Shercon Guest Homes

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced Annual Required inspection. Upon arrival, LPA Tea was greeted and granted entry into the facility by Administrator (AD) Consolacion Lumauig. LPA explained the purpose of the visit. The facility is licensed for six non-ambulatory residents and has a hospice waiver for four residents. The facility currently has a census of four residents, none are receiving hospice services at the time of today's visit. LPA Tea reviewed four resident records and one staff record. Discrepancies were identified during the records review. LPA observed forms in resident records that were not signed and/or were not the appropriate forms. Additionally, the staff record reviewed did not contain documentation demonstrating completion of required annual staff training. The Administrator Certificate expires on August 8, 2027. LPA Tea, accompanied by AD Lumauig, conducted a tour of the facility. LPA inspected the physical plant, food service areas, and first aid supplies. The facility consists of five resident bedrooms, one staff room, three bathrooms, a laundry room, living room, dining room, staff office area, kitchen, and attached garage. Smoke and carbon monoxide detectors located in the common areas and resident bedrooms were tested and observed to be operational. Resident bedrooms contained the required furniture, bed linens, and adequate closet and drawer space. Resident bathrooms were inspected. Toilets and faucets were operational, grab bars were secure, and the shower areas were free of mold and mildew. The hot water temperature measured 119.7 degrees Fahrenheit. Resident bath towels, toiletries, and personal hygiene supplies were adequately stocked at the time of the visit. (Annual Inspection continued on LIC809C) Common areas were clean and free of hazards, and passageways and doorways were free of obstructions. The first aid kit contained required supplies, including dressings, bandages, tweezers, a thermometer, and scissors. LPA inspected the kitchen and observed an adequate supply of perishable and nonperishable food. Kitchen appliances were operational at the time of the visit. Sharp objects were secured in a locked kitchen drawer. Toxic substances were secured and inaccessible to residents in locked cabinets located in the laundry room and underneath the kitchen sink. Fire extinguishers located throughout the facility were observed to be fully charged. During the records review, the facility was unable to provide documentation demonstrating that required quarterly disaster drills had been conducted. LPA toured the exterior grounds and observed an exit gate located on the left side of the facility that was self-latching and operational. The backyard contained a shaded patio area available for resident use. Emergency food and water supplies were observed and stored in the garage. Activities are provided based on residents' individual preferences, abilities, and health conditions. The facility provides activities such as light exercise. During today's visit, LPA observed residents walking throughout the facility and watching television. LPA reviewed medication storage and administration. Medications were stored in a locked cabinet located in the staff office area and were inaccessible to residents. Medications reviewed were being administered in accordance with physicians' orders. LPA interviewed residents regarding the quality of care and services provided and spoke with staff regarding care and supervision provided to residents. Based on observations and records reviewed during today's visit, deficiencies are being cited pursuant to Title 22, Division 6, Chapter 8 of the California Code of Regulations. See LIC 809-D for deficiencies cited. An exit interview was conducted with Administrator Consolacion Lumauig. This report was reviewed with AD Lumauig. Copies of the LIC 809, LIC 809-C, LIC 858, LIC 859, LIC 809-D, and Appeal Rights were reviewed and provided to the facility.the state’s words, verbatim · CDSS document, Oct 1, 2026

Allegation investigated: Facility staff not dispensing medications as prescribed

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA was greeted and granted entry into the facility and explained the reason for the visit. The Department received a complaint on 02/18/2025 and LPA Mendivil conducted the initial 10 day visit on 02/25/2025. LPA Mendivil obtained copies of admission agreements, physicians reports, hospice documentation, and staff training documentation. LPA Mendivil interviewed staff and residents. Regarding the allegation, facility staff not dispensing medication as prescribed, the investigation revealed the following: It was alleged that the facility is not dispensing medication as prescribed for Resident 1 (R1). R1 was admitted to the facility on or around November 2024. Per review of R1’s physician report R1 was diagnosed with major neurocognitive disorder due to Alzheimer’s and R1 was able to communicate needs and is able to follow directions. Substantiated During the visit on 02/25/2025 LPA Mendivil witnessed a conversation between Licensee/Administrator Connie Lumauig asking R1’s family about a medication that the Licensee was no longer giving R1. Per LPA’s observation R1's family denied stating that R1’s medication was discontinued. LPA Mendivil questioned Licensee regarding the discontinuation of medication and asked if a physician discontinued, Licensee stated “no” Therefore based on the preponderance of evidence through observations the allegation that the facility is not dispensing medication as prescribed is determined to be SUBSTANTIATED , meaning the complaint allegation as valid and that a violation has occurred. Based on above findings deficiencies are being cited per California Code of Regulations Title 22 Divison 6 chapter 8, An exit interview was conducted and a copy of this report was provided. Interviews with 3 out of 3 staff stated they follow all care plans and they are able to meet residents needs. Based on interviews with 2 out of 6 current residents stated their needs are being met. LPA Mendivil was unable to interview 4 residents are they were not oriented to time and space. LPA reviewed hospice records provided for R1's needed assistance with wound care, medication administration, bathing, and restroom assistance. Licensee stated they met all of R1's needs. Therefore based on the preponderance of evidence through interviews and records reviewed the allegation that facility staff not following resident's hospice plan is determined to be UNSUBSTANTIATED, meaning although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred. No deficiencies noted. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 17, 2026 · control 22-AS-20250218161612

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(4) · Plan of correction due date: Feb 18, 2026

(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidence by staff discontinued R1's medication without physician's orders. This poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Feb 17, 2026

Plan of correction: Licensee to conduct inservice regarding reviewing physicians orders and provide proof to LPA by POC due date.

Type of visit: Case Management - Deficiencies

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced case management visit inconjunction with complaint control # 22-AS-20250218161612. During the course of the visit LPA Mendivil requested to review Resident 1's (R1s) file. Licensee Connie Lumauig stated she could not find the file. Connie stated that R1 left the facility in 2025 and understands the regulation to retain records. The following is being cited per California Code of Regulations Title 22 Divison 6 chapter 8, An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 17, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(e) · Plan of correction due date: Mar 2, 2026

(e) Original records or photographic reproductions shall be retained for a minimum of three (3) years following termination of service to the resident. This requirement was not met as evidence by Licensee could not produce R1's documents. R1 left facility in 2025. This poses a potential health and safety risks to persons in care.the state’s words, verbatim · CDSS document, Feb 17, 2026

Plan of correction: Licensee will audit all records and provide a list of all residents past and current for the last 3 years and provide proof of all records are retained by POC due date.

Type of visit: Required - 1 Year

On December 30, 2025, Licensing Program Analyst (LPA) Eboni Bentley conducted an unannounced required 1-Year annual visit. LPA was greeted and granted entry after stating the purpose of the visit to Licensee/Administrator (LI) Consolacion Lumauig. The facility is licensed to operate for six (6) non-ambulatory residents and has a hospice waiver for four (4) residents. The facility is a single-story building located in a residential neighborhood. It consists of the following: six (6) resident bedrooms, two (2) resident bathrooms, one (1) staff bedroom, one (1) staff bathroom, two living room areas, dining area, kitchen, an outdoor covered seating area, and detached two car garage. LPA conducted a tour inside and outside of the physical plant with LI and requested copies of facility documents including: Resident Roster, Staff Roster, Staff Schedule, Resident Emergency Contact Forms, Physician’s Reports, Hospice/Home Health records, and Service Plans for residents. During the visit, LPA Bentley observed a comfortable temperature of 75 degrees F was maintained in the facility. The smoke detectors and carbon monoxide detectors were operable. The facility has one (1) fire extinguisher that was charged, mounted, and purchased on December 30, 2025. First aid kit is maintained and contains all the necessary elements. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. CONTINUE TO LIC809-C.... Based on observations, interviews and record reviews LPA observed Physician’s Report for R1, indicating resident is Bedridden and the facility does not have an approved fire clearance for Bedridden residents. A deficiency is being cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. CIVIL PENALTY ASSESSED. Due to to time constraints, LPA will address the following during the continuation annual visit: · Fire clearance for Bedridden · Medication and MAR · Food Storage · Staff Records · Resident Records LPA informed LI that subsequent visit will be conducted and additional deficiencies may be cited. LI stated they understood. An exit interview was conducted with Licensee/Administrator (LI) Consolacion Lumauig and a copy of this report, LIC809-D, and LIC421 were provided at the end of the visit.the state’s words, verbatim · CDSS document, Dec 30, 2025

Allegation investigated: Staff told Home Health nurse they do not need their help resulting in Home Care no longer assisting the resident

Licensing Program Analysts (LPAs) Hanna Gough and Andrea Mendivil made an unannounced visit for the purpose of investigating the mentioned above complaint allegation. LPAs met with Administrator (AD) Connie Lumauig and discussed the purpose of the investigation. The investigation into the allegation that staff told home health nurse they do not need their help resulting in home care no longer assisting the resident revealed the following: During investigation, LPA inspected the facility, interviewed staff, residents, witnesses and obtained documents from facility files. Record review revealed that Resident #1 (R1) had a home health plan of care from April 15, 2025 until June 13, 2025. LPA reviewed discharge paperwork for R1 dated May 27, 2025. At the time of discharge R1 had no pressure ulcers present but the care is being cancelled due to the AD refusing care for R1. During interviews it was revealed by witness #1 (W1) who is the medical power of attorney on the home health discharge paperwork, that they asked home health to stop coming to the facility due to the lack of cooperation from the nurses. Cont on LIC 9099-C Unsubstantiated W1 informed the AD that they had cancelled the services multiple times, but the home health agency kept coming. W1 instructed AD to inform the home health agency that they had cancelled the services for R1 due to the home health agency not contacting W1. W1 informed LPA that the AD did not cancel the services for the resident. LPA interviewed Home Health staff and they informed LPA that they were already going to discharged the resident in care due to the wound healing and lack of cooperation from the AD due to R1 having behaviors during the visits. Home health notes revealed that R1 had behaviors during 1 out of 7 visits. Home health staff notes dated April 18, 2025 stated that R1 was having behaviors and the home health nurse was unable to perform wound care and that the caregiver stated they will perform wound care once the resident is back to normal status. Home health notes dated April 21st and 24th, May 1st, 6th, 13th, and 20th, 2025 revealed that the resident had no behaviors and wound care was successfully given. LPA observed medical supplies for wound dressing in R1s bedroom closet. Based on information gathered during the investigation the Department is unable to ascertain if the above allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred: therefore, this allegation is deemed UNSUBSTANTIATED. An exit interview was conducted with AD Connie Lumauig and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jun 27, 2025 · control 22-AS-20250530082124

Type of visit: Case Management - Deficiencies

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit in conjuction with complaint control #22-AS-20250218161612. LPA Mendivil observed AD grab unsecured medications for Resident #1 from the refrigerator. AD stated they have a lock box in the refrigerator, and could not provide a reason. During the course of the investigation Administrator Connie stated Staff 1 (S1) had not completed their background clearance and worked at the facility on 2/21/2025 Administrator stated S1 has not worked at the facility since 2/21/2025. Based on observations and interviews made during today's visit the following is being cited per Title 22. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 25, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Feb 26, 2025

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) This requirement was not met evidence by S1 not associated to the facility. This poses an immediate health and safety threat to persons in care.the state’s words, verbatim · CDSS document, Feb 25, 2025

Plan of correction: AD stated employee is not working and will not work until background check and association is completed.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87465(h)(2) · Plan of correction due date: Feb 26, 2025

(h) The following requirements shall apply to medications which are centrally stored: (2)Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not met as evidence by LPA observed AD remove unsecured medication from the refrigerator. This poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Feb 25, 2025

Plan of correction: Corrected during visit, AD placed medication in lockbox in the refridgerator.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Lydia Martinez made an unannounced visit to the facility to conduct a Required - 1 year inspection. LPA identified herself and was granted entry into the facility by Licensee/Administrator (AD) Consolacion "Connie" Lumauig. Facility appears clean, safe and sanitary. Administrator (AD) Lumauig certificate expires on 08/08/2025. Six residents and 2 staff were present during today's visit. Four of the six residents are receiving Hospice care. LPA, along with AD Lumauig toured the physical plant. LPA observed the facility to be clean and in good repair. The home is maintained at a comfortable temperature. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Bathrooms were checked, toilets, faucets worked properly and showers are free of mold/mildew. Hot water temperature is within regulatory requirements. Bath towels, toiletries and personal hygiene supplies are adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. Kitchen is clean and organized. LPA noted repair is being done under the kitchen sink due to a water leak. Per AD repair should be completed in a couple days. Perishable and non-perishable food supply was checked and adequately stocked. LPA observed sharps and cleaning supplies are inaccessible to the residents. Facility is equipped with working smoke detectors and carbon monoxide detectors. Fire extinguisher was fully charged and mounted. No bodies of water were observed outside. Walkways around the home were clear of hazards. Backyard has a covered patio with furniture for Residents and visitors. Emergency/Fire Drills are conducted but not documented. LPA observed emergency supplies including food and water. LPA reviewed 6 resident files and 1 staff file. Medication was observed to be in a centrally stored location and medication reviewed appeared to have been dispensed accurately. Based on the observations made during today’s visit, no deficiency is being cited. This report was discussed with AD Lumauig and a copy of LIC809 and LIC9102 Advisory were sent to the email on file.the state’s words, verbatim · CDSS document, Nov 14, 2024