Estela Home Care

Allegation investigated: Licensee admitted/retained a resident who is bedridden without bedridden fire clearance.

On 07/20/2026, Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to this facility to conduct a complaint visit. LPA met with the facility administrator Mulu Rufael and explained the purpose of the visit. The purpose of this visit is to deliver complaint findings for the allegation above. The current census is 4. Allegation: Licensee admitted/retained a resident who is bedridden without bedridden fire clearance. It was alleged that the licensee admitted and retained a resident who is bedridden without a bedridden fire clearance. This investigation consisted of interviews with facility staff, residents, and records review. On 07/20/2026, LPA Hughes conducted a visit to the facility and interviewed the facility administrator, who stated they became concerned that Resident (R1) was not repositioning in bed independently and contacted the Sacramento Metro Fire District for guidance. The administrator further stated they observed R1 occasionally reposition themselves in bed and, therefore believed R1 was bedbound. Continuation 9099-C Substantiated Although the administrator believed that R1 was bedbound rather than bedridden, the administrator acknowledged that R1 required ongoing assistance with repositioning and was unable to independently leave or reposition in bed. LPA interviewed R1, who stated they are unable to reposition themselves in bed without assistance due to pain and require staff assistance to transfer into their wheelchair. LPA reviewed the facility’s STD 850 Fire Inspection Report, which confirmed the facility does not have an approved bedridden fire clearance. LPA also reviewed R1’s LIC 602 Physician’s Report, which identified R1 as non-ambulatory. This was observed not in compliance with Title 22 regulation 87202(a)(2) as the facility did not ensure an approved fire clearance was obtained prior to admitting and retaining a bedridden resident. As a result, this allegation is SUBSTANTIATED. A finding that the complaint is substantiated means that the allegation are valid because the preponderance of the evidence standard has been met. Deficiencies cited on the LIC 9099-D, per Title 22 Regulations. An exit interview was conducted and a copy of the LIC 9099, LIC 9099-D pages and appeal rights were provided to facility.the state’s words, verbatim · CDSS document, Jul 20, 2026 · control 27-AS-20260715140549

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a)(2) · Plan of correction due date: Jul 21, 2026

87202 Fire Clearance (a) All facilities shall maintain a fire clearance approved... or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance…(2) Bedridden persons This requirement was not met as evidenced by: Based on interviews, and records review, the licensee did not ensure that the facility obtained an approved fire clearance prior to accepting and retaining resident (R1) who was determined to be bedridden.the state’s words, verbatim · CDSS document, Jul 20, 2026

Plan of correction: The licensee agrees to have resident (R1) re-evaluated by a licensed physician, to determine the resident's current ambulatory status and obtain an updated LIC 602 Physicians Report. The licensee wil also submit a request for a fire inspection to obtain the appropriate.. fire clearance based on the resident's ambulatory status and will provide the request to licensing for approval. The licensee will send the residents updated LIC 602 Physicians Report and request for a new fire clearance to LPM Arielle.Pascua@dss.ca.gov.

Type of visit: Case Management - Other

On 07/20/2026, Licensing Program Analyst (LPA) Shakaricka Hughes conducted an unannounced complaint visit to the facility. During the visit, LPA discussed the complaint findings with the licensee and provided technical assistance regarding the requirements for maintaining the appropriate fire clearance based on resident ambulatory status. LPA also informed the licensee of the Department’s Technical Support Program (TSP), explained the purpose of the program, and discussed how participation may assist the facility maintaining compliance with Title 22 regulations. LPA offered the Department’s Technical Support Program (TSP), and the licensee expressed interest in participating to receive additional guidance regarding regulatory compliance and resident care requirements. An exit interview was conducted with the licensee. A copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jul 20, 2026

Type of visit: Prelicensing

On 2/23/2026 at 1:00 PM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived announced to conduct a Pre-Licensing Inspection of the facility to ensure compliance with Title 22 regulations. LPA Hughes met with the licensee Mulu, who assisted LPA Hughes in today’s inspection. This Applicant is seeking licensure for a (5) Non-ambulatory and (1) Ambulatory Residential Care Facility for the Elderly (RCFE) to accept and retain at any given time. The facility will have (2) facility staff with no live-in care staff. There were no residents at this time. The facility administrator's certificate # 7027211740 expires on 01/09/2028. The facility has an infection control plan and an emergency disaster plan completed and provided to Licensing for approval. LPA Hughes toured the facility, and inspected the kitchen area cabinets and drawers were opened and reviewed, silverware, plates, and utensils were observed to be sufficient to meet the needs of the residents at this time. Knives, cleaning agents, and bleach were observed to be locked and made inaccessible to the residents. The food storage unit, facility refrigerator, was observed to be functional and in good repair. Food supplies were reviewed for adequate 2-day perishables and 7-day non-perishable quantities, and they both were observed sufficient a this time. The common area and dining area were observed to be furnished and sufficient to meet the needs of the residents at this time. LPA observed activities and board games made available in the facility. LPA Hughes observed a telephone made available to residents in the common area, LPA observed the required posters posted. The facility smoke detectors, carbon detectors and fire extinguisher were observed to be in good condition. The fire extinguisher was last serviced on 10/22/2025. The water temperature measured at 107.6 degrees Fahrenheit, and the facility temperature measured at 68 degrees Fahrenheit. Continuation 809-C Linen closet was observed and a sufficient supply of sheets, bedding, pillowcases, and blankets to were available to meet the needs of the residents. LPA observed a washer and dryer in the facility, in good repair at this time. LPA observed sufficient hygiene items on the premises. Residents’ bedrooms were toured, furniture and furnishings were observed to be sufficient and able to meet the needs of the residents. LPA observed the centrally stored medication areas to be locked. LPA observed a storage cabinet located inside of the staff room for personnel and resident records. LPA inspected the first aid kit and it was complete. LPA toured the garage and courtyard. LPA observed the outdoor area equipped for outdoor use, free of obstruction and enclosed by a fence with a self latching side gate. LPA observed a outdoor shed, clean and empty at this time. The emergency exits were observed unobstructed. A Component III was completed at this time with the Applicant. The applicant has passed the pre-licensing component of the application process. LPA Hughes will notify the Central Application Bureau (CAB) that the pre-licensing has been completed and passed. An exit interview was conducted, and a copy of this report was provided to the Applicant.the state’s words, verbatim · CDSS document, Feb 23, 2026