Twin Homecare - B

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Allegation investigated: Staff handled resident in a rough manner. Facility does not provide good quality food.

On 09/17/2026 at 8:45am, Licensing Program Analyst (LPA) Zina Brown arrived at the facility to conduct an initial complaint investigation to reveal and deliver the findings. The Department spoke with Roneilio Garcia (Administrator) over the phone, and the purpose of the visit was explained. The investigation consisted of the following: On 09/17/2026 between the hours of 9:00am - 11:39am, the Department interviewed Administrator (A1), 3 Staff (S1 - S3), 4 Residents (R2-R5), and 4 Witnesses (W1 - W4). The Department also requested and obtained documentation, which included LIC 9020 Register of Facility Clients/Residents (dated 09/01/2026), LIC 500 Personnel Report (dated 09/01/2026), R1's records such as LIC 601: Identification & Emergency Information (dated 12/31/2024), LIC 604A: Admission Agreement (dated 12/31/2024), LIC 602A: Physician's Report for RCFE (dated 06/05/2026), LIC 603 Resident Appraisal (dated 06/05/2024), LIC 625: Appraisal Needs & Service Plan (dated 06/05/2026), LIC 622 Centrally Stored Medication & Destruction Record, and the Week 4 Food Menu. Unsubstantiated The investigation revealed the following: Allegation: Staff handled a resident in a rough manner. It was alleged that during a nighttime care assistance encounter, a newly assigned male caregiver entered a resident's room and physically assisted the resident in a manner that caused the resident to feel unsafe. On 09/17/2026 between the hours of 9:00am - 9:16am, the Department interviewed Administrator (A1) regarding the allegation. A1 denied the allegation and stated being unaware that Resident 1 (R1) reported feeling unsafe with a staff member. A1 stated no investigation was conducted because the concern was never brought to their attention and reported there were no prior complaints regarding rough handling by staff. On 09/17/2026 between the hours of 9:37am - 10:06am, the Department interviewed 3 staff regarding the allegation. 1 out of 3 staff confirmed the allegation and reported observing rough handling by a former caregiver. The staff member indicated Resident 1 (R1) experienced distress following the changes in caregivers and would compare current caregivers to former caregivers. 2 out of 3 staff denied the allegation and indicated R1 did not express concerns or discomfort while receiving care, and they did not observe staff handling R1 roughly. S1 stated R1's crying and emotional distress were due to the termination and resignation of caregivers. On 09/17/2026 between the hours of 10:15am - 10:45am, the Department interviewed 4 residents regarding the allegation. 2 out of 4 residents denied the allegation and indicated they felt safe at the facility, had not heard of staff handling R1 roughly, and had not been handled roughly by staff themselves. 2 out of 4 residents did not confirm nor deny the allegation. R2 stated they did not believe R1 was handled roughly. However, R2 indicated from personal experience that W4 handled them badly. R4 stated they had recently moved into the facility on 09/11/2026 and did not know R1, but they had not observed or experienced staff handling residents roughly. On 09/17/2026 between the hours of 11:05am - 11:39am, the Department interviewed 3 witnesses regarding the allegation. The 3 witnesses interviewed on 09/17/2026 were former employees of the facility. 2 out of 3 witnesses confirmed the allegation. W2 and W4 reported that R1 did not express concerns regarding the care they provided; however, W2 reported observing W3 handle R1 roughly. W4 further stated R1 was alert, oriented, and capable of expressing concerns regarding their care. 1 out of 3 witnesses denied the allegation. W3 stated they never handled R1 roughly and never observed R1 being handled roughly by staff. W3 reported that R1 thanked them after receiving care. On 09/17/2026 between the hours of 1:00pm - 1:30pm, the Department conducted a records review and observed the following: There was no history or record of a LIC 624: Unusual Incident/Injury Report regarding the allegation that staff handled a resident in a rough manner. Unsubstantiated: Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED. Allegation: Facility does not provide good quality food. It was alleged that Resident 1 does not eat meals prepared by the facility because the food is not acceptable to the resident, resulting in the reporting party purchasing food for the resident. On 09/17/2026 between the hours of 9:00am - 9:16am, the Department interviewed Administrator (A1) regarding the allegation. A1 denied the allegation and stated being unaware of R1 complaining about food quality, was not aware that family routinely brought food for R1, did not believe R1 regularly refused meals, and reported no complaints from other residents regarding food quality. On 09/17/2026 between the hours of 9:37am - 10:06am, the Department interviewed 3 staff regarding the allegation. 1 out of 3 staff confirmed the allegation and stated R1 sometimes would not eat facility meals and reported residents occasionally complained that meals were not hot enough. 1 out of 3 staff denied the allegation and reported R1 usually ate facility meals, did not complain about the food served, the food provided was based on R1's requests, and no other residents complained about food quality. 1 out of 3 staff did not confirm nor deny the allegation and indicated R1 sometimes did not eat facility meals and food was brought by family members; however, R1 did not complain about food quality and no other residents complained. On 09/17/2026 between the hours of 10:15am - 10:45am, the Department interviewed 4 residents regarding the allegation. 3 out of 4 residents denied the allegation. R2, R3, and R4 reported being satisfied with the meals provided by the facility, ate the meals served, and had no complaints regarding food quality. 1 out of 4 residents did not confirm nor deny the allegation and stated the food was fair but indicated some meals were better when former staff worked at the facility. On 09/17/2026 between the hours of 11:05am - 11:39am, the Department interviewed 3 witnesses regarding the allegation. The 3 witnesses interviewed on 09/17/2026 were former employees of the facility. 1 out of 3 witnesses denied the allegation and stated they had not observed R1 refuse meals, had not heard R1 complain about the food, had not heard complaints from other residents, and had no information supporting food quality concerns. 2 out of 3 witnesses confirmed the allegation. W2 and W4 stated R1 sometimes refused facility meals and staff would occasionally purchase alternative food using their own money. On 09/17/2026 between the hours of 1:00pm - 1:30pm, the Department conducted a records review and observed the following: According to the LIC 602A Physician's Report for RCFE (dated 06/05/2026), page 3 of 6, Item 13, Physical Health Status, is marked "Yes"; however, no information was documented in the explanation section. On the LIC 603 Resident Appraisal (dated 06/05/2026), page 2, under Services Needed, "No" is marked for special diet/observation of food intake. The facility maintained a written weekly menu (Week 4) identifying planned breakfast, lunch, dinner, and snack items for each day of the week. The menu reflected a variety of food options, including oatmeal, eggs, fruit, soup, sandwiches, chicken, turkey, pork, vegetables, salads, rice, potatoes, desserts, and snacks. The menu also identified designated meal and snack times. Unsubstantiated: Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED. Exit interview conducted with Liza Buencillo (Caregiver) and a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 17, 2026 · control 11-AS-20260909133927

Type of visit: Case Management - Deficiencies

On 09/17/2026 at 1:30pm, the Department conducted an unannounced case management deficiencies at the facility listed above. Licensing Program Analyst (LPA) Zina Brown spoke with Roneilio Garcia (Administrator) over the phone and explained the purpose of the visit. During the complaint investigation for 11-AS-20260909133927, the Department observed 1 employee: Staff 3 (S3) was not associated to the facility at the time of unannounced complaint investigation. As a result, civil penalties are being assessed and a deficiency is being cited under California Code of Regulation Title 22, Division 6, Chapter 8 are being cited on the LIC 809-D. Exit interview conducted with Liza Buencillo (Caregiver) and a copy of this report was provided with appeal rights.the state’s words, verbatim · CDSS document, Sep 17, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Sep 18, 2026

Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2)Obtain a California clearance or a criminal record exemption as required by the Department Based on observation and interview, S3 Malia Sau was not associated to the facility as the time of unannounced complaint investigation which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 17, 2026

Plan of correction: The facility shall associate S3 Malia Sau in Guardian and submit proof of update via email at zina.brown@dss.ca.gov by POC due date.

Type of visit: Required - 1 Year

On 09/24/2025 at 11:30 AM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Twin Home Care B Facility. LPA Calderon was allowed entry into the facility by Staff Hermi Ocampo. The facility is licensed to serve six (6) non-ambulatory residents, of which six (6) may be bedridden and may retain six (6) hospice residents, over the age of 59. Currently residing in the facility there are six (6) residents. LPA Calderon explained to Staff Hermi Ocampo the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: Six (6) client service records, six (6) client medication records, three (3) staff records, and inspected the inside facility and outside grounds. The facility’s last fire drill was conducted on 09/01/2025. The one-story residential home consists of six (6) client bedrooms, three (3) client bathrooms, living room, family room, dining room, kitchen, staff room, office area, garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored on the premises. The kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is found in the garage and kitchen area. LPA Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Calderon observed the following during inspection of client’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Calderon observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 108 degrees Fahrenheit. Bathroom #2 hot water temperature properly measured at 107 degrees Fahrenheit. Bathroom #3 hot water temperature measured at 108 degrees Fahrenheit. Kitchen hot water temperature is properly measured at 115 degrees Fahrenheit. Facility two (2), Carbon Monoxide and ten (10) Smoke Detectors, hard-wired and connected, were tested and are working properly. The facility two (2) Fire Extinguishers were checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. All toxins and knives are locked/secured and inaccessible to clients. Medications are centrally stored and in a locked storage cabinet. Facility one (1) first aid kit is fully stocked with manuals was checked and in order. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to clients. Six (6) client files were reviewed and found to be complete. LPA Calderon reviewed six (6) resident medications, and they were all found to be administered according to doctor's orders. Three (3) staff files were checked, and they have the required documents. LPA Calderon noted the Administrator Charesa Reyes Certification # 7029005740 expiration date of 11/20/2026 was valid at time of inspection. Commercial General Liability Policy #0102655131 policy period from 10/28/2024 to 10/28/2025 underwritten by Kinsale Insurance Company, coverage 1,000,000/3,000,000 is valid at time of inspection. All the required documents are posted in the facility in a clearly visible area. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Calderon did not observe deficiencies therefore no citations were issued at this time. The annual Licensing Fee, $495.00 PIN 847810, is due on 09/27/2025. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Staff Hermi Ocampo.the state’s words, verbatim · CDSS document, Sep 24, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sparkle Day conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one-year inspection. LPA met with Hermie Ocampo , caregiver and the purpose of the visit was discussed. During this visit Designated Administrator Charesa Reyes joined and assisted with the visit.The facility is licensed to serve (6) non ambulatory elderly residents ages 60 and over; of which (6) may be bedridden. There is a hospice waiver for (4) residents. There is currently (1) resident on hospice and (1) resident receiving home health services. LPA reviewed 4 staff Administrative files and 6 resident Administrative and Medication files. The facility is a single story home consisting of 6 resident bedrooms, 1 staff bed room, 3 bathrooms, living room, dining room, kitchen, front yard, back yard/ patio,laundry room and attached garage. LPA and Ms Charesa Reyes toured the facility inside and outside. All rooms had the required furniture, bed linens and closet/drawer space required to accommodate each resident comfortably .Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured between 108 F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. During todays visit LPA did not observe any deficiencies. Exit interview conducted with Charesa Reyes and a copy of this report was left.the state’s words, verbatim · CDSS document, Aug 29, 2024

Type of visit: Required - 1 Year

On 11/17/2023 at around 9:30 AM, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with the Administrator Charesa Reyes. LPA explained the purpose of the visit and was accompanied by a Caregiver inside and outside the facility during this inspection. This facility is licensed to serve 6 non-ambulatory residents, of which 6 may be bedridden, and 4 residents may be in hospice care. A total of 5 non-ambulatory residents are currently residing in this facility. The Annual Licensing Fees are current. The home consists of 6 resident bedrooms, 3 resident bathrooms, 1 staff bedroom, 1 staff bathroom, 1 living room, 1 entrance/dining room, 1 kitchen, 3 car garage, 1 laundry room, 1 linen room, and 1 backyard patio area with shaded seating. Outside grounds were toured and no bodies of water were observed. The patio furniture is under a shaded area and accessible to residents. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. Facility has a double door for their main entrance. LPA observed a missing door knob on one of the main entrance doors. LPA toured the kitchen area and observed supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Knives and toxins were kept in a locked storage cabinet. LPA observed that medications were safe, locked, and inaccessible. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Documents are posted as mandated. Last fire and earthquake drill was conducted on 11/1/2023. First aid kit is fully stocked with manual. Smoke and carbon monoxide detectors were in compliance and operational. A fire extinguisher was observed near the kitchen area and was last serviced on March 2023. 6 out of 6 resident’s bedrooms were checked. Mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Comforters, bed linen, bath towels and mattress protectors were adequately stocked. Bathroom toilets and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries accessible to residents. LPA tested hot water temperature in resident bathroom sinks, and it measured between 130.4 to 132.2 Fahrenheit. This facility provides residents with hygiene products such as feminine napkins, non-medicated soap, toilet paper, toothbrush, toothpaste, and comb. 5 resident records were reviewed and, 5 out of 5 resident records had Admission Agreements, Medical Assessments, Consent Forms, Weight Record, Emergency Information, Appraisal & Needs Service Plan, Tuberculosis Test, Centrally Stored Medication Destruction Record, and Personal Rights. 5 staff records were reviewed, 5 out of 5 staff records had current First Aid Certificates, Criminal Record Clearances, Job Applications, Tuberculosis Test, Facility Training/Drills, and signed Employee Rights. Deficiencies are being cited based on LPA observation in accordance with the California Code of Regulations, Title 22, see LIC809D. A violation regarding hot water temperature measuring above 120 Fahrenheit and facility not being in good repair due to missing door knob. An exit interview was conducted, Plans of Corrections were reviewed and developed. A copy of this report and appeal rights were discussed and left with the Administrator.the state’s words, verbatim · CDSS document, Nov 17, 2023