My New Home - Lodi Gardens

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA Domingo was welcomed by, identified herself to, and discussed the purpose of the visit with Diep Malmberg, Administrator. The facility's license shows a maximum capacity of six (6) non-ambulatory residents. The facility is approved for four (4) hospice waivers. During today’s inspection there were six (6) residents in care, with five (5) present at the facility. Administrator Diep Malmberg also participated in the annual visit. LPA, accompanied by licensee’s staff, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Call box was available in each resident unit and were tested for functionality. Resident's room temperatures were within a comfortable range. The facility’s ambient internal temperature was 75 F. Hot water temperature at taps accessible to clients were all compliant: Kitchen sink was X F, Bathroom #1 sink was 115 F, and Bathroom #2 sink was 116 F. Refrigerator temperature was 38 F and freezer temperature was -0 F. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. [CONTINUED ON LIC 809C] [CONTINUED FROM LIC 809] No pools or bodies of water were observed on the premises. Per the licensee's staff, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPAs interviewed multiple staff and clients. LPA reviewed multiple staff and client records/files. The interviews did not raise any significant licensing concerns. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. The reviewed files contained required documents. Confidential records were stored in locked areas. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with the Administrator, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Jul 18, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to caregivers Kashian "Eric" Apilan and Alma Meza. The facility's license shows a maximum capacity of six (6) non-ambulatory residents. The facility is approved for four (4) hospice waivers. During today’s inspection there were six (6) residents in care, with five (5) present at the facility. Administrator Diep Malmberg arrived at the end of LPA's visit. LPA and Caregiver Apilan toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to clients were all compliant: Bathroom sink was 105F and kitchen sink read at 108.1F. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. LPA observed knives to be in an unlocked drawer and accessible to residents in care. Staff interviews revealed that the drawer is kept unlocked while staff are working in the area then locked afterwards. Staff interviewed revealed that residents are unable to ambulate without assistance, but as LPA could not access files during their visit to confirm, a citation was issued per Title 22 regulations regarding the unlocked knives. [Continued on LIC 809-C] [Continued from LIC 809] No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per caregiver Apilan, no firearms or ammunition are kept at the facility. Smoke and carbon monoxide detectors, as well as emergency lighting were present and all in working order. Fire extinguishers were noted to have been purchased over one (1) year ago and were not serviced within that time. A deficiency is being cited per Title 22 regulations and noted on the attached LIC 809D. In addition, a Civil Penalty is being assessed for a Zero Tolerance Violation regarding Fire Safety and are noted on the attached LIC 421IM in the amount of $500. First aid kit was incomplete, missing a first aid manual and thermometer, for which a Technical Violation was issued. Required licensing postings were observed in visible areas of the facility, however there was no posting of the required "Let us Know" poster, for which another Technical Violation was issued. LPA interviewed two (2) staff and one (1) client, and interviews did reveal concerns of staff being unable to access resident files. LPA was unable to review facility records as they were locked and inaccessible to facility staff present and the Administrator unable to arrive to present them. A deficiency was cited for failure of staff to have access to necessary records and inability to present records to licensing staff. While conducting the physical tour of the building, LPA noted that the copy of proof of liability insurance for the facility was expired and staff were unable to present LPA with a copy of valid and current coverage. A deficiency was cited per Title 22 regulations. Four deficiencies were cited during the inspection. An exit interview was conducted with Administrator Malmberg to whom a copy of this report, the LIC 421IM, two LIC 9102 forms (Technical Violations), and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Jul 23, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Continuation Required Annual Inspection. The LPA introduced himself and disclosed the purpose of the visit to Administrator Pontius Malmberg. The facility was licensed for a capacity of six (6) non-ambulatory residents and approved for a hospice waiver for four (4) residents. Administrator Diep Malmberg arrived during the visit and assisted the LPA. During today's visit the LPA reviewed additional records and conducted interviews. Technical advise was provided and deficiencies were cited in an LIC 809D page. A plan of correction was jointly formulated with Administrator Diep Malmberg. An exit interview was conducted with Administrator Diep Malmberg, to whom a copy of this report, LIC 811, LIC 809D, and the Licensee/Appeal Rights (LIC9058), were provided.the state’s words, verbatim · CDSS document, Jul 22, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced follow up Case Management Visit to observe the facility's physical plant. The LPA introduced himself and disclosed the purpose of the visit to Administrator Diep Malmberg.. The visit was in response to an email received by the Department from the facility administrator. This email notified the Department of remodeling of bathrooms and a modification in shower schedule. After a tour of the facility, review of records, and an interview of the administrator, it was determined the administrator did not secure building permits. This deficiency was cited in accordance with California Code of Regulations, Title 22, in an LIC 809D form. A plan of correction was jointly formulated with Diep Malmberg. An exit interview was conducted with Administrator Dep Malmberg, to whom a copy of this report, LIC 809D, and Licensee/ Appeal Rights (LIC 9058), were provided.the state’s words, verbatim · CDSS document, Jul 10, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87305(a) · Plan of correction due date: Jul 10, 2024

87305 Alterations to Existing Building or New Facilities(a) Prior to construction or alterations, all facilities shall obtain a building permit. This requirement was not met as evidenced by: Based on observation, review of records, and an interview of the administrator, the licensee did not obtain a building permit prior to construction and alterations made to the facility, which posed a potential personal rights, health, and safety risk to 5 of 5 residnets in care.the state’s words, verbatim · CDSS document, Jul 10, 2024

Plan of correction: Administrator agreed to reach out to the city for a building permit and submit a new facility sketch to the LPA, 8/10/24.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The LPA introduced himself and disclosed the purpose of the visit to Administrator Diep Malmberg. The facility was licensed for a capacity of six (6) non-ambulatory residents and approved for a hospice waiver for four (4) residents. The LPA, accompanied by the administrator, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstructions and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking and dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, and stored in a locked area.. No pools or bodies of water on the premises. Per staff, no firearms or ammunition are kept at the facility. A Carbon monoxide detectors, emergency lighting, and Fire extinguisher were present. The LPA reviewed resident records. No immediate health, nor safety concerns were observed, nor cited on today's date. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection. An exit interview was conducted with Administrator Diep Malmberg, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058) were provided via electronic mail. An electronic mail read receipt confirms the documents were received by Malmberg.the state’s words, verbatim · CDSS document, Jul 10, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Case Management Visit to observe the facility's physical plant. The LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Alma Meza. Administrator Diep Malmberg arrived during the visit and assisted the LPA. During the visit, the LPA toured the facility and inspected the facility's bathrooms. It was previously reported to the Department the facility was in the process of remodeling the facility bathrooms. No deficiencies were cited on today's date, but additional visits may be necessary. An exit interview was conducted with Administrator Malmberg, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058), were provided via email. An email read receipt confirms the documents were received by Malmberg.the state’s words, verbatim · CDSS document, Jun 18, 2024