A Pericles Elderly Care Home

Type of visit: Required - 1 Year

On January 26, 2026, Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation using the CARE Inspection Tool. LPA was greeted and granted entry by Administrator Luis Gaitan after introducing self and stating the reason for the visit. House Manager (HM) Concepcion Jimenez and Administrator Lisa Gaitan were present during today's inspection. Admin Luis has a valid certificating expiring May 6, 2027. The inspection is as follows: This is a single story property located in a residential neighborhood comprised of five resident bedrooms, one private staff bedroom, and two (2) resident bathrooms. Facility is not operating within the conditions and limitations specified on the license. Facility has an approved hospice waiver for four (4) and is exceeding the number of hospice residents that can be served at one time. There are five (5) residents receiving care from a hospice agency during today's visit where the 5th resident was admitted on January 23, 2026. LPA along with Caregiver Omar Escalante toured the interior portion of the facility. The facility is clean, sanitary, and in good repair. LPA inspected all resident bedrooms. The resident bedrooms' were appropriately furnished, beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage space for each residents' personal belongings were observed. The sliding doors are in good repair. All bathrooms were found be in compliance, clean, and operational. Slip resistant mats were available. The hot water temperature in the bathrooms measured at 119.4 and 117.4 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed two-day supply of perishables and seven-day supply of non-perishable food. In addition to the resident bedroom inspections, LPA inspected all common areas including the attached two car garage. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The exit gate is operational, and there were sufficient seating and shading in the patio area. There are no bodies of water on premise, and the fire place was screened. LPA observed the fire extinguisher was mounted, charged, and serviced on October 2, 2025. The indoor temperature remains at a comfortable range. The auditory devices and smoke/carbon monoxide detectors were tested and operational. Facility maintains emergency food, water, and supplies (such as portable radios, flashlights, and batteries) in the medication closet. The 'See Something, Say Something' Poster (PUB475) was posted in the required size. The first aid manual was available. LPA reviewed six of six resident and two personnel files in which no discrepancies were found. Medications were audited for two out of six residents. No discrepancies were found with medication administration. Staff training is up-to-date including CPR/First Aid. Present staff are background cleared and associated to the facility. Disaster drills of various emergency scenarios are conducted quarterly and documented as required. Based on the observations made during today's visit, a deficiency is being cited. An exit interview was conducted with Administrator Lisa Gaitan and House Manager Concepcion Jimenez, and a copy of this report including the appeal rights were provided at exit.the state’s words, verbatim · CDSS document, Jan 26, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual inspection using the CARE Inspection Tool. LPA was greeted and granted entry by House Manager (HM) Concepcion Jimenez after explaining the purpose of the visit. Administrator (Admin) Lisa Gaitan arrived and assisted with the inspection. The facility is a single story structure located in a residential neighborhood. Facility is licensed to operate for six (6) non-ambulatory and maintains a hospice waiver for four (4) residents. There are three residents in care during today's visit with one caregiver and HM on duty. LPA observed the facility to be clean and sanitary. There are six resident bedrooms and two resident bathrooms. One additional bedroom is occupied by the HM who is a live in staff. All common areas were inspected including the attached two car garage and office/medication room. The residents' bedrooms were appropriately furnished. Beds and bedding supplies were in good condition, adequate lighting was provided, sufficient storage space for each residents' personal belongings were observed. Bathrooms were found to be in compliance, clean, and operational. The water temperature measured at 108.6 and 109.2 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food available. 18 non-perishable food items were observed expired and were immediately discarded during the visit. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The exit gate was self-closing and self-latching. LPA observed sufficient seating and shading. Facility maintains a fire extinguisher which was observed mounted, charged, and serviced on October 1, 2024. The auditory devices and smoke/carbon monoxide detectors were tested and operational except for one auditory device in one out of the six resident bedrooms. In the same resident bedroom, the screen door handle was loose and a tear was present on the screen sliding door. LPA observed some of the emergency disaster supplies including food/water in the office/medication room. However, the generator, portable radios, and etc. were not maintained by the facility as indicated on the Emergency Disaster Plan (LIC610E). Emergency evacuation drills are being conducted quarterly. The first aid kit contains all necessary elements. The first aid manual was not current which was published in 2006. The facility land line number, 949-859-5113, was tested and remains available. The liability insurance is also current. LPA observed the required 'See Something, Say Something' poster (PUB475) framed in an incorrect size in the living room. The Administrator's Certificate for Luis Gaitan expires on May 6, 2025. LPA conducted an audit of three residents' files and one personnel files. Discrepancies were noted in one staff file as the Tuberculosis (TB) test results were not present. Medications were audited for three residents. No discrepancies noted. Staff and resident interviews were conducted. The following items were noted and discussed with Admin Lisa Gaitan and HM Jimenez: to enlarge the complaint poster in the correct size and to post it in the entry way, to obtain a current first aid manual, generator, portable radios, and etc, to repair one auditory device, screen, and sliding door handle in one resident's room, clean out pantry and the food crumbs on the canned food, and to label the expiration dates, and to obtain the TB Test results for one staff. Admin was also reminded to ensure timely payment of the annual licensing fee due January 20, 2025. Based on the observations made during today's visit, deficiencies are being cited today. Advisory Notes are also being issued. An exit interview was conducted with Administrator Lisa Gaitan and House Manager Concepcion Jimenez, and a copy of this report and the LIC809-D, and LIC9102s were provided at the end of the visit.the state’s words, verbatim · CDSS document, Jan 13, 2025

The state marks this report as 8 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: POC

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced Plan of Correction (POC) visit to follow up on deficiencies cited on 01/30/2024. LPA was greeted and granted entry into the facility by CEO Concepcion Jimenez and explained the reason for the visit. Administrator Luis Gatan was present as well. Deficiency cited under Title 22 Regulation 87307(a) pertaining to Maintenance and Operation has been cleared. During the visit, LPA observed the exit gate has been repaired. Licensee has complied with the POC. Deficiency cited under Title 22 Regulation 87412(c) pertaining to Personnel Records has been cleared. Licensee provided proof of staff training. Licensee has complied with the POC. LPA observed items on the advisory note given 01/30/2024 have been addressed. Exit interview conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Feb 16, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to A Pericles Elderly Care Home. The purpose of today’s visit was to conduct the Annual Required inspection. LPA was allowed entry into the home and met with CEO Concepcion Jimenez. Facility is licensed for 6 non-ambulatory residents. Facility has an approved hospice waiver for 6 residents and the home currently has 4 residents present. There are three residents on hospice during today's visit. Luis Gaitan has an Administrator Certificate expiring on 05/06/2025. Administrator Lisa Branson arrived during the visit. LPA Lyman along with Concepcion Jimenez toured the facility at 9:07 AM. Facility appears to be clean, safe, and sanitary. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of five resident bedrooms, one resident bathroom, one office area, one shared hall bathroom, staff room, living room, dining room, and kitchen. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 107.2 and 107.4 degrees F in all facility bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Resident hygiene and cleaning supplies are locked and inaccessible to residents. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including tweezers, thermometer, and scissors. During today's visit, auditory door alarms are operational. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. Smoke detectors and Carbon Monoxide detectors tested operational during today's visit. Fire extinguishers are fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample shaded seating for residents. At 9:30 AM, LPA observed the exit gate is in need of repair (photo). LPA observed emergency water supply on-site. LPA reviewed the emergency disaster plan during the visit. Plan is thorough and complete. Facility provided documentation of last fire drill conducted on 11/12/2023. Facility provides activities in the form of games and exercise. CONT ON LIC 809C DATED 01/30/2024. At 10:00 AM, LPA reviewed five resident files and four staff files. Resident files contained required documents including admission agreements, physician reports and resident appraisals. Staff files reviewed contained required documentation of health screen/TB, and criminal record clearance. Three out of four staff do not have proof of training in the file. At 10:30 AM, LPA reviewed medication storage and administration. Medications are stored in a locked cabinet and are audited weekly by staff. Medications are being administered per physician order. Based on the observations made during today's visit, the following violations are being cited per California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted and a copy of this report as well as appeal rights were discussed and provided with facility representative.the state’s words, verbatim · CDSS document, Jan 30, 2024