Oceanside Senior Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Rebecca Borunda conducted an unannounced Required 1-Year visit. The facility file was reviewed prior to the visit. LPA was greeted by, identified herself to, and explained the purpose of the visit with Caregiver Nancy Virgen. Licensee Lady Camille Parker arrived during the visit. The facility is licensed for a maximum capacity of 6 bedridden residents. The facility has a waiver for 6 hospice residents. During today’s visit, the facility had a census of 4 non-ambulatory residents, 1 of which was bedridden. The Administrator for the facility is Lady Camille Parker and their certificate was valid and current. During today’s visit, LPA toured the facility and inspected each room of the facility, including resident and staff rooms, common and private bathrooms, kitchen, garage, common areas, and outside space. No bodies of water were observed on the premises. LPA did not observe any aspects of delayed egress or secured perimeter. The facility was found to be clean, safe, and in good repair with no pathway obstructions. The facility’s water temperature was measured at 108.5 degrees Fahrenheit in a private bathroom and 114.1 degrees Fahrenheit in a common bathroom. The facility’s internal temperature was measured at 74 degrees Fahrenheit. LPA observed locked storage for all hazardous and/or toxic chemicals and were stored separately from food supplies. According to Lady Camille Parker, no firearms or weapons are stored on the premises. LPA also observed locked storage for resident medications and resident and staff files. Resident medications are stored in their original container and labelled. LPA observed a minimum of a 2-day supply of perishable food and a 7-day supply of non-perishable food present at the facility. The facility refrigerator was kept at 35 degrees Fahrenheit, and the facility freezer was kept at 0 degrees Fahrenheit. Continued on LIC809-C page… LPA observed linens and hygiene products provided to the residents that are in good repair and sufficient to meet their needs. Staff present at the facility during the time of the inspection had a criminal background clearance, were associated to the facility, and had a first aid certificate. LPA reviewed multiple resident and staff records. Each resident record was complete and contained a signed admission agreement, initial medical assessment, updated annual reappraisal, documents regarding safeguarding personal property and personal rights. Each staff file was complete and contained a personnel record, first aid certificate, fingerprint clearance and association, and a health screening. LPA provided consultation and training with staff and the Licensee regarding the dementia care regulation changes that became effective 1/1/2025. No deficiencies were cited on today’s date. An exit interview was conducted with Licensee Lady Camille Parker, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).the state’s words, verbatim · CDSS document, May 30, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Rebecca Ruiz conducted an announced Pre-Licensing visit. LPA was met by Applicant Lady Camille Parker and was granted entry into the facility. The purpose of today's visit is to inspect the facility to ensure that the facility is in compliance with California Code of Regulations, Title 22, Division 6. The fire inspection was completed on 1/18/2024 and the facility is approved for 6 bedridden residents. Facility is approved for 6 hospice residents. During today's visit, LPA toured the facility and inspected every room. The facility was found to be clean, safe, and in good repair with no pathway obstructions. Resident bathrooms were observed to be clean and the toilets and showers were found to be in working order. The facility's water temperature in a common bathroom was measured at 118.6 degrees Fahrenheit and the kitchen sink was measured at 118.6 degrees Fahrenheit. LPA observed locked storage areas where all hazardous and/or toxic chemicals were stored and secured. LPA observed locked storage for resident medications. Fire extinguishers were observed throughout the facility and found to be in compliance. A functioning carbon monoxide detector and smoke detectors were observed in the facility. No bodies of water were observed near or on the premises. LPA observed 7-day supply of non-perishable food and a 2-day supply of perishable food. Required postings were observed in a common area of the facility. LPA reviewed facility’s Infection Control Plan and Emergency Disaster Plan. LPA conducted Component III with the applicant. The topics discussed were continuing operation requirements, record keeping/reporting, and physical plant compliance. Pre-licensing is complete, and this facility has no deficiencies. It is recommended that this facility be licensed pending final review and approval. An exit interview was conducted with the applicant, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).the state’s words, verbatim · CDSS document, May 7, 2024

Type of visit: Prelicensing

Licensing Program Analysts (LPAs) Rebecca Ruiz and Ryan Fulton conducted an announced Pre-Licensing visit. LPAs were met by Applicant Lady Camille Parker and were granted entry into the facility. The purpose of today's visit is to inspect the facility to ensure that the facility is in compliance with California Code of Regulations, Title 22, Division 6. The fire inspection was completed on 1/18/2024 and the facility is approved for 6 bedridden residents. Facility is approved for 6 hospice residents. During today's visit, LPAs toured the facility and inspected every room. The facility was found to be clean, safe, and in good repair with no pathway obstructions. Resident bathrooms were observed to be clean and the toilets and showers were found to be in working order. There was no grab bar for the toilet in the private bathroom. The facility's water temperature in private bathroom was measured at 111.7 degrees Fahrenheit and common bathroom was measured at 107.0 degrees Fahrenheit. LPAs observed locked storage areas where all hazardous and/or toxic chemicals were stored and secured. LPAs observed locked storage for resident medications. A functioning carbon monoxide detector and smoke detectors were observed in the facility. No bodies of water were observed on the premises. LPAs did not observe enough linens for resident use or chairs in resident rooms. LPAs did not observe emergency lighting or a first aid kit and manual present at the facility. Additionally, hazardous items were accessible in the facility garage and backyard. LPAs observed 7-day supply of non-perishable food. Required postings were observed in a common area of the facility. LPAs reviewed facility’s Infection Control Plan and Emergency Disaster Plan. LPAs did not conduct Component III training during today's visit. Pre-licensing is incomplete and the facility is not ready to be licensed at this time. Applicant will install grab bars, purchase linens and furniture, emergency lighting, first aid kit and manual and will notify LPAs when facility is ready for another inspection. An exit interview was conducted with the applicant, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).the state’s words, verbatim · CDSS document, Apr 18, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: LADYCAMILLE M PARKER Interview Method: Telephone interview On March 13, 2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restricted/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Mar 13, 2024