MISSION VILLA RESIDENTIAL CARE HOME

42423 PASEO PADRE PARKWAY, Fremont CA 94539

Facility 015601017 · RESIDENTIAL CARE ELDERLY (740)

6 bedsLatest official report Jul 2, 2026Licensed

Additional info
Licensee
RUBIO, MARISSA
Administrator
RUBIO, MARISSA
Contact
RUBIO, MARISSA
License first date
Jul 7, 2004
License effective date
Jul 7, 2004
District office
OAKLAND ASC · (510) 286-4201
Regional office
15
Clients served
983 - RCFE / DEMENTIA

Summary

The available records show 1 Type A and 4 Type B deficiencies for this facility.

Most recent inspection
Jul 2, 2026
Most recent deficiency
Jul 2, 2026

No later report is available, so the records do not show what happened afterward.

What Type A and Type B mean
Type A
Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
Type B
Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.

Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.

At a glance

Counts cover the five-year public record. Typical figures are the median for the 152 Alameda County facilities licensed for 6 or fewer beds.

In the available public five-year record, CCLD published 5 reports for this facility: 5 inspections, 0 complaint investigations, and 0 licensing or administrative records.

Those records contain 1 Type A and 4 Type B deficiencies.

1 deficiencies have explicit official correction or clearance evidence in the loaded records.

Official inspections
5

More than the typical 4

1 in the last 12 months

Recorded deficiencies
5

More than the typical 4

1 in the last 12 months

Type A deficiencies
1

About the same as most this size

0 in the last 12 months

Type B deficiencies
4

More than the typical 2

1 in the last 12 months

Substantiated complaints
0

Most this size also have none

0 in the last 12 months

Repeated topics
0

Last 36 months

Repeated topics

Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.

No topic repeats in the last 36 months

No deficiency topic appears in more than one report during that window. This does not establish that nothing repeated earlier in the five-year record, and it is not a statement about current conditions.

Official report history

All preserved reports from the most recent to the oldest, sortable by report type.

Inspection
Medical and dental careType B
Official classification
Type B
Official code
87465(a)(4)
Regulation authority
CCR

What the official deficiency says

(4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having R5's Medication Administration Record (MAR) for June 30, 2026 signed and there was no doctor's order for R2's medication which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/20/2026 Plan of Correction By POC date, the Administrator agrees to have in-service training on documentation of the MAR and obtain doctor's order for R2.

Plan of correction recorded
Correction not verified in available records
View official report
Inspection
Licensing and administrationType B
Official classification
Type B
Official code
87216(a)(1)
Regulation authority
CCR

What the official deficiency says

(1) The amount of the bond shall be in accordance with the following schedule: Total Safeguarded Per Month Bond Required $750 or less $1,000 $751 to $1,500. $2,000 $1,501 to $2,500 $3,000 Every further increment of $1,000 or fraction thereof shall require an additional $1,000 on the bond. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having sufficient surety bond for the P & I money which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 07/03/2025 Plan of Correction The Administrator will increase the surety bond and send proof to CCLD by POC date.

Plan of correction recorded
Correction not verified in available records
View official report
Hazardous items and storageType A
Official classification
Type A
Official code
87309(a)
Regulation authority
CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having a knife by the kitchen sink unlocked which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 06/20/2025 Plan of Correction The Administrator locked the knife during the visit. Deficiency cleared.

Official record says corrected or clearedOn or before Jun 19, 2025
Plan of correction recorded
View official report
Staffing, personnel, and trainingType B
Official classification
Type B
Official code
87411(f)
Regulation authority
CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having a TB test for S4 which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 06/26/2025 Plan of Correction The Administrator will obtain S4's TB test and send proof to CCLD by POC date.

Plan of correction recorded
Correction not verified in available records
View official report
Records and plan of operationType B
Official classification
Type B
Official code
87506(b)
Regulation authority
CCR

What the official deficiency says

(b) Each resident's record shall contain at least the following information: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having incomplete files for all the residents in care which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/03/2025 Plan of Correction The Administrator agrees to complete all residents' files and send proof to CCLD by POC date.

Plan of correction recorded
Correction not verified in available records
View official report

Source and limits

California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.

Read the data methodology