Felson Board and Care

Type of visit: Annual/Random

On 9/01/2026, Licensing Program Analyst(s) (LPA) Jewel Baptiste conducted an unannounced annual visit at Felson Board and Care. LPA Baptiste met with DSP Jocelyn Lanorias and explained the reason for the visit. Assistant Administrator Connie Duldulao arrived at 20 minutes and further assisted with the visit. The facility is licensed to serve age range 60 and over. Fire clearance was approved for six (6) non-ambulatory, of which one (1) may be bedridden. Bedrooms two (2) and three (3) are allowed one (1) non-ambulatory each. Bedroom one (1) is allowed two (2) non-ambulatory. Bedroom four (4) is allowed 1 non-ambulatory and 1 bedridden. Hospice waiver for six (6). The facility is a single-story home, located in a residential area. It consists of 3-resident bedroom, 1-resident bedroom with bathroom, 1 staff bedroom, 1 resident bathroom, 1 dining room, 1 living room with non-working fireplace, kitchen, a garage, and a backyard. The facility has delayed egress system in place. (CONTINUED LIC 809C) LPA Baptiste conducted a tour of the facility with Assistant Administrator and observed the following: Facility is clean and in good repair indoors and outdoors. Kitchen is clean, sharps were locked and inaccessible to residents. Fire extinguisher observed in hallway, garage charged and updated. The cleaning supplies were locked under kitchen sink and garage. Sufficient food supplies were observed, at least 2 days of perishables and 7 days of non-perishables. (3) Resident's bedrooms were observed with sufficient lighting, furniture, and bedding supplies. (2) Resident bathrooms were observed in working conditions with grab bars, and skid mats. The water temperature was tested between 111.6 -111.7, which is within the required 105-120 degrees F. The dining room and living room were observed with sufficient sitting area. Smoke/Carbon monoxide detectors were tested and in working condition. The garage contained storage supplies, washer and dryer, PPE’s, water, toiletries, emergency food, and small storage room. Backyard were observed with covered sitting area. The facility does not have any large body of water. Last emergency drill was conducted on 06/01/2026. LPA Baptiste reviewed medication and files for 6 residents. Each resident file reviewed has all the required documentation. Staff files were reviewed for (3) staff and they have all the required documentation. An administrator certificate was reviewed for Isabel Tangonan exp: 12/30/27. Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview was held and a copy of the report was provided to the Assistant Administrator.the state’s words, verbatim · CDSS document, Sep 1, 2026

Allegation investigated: Personal Rights: Staff left resident unsupervised resulting in an injury.

Licensing Program Analyst (LPA) Elizabeth Irra conducted a subsequent visit to deliver findings for the above allegations. LPA met with Maria Isabel Tangonan and discussed the purpose of today’s visit. On 01/13/25, LPA Irra conducted an initial complaint visit. During this visit, LPA conducted a tour of the building and grounds and did not observe any signs of neglect, abuse or other immediate health and safety threats. LPA also reviewed Resident #1 (R-1) files and obtained relevant documentation. Additionally, LPA obtained a copy of the staff schedule and resident roster. During this investigation, Dennis Douglas (Department of Social Services Community Care Licensing Investigation Branch) interviewed Staff #1 (S-1) through Staff #3 (S-3), R-1’s family member, R-1’s hospice agency and obtained R-1’s medical records from the hospital. **Refer to LIC 9099C for the continuation of this report.** Substantiated Personal Rights: Staff left resident unsupervised resulting in an injury. During IBs investigation, it was discovered that on 01/01/25, R-1 experienced a fall at the facility while in the bathroom. It was revealed that R-1 is legally blind. R-1 was initially escorted to the bathroom by S-2 who then momentarily left R-1 in the bathroom while S-2 tended to another resident. S-1 was also present at the facility at that time. Staff interviews revealed that R-1 was equipped with a pendant around R-1’s neck which allows for R-1 to notify staff when R-1 needs assistance. Staff interviews revealed that at the time of the incident, R-1 pressed their pendant alerting them R-1 was done in the bathroom and needed assistance. Interviewed staff indicated they were both tending to other resident at that time and could not assist R-1 in the bathroom right away. During IBs investigation, S-1 also acknowledged that S-1 instructed S-2 to wait because, in the past when R-1 would push the pendant requesting assistance R-1 would not quite be ready. By the time S-2 proceeded to the bathroom to assist R-1, R-1 was discovered laying on the bathroom floor and had already put their diaper on. Interviewed staff indicated they observed an injury to R-1’s left eye as a result of the fall. Per hospital records obtained, as a result of R-1’s fall, R-1 sustained an “impacted femoral neck fracture of the right hip” which required surgery and had a laceration of the left eye cornea. Interviews and documentation corroborate this allegation. Deficiency cited. Refer to LIC 9099D. Due to the seriousness of R-1’s injuries, an immediate Civil Penalty of $500.00 is being issued during today’s visit. Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. An exit interview was conducted. A copy of this report and appeals rights were provided to Maria Isabel Tangonan. Personal Rights: Staff did not seek timely medical care for resident in care. During IBs investigation, it was discovered that on 01/01/25, staff called the Administrator/S-3 and informed S-3 of R-1’s fall. Per staff interviews, staff notified S-3 of R-1’s fall within “minutes” of the incident. Per interviews, S-3 contacted R-1’s family member and hospice agency and informed them of R-1’s fall. Staff interviews revealed that staff did not call 911 at that time as R-1 was receiving hospice services (the protocol is to contact the hospice agency prior to calling 911 as hospice services may be interrupted when calling 911). Per interviews, R-1’s family member and hospice agency nurse arrived to this facility within approximately 30 minutes to assess R-1. R-1’s family member decided to take R-1 to the hospital for further evaluation. Interviews do not corroborate this allegation. Although the allegation(s) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. Exit interview was conducted and a copy of this report and appeal rights were provided to Maria Isabel Tangonanthe state’s words, verbatim · CDSS document, Oct 21, 2025 · control 28-AS-20250109162007

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87411(a) · Plan of correction due date: Oct 22, 2025

PERSONNEL REQUIREMENT. Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This standard is not met at evidence by: R-1 fell and sustained injuries while waiting in the bathroom for staff assistance.the state’s words, verbatim · CDSS document, Oct 21, 2025

Plan of correction: Administrator to provide an in-service training to staff and discuss the importance of providing adequate assistance in a timely manner to residents. Administrator to develop and implement a policy pertaining to answering residents’ pendant calls in a timely manner. Administrator to submit proof of training and a copy of the policy to LPA Irra by POC due date.

Type of visit: Required - 1 Year

On 09/28/2025, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced annual inspection. Upon arrival LPA met with staff Christyna Blanco. Later, the Administrator Tangonan Maria joined LPA and explained the reason for the visit. The facility has an approved fire clearance to be licensed to serve residents aged 60 and above, six (6) non-ambulatory, and (1) of which may be bedridden. Bedrooms 2 and 3 are allowed 1 non-ambulatory each. Bedroom 1 is allowed 2 non-ambulatory. Bedroom 4 is allowed 1 non-ambulatory and 1 bedridden. Hospice waiver approved for six (6). The facility is a single-story home: 4 bedrooms, 1 staff bedroom, 2 bathrooms, dining room, living room, kitchen, backyard, and an attached garage. Emergency disaster drill last conducted 09/09/2025. During today's visit LPA Richard toured the physical plant inside and outside, reviewed the food supply, tested the smoke/carbon monoxide detectors, reviewed (4) staff files, (6) resident files, medications, and medication administration records for (6) residents. All (6) resident bedrooms contained required furniture's, lamps, dresser, chair, and closet. Report Continued LIC9099C The two bathrooms contain a working toilet, basin, and water faucet, shower with grab bar, shower chair, and bath mat. The two bathrooms hot water temperature tested at 108.3F-108.5F. The smoke detectors were battery operated and individually tested and observed to be working properly. The carbon monoxide detector was located throughout the facility, tested, and functioning properly. There were (3) fire extinguisher located in kitchen, hall way, and garage fully charged and up to date. The kitchen was toured and contained working appliances; refrigerator, stove, oven and contained dishware, cups, plates, utensils, pots, and pans with knives secured and locked in Kitchen cabinet. The cleaning agents and toxins were locked underneath kitchen sink. The pantry was well stocked with canned goods, pasta, cereals, and the food supply contained a sufficient supply with a two day supply of perishables and a seven-day supply of non-perishables that met title 22 guidelines. Walls and floors, cabinets and counters were clean and sanitary throughout the home. The outdoor grounds were toured and inspected, and the patio was well maintained with shaded seating area accessible for resident’s use. The garage contained cabinetry that contained emergency supply kits, bottled water, toiletries, personal care supplies, washer and dryer, toxins and cleaning agents stored locked and inaccessible to the residents. The entrance contained notifications and postings: California Labor Laws, Emergency Disaster Plan, personal rights, facility license, business license, medical emergency information, let-us-know licensing contact information, consumer grievance, support services, and community resources. Exit interview conducted. A copy of this report was provided to the Administrator Tangonan Maria Isabel.the state’s words, verbatim · CDSS document, Sep 28, 2025

Type of visit: Required - 1 Year

On 10/15/2024 Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced annual inspection. Upon arrival LPA met with Direct support Professional (DSP) Christyna Blanco. Staff contacted the Administrator and LPA explained the reason for the visit. The Administrator Isabel Tangonan arrived at 9:17 am to assist with the visit. The facility has an approved fire clearance to be licensed to serve residents aged 60 and above, six (6) non-ambulatory, and (1) of which may be bedridden. Bedrooms 2 and 3 are allowed 1 non ambulatory each. Bedroom 1 is allowed 2 non ambulatory. Bedroom 4 is allowed 1 non ambulatory and 1 bedridden. Hospice waiver approved for six (6). The facility is a single-story home: 4 bedrooms, 1 staff bedroom, 2 bathrooms, dining room, living room, kitchen, backyard, and an attached garage. Administrator certificate # 7020686740 expired 10/30/2025. Emergency disaster drill last conducted 10/04/2024. During today's visit LPA inspected the physical plant inside and outside, reviewed the food supply, tested the smoke/carbon monoxide detectors, reviewed (4) staff files, (6) resident files, medications, and medication administration records for (6) residents. All (6) resident bedrooms contained required furniture, lamps, dresser, chair, and closet space. The two bathrooms contain a working toilet, basin, and water faucet, shower with grab bar, shower chair, and bathmat. The temperature measured at 113.0*F-113.3*F. The smoke detectors were battery operated and individually tested and observed to be working properly. The carbon monoxide detector was located throughout the facility, tested, and functioning properly. There were (2) fire extinguisher located in kitchen and garage fully charged and up to date. The kitchen was toured and contained working appliances; refrigerator, stove, oven and contained dishware, cups, plates, utensils, pots, and pans with knives secured and locked in Kitchen cabinet. The cleaning agents and toxins were locked underneath kitchen sink. The pantry was well stocked with canned goods, pasta, cereals, and the food supply contained a sufficient supply with a two-day supply of perishables and a seven-day supply of non-perishables that met title 22 guidelines. Walls and floors, cabinets and counters were clean and sanitary throughout the home. (Report continued on LIC809C) The outdoor grounds were toured and inspected, and the patio was well maintained with shaded seating area accessible for resident’s use. The garage contained cabinetry that contained emergency supply kits, bottled water, toiletries, personal care supplies, washer and dryer, toxins and cleaning agents stored locked and inaccessible to the residents. The entrance contained notifications and postings: California Labor Laws, Emergency Disaster Plan, personal rights, facility license, business license, medical emergency information, let-us-know licensing contact information, consumer grievance, support services, and community resources. Exit interview conducted with Isabel Tangonan, Administrator, a copy of this report was provided via email.the state’s words, verbatim · CDSS document, Oct 15, 2024