Patricia Home

Type of visit: Required - 1 Year

LPA Audrey Jeung toured facility and grounds of this RCFE for developmentally disabled elderly. No accessible bodies of water or fire safety hazards are observed. Carbon monoxide detector is tested as operational. There are 3 shared bedrooms for residents and 2 bathrooms--one designated for residents. As per San Mateo Fire Dept.(5/2010), exit doors in bedrooms are not required to be exits. In addition, there are 2 staff rooms for 3 live-in staff. There is a detached storage shed in backyard. Washer and dryer are located in one car attached garage. Food supplies are adequate. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Hot water temperature tested at 109 degrees in clients' bathroom. Soap and paper towels are present in bathrooms and kitchen sink. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan is posted. There are 2 residents present, and 3 staff; other clients are participating in day programming off site. Criminal record clearances or exemptions for facility staff or other individuals who have client contact are reviewed, as well as other staff and training records. Client records are reviewed, including Centrally Stored Medications Records. Aurelia Navarro is a certified RCFE administrator (x 9/27) that oversees facility operations. The following information/forms are requested to be updated and submitted to CCLD BY 7/10/26: - Proof of current liability insurance - Personnel Report (LIC500) Deficiency of the California Code of Regulations, Title 22, Division 6, is cited. Also see Technical Advisory Notes--1 page--for additional information.the state’s words, verbatim · CDSS document, Jun 26, 2026

Type of visit: Case Management - Deficiencies

To follow up on denied age exception dated 5/19/25 for under age male resident, LPA Jeung met for administrator and issued deficiency of California Code or Regulations, Title 22, which is cited on a following pagethe state’s words, verbatim · CDSS document, Jun 19, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87455(b)(8) · Plan of correction due date: Jul 3, 2025

ACCEPTANCE & RETENTION LIMIT The following persons may be accepted or retained.....Persons who are under 60 years... whose needs are compatible with other residents in care, if they require the same amount of care and supervision as do the other residents in the facility. This requirement is not met, as 22 year old client has needs which are not compatible with other elderly residents. Licensee failed to ensure that all clients require the same amount of care and supervision, which poses a potential health, safety or personal rights risk to clients in care.the state’s words, verbatim · CDSS document, Jun 19, 2025

Plan of correction: Plan of correction to be sent to CCLD BY DUE DATE, which shall include a 30-day notice of eviction.

Type of visit: Required - 1 Year

LPA Audrey Jeung toured facility and grounds of this RCFE for developmentally disabled elderly. No accessible bodies of water or fire safety hazards are observed. There are 3 shared bedrooms for residents and 2 bathrooms--one designated for residents. As per San Mateo Fire Dept.(5/2010), exit doors in bedrooms are not required to be exits. In addition, there are 2 staff rooms for 3 live-in staff. There is a detached storage shed in backyard. Washer and dryer are located in one car attached garage. Staff confirmed that facility is currently COVID free. PPE and food supplies are adequate. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Hot water temperature tested at 111 degrees in clients' bathroom. Soap and paper towels are present in bathrooms and kitchen sink. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan is posted. There are 3 residents present, and 3 staff; other clients are participating in day programming off site. Criminal record clearances or exemptions for facility staff or other individuals who have client contact are reviewed, as well as other staff and client records. Personal and incidental cash transaction records are maintained accurate, including safeguarded cash for 4 residents. Aurelia Navarro is a certified RCFE administrator (x 9/25) that oversees facility operations. - Administrative Organization (LIC309) is requested to be updated and submitted to CCLD by 5/27/25: The following information is provided to LPA today: - Proof of current liability insurance - Proof of current surety bonding. Deficiencies of the General Licensing Regulations, of the California Code of Regulations, Title 22, Division 6, are cited. Also see Technical Advisory Notes--1 page--for additional information.the state’s words, verbatim · CDSS document, May 13, 2025

Type of visit: Required - 1 Year

LPA Audrey Jeung toured facility and grounds of this RCFE for developmentally disabled elderly. No accessible bodies of water or fire safety hazards are observed. There are 3 shared bedrooms for residents and 2 bathrooms--one designated for residents. As per San Mateo Fire Dept.(5/2010), exit doors in bedrooms are not required to be exits. In addition, there are 2 staff rooms for 4 live-in staff. There is a detached storage shed in backyard. Washer and dryer are located in one car attached garage. Staff confirmed that facility is currently COVID free. PPE and food supplies are adequate. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Soap and paper towels are present in bathrooms and kitchen sink. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan is posted. There are 2 residents present, and 3 staff; other clients are participating in day programming off site. Criminal record clearances or exemptions for facility staff or other individuals who have client contact are reviewed, as well as other staff and client records. Aurelia Navarro is a certified RCFE administrator (x 9/25) that oversees facility operations. The following forms/information are requested to be updated and submitted to CCLD by 7/22/24: - Administrative Organization (LIC309) - Designation of Administrative Responsibility (LIC308) - Personnel REport (LIC500) - Emergency Disaster Plan (LIC610 revised 9 page version) - Facility Sketch (LIC999) - Control of property (recorded grant deed and current signed lease) Proof of current liability insurance is given to LPA today. Deficiency of the General Licensing Regulations, of the California Code of Regulations, Title 22, Division 6, is cited. Also see Technical Advisory Notes--5 pages--for additional information.the state’s words, verbatim · CDSS document, Jul 8, 2024

The state marks this report as 7 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.