Elwyn California Ginger Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator (ADM) Marvin Matamis. During the visit, LPA observed 4 residents and 2 staff. LPA explained the purpose of the visit. LPA toured the facility inside out with ADM which included the Living room, kitchen, dining room, 3 restrooms and 4 residents bedrooms. The staff area of the facility was also inspected. The front yard and backyard were inspected. There was no obstruction to block the walkways. Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 74 degrees F, and hot water temperature was measured to range from 114-116 degrees F in resident bathrooms. Fire extinguisher was serviced in September 17, 2025. The facility was equipped with centralized sprinkler system, which was last checked on May 6, 2025. Smoke detectors was tested by ADM, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on October 19, 2025 LPA reviewed facility records for 3 staff and 3 residents. LPA reviewed 3 resident medications and centrally stored medication records. LPA reviewed 3 resident P&I records. Residents were participating in arts & crafts activity, then an trivia game during LPA's visit. Page 1 Out of 2. ADM stated he is the new administrator for Elwyn California Ginger home since July 2025. LPA requested a copy of the following documents to process the change in administrator: 1.Board of resolutions letter, stating the Date the new administrator will begin working as Administrator and signed by the licensee, who is part of the corporation. 2. Administrators Certificate 3.LIC 501 4.Resume 5.LIC 500 6.LIC308 7. Valid Photo ID 8. LIC9182/ Or have the new Administrator designated, as administrator on Guardian. No deficiencies cited during today's visit. This report was reviewed with Administrator Marvin Matamis and a copy of the signed report was provided. Page 2 Out of 2. END OF REPORT.the state’s words, verbatim · CDSS document, Nov 6, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct the facility's required 1 year annual inspection. LPA met with Administrator, Judy Reyes. During visit, LPA toured the facility with the Administrator to include the kitchen, dining room, resident bedrooms, bathrooms, laundry room, garage, and exterior. All fire exit routes are free and clear of obstruction. There are 3 staff to 3 residents present. All staff are fingerprint cleared. Facility temperature maintained at 68 degrees F. Kitchen is supplied with at least 2 days worth of perishables and 7 days worth of non-perishable foods. Refrigerator temperature maintained at 36 degrees F and freezer temperature at 0 degrees F. Resident bedrooms equipped with individual beds, linens, night stand, closet space, and adequate lighting. Each resident bedroom has overhead lifts. Resident (R1)'s bed is equipped with half bed rails. Facility was unable to produce the physician's report for the use of half-bed rails for resident (R1). Administrator states R1 uses the half bed rails for mobility. Bathroom is equipped with hygiene and paper supplies. LPA Dolores did not have a water thermometer during visit. The Administrator measured the hot water temperature in the bathroom using the facility's water thermometer, LPA observed the hot water is maintained at 108 degrees F. Facility has an infection control plan. LPA observed PPE supplies to include face shields, gloves, and gowns. Facility has an emergency disaster plan. Emergency drills are being conducted quarterly. Facility's fire inspection was completed on 04/10/2024. See LIC809-C. Fire extinguisher last serviced on 08/12/2024. LPA observed an operable carbon monoxide detector located in the hallway. Emergency bins filled with medical supplies and non-perishable foods observed in the garage. Each resident has a grab and go backpack. LPA observed lanterns (emergency lighting) throughout the facility. LPA reviewed 2 resident's files are maintained and complete. 2 residents centrally stored medications and centrally stored medication records observed maintained. 2 resident's P&I money was reviewed with the Administrator and all money was accounted for. LPA reviewed 2 staff files are complete to include a fingerprint clearance, 1st aid certification, health screening, TB result, and job application. The Administrator was unable to produce at least 20 hours of annual training documentation for the 2 staff. The Administrator states plan to ensure all staff completes the required 20 hours of annual training. Documents were obtained to include the updated liability insurance and LIC500. Deficiencies were cited per California Code of Regulations, Title 22. See LIC809-D. This report was reviewed with Administrator, Judy Reyes and a copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Nov 25, 2024