Delta Home Care

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Nune Margaryan conducted an unannounced annual inspection visit. LPA met with Assistant Administrator Maximo Danielle who assisted with the visit. LPA explained the reason for the visit. The facility is licensed for non ambulatory residents age range 60 and over. The facility vendorized as a level 4 RCFE by San Gabriel/Pomona Regional Center. The facility has a Dementia plan and hospice waiver for four (4) residents which one can be bedridden. The facility is a single story structure located in a residential neighborhood. It consists of the following: (5) resident bedrooms, (2) resident bathroom, kitchen, living room, dinning area. Laundry are observed in the attached garage. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the residents located in the backyard. LPA toured the facility. All indoor and outdoor passageways were free of obstruction. The kitchen was inspected. LPA observed a layer of grease and debris accumulated on and around the kitchen gas stove and kitchen cabinets. Also observed that kitchen cabinet drawer was loose and unstable. LPA observed sufficient supply of perishable and non-perishable foods. Sharps, cleaning supplies are locked in the kitchen and in the garage and inaccessible to residents. Smoke / Carbon monoxide detectors observed in the common areas and in the residents rooms. There is (1) fire extinguisher located in the dining area which is fully charged. The common areas were properly furnished. Residents rooms were toured. All rooms had the required furniture and furnishings. LPA observed dust and debris accumulated along windows and sliding door tracks throughout the facility, including in residents rooms. Medications are centrally stored in a locked cabinet in the kitchen and inaccessible to residents. The resident bathrooms are clean and operational w/grab bars and non-skid surface/mats in place. The hot water temperature was tested and maintained within the required range of 105-120*F. The first aid kit was observed and found to be in compliance with the Title 22 Regulations. Continue 809C The first aid kit was observed and found to be in compliance with the Title 22 Regulations. LPA reviewed client's and staff files. All files are updated. LPA confirmed staff working have fingerprint clearances. LPA reviewed clients medications. Medications are documented properly and given as prescribed. Fire drill was conducted on 08/15/2026. Deficiency has been noted on LIC 809D under Title 22 Regulations. Exit interview conducted with Assistant Administrator and a copy of this report and appeal right were provided.the state’s words, verbatim · CDSS document, Sep 25, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Oct 9, 2026

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 requirement not met as evidenced by: Based on observation, the Licensee/ Administrator did not ensure that the facility was maintained clean, sanitary and in good repair. LPA observed a layer of grease and debris accumulated on and around the kitchen gas stove and kitchen cabinets, LPA also observed dust and debris accumulated along windows and sliding door tracks throughout the facility, including in residents rooms. Additionally LPA observed a kitchen cabinet drawer that was loose and unstable. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Sep 25, 2026

Plan of correction: Licensee / Administrator will thoroughly clean and remove grease, dust, and debris from all affected areas for the facility. Licensee / Administrator will also repair or replace the loose and unstable drawer in the kitchen. Submit proof of corrections to CCL by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Galarza conducted an unannounced annual inspection visit. The purpose of the visit was explained to DSP Alma Lor. Assistant Administrator Danielle Maximo arrived shortly after. The facility serves elderly residents ages 60 and older whom are developmentally disabled. The facility is licensed as a level 4 RCFE vendored by San Gabriel/Pomona Regional Center. The following were observed/inspected: Infection Control: The Infection Control Plan was reviewed and includes environmental cleaning and disinfection activities. Facility has sufficient Personal Protective Equipment. Operational Requirements: A hospice waiver for 4 residents is approved. A fire clearance was granted for 4 non-ambulatory residents, of which 1 may be bedridden. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 6/20/2026. Facility handles resident P & I monies. The Surety bond expires 2/8/2028. Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood consisting of 4 private resident bedrooms, 2 bathrooms, office, living room, dining room/kitchen, outdoor patio area with patio furniture, and 2 car detached garage with laundry area. 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 and a 1st Aid Kit and Manual. Smoke and carbon monoxide detectors were tested and are operational. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Cleaning supplies, knives, and toxic substances were observed unlocked/accessible to residents above the washer/laundry area. The last Emergency Disaster drill was conducted on 10/4/2025. Resident (R1's) medical bed has full bed rails, but is not receiving hospice care. A citation was issued. Staffing: A total 8 staff members provide care and supervision to the clients. Personnel Records/Staff Training: Administrator certificate expires 7/20/2026. Staff have criminal background clearance and training. Six (6) staff files were reviewed. Proof of continuing education/staff training, health clearance, and 1st Aid/CPR training is current. Resident Records/Incident Reports: Four (4) resident files were reviewed. They contained admission agreements, Physician's Reports, Appraisals, TB clearance, Physician's Orders, medical consent, and Medication Administration records. One resident has a restricted healthcare plan in place. RCFE and Ombudsman complaint posters are posted in the facility. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. The facility does not have a Resident Council due to cognitive impairment of residents. Food Service: Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies. One (1) resident requires a modified diet. Incident Medical and Dental: Centrally stored resident medications were reviewed. 30-day supply of medications was observed. Medical and dental transportation is provided by facility staff. Disaster Preparedness: Emergency and Disaster Plan LIC 610E was reviewed. Facility has a First Aid Kit and Manual. Residents with Special Health Needs: No residents receive hospice care or home health services at this time. No residents have prohibited health conditions. Pursuant to Title 22, a deficiency was cited. An exit interview was conducted with Assistant Administrator Danielle Maximo. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Nov 25, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit. The purpose of the visit was explained to staff Jeffrey Sandejas. Assistant Administrator Danielle Maximo arrived shortly after. The facility is licensed for 4 elderly developmentally disabled residents 60 years and older. The facility is licensed as a level 4C RCFE vendored by San Gabriel/Pomona Regional Center. The following 12 Care Compliance and Regulatory Enforcement (CARE) tool domains were utilized during the inspection. The following were observed/inspected: Infection Control: The Infection Control Plan was reviewed. The facility has a supply of Personal Protective Equipment (PPEs). Operational Requirements: The facility has a Dementia plan and hospice waiver for four (4) residents. A fire clearance for four (4) [3 non-ambulatory & 1 bedridden] residents age 60 and above, of which 1 resident may be bedridden in room #1. Facility handles resident P & I monies. The Surety Bond expires 2/8/2025. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 6/20/2025. Physical Plant/Environment Safety: 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. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Cleaning supplies, knives, and toxic substances were observed unlocked/accessible to residents above the washer/laundry area. Two (2) broken chairs and a dresser were observed in the patio area. The side yard has a discarded shelf rack. Citation was issued. Staffing: A total of 8 staff members provide care and supervision to the clients. Personnel Records/Staff Training: Administrator certificate expired 7/10/2024. Proof of pending approval from CCL Recertification Unit was provided. Staff have criminal background clearance and training. Four (4) staff files were reviewed. Proof of staff training, health and TB clearance, and 1st Aid/CPR training are on file. Resident Records/Incident Reports: Four (4) resident files were reviewed. They contained admission agreements, IPPs, Behavior Plans, Physician's Reports, Appraisals, TB clearance, Physician's Orders, medical consent. The facility maintains centrally stored medication records. RCFE complaint poster and Personal rights were observed posted. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. The facility has a Resident Council. Food Service: Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies. Two (2) residents have a modified diet plan. Incident Medical and Dental: Centrally stored resident medications were reviewed, which contained a 30-day supply of medications. Medical and dental transportation is provided by facility staff. Disaster Preparedness: Emergency and Disaster Plan LIC 610E was reviewed. Facility has a First Aid Kit and Manual. The last emergency disaster drill was conducted on 9/13/2024. Residents with Special Health Needs: No residents are receiving hospice services or home health services. One (1) resident has a restricted health care plan on file. Per California Code of Regulations, Title 22, deficiencies were cited. Exit interview was conducted with Assistant Administrator Danielle Maximo. A copy of the report and appeal rights was issued.the state’s words, verbatim · CDSS document, Oct 29, 2024