Piner's Guest Home

Type of visit: Required - 1 Year

At approximately 11:00 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and met with Deirdre Villante, Supervisor. Facility is a Residential Care Facility for the Elderly (RCFE) with thirteen (13) residents in care. Facility serves assisted living residents, has a Hospice waiver for 2, and is approved for all non-ambulatory residents. At approximately 12:00 PM, LPA initiated a tour of the facility with Supervisor and observed the following: Facility is a one story building, was a comfortable temperature, and passageways were free from obstructions. LPA observed call bells in each resident bedroom and staff responded timely when activated. Water temperatures in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Closets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. Medications were centrally stored and locked. There are outdoor shaded seating areas for activities. LPA observed residents engaged in activities in common areas. Facility has internet service and Supervisor agrees to have an internet access device designated for resident use as required per regulation. Facility's last fire inspection was conducted 03/2026. Fire extinguishers were observed fully charged and were last inspected 01/2026. Emergency Disaster Plan was reviewed and updated 10/2025. Facility conducts quarterly disaster drills but the most recent drill was conducted 06/2025. Continued on LIC809-C... Continued from LIC809C... Supervisor agrees to conduct a drill immediately to bring the facility back into compliance with regulation and understands that drills shall be conducted no less than quarterly. At approximately 1:00 PM, LPA conducted file review of five (5) staff files. Three (3) of five (5) staff files reviewed were observed missing proof of current first aid training as required per regulation, (see LIC809D). Four (4) of five (5) staff files reviewed were also observed missing proof of all of the required annual training and annual medication training hours, (see LIC809D). At approximately 3:30 PM, LPA reviewed five (5) resident files. Supervisor agrees to ensure that all resident files contain updated annual appraisal needs and services plans as required to ensure compliance with regulation. All resident files reviewed contained the remaining required documentation. Facility assists with coordinating medical and dental appointments as well as third party transportation services to and from appointments when residents have the need. Medications and medication records were inspected and the logs were observed maintained in compliance with regulation. Facility does not handle P&I cash resources. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit: Proof of current liability insurance in the required amounts Current Fire Inspection Report LIC500 - Personnel Report (updated) The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and/or The Health and Safety Code. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Supervisor and appeal of rights provided. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Apr 7, 2026

The state marks this report as 8 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

At approximately 10:20am, Licensing Program Analysts (LPAs) Elias Magdaleno and Chris Arnhold arrived unannounced to conduct a required 1-year annual inspection and were greeted by Supervisor Deirdre Villante. Facility is a Residential Care Facility for the Elderly (RCFE) with eight (8) residents in care. Facility has a Hospice waiver for two (2), with no Hospice residents currently in care, and is approved for all non-ambulatory residents. At approximately 10:45am, LPAs initiated a tour of the facility with Supervisor and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Fire extinguishers were last inspected 1/27/2025. Water temperatures measured 116.2 degrees F in room 200 and 123.4 degrees F in room 214, a discussion was had with supervisor about water temperature. LPAs observed a supply of clean linens, hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. LPAs observed at least a 2-day supply of perishable food, 7-day supply of non-perishable food, and emergency water supplies. Per discussion with Supervisor, breakfast is made in facility with lunch and dinner sourced from off-site facility elsewhere on property. Food was found to be stored in a safe manner with open items covered. LPAs observed a piano, puzzles, and a movie room accessible to residents. Outdoor seating and tables are available to residents weather permitting. Internet service available, discussion had with Supervisor about acquiring a shared internet accessible device. Continued 809C... Continued from 809... At approximately 12:00pm LPAs conducted review of five (5) resident records. All required documentation present. At approximately 12:45pm LPAs conducted a review of five (5) staff records. Three (3) of five (5) staff did not have training hours complete. At approximately 1:40pm LPAs and Supervisor Deirdre Villante conducted a spot check of medication and medication records. Medication is centrally stored and locked. Gary Piner Administrator Certificate 7034473740 expires 12/01/2025. All fees are current as of this time. LPAs and Administrator discussed facility's Infection Control Plan and Emergency Disaster plan, No new updates. Facility’s last quarterly disaster drill was conducted on 2/3/2025. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Supervisor. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: Liability Insurance LIC500- Personnel Report LIC308- Designation of Responsibility Exit interview conducted with Supervisor and a copy of this report was given.the state’s words, verbatim · CDSS document, Feb 19, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Shannan Hansen arrived at 10:30 AM to complete an unannounced annual inspection and was welcomed by staff Mary R. Staff called Supervisor Deirdre Villante who arrived shortly after. There is a total of 7 residents in care, no dementia and none on hospice. A review of seven residents & four staff records as well as two resident’s medications was conducted. LPA reviewed resident’s files at 11:00AM on 2/28/2024 and learned that 7out of 7 residents do not have update reappraisal/needs & care plan on file at this time (see LIC809-D) and 1 out of 7 residents (R1) does not have a Physicians Report (602) as required by Title 22 Regulation (see LIC809-D). Medications were centrally stored in a locked medication cabinet in the facility medication room. The Medications of 2 out of 2 residents were found to be given according to physicians’ directions on 2/28/2024 at 1:30 PM. Centrally Stored Medication Record (CSMR) of 2 out of 2 residents were found to be complete and accurate; although LPA advised during original inspection on 2/22/24 not to pre-pour medications, during today’s inspection facility had pre-poured medication again (see pics & see LIC809-D). LPA conducted a sample review of staff records at 12:00PM on 2/28/2024 and learned that all facility staff and other individuals who require caregiver background checks have received criminal record clearances or exemptions. In addition, Direct care staff have received the additional training requirements as per Title 22 Regulations and H&S Code. LPA was presented with proof of CPR & 1st Aid certification for all staff. Gary Piner, Administrator Certificate # 6012080740 is pending, payment was received 11/6/2023. Smoke detectors are hardwired into the fire system with fire sprinklers throughout. Fire Records indicate last inspection was conducted 3/2023. Continue to LIC809-C LPA reviewed Licensing Information System (LIS) with Supervisor who stated that is current and updated at this time; no need to change any of the information. In addition, LPA advised facility to check with the County regarding what is the County Emergency Plan; ensure that disaster drills are conducted in different shifts, and review facility emergency plan to ensure accuracy according to the needs of facility residents. Disaster Drills have not been conducted quarterly with the last one being conducted prior to 7/2023 (see LIC809-D). Appeal Rights Given. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal rights provided. LPA Hansen is requesting Licensee to update and submit the following documents to CCL by 3/15/2024: Copy of Annual Sprinkler Inspection LIC 308 Designation of Responsibility LIC 309 Administrative Organization LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan LIC 9020 Register of Facility Client’s/Resident’s Copy of Control of Property Lease/Grant Deed Copy of Administrator’s Certificate Proof of Liability Insurancethe state’s words, verbatim · CDSS document, Feb 28, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87463(c) · Plan of correction due date: Mar 8, 2024

87463(c) Reappraisals- (c)The licensee shall arrange a meeting with the resident, the resident’s representative... when there is significant change in the resident’s condition, or once every 12 months, whichever occurs first... This requirement has not been met as evidenced by: Based on LPA/Administrator's file review showing that resident's care plans for 2 out of 2 residents (R1 - R7) were not been performed and signed by the resident of their representative within last 12 months. This is a potential risk to the health and safety of residents in care.the state’s words, verbatim · CDSS document, Feb 28, 2024

Plan of correction: Administrator to review all resident's care plans, update them accordingly and send self-certification that this process had been done to CCL by POC due date 3/8/2024.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87458(a) · Plan of correction due date: Mar 8, 2024

87458(a) Medical Assessment. Prior to accepting a person as a resident the licensee must obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. ** This requirement was not met. Based on LPAs record review the facility did not ensure Resident (R1) had submitted a completed medical assessment in their file, which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Feb 28, 2024

Plan of correction: Supervisor/Administrator agrees to review resident records and make sure R1 has 602 in file and submit copy to CCL by POC due date of 3/08/2024.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(5) · Plan of correction due date: Mar 8, 2024

87465(h)(5) Incidental Medical and Dental Care -(h)The following requirements shall apply to medications which are centrally stored: (5)Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement was not met as evidenced by: LPA observed all residents medications had been prepoured into plastic containers which were to be given to the residents as stated. Medications are to remain in original containers. This is a potenitial risk to health & safety and/or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Feb 28, 2024

Plan of correction: Facility to ensure that medications are not transferred between containers at any time, per regulation medications are to remain in origianl containers. Licensee to ensure all staff are retrained in medication procedures, submit proof of training with Signatures of Staff, dates, & training type by 3/8/24.

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.695(c) · Plan of correction due date: Mar 8, 2024

1569.695(c)A facility shall conduct a drill at least quarterly for each shift..type of emergency covered in a drill shall vary ... Documentation of the drills shall include date,type of emergency covered by the drill, and names of staff participating in the drill. This requirement is not met as evidenced by: This requirement is not met as evidenced by: Based on interview, the licensee did not comply w/section cited above in 1 of 1 facility drill which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 28, 2024

Plan of correction: Facility to ensure that facility will conduct quarterly disaster drills as required by Health & Safety Code. Licensee to submit to CCL proof of disaster drill conducted with the facility by POC date of 3/8/2024

Type of visit: Required - 1 Year

License Program Analyst (LPA) Hansen arrived unannounced to conduct an Annual inspection of facility. LPA met with Deirdre Villante, Supervisor of Building. Administrator was called at other building of visit. There is a total of 7 residents with none currently on Hospice. At approximately 1:45 PM, LPA toured the building and grounds with Supervisor which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. Meals are prepared in the main kitchen. Snacks and drinks are stored in the dining area. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations at the time of the visit. Hot water temperature measured between 115.5 degrees F and 117.8 degrees F. within Title 22 acceptable regulation of 105 to 120 degrees F in 5 of 5 resident’s bathrooms while touring facility on 2/22/2024 at aprox 2:00 pm. There was a supply of cleaners, hygiene products and paper products available for residents. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present in bathroom showers. A sample tour of resident’s bedrooms was conducted, and bedrooms inspected have lighting & appropriate furnishing. Fire Extinguisher was found to be last charged on 1/18/2024 at the time of the visit. LPA observed Carbon Monoxide detectors to be operational during the visit. Medication is centrally stored, well organized and secure. There is a daily activity schedule for residents. LPA initiated a file review of seven residents files and five personnel files but were unable to complete. LPA was also unable to review medication and will return at a later date to complete annual inspection. No deficiencies cited during today's inspection.the state’s words, verbatim · CDSS document, Feb 22, 2024