Heart to Heart Provider

Type of visit: Case Management - Annual Continuation

At approximately 10:15 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and met with Leonardo Lalim, Administrator. Facility is a Residential Care Facility for the Elderly (RCFE) with five (5) residents in care, all of whom were present during today's inspection. Facility has a Dementia Care Plan, a Hospice waiver for six (6), is approved for all non-ambulatory residents, and is vendored with the North Bay Regional Center (NBRC). At approximately 10:30 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. LPA observed egress devices activated on all facility doors. 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 clean linens, and hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in regulations. Cabinets 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 shaded seating areas in both the front- and backyards with outdoor space for activities. LPA observed residents resting in their rooms or watching TV in the common area. Facility has internet service and during inspection Administrator purchased an internet access device designated for resident use to bring the facility into compliance with regulation. The telephone was tested and was operational during inspection. Facility has a generator to supply power in an emergency. Emergency lighting devices were present. First aid kit was present. All employees are background checked and cleared to work in the facility. Continued on LIC809-C... Continued from LIC809... No pools/bodies of water are on the premises. Facility conducts emergency drills every 3 months with the most recent drill conducted 06/2026. Facility's emergency disaster plan was observed posted in the facility and was last updated 01/2026. Fire extinguishers were observed fully charged and were last inspected 09/2025. During inspection, LPA observed Resident 1 (R1) in bed with legs and feet floated off of the bed with padding and air filled booties and a sheet tented over the lower extremities. LPA observed R1 with a reddish dime sized area with a scab on R1's left heel. Administrator stated that R1 had been on home health for the care of the heel wound which is reflected as a stage 3 pressure injury in R1's physician's reports dated 10/18/2024, 04/16/2025, and 05/18/2025. R1's most recent physician's report dated 03/18/2026 does not mention the pressure injury. LPA also observed progress notes from the home health agency providing care for R1's wound dated 08/06/2024, 06/30/2025, and 08/19/2026. Administrator states that home health was discontinued after 08/19/2026 visit. Administrator states they observed redness and a discoloration on R1's left calf area approximately two days ago. LPA observed a bandage placed on R1's left calf area which fell off when administrator lifted R1's leg for observation. LPA observed a red area approximately 4 inches in diameter and a black and blue area in the middle approximately 2 inches in diameter under that bandage on R1's left calf area, (see LIC809D). LPA discussed prohibited health conditions with administrator and provided administrator a copy of regulation 87631: Healing Wounds. LPA requested Administrator have the wound evaluated by a medical professional, staged, and obtain any orders for care as well as confirmation of R1's ambulatory status. Administrator conveyed understanding and agreed to comply. Administrator scheduled an appointment with R1's podietrist on 09/02/2026 but after discussion during today's visit contacted EMS to send R1 to the hospital for evaluation today. At approximately 11:15 AM, LPA followed up on an incident report received by the Department on 08/26/2026 regarding an incident that occurred on 08/22/2026 involving Resident 2 (R2). LPA reviewed R2's physician's reports dated 08/17/2026 and 08/28/2026 and appraisal needs a services plan dated 06/01/2026. Continued on LIC809C... Continued from LIC809C... LPA also interviewed Administrator who stated that the responsible party and home health nurse were both aware of the situation when a small amount of blood was observed in R2's catheter bag and advised facility to continue monitoring it and to send R2 to the ER if signs and symptoms worsened, which facility did the next morning upon observing increased blood in the catheter bag. Additionally, R2's 08/17/2026 physician's report indicates a bedridden status. LPA requested the facility have R2 re-evaluated to confirm whether R2 in bedridden. Administrator understands that the facility is not approved for bedridden residents and agrees to work with the resident and their family on placement in another facility if a bedridden status is confirmed. At approximately 12:00 PM, LPA reviewed 4 of 5 resident files. All resident files contained the required documentation. Reappraisals were conducted within the last 12 months. Documentation of physician visits within the last 12 months were present. At approximately 2:30, LPA reviewed 2 of 4 staff files which were observed to contain all of the required documentation including current first aid certificates and training. Both files also contained current CPR certificates. LPA reviewed medications and medication logs which were inspected and observed stored and maintained in compliance with regulation. Facility does not manage P&I cash resources. Deficiencies are being cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Failure to correct the deficiencies by the plan of correction date and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator whose signature on form confirms receipt of documents. Appeal rights provided.the state’s words, verbatim · CDSS document, Aug 31, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87631(a)(3)(A) · Plan of correction due date: Sep 1, 2026

Healing Wounds 87631(a)(3)(A) The resident shall receive care for the pressure injury from a physician or an appropriately skilled professional. This requirement is not met as evidenced by: Based on observation, the Licensee did not comply with the section cited above in ensuring that R1 is receiving the required medical care for observed wounds on their left heel and left calf area which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 31, 2026

Plan of correction: Licensee immediately contacted emergency medical services (EMS) to have R1 sent to the hospital for evaluation of their wounds. Licensee to submit a self-certification that they have reviewed the regulation with all staff to CCL by POC due date 09/01/2026.

Type of visit: Required - 1 Year

At approximately 10:35AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct a Required-1 Year inspection. LPA met with Administrator Leonardo Lalim and explained the purpose of the visit. Administrator certificate is current. Facility has a Hospice waiver for 6 residents. At approximately 11:00AM, LPA toured the facility to ensure the health and safety of residents in care. The facility was observed to be at a comfortable temperature. Areas toured include but are not limited to resident rooms, common areas, bathrooms, kitchen, storage areas and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. Fire extinguishers were fully charged. Smoke detectors are all operational. Carbon Monoxide Detector was present. The common areas, bathrooms and kitchen were clean and in good repair. All bedrooms had required furniture, bedding, and lighting. The kitchen contained cooking/dining equipment that was clean and orderly. Food appears to be stored and prepared properly. Refrigerators and freezers were maintained at the proper temperature. Facility has the required non-perishable and perishable supply of food. Emergency food stores and water was present to ensure facility can be self-sufficient for 72 hours. Facility has a generator to supply power in an emergency. Emergency lighting devices were present. First aid kit was present. All employees requiring background checks are cleared. No pools/bodies of water are on the premises. Facility has been conducting Emergency drills every 3 months. At approximately 11:25AM, LPA reviewed 4 of 6 resident files. All resident files contained the required documentation. Reappraisals were conducted within the last 12 months. Documentation of physician visits within the last 12 months were present. Hospice care plans were current and on file. LPA conducted a review of medications. Medication is locked and not accessible. Documentation of medications and physician orders were current. Continued on LIC809-C… At approximately 1:30PM, LPA reviewed staff files. Staff files reviewed contained evidence of completed annual training. First Aid/CPR certification was current. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: Evidence of control of Property, (Current Rental/Lease Agreement/Deed) LIC500- Personnel Report Evidence of Liability Insurance No deficiencies were observed in the areas inspected, No citations were issued during today’s visit.the state’s words, verbatim · CDSS document, Jul 9, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) J. Macias arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Leonardo Lalim. Facility contact information was reviewed. All fees paid and current. Currently six (6) residents in care. Facility has an approved fire clearance for six (6) non-ambulatory residents. There are 2 shared rooms and 2 private rooms. The facility has required emergency disaster plan. At approximately 1:30pm LPA and Administrator toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered and dated. Kitchen drawer with sharp knives was locked. Cleaning supplies were locked underneath kitchen sink and inaccessible to residents in care. All bedrooms were equipped with lighting, night stand, and chest of drawers per regulation. All bedrooms were clean and in good repair. Restrooms were equipped with necessary grab bars and non-slip bath mats. Extra hygiene products and linens were secured and readily available. Water temperature in sink accessible to residents in care measured at 108.6 and 110.8 degrees F, which is within the allowable range of 105 to 120 degrees F per regulation. Fire extinguishers were last inspected September 25, 2023. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Facility’s last quarterly disaster drill was conducted July 19, 2024. At approximately 2:00pm, LPA reviewed three (3) staff records. All staff files were found to be complete with all required documentation. First Aid and CPR certifications were all current. At approximately 2:30pm, LPA reviewed five (5) resident files which were all found to be well organized, thorough, and contained the required documentation At approximately 3:00pm LPA and Administrator conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet drawer. No deficiencies. Continued on 809C... Continued from 809... Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: 8/24/2024 LIC500- Personnel Report LIC308- Designation of Responsibility Liability Insurance LIC 610 Emergency Disaster Plan (If changes) Infection Control Plan (If changes) No deficiencies cited during this inspection. Exit interview conducted with Administrator and a copy of this report was given.the state’s words, verbatim · CDSS document, Jul 24, 2024