Karen's Board and Care

Type of visit: Required - 1 Year

On 12/09/25, at 9:10am., Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, annual visit. LPA was met by Nelson Panganiban, Caregiver. One (1) of the administrators were called and Brandon Zinkofslay-Administrator arrived shortly after. LPA asked for the census, resident, and staff rosters. At the entrance of the facility there is a sign for Resident Bill of Rights. There is also a staff, storage closet locked and inaccessible to residents. The physical tour started at 10:20am. There is no garage but there is a carport area. There is also a shed in the backyard locked where there is extra wheelchairs and beds for residents. There is an extra refrigerator outside with extra food. Backyard: There is a table set and chairs for residents use. There is enough seating for six (6) residents. There is a pool that is fenced and gated inaccessible to the residents. Medications are in a cabinet locked and secured in the kitchen area. It is inaccessible to residents. The first aid is also located in this cabinet. LIC 809C-continued Kitchen area was observed to be clean. The refrigerator is fully stacked for six (6) residents. LPA reviewed the food service area, food storage and supply (perishable and nonperishable foods). The kitchen food supply was observed and sufficient for the six (6) residents currently residing there. There is an excess of perishables in several of the cabinets. In addition, there is the YES sign, Rights of Residents and Ombudsman signs. There is a fire extinguisher located in the kitchen against the wall, dated April 2025 and fully charged. Living and dining room furniture is accessible for six (6) residents. There is a television and enough seating for six (6) residents. There is internet accessibility a phone line available for resident use. Furniture was observed to be in good condition and the fireplace has a covering around it. There is a laundry area with one (1) washer and dryer. The toxins and sharps are kept on the side and on top of the laundry area locked and secured inaccessible to he residents. There is smoke detectors and carbon monoxide detectors that are functional throughout the house. Bedrooms: There is seven (7) bedrooms. Six (6) bedrooms are single, occupied for residents, One (1) bedroom is for staff use. There is three (3) bathrooms. One (1) private bathroom is in a resident's room and one (1) full bathroom is in the hallway along with a half bathroom. The bathrooms read a temperature between 115 and 116 Fahrenheit. All bedrooms are properly furnished with proper lightning. The bathrooms have proper toiletry and grab bars. There are several extra closets in the hallway with extra linen. Temperature of facility wall thermostat is observed and set to 75 degrees Fahrenheit. Administrative: The administrator showed proof of insurance plan which is effective until 01/22/26. The last earthquake/fire drill was conducted in October 2025. Staff/Resident Files: Four (4) staff files were reviewed. Four (4) staff did not have a current CPR and one (1) staff was missing health screening. Six (6) resident files were reviewed. Six (6) files were missing resident appraisal. An exit interview was conducted, citation(s) were issued, appeals rights and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Dec 9, 2025

Type of visit: Required - 1 Year

On 10/16/24, at 11:07 am., Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, annual visit. LPA was met by Rose Panganiban. One (1) of the administrators was called and Brandon Zinkofslay-Administrator arrived at 12:30pm. LPA asked for the census, resident, and staff rosters. At the entrance of the facility there is a sign for Resident Bill of Rights. There is also a staff, storage closet locked and inaccessible to residents. The physical tour started at 12:10 pm. There is no garage but there is a carport area. There is also a shed in the backyard locked where there is extra wheelchairs and beds for residents. There is an extra refrigerator outside with extra food. Backyard: There is a table set and chairs for residents use. There is enough seating for six (6) residents. There is a pool that is fenced and gated inaccessible to the residents. Medications are in a cabinet locked and secured in the kitchen area. It is inaccessible to residents. The first aid is also located in this cabinet. Kitchen area was observed to be clean. The refrigerator is fully stacked for six (6) residents. LPA reviewed the food service area, food storage and supply (perishable and nonperishable foods). The kitchen food supply was observed and sufficient for the six (6) residents currently residing there. There is an excess of perishables in several of the cabinets. The disaster plan is located against the wall in a frame on your right hand side of the kitchen area. In addition, there is the YES sign, Rights of Residents and Ombudsman signs. There is a fire extinguisher located in the kitchen against the wall, dated January 2024 and fully charged. LIC 809C-continued Living and dining room furniture is accessible for six (6) residents. There is a television and enough seating for six (6) residents. There is internet accessibility a phone line available for resident use. Furniture was observed to be in good condition and the fireplace has a covering around it. There is a laundry area with one (1) washer and dryer. The toxins and sharps are kept on the side and on top of the laundry area locked and secured inaccessible to he residents. There is smoke detectors and carbon monoxide detectors that are functional throughout the house. Bedrooms: There is seven (7) bedrooms. Six (6) bedrooms are single, occupied for residents, One (1) bedroom is for staff use. There is three (3) bathrooms. Half bathroom used for staff and residents, one (1) private bathroom in a resident's room and one (1) full bathroom. The bathrooms read a temperature between 112.5 and 115.5 Fahrenheit. All bedrooms are properly furnished with proper lightning. The bathrooms have proper toiletry and grab bars. There are several extra closets in the hallway with extra linen. Temperature of facility wall thermostat is observed and set to 73 degrees Fahrenheit. Administrative: There is an annual fee due by December of 2024. The administrator showed proof of insurance plan. An exit interview was conducted, no citation(s) issued and a copy of this report was given to the administratorthe state’s words, verbatim · CDSS document, Oct 16, 2024

Allegation investigated: Staff did not provide medical attention to the resident in a timely manner Facility refuses to accept the resident back from the hospital

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced subsequent complaint visit to this facility to further investigate the above allegations. LPA met with the Administrator and explained the reason for the visit. LPA conducted a physical plant tour at 9:23 AM, requested copies of facility documents relevant to the investigation at 9:50 AM and interviewed staff and residents between 10:00 AM to 12:00 PM. LPA also conducted record review at 12:15 PM. Regarding the allegation that the staff did not provide medical attention to the resident in a timely manner, it was alleged that Resident #1 (R1) was dehydrated and in questionable condition and had wounds and had been weak since getting COVID and presents with the wounds that R1 had never had before. LPA's record review today at 1:34 PM revealed that R1 was admitted at this facility on 09/22/2019 with rashes. R1's recent hospitalization record dated 08/17/23 or immediately prior to R1's transfer to another facility did not indicate any wound nor R1 was diagnosed with dehydration. (continued on LIC 9099-C) Unsubstantiated (continued from LIC 9099) LPA's interview with the administrator today at 11:45 AM also revealed that R1 was not receiving hospice or home health services prior to R1's last hospitalization on 08/23/23. Regarding the allegation that Facility refuses to accept the resident back from the hospital, it was alleged that R1's family member feels that R1 is being discriminated against for contracting COVID while at the facility as they are now refusing R1 to return. LPA's interview with the administrator on 08/30/23 at 1:05 PM and today at 11:45 AM, revealed that it was the family member who did not return R1 to the facility and moved to another facility. Further, R1 had contracted Covid initially on 08/17/23 and was brought to the hospital via 911. R1 returned the next day to the facility. R1 was again brought to the hospital on 08/23/23 due to shortness of breath, confusion, and agitation. The administrator denied refusing to accept R1 back at the facility and was willing to accept the resident but suggested R1 to be further evaluated by Kaiser Hospital due to R1's continued decline and may require hospice of home health services to attend to R1's medical needs, if any. Based on the information gathered during this and prior visit, the allegations are deemed unsubstantiated at this time. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Jan 23, 2024 · control 31-AS-20230824091140

Type of visit: Required - 1 Year

On 01/02/24, at 10:20 a.m., Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, annual visit. LPA was met by Jim Estabaya. One of the administrators was called and Brandon Zinkofslay-Administrator arrived at 11:05 am. LPA asked for the census, resident, and staff rosters. At the entrance of the facility there is a sign for Resident Bill of Rights. There is also a staff, storage closet locked and inaccessible to residents. The physical tour started at 11:30 am. There is no garage but there is a carport area. There is also a shed in the backyard locked where there is extra wheelchairs and beds for residents. There is an extra refrigerator outside with extra food. Backyard: There is a table set and chairs for residents use. There is enough seating for five (5) residents. There is a pool that is fenced and gated inaccessible to the residents. Medications and sharps are in a cabinet locked and secured in the kitchen area. It is inaccessible to residents. The first aid is also located in this cabinet. Kitchen area was observed to be clean. The refrigerator is fully stacked for five (5) residents. LPA reviewed the food service area, food storage and supply (perishable and nonperishable foods). The kitchen food supply was observed and sufficient for the five (5) residents currently residing there. There is an excess of perishables in several of the cabinets. The disaster plan is located against the wall in a frame on your right hand side of the kitchen area. In addition, there is the YES sign, Rights of Residents and Ombudsman signs. There is a fire extinguisher located in the kitchen against the wall, dated April 2023 and fully charged. LIC 809C-continued Living and dining room furniture is accessible for five (5) residents. There is a television and enough seating for five (5) residents. There is internet accessibility a phone line available for resident use. Furniture was observed to be in good condition and the fireplace has a covering around it. There is a laundry area with one washer and dryer. The toxins are kept on the side and on top of the laundry area locked and secured inaccessible to he residents. There is smoke detectors and carbon monoxide detectors that are functional throughout the house. Bedrooms: There is seven (7) bedrooms. Six (6) bedrooms are single, occupied for residents, One (1) bedroom is for staff use. There is three bathrooms. One and a half bathroom use for staff and residents and one private bathroom. The bathrooms read a temperature between 110.5 and 111.5 Fahrenheit. All bedrooms are properly furnished with proper lightning. The bathrooms have proper toiletry and grab bars. There are several extra closets in the hallway with extra linen. Temperature of facility wall thermostat is observed and set to 73 degrees Fahrenheit. Administrative: There is an annual fee due of $495.00 as of 12/23/2023. The administrator showed proof of insurance plan. An exit interview was conducted, two different citations were issued-one for staff not having current and/or CPR/Firstaid and one for not having over-night staff for dementia residents, and a copy of this report was given to the administrator with the appeal rights.the state’s words, verbatim · CDSS document, Jan 2, 2024