Selena Senior Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Facility Administrator Shaden Hussein and was granted entry to the facility. At the time of the visit there was three (3) staff present, and five (5) residents present. The facility is a five (5) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (5). LPA was accompanied by Facility Administrator, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for residents/staff files. Medications are kept inside kitchen cabinet inaccessible to residents. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed five (5) residents files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Administrator Shaden Hussein.the state’s words, verbatim · CDSS document, Nov 4, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to conduct a case management visit. Upon arrival, LPA met with Facility Administrator Shaden Hussein. On 2/13/2025, the Licensee received an approved fire clearance from San Bernardino County Fire Department for one (1) approved bedridden. Capacity of 6 will remain the same. LPA will update the facility's file and issue a new license stating the change for the approval of one (1) bedridden only and five (5) ambulatory only. An exit interview was conducted where this report LIC809 was discussed and provided to Facility Administrator Shaden Hussein at the end of the visit.the state’s words, verbatim · CDSS document, Mar 18, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Facility Administrator Shaden Hussein and was granted entry to the facility. At the time of the visit there was two (2) staff present, and four (4) residents present. The facility is a five (5) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (4). LPA was accompanied by Facility Administrator, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for residents/staff files. Medications are kept inside kitchen cabinet inaccessible to residents. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed four (4) residents files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Administrator Shaden Hussein.the state’s words, verbatim · CDSS document, Nov 8, 2024

Allegation investigated: Staff illegally evicted resident

Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegation listed above. LPA met with Facility Administrator Fadi Suleiman and explained the purpose of the visit. The investigation consisted of interviews and record review. First allegation, Staff illegally evicted resident. During the course of the investigation, interviews were conducted, a review of resident (R1) records was completed and copy of pertinent documents were obtained. Regarding the alleged violation of staff illegally evicted resident, LPA reviewed Title 22 of The California Code of Regulations section pertaining to eviction procedures. LPA discovered that facility did not provide resident (R1) or the responsible party with a 30-day notice discussing the reason for the eviction in addition, the facility did not seek licensing approval for the eviction. Substantiated Based on the evidence gathered during the investigation, the above allegation is Substantiated. Substantiated A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Title 22 regulations, Eviction Procedures 87224(a)(2) from division 6, chapter, article 6, is being cited on the attached LIC 9099 D. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided, along with a copy of the appeal rights to Facility Administrator.the state’s words, verbatim · CDSS document, Jun 19, 2024 · control 56-AS-20240227125805

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(a)(2) · Plan of correction due date: Jul 12, 2024

87224(a)(2) Eviction Procedures... (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5).... (2)Provide each resident or the resident’s responsible person with a written notice no later than 60 days before the intended eviction. The notice shall include all of the following: This requirement is not met as evidence by: Bases on review of records the licensee did not ensure to follow the proper eviction procedures for Resident #1 based on Title 22 regulations, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 19, 2024

Plan of correction: Administrator has agreed to review the entire Eviction Procedures regulation and complete a statement of understanding and provide a signed and dated copy of the understanding to LPA Guerrero by POC date 7/12/2024.