Crown Manor at Paseo Grande

Type of visit: Required - 1 Year

On March 2, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Administrator Kevin Bim was notified via telephone and later arrived to assist with the inspection. LPA observed that Kevin Bim has a valid Administrator certificate which expires on June 8, 2027. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents, of which one may be bedridden, and has a hospice waiver for three. The facility is a single story home with four resident bedrooms, two of which are shared, one staff bedroom, two bathrooms, one of which is for dedicated resident use, a living room, a dining room, a kitchen, a game room, a laundry room, and an unattached two car garage. LPA, accompanied by the AD, conducted a tour of the interior portions of the facility. On today's visit, LPA observed six residents in care and two care giving staff present. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall in the resident hallway. LPA inspected the four resident bedrooms and observed them to be free of any hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in a hallway cabinet. LPA inspected the one shared resident bathroom and observed it to be clean. The resident bathroom was equipped with grab bars and a non-skid floor mat. The faucet and toilet was operational. The hot water temperature measured 117.3 degrees Fahrenheit. LPA observed the staff bedroom to be kept locked and inaccessible to residents in care. LPA observed the facility has a two day perishable and a seven day non-perishable food supply on hand. LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. CONTINUED ON LIC809-C LPA observed chemicals and toxins to be stored in a locked kitchen cabinet under the sink. LPA observed a fire extinguisher to be mounted on the wall in the kitchen. LPA observed the fire extinguisher to be charged and purchased on January 14, 2026. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their most recent emergency disaster drill on January 12, 2026. LPA observed the centrally stored medication to be kept in a locked cabinet located in the resident hallway. LPA observed a first aid kit is stored in the same locked cabinet, and it has all the required components. LPA observed all other common areas such as the living room, dining room, game room, and laundry room, to be clear of any hazards. LPA, accompanied by the AD conducted a tour of the exterior portion of the facility. LPA observed the exterior portion of the facility to be free of obstructions and hazards. LPA observed the unattached two car garage is kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage. LPA observed the facility has a three day emergency food and water supply stored in the garage. LPA observed a shaded outdoor seating area with furniture for resident use. The perimeter gates of the facility are self-latching and can be open in an evacuation. There are no bodies of water on the premises. LPA reviewed all six resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed all six residents' medication and medication administration records. LPA reviewed four staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, no deficiencies are being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator Kevin Bim and a copy of the report was provided.the state’s words, verbatim · CDSS document, Mar 2, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit for the purpose of conducting the required annual inspection. LPA was greeted and granted entry by care giving staff after explaining the purpose for the visit. Administrator (AD) Kevin Bim was notified via telephone and later arrived to assist with the inspection. LPA observed that Administrator Kevin Bim has a valid Administrator certificate which expires on June 8, 2025. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents, of which one may be bedridden, and has a hospice waiver for three. The facility is a single story home with four resident bedrooms, of which two are shared, one staff room, one shared resident bathroom, a living room, a dining room, a kitchen, a game room, and an unattached two car garage. LPA, accompanied by the AD conducted a tour of the interior portion of the facility. On today's visit, LPA observed six residents in care and two care giving staff present. LPA observed the resident relaxing in their respective bedrooms and in the common areas. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall in the resident hallway. LPA inspected all four resident bedrooms and they were observed to be free of any hazards. LPA observed the resident bedrooms had all the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds had clean linens and blankets. LPA observed additional linens are stored in a hallway cabinet. LPA inspected the one shared resident bathroom. The resident bathroom is clean. Resident bathroom was equipped with grab bars and a nonskid floor mat. The faucet and toilet was operational. Hot water temperature measured 107.4 degrees Fahrenheit. LPA observed the staff room to be free of hazards. LPA observed that the kitchen has a two day perishable and a seven day nonperishable food supply on hand. The kitchen is clean and appliances were operational. LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. LPA observed toxins and chemicals to be stored in a locked kitchen cabinet under the sink. CONTINUED ON LIC809-C A fire extinguisher is located in the kitchen and it was observed to be charged and up to date on service. LPA tested the smoke detectors and carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on September 17, 2024. The centrally stored medication is kept in a locked cabinet in the resident hallway. LPA observed a First Aid Kit to be stored in the locked cabinet and it was observed to have all the required components. LPA observed a fireplace in the living room and it was observed to be adequately fenced and not in operation at time of visit. LPA, accompanied by the AD conducted a tour of the exterior portion of the facility. LPA observed the exterior portion of the facility to be free of obstructions and hazards. LPA observed the unattached two car garage is kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage. LPA observed the facility has a three day emergency food and water supply stored in the garage. LPA observed a shaded outdoor seating area with furniture for resident use. The perimeter gate on the north side and south side of the facility are self-latching and can be open in an evacuation. There are no bodies of water on the premises. LPA reviewed all six resident files. LPA observed that the Reappraisals for Resident #1 (R1), Resident #5 (R5), and Resident #6 (R6) were outdated. LPA observed that the facility did not have a Reappraisal on file for Resident #3 (R3). LPA reviewed all six residents' medication and medication records. LPA observed that Resident #3 (R3), Resident #5 (R5), and Resident #6 (R6) were being provided medication without the proper Physician's order. LPA reviewed four staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, deficiencies are being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator Kevin Bim. A copy of the report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Feb 20, 2025

Type of visit: Required - 1 Year

On this day Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to complete anrequired annual visit. LPA was greeted and granted entry into the facility by Caregiver Danica Mallari and explained the reason for the visit. Administrator Kevin Bim arrived shortly after. At 8:50AM LPA Mendivil toured the facility with Caregiver Danica. At 8:55am LPA Mendivil observed unsecured pre-poured medications on kitchen counter. At 8:56 am LPA Mendivil observed unsecured PRN medications on kitchen counter. At 8:57 am LPA Mendivil observed unsecured toxins underneath kitchen sink. At 9:00am LPA Mendivil observed unsecured medications in refrigerator drawer. At 9:01 am LPA Mendivil observed unsecured sharps in kitchen drawer near kitchen stove. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. There is a minimum of one week of non-perishables foods and two days of perishables foods available. The facility is maintained at a comfortable temperature. LPA inspected the bathroom and LPA measured the hot water temperature which measured 108 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. The facility has an available clean supply of linens. LPA inspected residents’ bedrooms which has sufficient lighting to ensure the safety and comfort. All bedrooms observed to have all required components. Storage space is provided for residents in their bedroom. Smoke detectors were tested and found to be operational. LPA toured the outside of the facility and observed outdoor passageways are free of obstructions. Facility provides activities in the form of games and exercise. LPA Mendivil reviewed 5 out of 6 residents files all except 1 contained all required documents. LPA observed 1 out of 6 residents did not have an updated LIC 602 Physician's Report. LPA Mendivil observed 4 out of 6 residents had half bed rails without physicians' order, the remaining 2 residents are on hospice. LPA Mendivil observed facility's emergency drill has not been completed since 9/12/2023. LPA Mendivil observed fireplace that was not adequately secured. LPA did not observe emergency food and water. LPA observed in 2 out of 4 residents bedrooms contained auditory monitors which provide audio from residents rooms to kitchen, without resident consent documented. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided as well as appeal rights.the state’s words, verbatim · CDSS document, Mar 25, 2024