Jla Healthcare Services

Type of visit: Case Management - Other

On June 16, 2026, Licensing Program Analyst (LPA) Murial Han conducted an unannounced Case Management-Other visit. LPA met co-administrator, Loi Bautamante and explained the purpose of today's visit. LPA delivered an immediate exclusion letter for staff #1 (S1). The co-administrator confirmed that this staff no longer works at the facility. The exclusion letter was provided to the co- administrator. This report is reviewed and discussed, and a copy is provided.the state’s words, verbatim · CDSS document, Jun 16, 2026

Type of visit: Required - 1 Year

On 6/11/2026, LPA Grace Donato made an unannounced annual visit to the facility. LPA met with Administrator Loi Bustamante. LPA explained the purpose of the visit. LPA toured the facility inside and outside including resident rooms, activity rooms, kitchen and backyard. Facility is a 1-story building. There is a storage shed at the back of the facility. While touring the facility it was observed that the room temperature was at 70 deg F. Hot water was also tested in the bathrooms and the temperature was 106 deg F. "No Smoking-Oxygen in Use" signs are posted in appropriate areas. All exits are free from obstructions. The facility is observed to be clean, odorless, and well maintained. Residents bedrooms were observed to be well organized and fully furnished with adequate lighting. Sharps and toxic materials were observed locked. Food supply in kitchen was observed with an adequate two day perishable and seven day non-perishable food supply. Carbon monoxide/smoke detectors, and fire extinguisher were present throughout the facility. Facility has an updated log for emergency drill is done every quarter. Five resident records and five staff records were reviewed. Centrally stored medication was locked and inaccessible by residents. All medication was labeled and sorted by resident name. All medication logs are complete and updated. No deficiencies cited today. Report is reviewed and copy is provided.the state’s words, verbatim · CDSS document, Jun 11, 2026

Type of visit: Case Management - Health Checks

On 5/5/2026, Licensing Program Analyst (LPA) Murial Han conducted an unannounced Case Management Health and Safety visit to follow up on an incident report that was report to CCL. Upon entry, LPA was greeted by Registered Nurse Araceli Aguilar and Administrator Assistant, Julie Gossage and LPA explained the purpose of today's visit. The administrator arrived towards the middle of the visit and assisted with the rest of the visit. During the visit, the administrator assistant provided a tour of the facility and LPA observed the exit door by room 103 was broken and not able to close, LPA observed 3 rooms (205, 303, and 305 ) were converted into staff rooms and staff #1 (S1) reported that the resident's shower room by the bathroom is being shared with the live-in staff members; LPA observed the laundry room consisted of chemicals was unlocked and unattended by staff; LPA observed bath tub in the shower room between room 301 and 302 was dirty, brown stains by the grab bar, hair inside the tub, white particles around the faucets and no non-skid mat; LPA observed resident #1 (R1) and resident #2 (R2) required oxygen and there was no “no smoking sign” posted, LPA observed resident #3 (R3) has a prohibited health condition in which the facility did not notify CCL and requested for an exception. LPA requested for an updated facility sketch reflecting the current room status as some of the resident rooms were converted into staff rooms and provide a copy of the updated sketch to CCL by 5/14/2026. Deficiencies are cited under the California Code of Regulations, Title 22. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with the administrator.the state’s words, verbatim · CDSS document, May 5, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: May 6, 2026

87309 Storage Space and Access a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions,..a danger to residents are in locked storage and are not left unattended if outside the locked storage. The requirement is not met as evidenced by LPA observed on 5/5/2026, during the facility tour, LPA observed the laundry room filled with chemicals was unlocked and accessible to residents in care which poses an immediately health and safety risks to residents in care.the state’s words, verbatim · CDSS document, May 5, 2026

Plan of correction: The administrator will develop a plan to ensure chemicals are locked and inaccessible to residents at all times. The plan of correction shall include staff education. The administrator will submit a copy of the plan of correction and staff in-service to CCL by 5/6/2026.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87616(a) · Plan of correction due date: May 6, 2026

87616 Exceptions for Health Conditions (a) As specified in Section 87209, Program Flexibility, the licensee may submit a written exception request if he/she agrees that the resident has a prohibited and/or restrictive health condition but believes that the intent of the law can be met through alternative means. This requirement is not met as evidenced by during the tour of the facility, LPA observed R3 has a sign of contact isolation posted on the door but the facility did not notify CCL which poses an immediately health and safety risks to residents in care.the state’s words, verbatim · CDSS document, May 5, 2026

Plan of correction: The administrator will review the regulation and develop a plan of correction on how the facility is going to prevent this from happening again. The administrator will provide a copy of the plan of correction by 5/6/2026. The administrator will obtain documentation from resident's provider to clarify if resident shall remain on isolation and will communicate with CCL by 5/8/2026.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(a) · Plan of correction due date: May 6, 2026

87303 Maintenance and Operation..(a)The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as during the facility tour, LPA observed the exit door by room 103 was broken and not able to close. LPA observed the shower tub between rooms 301 and 302 was dirty which poses an immediately health and safety risks to residents in care.the state’s words, verbatim · CDSS document, May 5, 2026

Plan of correction: The administrator will call the contractor today to fix the exit door and the administrator will clean the shower room by room 301 and 302. The administrator will take photos of the shower room between 301 and 302 and submitted to CCL by 5/6/2026 and will provide photos for the exit door by 5/12/2026.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87618(b)(3)(B) · Plan of correction due date: May 6, 2026

87618 Oxygen Administration - Gas and Liquid (b)In addition to Section 87611(b), the licensee shall be responsible for the following:(3) Ensuring that the use of oxygen equipment meets the following requirements: (B) "No Smoking-Oxygen in Use" signs shall be posted in the appropriate areas. This requirement is not met as evidenced by during the tour of the facility, LPA observed R1 and R3 required oxygen and LPA did not observed "no smoking signs" posted by the room and around the area which poses an immediate health and safety risks to residents in care.the state’s words, verbatim · CDSS document, May 5, 2026

Plan of correction: During the visit, LPA observed the "no smoking signs" were posted resident's rooms. The administrator will develop a plan of correction to ensure signs are posted accordingly and will provide a copy of the plan to CCL by 5/6/2026.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87618(b)(3)(A) · Plan of correction due date: May 14, 2026

87618 Oxygen Administration - Gas and Liquid (b)In addition to Section 87611(b), the licensee shall be responsible for the following: (3) Ensuring that the use of oxygen equipment meets the following requirements: (A) A report shall be made in writing to the local fire jurisdiction that oxygen is in use at the facility. This requirement is not met as LPA observed R1 and R3 requires oxygen and the administrator stated that the local fire jurisdiction was not notified of the oxygen usage.the state’s words, verbatim · CDSS document, May 5, 2026

Plan of correction: The administrator will develop a plan of correction to ensure the local fire jurisdiction is notified accordingly when oxygen is in use at the facility and will provide a copy of the written notices for R1 and R2. The administrator will provide a copy of the notification and a copy of the plan of correction to CCL by 5/14/2026.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87307(a) · Plan of correction due date: May 14, 2026

87307 Personal Accommodations and Services(a) Living accommodations and grounds.. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility.. This requirement has not been as evidenced by during the tour of the facility, staff #1 (S1) reported that the resident's shower room by the bathroom is being shared with the live-in staff members which poses an immediate health and safety risks to residents in care.the state’s words, verbatim · CDSS document, May 5, 2026

Plan of correction: The administrator will develop a plan to ensure staff and resident are not sharing a common shower room and will provide a copy of the plan to CCL by 5/14/2026.

Type of visit: Case Management - Incident

On 5/5/2026, Licensing Program Analyst (LPA) Murial Han conducted an unannounced Case Management Health and Safety visit to follow up on an incident report that was reported to CCL. Upon entry, LPA was greeted by Registered Nurse Araceli Aguilar and Administrator Assistant, Julie Gossage and LPA explained the purpose of today's visit. The administrator arrived towards the middle of the visit and assisted with the rest of the visit. On May 1, 2026, the administrator reported an incident that happened on April 29, 2026, in which resident #1 (R1) was showered by two male staff (S2 and S3) and after the shower, R1 verbalized to staff #1 (S1) that R1 was hurting and did not want to talk about it. Subsequently, S1 was told by S4 that S2 and S3 provided a shower to R1. S1 reported it to the administrator as R1 verbalized that he/she was in pain after being showered. The administrator started the investigation and interviewed staff members, reported it to the local law enforcement, R1's responsible party and the physician. The facility licensed professional completed an assessment of R1 on the day of the incident and no injuries were noted. However, a reassessment was completed a couple of days later and injury was noted on R1's back. During today's visit, LPA attempted to interview R1, LPA interviewed resident #2 (R2) and collected documents. No deficiency is cited today. This report is reviewed and discussed with the administrator.the state’s words, verbatim · CDSS document, May 5, 2026

Type of visit: Required - 1 Year

On June 19, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual visit. LPA met with Administrator, Eloisa Bustamante and explained the purpose of the visit. LPA toured the facility inside and outside including all of resident rooms, common areas & kitchen. The indoor and outdoor passageway was free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a single story facility. LPA observed a random sample of resident rooms and observed required furniture. LPA observed 2- days perishables and 7- days of non-perishables. Toilet, hand washing and bathing areas were observed clean and odor-free. Shower room was observed equipped with non-skid mats and grab bars. Comfortable temperature is maintained and lighting is sufficient for comfort. Extra linen was observed present. Medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. Water temperature throughout the facility measured between 105-119 degrees F. Hot water temperature in the kitchen and bathroom were measured at 108-117 degrees Fahrenheit. Fire extinguishers were checked and last inspected on 4/22/2024. Dining room was observed free from tripping hazards. Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of April 2025. LPA reviewed 5 resident records and 4 staff records. Resident records are updated, complete and signed. Staff records have training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. 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. Report is reviewed with Administrator and a copy is provided.the state’s words, verbatim · CDSS document, Jun 19, 2025

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Allegation investigated: Facility is in financial distress.

On December 9, 2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced visit to deliver the investigation findings. Upon entry, LPA met with med tech, Hurry Valdez and LPA explained the purpose of the visit. The Administrator, Loi Bustamante arrived shortly thereafter and LPA explained the purpose of the visit. Regarding to the allegation of facility is in financial distress, there is no additional information forthcoming from the reporting party, however, during the initial reporting, the reporting party stated that they received validated information that the facility and its licensees recently filed Bankruptcy and based on foregoing, they could say that the facility and its licensees are now in a big financial crisis and distress. As part of the investigation, LPA interviewed the administrator/licensee, facility staff, residents and responsible party. The administrator/licensee acknowledged that the facility filed for bankruptcy but denied the allegation and stated that the facility is not in financial distress and the bankruptcy was filed to resolve a pending litigation that was filed many years ago and it did not have anything to do with the facility's operation/ expenses. Unfounded LPA interviewed four staff members and all them stated that they were informed of the bankruptcy by the administrator and they did not experience any changes with caring for the residents and their pay reminded accurate and on time. LPA interviewed two residents and both of them reported that they were being well cared for and they did not notice any changes with the services that they were receiving. LPA interviewed a responsible party who visited the facility on a regular basis and he/she did not notice any changes with the level of care that his/her loved one was receiving due to the bankruptcy. Based on observation and interviews, this allegation is deemed to be unfounded. The agency has investigated the allegation and we have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. This report is reviewed and discussed with the administrator. A copy is provided.the state’s words, verbatim · CDSS document, Dec 9, 2024 · control 14-AS-20241031162122

Type of visit: Case Management - Incident

On 11/6/2024, Licensing Program Analyst (LPA), Murial Han conducted an unannounced case management visit to follow-up on an incident that was reported by the facility. LPA met with the administrator and explained the purpose of today's visit. On 10/8/2024, the facility reported that resident #1 (R1) reporting that resident #2(R2) hit him/her in the room and there was no witness. The facility completed a change of condition for R1 and reported the alleged incident to R1's responsible party, the Ombudsman and the physician. In addition, the facility completed an assessment for R1 and no injuries were noted. The facility also started hourly rounds on R1 and R2 to ensure their safety. During today's visit, LPA observed R1 and R2 were pleasant and calm and the administrator reported that there were no more reporting of the alleged incident. According to the administrator, both residents were new to the facility when this alleged incident was report and they are adjusting well now. No deficiency is cited today. This report is reviewed and discussed with the administrator.the state’s words, verbatim · CDSS document, Nov 6, 2024

Type of visit: Required - 1 Year

On June 17, 2024 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA was met with the administrator, Loi Bustamante and LPA explained the purpose of the visit. LPA toured the facility inside out and inspected the living room, dining area, kitchen, bedrooms, bathrooms, and backyard. The indoor and outdoor passageways were free of obstruction. A tour of resident's room was conducted and observed to have sufficient furniture and furnishings. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Toilet, hand washing and bathing areas were observed clean and in operating condition. Showers were observed equipped with non-skid mats and grab bars. Comfortable temperature is maintained and lighting is sufficient for comfort. Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time. Residents observed to have a call pendant for assistance, Central storage for medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. Hot water temperature in the kitchen and bathroom were measured at 108-117 degrees Fahrenheit. Fire extinguishers were checked and last inspected on 4/22/2024. A review of (5) resident files was conducted and noted on the LIC 858. A review of (5) staff files was conducted and noted on the LIC 859. The following documents were requested submitted to CCL by 6/24/24: - Control of Property, LIC 500, Liability Insurance, Administrator Certification 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 administrator. A copy of this report and the appeal rights were provided.the state’s words, verbatim · CDSS document, Jun 17, 2024

Allegation investigated: Staff neglected to supervise resident who swallowed their dentures leading to resident's death

On January 18, 2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced visit to deliver the complaint investigation findings. LPA met with administrator and explained the purpose of today's visit. Regarding to the allegation of- staff neglected to supervise resident who swallowed their dentures leading to resident's death, there is no additional information forthcoming from the reporting party. However, during the initial reporting, the reporting party reporting that resident #1 (R1) was transferred to the hospital because R1 accidentally swallowed the denture and such accident caused an infection resulted R1's death and the incident was a gross negligence of the facility. Unfounded The Department has completed the investigation and based on hospital records and R1's death certificate, R1's death was not questionable and the facility seek for proper medical assistance when R1 had a change in health condition. Based on the above information, the Department has found that this allegation to be UNFOUNDED, meaning that this allegation was false, could not have happened and/or is without a reasonable basis. Report is reviewed with administrator Loi Bustamante and a copy is provided.the state’s words, verbatim · CDSS document, Jan 18, 2024 · control 14-AS-20231120125621

Type of visit: Case Management - Other

On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced case management - other visit to amend LIC9099 and LIC9099A reports dated from 11/21/2023. LPA met with administrator Eloisa Bustamante and explained the purpose of today's visit. LPA discussed the amendments made and reviewed the amended documents with her. No new citations issued. Report is reviewed with Eloisa.the state’s words, verbatim · CDSS document, Nov 27, 2023

Allegation investigated: - Staff recorded or live broadcased residents onto a public social media platform

On this day, Licensing Program Analyst (LPA) Jaime Vado and John Calandra conducted an unannounced complaint investigation visit to open the investigation into the allegations received. During today's visit LPAs met with administrator Eloisa Bustamante and explained the purpose of today's visit. During today's visit LPAs made facility observations. LPAs were able to determine which room of the facility the video recording took place based on the surroundings observed in the video. The video did show resident faces as well which is a violation of resident personal rights. LPAs also interviewed the staff person (S1) who broadcasted the video and S1 did confirm that S1 posted the video to their personal social media account. According to S1 they only posted it with good intiontions and that they did not know they were not allowed to post such without consent. This allegation is substantiated. Based on LPA interviews and items letters received, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, are being cited on the attached LIC9099D. Report is reviewed with Eloisa. Substantiatedthe state’s words, verbatim · CDSS document, Nov 21, 2023 · control 14-AS-20231120125621

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Nov 22, 2023

Personal Rights of Residents in All Facilities - (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This regulation was not met as evidenced by: Per video evidence received it was observed that residents were being recorded/broadcasted and posted onto a public social media platform without consent. S1 was interviewed and S1 confirmed posting the video to S1's social media account. S1 did not observe residents’ personal rights and accorded their dignity as staff videotaped residents and posted the video in Facebook/social mediathe state’s words, verbatim · CDSS document, Nov 21, 2023

Plan of correction: Licensee shall ensure that a violation of this regualtion shall not occur in the future. According to the administrator today, she will conduct training and inform staff that it is not allowed and will go over scenarios about what is a personal rights violation as well as sign off acknowledging the understaning of person rights. POC to be received by due date stated 11/22/2023.

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.