Elegant Care

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Elena Mallett conducted an unannounced Case Management visit to the facility to address deficiencies observed while LPA was conducting a complaint investigation at the facility. LPA met with staff in charge Samuel Omotoso and the purpose of the visit was explained. Staff in charge contacted Administrator Taiwo Odunola by telephone and LPA spoke with Administrator and explained the deficiencies noted. Administrator Odunola joined the visit shortly after. LPA reviewed the resident file for Resident (R1) and a found that R1 has a prohibited health condition and the facility retained R1. Per Title 22, residents with a prohibited health condition cannot be admitted or retained at Residential Care Facility for the Elderly. Per interviews with Administrator, R1 had been residing at the facility. Records indicate R1 was at the facility from 06/17/26 until 08/06/26. A deficiency was cited. See 809-D LPA learned during the complaint investigation visit at the facility that R1 had been admitted to the hospital and missed several medical appointments due to transportation issues. Per Administrator, no Special Incident Reports had been faxed to licensing to make licensing aware of these events involving a resident in care. A deficiency was cited. See 809-D. Per Title 22 citations were issued today. An exit interview was conducted with Administrator Taiwo Odunola and a copy of this licensing report was provided along with appeal rights.the state’s words, verbatim · CDSS document, Aug 11, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87615(a)(5) · Plan of correction due date: Aug 12, 2026

87615 Prohibited Health Conditions (a) Persons who require health services for or have a health condition ... specified below shall not be admitted or retained in a residential care facility for the elderly (5) Residents who depend on others to perform all activities of daily living... The facility did not meet the above requirement in that R1 's files contains a Medical Assessment that details that R1 has a Prohibted Health Condition. This poses an immediate heatlh and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 11, 2026

Plan of correction: By POC due date Administrator will fax to licensing a staement of understanding of cited regulation and will agree to not retain residents with Prohibited Health Conditions and add addendum to facility Plan of Operations that includes not admitting Prohibited Health Conditions

From the deficiency page — Deficiency type: Type B · Section cited: CCR87211(a)(1)(D) · Plan of correction due date: Aug 18, 2026

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports...((1) A written report shall be submitted... (D) Any incident which threatens the welfare, safety or health of any resident... The facility did not meet the above requirement in that Special Incident Reports were not recieved by licensing when R1 was taken to the hospital on 08/06/26 and when R1 missed medical appointments . This poses a potential health and safety risk.the state’s words, verbatim · CDSS document, Aug 11, 2026

Plan of correction: By POC due date Administrator will fax to LPA Special Incident Reports for R1 being taken to the hospital and for the R1's missed medical appointments. Administrator provided Special Incident Reports to LPA during visit.

Type of visit: Required - 1 Year

“***This amended report supersedes report dated 11/25/2025; it was created to correct LIC 809C narrative information. All other aspects of the report remain in effect. Licensing Program Analyst (LPA) Sakinah Madyun conducted an unannounced Required Annual Visit on 11/25/25 using the CARE Inspection tool. LPA was met by House Manager Ford Hunt and explained the purpose of the visit. At approximately 9:18 AM, House Manager began in assisting LPA with a tour of the facility and Administrator Taiwo Odunola arrived shortly after during the facility tour. The facility is a single-story house located in a residential neighborhood. The facility is fire clearance approved to serve a capacity of six (6) non-ambulatory of which one (1) may be bedridden and approved hospice waiver for two (2) clients. During the required annual visit, LPA Madyun observed the following: Four (4) residents’ rooms in which two (2) beds are vacant, one and half (1 1/2) bathrooms, living room/dinning area, kitchen, laundry area, and front yard. All residents’ bedrooms have the required furniture for privacy, comfort, and safety. Additional bedding supplies and grooming supplies were observed in the hallway cabinets securely locked. Bedrooms #2 had an exit door. Shared bathroom observed to be clean and in good repair with required grab bars and skid mat. Water temperature measured within the range of 105-120 degrees Fahrenheit Physical Plant & Environmental Safety: LPA observed an updated and revised Infection Control Plan and Emergency Disaster Plan. Last documented emergency drill conducted on 10/20/25. First Aid kit observed and (1) Fire Extinguisher were observed and last checked on 11/04/25. Carbon monoxide detector and smoke detectors located throughout facility. LPA Madyun observed facility sketches with exits and emergency exits routes posted. *****See LIC 809C***** Food Service: LPA Madyun observed the emergency food supply in kitchen cabinet. LPA observed more than enough of 2 days perishable and 7 days non- perishable food for resident's in care. Knives, sharps or other items that could pose a danger to resident's, were observed to be inaccessible. The kitchen water temperature measured within the range of 105-120 degrees Fahrenheit Staffing/Personnel Files: Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. Staff are cleaning and disinfecting often for high touched surfaces. Facility has an Infection Control Plan in place. LPA observed four (4) of four (4) staff files. Due to time constraints LPA will return for a continuation visit for staff file reviews and conduct staff interviews. Client Records/Centrally Stored Medications: The medications are centrally stored in the medication cabinet securely locked inaccessible to resident's. The facility uses the Medication Administration Record (MAR) log to document medications given. LPA observed three (3) of three (3) resident files. Due to time constraints LPA will return at a later date and time for a continuation visit for resident file reviews, medication logs, and resident interviews. Due to time constraint LPA will return a later date and time for a continuation visit. Per Title 22 Regulations deficiencies were observed please see LIC 809D. Exit interview conducted with Taiwo Odunola and a copy of this report was provided.the state’s words, verbatim · CDSS document, Nov 25, 2025

Allegation investigated: Staff are not meeting resident's hygiene needs.

Licensing Program Analyst (LPA) Tena Herrera conducted an initial 10-day visit to investigate the above allegation. LPA met with Caregiver Peter and discussed the purpose of today's visit, shortly after Administrator Taiwo Odunola arrived to assist with the visit. The investigation consisted of the following: LPA toured facility, inspected restroom, laundry area, and hygeine supplies and interviewed 2 staff and 3 residents. (Continued on LIC9099-C) Unsubstantiated The investigation revealed the following: Allegation: Staff are not meeting resident's hygiene needs. It is alleged that R1 is not being showered regularly and has been observed to be with dirty clothes and oily hair. LPA toured facility and observed sufficient supply of hygiene and cleaning products. LPA interviewed 2 staff and each denied the allegation stating residents are encouraged to shower and assisted if needed. LPA interviewed 3 residents and each denied that allegation stating they are able to shower when they want, each resident appeared clean and well-groomed with clean clothing. R1 stated that they are able to shower when they please, are provided with hygiene products and took a shower in the morning. Based on statements and interviews conducted with staff/residents, tour of facility and LPA's observations, there was not enough supportive evidence to concur with the reported 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 held, and a copy of this report will be emailed to administrator at taiwodunola@gmail.comthe state’s words, verbatim · CDSS document, Oct 2, 2025 · control 28-AS-20250929083107

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced Required 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA explained the purpose of the visit to S1 (Staff #1),and was granted entrance into the facility. S1 assisted with the tour of the facility. The Administrator was not present for the annual visit but S1 was able to assist the LPA for the annual visit. There are five (5) residents who currently reside within the facility. The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Resident Rights/Information, Resident Records/Incident Reports, Food Service, Planned Activities, Incident Medical and Dental, Disaster Preparedness, and Residents with Special Health Needs. Infection Control: · Infection control practices and Personal Protective Equipment (PPEs) were observed. · LPA observed that the facility did not have a current Infection Control Plan on file in place. Physical Plant/Environment Safety: · The facility is a single-story house located in a residential neighborhood. It is licensed for a capacity of six (6) non-ambulatory residents, of which one (1) resident may be bedridden, and they also have a hospice waiver approved for two (2) hospice residents. It has four (4) client rooms, a dining/living room, a kitchen, one shared restroom which had a hot water temperature reading measured at 105.2 Degrees F which also held the facility’s washing and drying machine, a second shared client bathroom attached to Room #2 which had a hot temperature reading of 109.2 Degrees F, and a front and back yard patio area. · The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. The facility has one (1) fully charged fire extinguisher located near the kitchen of the facility. · Cleaning supplies were observed in a secured area in the kitchen. · Sharps were observed in a secured area in the kitchen. · Carbon monoxide detector is tested and in working condition. · Water temperature readings measure between the required 105 - 120 degrees Fahrenheit in compliance with Tile 22 Regulations. Operational Requirements: · The Program Design was reviewed. · Fire clearance was approved by LA County Fire Department for six (6) non-ambulatory residents, one (1) of which can be bedridden, and a hospice waiver approved for two (2). · Care and supervision to meet the clients’ needs was observed. · LPA observed that facility did not have a current Liability Insurance on file in place to review. Staffing: · A total of five (5) full-time staff members provide care and supervision to the clients. Personnel Records/Staff Training: · LPA unable to review five (5) staff Admin, S1 to S4 (Staff #4) personnel records and staff training due to the facility could not produce the files and staff training which were not available to review during the visit. Resident Rights/Information: · Physician orders were reviewed in resident files. · Personal Rights is posted. · Facility provides phone and internet access to residents. Resident Records/Incident Reports: · Five (5) resident files were reviewed containing admission agreements, Physician's Report, medical/functional assessments, Needs and Services Plans, TB clearance, Appraisal/Needs and Services Plan, personal rights, and medication records were reviewed. · During medication review, LPA observed the MARs for R1 (Resident #1) to R4 (Resident#4) recorded was dated May 1st, 2024 and the last initialed on the MARs was on May 14th, 2024 which is inaccurate. Food Service: · The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. Incident Medical and Dental: · Resident medical and dental records in resident files. Disaster Preparedness: · Emergency and Disaster Plan was publicly posted and found within the facility. · An emergency and disaster drill was last conducted on 04/07/2024 Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiency observed during the visit is documented on the LIC809D. Exit interview held and a copy of the report along with appeal rights were provided to S1.the state’s words, verbatim · CDSS document, Aug 15, 2024

Allegation investigated: Staff did not prevent facility roof from being in disrepair

**This report supersedes report dated 2/9/2024. The reason it is being superseded is to correct the deficiency type of the citation that was issued on 2/9/2024. Title 22 Section 87303(a) was cited as a Type A deficiency, however it should have been citated as a Type B deficiency. The finding will remain the same.** Licensing Program Analsyt (LPA) Erik Zaragoza conducted an unannounced complaint visit in regards to the allegation listed above. LPA explained the purpose of the visit to Chyna Tucker, caregiver for the facility, and was granted entrance. Administrator Jewell Reese was not able to arrive at the facility due to being hospitalized. The investigation consisted of the following: LPA Erik Zaragoza interviewed staff #1 - 2 (S1 - S2), residents #1 - 2 (R1 - R2), and conducted a tour of the facility focusing on the ceiling in the living room as well as in rooms #3 and #4. Substantiated The investigation revealed the following: In regards to the allegation that "Staff did not prevent facility roof from being in disrepair", it is alleged that for the past two (2) years that whenever it has rained, including in recent days from this report being made, rainwater has leaked through the roof and into the living room, along with resident rooms #3 and #4. During interviews with residents, neither of the two (2) residents interviewed corroborated the allegation, although they live in rooms #1 and #2, and one of the residents explained that they cannot see. The residents in rooms #3 and #4 were not available to be interviewed because they were out in the community. During interviews with the two (2) staff members present in the facility, both of them corroborated that they have heard of issues with rainwater leaking into the facility through the roof during the days that it rains. S1 and S2 stated that they have heard that repair on the roof is being initiated, however they have not personally seen water leak through the roof due to not being at the facility when it has rained in recent days. During the physical plant tour, LPA observed that there were holes in the ceiling of the living room approximately one (1) inch in diameter through which rainwater may be able to leak in from. In room #3 there was an observed hole approximately five (5) inches in diameter, and one of the staff members explained that through this opening rainwater has come into the room. Pictures were taken of the holes found in the living room as well as in room #3. No holes in the ceiling were observed in room #4, although one staff member indicated that rainwater has come in around the base of the ceiling fan of the room, which has forced the staff to duct tape the light switch in the room to prevent any electrical hazards to the resident. LPA observed that there was still duct tape covering the light switch of the room, preventing anyone from switching it on or off. Based on LPAs interviews conducted with the clients and staff, the preponderance of evidence standard has been met for the above allegation, therefore the allegation is found to be SUBSTANTIATED. California Code of Regulations Title 22, Division 6, Chapter 8 are being cited on the attached LIC9099D. Exit interview held and a copy of the report and appeal rights was provided to the caregiver Chyna Tucker.the state’s words, verbatim · CDSS document, Mar 7, 2024 · control 28-AS-20240206150056

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Feb 23, 2024

Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This regulation is not met as evidenced by: Based on observation and interview, LPA determined that there are currently gaps in the ceiling of the facility through which rainwater has leaked into the facility, which poses a potential health and safety risk to the residents in care.the state’s words, verbatim · CDSS document, Mar 7, 2024

Plan of correction: Administrator is to ensure that the the facility's roof and ceiling is in good repair at all times. Administrator is to send an invoice of the roof repairs to LPA by the POC due date.

Allegation investigated: Staff did not prevent facility roof from being in disrepair

Licensing Program Analsyt (LPA) Erik Zaragoza conducted an unannounced complaint visit in regards to the allegation listed above. LPA explained the purpose of the visit to Chyna Tucker, Caregiver for the facility, and was granted entrance. Administrator Jewell Reese was not able to arrive at the facility due to being hospitalized. The investigation consisted of the following: LPA Erik Zaragoza and Sanjay Vaid obtained copies of the staff and resident roster, reviewed the Medication Administration Records (MARs) for five (5) clients, interviewed Staff #1 - 2 (S1 - S2), and also interviewed Residents #1 - 2 (R1 - R2). The investigation revealed the following: In regards to the allegation that "Staff did not prevent facility roof from being in disrepair", it is alleged that for the past two (2) years that whenever it has rained, including in recent days from this report being made, rainwater has leaked through the roof and into the living room, along with resident rooms #3 and #4. Substantiated During interviews with residents, neither of the two (2) residents interviewed corroborated the allegation, although they live in rooms #1 and #2, and one of the residents explained that they cannot see. The residents in rooms #3 and #4 were not available to be interviewed because they were out in the community. During interviews with the two (2) staff members present in the facility, both of them corroborated that they have heard of issues with rainwater leaking into the facility through the roof during the days that it rains. S1 and S2 stated that they have heard that repair on the roof is being initiated, however they have not personally seen water leak through the roof due to not being at the facility when it has rained in recent days. During the physical plant tour, LPA observed that there were holes in the ceiling of the living room approximately one (1) inch in diameter through which rainwater may be able to leak in from. In room #3 there was an observed hole approximately five (5) inches in diameter, and one of the staff members explained that through this opening rainwater has come into the room. Pictures were taken of the holes found in the living room as well as in room #3. No holes in the ceiling were observed in room #4, although one staff member indicated that rainwater has come in around the base of the ceiling fan of the room, which has forced the staff to duct tape the light switch in the room to prevent any electrical hazards to the resident. LPA observed that there was still duct tape covering the light switch of the room, preventing anyone from switching it on or off. Based on LPAs interviews conducted with the clients and staff, the preponderance of evidence standard has been met for the above allegation, therefore the allegation is found to be SUBSTANTIATED. California Code of Regulations Title 22, Division 6, Chapter 8 are being cited on the attached LIC9099D. Exit interview held and a copy of the report and appeal rights was provided to the caregiver Chyna Tucker.the state’s words, verbatim · CDSS document, Feb 9, 2024 · control 28-AS-20240206150056

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(a) · Plan of correction due date: Feb 23, 2024

Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This regulation is not met as evidenced by: Based on observation and interview, LPA determined that there are currently gaps in the ceiling of the facility through which rainwater has leaked into the facility, which poses a potential health and safety risk to the residents in care.the state’s words, verbatim · CDSS document, Feb 9, 2024

Plan of correction: Administrator is to ensure that the the facility's roof and ceiling is in good repair at all times. Administrator is to send an invoice of the roof repairs to LPA by the POC due date.