Carson Guest Home

Type of visit: Required - 1 Year

On October 28, 2025, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with administrator Cora Resurreccion and explained the purpose of today’s visit. The facility is licensed to operate for six (6) non-ambulatory of which one (4) may be on hospice elderly residents ages 60 and above. The facility is approved for (4) hospice residents. Currently, the facility has (3) residents in hospice care. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident's rooms, two (2) common bathrooms, a living area, a dining area, a kitchen, and an outside covered patio area. LPA and administrator toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 117.9 degree F. A comfortable temperature of 74 degrees was maintained in the facility. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. Fire extinguisher were charged, smoke detectors and carbon monoxide were operable. A review of the Medication Administration Record (MAR) was complete and accurate. The facility has conducted a disaster drill on 10/01/25. A landline telephone was in working condition. A review of staff CPR/First Aid training is current. Evaluation Report Continues LIC 809-C During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted including Schedule Menu and Plan Activities. LPA observed First Aid Kit was maintained. The facility has current liability insurance policy #PC1861881-01 on file effective 08/15/25 through 08/15/26. The facility is current on Community Care Licensing annual dues. An audit of residents #1-#5 (R1-R5) service files and staff #1-#3 (S1-S3) personnel files revealed to be complete. The facility has the current administrator's certification on file for Cora Ressurreccion #7016959740 Expiration 10/03/26. No deficiencies during this inspection visit. An exit interview was conducted with Cora Ressurreccion, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Oct 28, 2025

Type of visit: Required - 1 Year

On 10/09/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with administrator Cora Resurreccion and explained the purpose of today’s visit. The facility is licensed to operate for six (6) non-ambulatory of which one (4) may be on hospice elderly residents ages 60 and above. The facility is approved for (4) hospice residents. Currently, the facility has (4) residents in hospice care. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident's rooms, two (2) common bathrooms, a living area, a dining area, a kitchen, and an outside covered patio area. LPA and administrator toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 110.9 degree F. A comfortable temperature of 77 degree was maintained in the facility. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. Fire extinguisher were charged, smoke detectors and carbon monoxide were operable. A review of the Medication Administration Record (MAR) was complete and accurate. The facility has conducted a disaster drill on 10/01/24. A landline telephone was in working condition. A review of staff CPR/First Aid training is current. Evaluation Report Continues LIC 809-C During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. The facility has current liability insurance on file effective 08/15/24 - 08/15/25. The facility is current on Community Care Licensing annual dues. An audit of residents #1-#6 (R1-R6) service files and staff #1-#5 (S1-S5) personnel files revealed to be complete. The facility has the current administrator's certification on file for Cora Ressurreccion #6049380740- Expiration 10/03/24. No deficiencies during this inspection visit. An exit interview was conducted with Cora Ressurreccion, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Oct 9, 2024

Allegation investigated: Staff are not providing adequate activities to resident in care.

On 08/16/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced complaint visit at this facility. LPA was greeted by Administrator Cora Resurrection. LPA explained the purpose of this visit was to interview the remaining residents and deliver findings for the allegation mentioned above. The investigation consisted of the following: A copy of the Register of Facility Residents LIC 9020, Facility Personnel Roster, Service records for resident #1 (R1) included: Physicians Report LIC 602A, Identification and Emergency Information LIC 601, Admission Agreement, Preplacement Appraisal Information LIC 603, Medication Administration Record, Vital Signs Log, Facility's Plan of Operation, and Activity's Schedule. An interview with the Administrator, residents #1-#5 (R1-R5), and witnesses #1-#5 (W1-W5). An inspection was conducted of the facility. (Evaluation Report continues LIC 9099) Unsubstantiated INVESTIGATION REVEALED THE FOLLOWING: Allegation: Staff are not providing adequate activities to resident in care. The details of the complaint alleged the facility staff are not providing suitable activities to resident # 1 (R1). The information provided indicated (R1) goes to bed early at 05:30 pm and watches television with limited access to television programming channels. Investigation revealed resident #1 (R1) was admitted at Carson Guest Home on 07/04/24 according to Identification and Emergency Information (dated: 07/01/24). Physician’s Report LIC 602A (dated: 07/03/24) is non-ambulatory and unable to self-care and requires assistance with the activities of daily living (ADLs). Preplacement Appraisal Information LIC 603 (dated: 07/04/24) identified that (R1) enjoyed puzzles, being outside, and watching TV (Family Feud, BET, and Westerns). On 08/15/24 and 08/16/24 between 09:00am – 02:59 pm, the Department interviewed (4) out of (5) residents #1-#4 (R1-R4) who expressed having no concerns or issues with the daily activities. (R1-R4) claimed the facility offers satisfactory activities daily to keep each resident interested in an active lifestyle. (R1-R4) stated that it is important for them to have the freedom to participate in activities like leisure time, physical exercises, and socialization according to their preferences. (R1) described the ability to have leisure time with family visits, telephone calls, and socializing with other residents. (R1) stated that (R1) is not limited to television programming and can watch favorite shows like BET and Family Feud. (R1) claimed that no staff mandates (R1) to go to bed early; it is (R1’s) choosing to sleep early on certain nights. (R1) stated bedtime is usually 08:30 pm or 9:00 pm is a normal time. (R1) indicated that (R1) is still adapting to life in a private home environment, but (R1) likes the care and supervision offered 24 hours a day. (R5) who was present at the facility was interviewed and unable to hold a conversation as a result of (R5's) health condition. On 08/15/24 between 01:15 pm – 01:45pm, the Department interviewed (1) out of (1) administrator #1 (A1) who stated that the facility offers plentiful activities for residents in care. (A1) stated is what is important is to match the social factor specifically to each resident interest. The facility program activities included: leisure time, physical exercises, and socialization. The residents are provided entertainment, occupational therapy, and outdoor activities suited to each need. The facility provides transportation to appointments, shopping, and planned trips. (A1) stated has the choice of what daily activities (R1) wants to participate in daily. (R1) often will participate in leisure time watching (R1’s) favorite programs or socializing with residents and visitors. (Evaluation Report continues LIC 9099) (A1) due to (R1’s) health condition and ambulatory status is limited in physical outdoor activities. (R1's) vitals are monitored daily and it is recommended by (R1's) medical physician to maintain a healthy blood pressure rate to sleep earlier and longer to reduce the risk of high blood pressure. On 08/15/24 and 08/16/24 between 08:00 am – 04:30 pm, the Department interviewed family representatives (5) out of (5) witnesses #1-#5 (W1-W5) who articulated to have no concerns with activities offered by the facility. (W1-W5) are completely satisfied with the care and supervision provided by staff. (W1) power attorney to (R1) is complimentary of staff and appreciative of their services provided 24 hours daily. (W1) reported to be involved with (R1) in at least two visits a week and has observed (R1) engaging in activities. Furthermore, (W1) has observed three (3) out of the five (5) residents participating in physical outdoor activities during (W1’s) visits. As a result of the Department reviewing (R1) Physician Report LIC 602A (dated: 07/01/24), Preplacement Appraisal Information LIC 623 (dated: 07/04/24); Medication Administration Record (dated: 08/01/24-08/31/24), Admissions Agreement LIC604A (dated: 0704/24) confirmed (R1) is limited to physical activities. Residents and administrators' statements were verified through observation of the facility's activities calendar and review of its Plan of Operation. During the investigation, the Department observed individual television in each resident rooms, activity room and living room. Based on the information gathered, an inspection of the facility, observation, and interviews conducted, an analysis of records reviewed, the Department found no evidence to support the allegation mentioned above. 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. An exit interview was conducted with Cora Resurreccion, and a hard copy was provided.the state’s words, verbatim · CDSS document, Aug 16, 2024 · control 11-AS-20240812150918