Primacare Home at Roxbury

Type of visit: Required - 1 Year

On this Day,Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to conduct a required annual inspection. LPA was greeted and granted entry into the facility and explained the reason for the visit. The facility is a one story building with an approved fire clearance for six non-ambulatory residents of which 1 may be bedridden and a hospice waiver is approved for four residents. The facility has a current census of five residents in care. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors and testing the hot water temperatures in bathrooms. The hot water temperatures measured between 113 to 115.1 degrees Fahrenheit. LPA observed all smoke detectors were operational. The facility’s last emergency drill was conducted on April 15th 2026. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed secured medication storage in kitchen cabinet. LPA observed emergency food and water in the facility garage. LPA reviewed two out of two staff training and fingerprint records. LPA conducted a complete review of resident records. LPA confirmed that administrator has a current administrator certificate which expires on May 23rd 2026, LPA confirmed renewal of administrator certificate has been completed and is currently pending. Based on the observations made during today’s visit no deficiencies cited on this date. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, May 1, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to the facility today to conduct an Annual Required inspection. LPA was greeted and granted entry by staff and explained the reason for the visit. The facility is a one story building with an approved fire clearance for six non-ambulatory residents of which 1 may be bedridden and a hospice waiver is approved for four residents. The facility has a current census of five residents in care. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in two bathrooms. The hot water temperature measured between 107.8 and 118 degrees Fahrenheit and all smoke detectors were operational. The facility’s last emergency drill was conducted on April 10th, 2025. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed expired seasonings one of which expired in 10/2022. LPA observed secured medication storage. LPA Mendivil observed cameras in common areas, per review of cameras on Administrator's phone the cameras are live streaming video and audio to the Administrator 24/7. LPA reviewed two of two staff training and fingerprint records. LPA conducted a complete review of resident records. LPA observed hospice residents to not have a completed hospice care plan on record. LPA confirmed that administrator has a current administrator certificate which expires on May 23rd 2026. Based on observations made the following is being cited per California Code of Regulations Title 22. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, May 13, 2025

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by caregivers, Arianne Vallestero and Queeny Sabobo and explained the reason for the visit. During today’s visit, LPA met with Beatriz Lapid, the administrator of the facility. Facility is licensed for 6 non-ambulatory residents, with a hospice waiver for four. Currently there are four residents, of which one is on hospice during today's visit. Around 10:52 AM LPA reviewed 2 staff files and training records. LPA reviewed four of four resident records. Residents files and staff files contained all required documentation. Administrator certificate expired on May 23, 2024 however administrator has complied with all course work and is pending renewal at this time. LPA Tea along with the Administrator toured the facility at 11:29 AM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of 5 resident bedrooms, 2 full bathrooms, living room, dining room, and kitchen. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms and operational. 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 105.2 degrees F to 111.0 F degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. 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. 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. LPA also observed toxin substances to be locked and inaccessible to clients in care underneath the kitchen sink. Fire extinguisher in the kitchen was fully charged. Kitchen appliances are operational during today's visit. Annual Report continuation on LIC 809-C LPA toured the outside grounds and there is ample seating with shade and the two exit gates on both sides of the facilities are self latching and operational. LPA observed emergency food and water supply in the garage. Residents participate in numerous activities such as puzzles, exercises, walking around the facility and the neighborhood. The residents like to lounge in the nice backyard. There is also gardening activities and music therapy as well. At 11:49 AM LPA reviewed medication storage and administration. Medications are stored in a locked cabinet. Medications are being administered per physician order. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. The following deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Beatriz Lapid and a copy of these reports were given to the facility along with a copy of the LIC 858; 859;809-D, and Appeal Rights.the state’s words, verbatim · CDSS document, Jun 10, 2024