility current has five(5) residents, one (1) of which is receiving hospice care. At approximately 11:30 AM LPA initiated a tour with RP and observed the following. Facility was a comfortable temperature, without odors and chemicals/sharps and medicines were observed to be locked. A small room in the garage contains extra supplies and paper goods. An exterior shed was found to be locked and full of DME and extra supplies. At approximately 11:50 AM LPA reviewed five (5) staff records and LPA observed that S1 who was not working today and had a complete record except, on-site evidence of 20 hour of annual education training and a Technical Violation of Health and Safety Code (HSC) 1569.625(b)(2) was issued. LPA was told by licensee that S1 works as an "on-call" staff member. At approximately 12:30 PM LPA review five (5) of 5 resident records and found all 5 to have the required documentation including Consent for Emergency Medical Care and Personal rights. Technical Violation is cited from the Health and Safety Code. Failure to correct the Technical Violation may result in a civil penalty assessment in the future. This report was reviewed with Ronald Lazaro and Appeal rights were given.