C & C Carehome

Type of visit: Case Management - Other

On April 1, 2026, Licensing Program Analyst (LPA) Murial Han conducted an unannounced case management visit for facility closure. Licensee notified CCLD of facility closure on 10/16/2025, as the licensee lost control of property. Upon arrival at the facility, LPA was not able to enter the facility as the licensee no longer has access to the facility. However, LPA walked around the outdoor area and did not observed resident care. Subsequently, LPA arrived at the new location fac # 415601179 and LPA met with caregivers, Delia Corteza and Cora Rodriguez and LPA explained the purpose of today's visit. Caregiver, Delia called and informed the administrator of LPA's visit and LPA explained the purpose of the visit. LPA spoke with the licensee over the phone who stated that the property has been sold. CCLD will be proceeding with the closure. A forfeiture letter will be sent to licensee and the facility number 415600425 shall be closed. This report is reviewed, and discussed with caregiver. A copy is provided.the state’s words, verbatim · CDSS document, Apr 1, 2026

Type of visit: Required - 1 Year

On August 5, 2025 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. Upon arrival, LPA was greeted by caregiver, Corazon Rodriguez and LPA explained the purpose of today's visit. The Administrator, Ethel Gumban arrival shortly thereafter and assisted with the inspection. LPAs toured the facility and grounds. No accessible bodies of water or fire safety hazards observed. This is a single story home with 4 resident rooms, 2 full baths, one a half bath, and 1 staff room. LPA observed 2 shared resident rooms. LPA observed the other 2 resident rooms to be private. LPA toured the living and dining room and observed it to be clean and clear from any tripping hazards. A comfortable temperate is maintained. Lighting was sufficient for comfort. Extra linen was observed to be present. LPA toured the kitchen and observed medication, and chemicals to be locked and inaccessible to residents in care. LPA observed sharps in the kitchen drawer to be unlocked and accessible to residents in care. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable. LPA toured the garage where the washer and dryer were observed to be in good working condition. Hot water temperature in the kitchen and bathroom were measured at 106- 112 degrees Fahrenheit. Fire extinguishers were checked and last inspected on 3/20/2025. Disaster drills were reviewed. A review of (5) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. During the tour of the facility at 9:47AM, LPA observed the kitchen floor edges, the bathroom floor and the living room floor appeared with black dust, and brown particles, the rice cooker has brown spots, the kitchen vent consists of black sticky particles and the top of the refrigerator has a layer of black and grey particle. In addition, LPA observed the tiles around the kitchen sink were broken and the wooden fence in the backyard moves with chipped paint and sharp edges. During the review of personnel file review, LPA observed, Staff #1 (S1) was hired in May 2025 and the facility was not able to provide training records to proof that the on-the-job training was completed accordingly and the facility was not able to provide training records to proof that S1 has received sufficient training. LPA observed the facility was not able to provide documents to proof that the annual training was completed for staff #2 (S2). During the review of resident files, LPA observed resident #6 (R6) was admitted on 8/4/2025 and the pre-admission appraisal was blank, and resident #2 (R2)'s Communicable Tuberculosis status was blank on the medical assessment In addition, R2 has bed rails without a written order by the physician and R1 has bed rails and pads on both sides of the bed that extend the entire bed. Based on S1’s Personnel Record (LIC501), S1 was hired on May 21, 2025, but the Dementia Training records included S1’s signatures for attending three in-services in February 2025. The administrator/licensee was not able to explain the signatures. The above findings poses/posed an immediate health, safety or personal rights risk to persons in care. During the review of the facility's records, the administrator/licensee was not able to provide a copy of the current Liability Insurance, the administrator/licensee was not able to provide proof that the emergency/disaster plan was reviewed annually and the administrator/licensee was not able to provide documents to proof that the reappraisals for resident #1( R1), resident #3 (R3) and resident #5 (R5) were completed. The above findings poses/posed a potential health, safety or personal rights risk to persons in care. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with the administrator/licensee. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Aug 5, 2025

Type of visit: Required - 1 Year

On August 13, 2024 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. Upon arrival, LPA was greeted by caregiver, Cesar Medina and LPA explained the purpose of today's visit. The Administrator, Ethel Gumban arrival shortly thereafter and assisted with the inspection. LPAs toured the facility and grounds. No accessible bodies of water or fire safety hazards observed. This is a single story home with 4 resident rooms, 2 full baths, one a half bath, and 1 staff room. LPA observed 2 shared resident rooms. LPA observed the other 2 resident rooms to be private. LPA observed all bathrooms to be clean and odor free. LPA toured the living and dining room and observed it to be clean and clear from any tripping hazards. A comfortable temperate is maintained. Lighting was sufficient for comfort. Extra linen was observed to be present. LPA toured the kitchen and observed medication, sharps, and chemicals to be locked and stored appropriately and inaccessible to residents. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable. LPA toured the garage where the washer and dryer were observed to be in good working condition. Hot water temperature in the kitchen and bathroom were measured at 112-114 degrees Fahrenheit. Fire extinguishers were checked and last inspected on 4/9/2024. Disaster drills were reviewed. A review of (5) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. No deficiency is cited today. LPA reviewed report with Administrator and a copy is providedthe state’s words, verbatim · CDSS document, Aug 13, 2024