At Home Camarillo

Allegation investigated: Facility administrator is not present at the facility an adequate number of hours Facility was understaffed during a medical emergency

At 10:45 A.M. Licensing Program Analyst (LPA) Valeria Conway conducted an unannounced 10-day initial complaint visit to investigate the allegation listed above. The LPA was greeted by caregiver Celso Espiritu. At approximately 11:20 A.M. LPA Conway contacted the Administrator by phone, Margarita Colon. Administrator was unavailable during today's visit, but authorized Celso Espiritu to sign today's report. Entrance interview conducted. During today’s visit from LPA and caregiver toured the physical plant to ensure there are no health and safety concerns, and the facility is in compliance with Title 22 regulation. Additionally, LPA conducted interviews with staff, residents, and visitors and reviewed and obtained pertinent documents relevant to the investigation. The following was then determined: Continued on LIC 9099-C Substantiated Continued from LIC 9099 Regarding allegation of “Uncleared staff worked at facility” it was reported that Individual #1 was conducting repairs inside and outside of the facility despite not being an employee and lacking clearance or association with the facility. Interviews conducted revealed that I1, who is a relative of the administrator, was present at the facility to perform random maintenance work. I1 was present only during normal waking hours for a limited duration and did not provide care or supervision to residents in care. Based on the information gathered during the investigation, the allegation of “Uncleared staff worked at facility” is deemed UNSUBSTANTIATED, as there is insufficient evidence to support that I1 was working in a staff capacity. No citations issued. Exit interview conducted. A copy of the report was provided. Continued from LIC 9099 Regarding allegation “Facility administrator is not present at the facility an adequate number of hours” It was reported that the Administrator does not regularly visit the facility due to distance, and is present approximately once a week and at times not at all during certain weeks. At approximately 11:20 A.M. a phone interview with the Administrator revealed that they were attending a meeting and were unable to arrive at the facility prior to 4:00 P.M. The LPA reviewed the LIC 500 Personnel Report, which indicates that the Administrator is scheduled as “on call” and assigned to work seven (7) days a week during evening hours from 07:00 P.M. to 07:00 A.M. However, the Administrator was not present on today's visit, the prior annual visit conducted on 01/23/2026, or during the reported scheduled hours. Interviews further revealed that the Administrator was last physically present at the facility several weeks ago, and it was also indicated that the Administrator’s presence at the facility was inconsistent. Additionally, it was reported that the Administrator’s primary residence is in Temecula, CA. Based on the information gathered during the investigation, the department has sufficient evidence to confirm this allegation occurred. Therefore, the allegation of “Facility administrator is not present at the facility an adequate number of hours” has been SUBSTANTIATED at this time. Regarding allegation “Facility was understaffed during a medical emergency” it was reported that a recent incident occurred in which the sole caregiver on duty experienced a medical emergency and was transported to the hospital. The Reporting Party expressed concern that, due to the Administrator residing hours away, individuals who were not scheduled employees temporarily provided care and supervision to residents until the Administrator arrived several hours later. An interview with the Administrator confirmed that on the day of the incident, Staff #1 (S1) experienced a medical emergency and was transported to the hospital. However, the Administrator requested help from a Family Member (FM) to provide temporary supervision until their arrival and that a visitor also remained at the facility for approximately 30 minutes to assist. The LPA reviewed the Guardian System and revealed that FM is fingerprinted cleared and associated to the facility. The Administrator further stated that the facility currently employs two (2) caregivers who work alternating live-in schedules for consecutive days. At the time of the incident, the relieving caregiver was unavailable due to being out of the area. Interviews with staff indicated that the current residents are generally easy to care for and do not require extensive assistance. Continued on LIC 9099-C Continued from LIC 9099-C However, additional interviews revealed that when only one (1) caregiver is on duty, residents may experience delays in receiving assistance when the caregiver is occupied with other tasks. It was also reported that residents are sometimes instructed to wait for assistance while the caregiver completes chores or assists another resident. During the visit, the LPA observed that while the sole caregiver assisted one resident with bathing and grooming for approximately 45 minutes, the other resident remained alone in the living room without supervision. Based on the information gathered during the investigation, the department has sufficient evidence to confirm this allegation occurred. Therefore, the allegation of “Facility was understaffed during a medical emergency” has been SUBSTANTIATED at this time. Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiency was cited (refer to LIC 9099-D.) Facility Designee was informed that failure to correct the deficiency may result in civil penalties. Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Mar 25, 2026 · control 29-AS-20260320140734

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(a) · Plan of correction due date: Mar 31, 2026

87405 (a) All facilities shall have a qualified and currently certified administrator...shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility...by written documentation. This requirement is not met as evidenced by: Based on observation and interview, the Administrator has not been present in the facility on their scheduled days for several weeks which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Mar 25, 2026

Plan of correction: The Administrator will submit a plan of action as to how the facility will come into complance by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(a) · Plan of correction due date: Mar 31, 2026

87411 Personnel Requirements General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the above cited section, as there are no ON CALL caregivers readily available in case of an emergency, which poses an potential safety risk to persons in care.the state’s words, verbatim · CDSS document, Mar 25, 2026

Plan of correction: The Administrator agreed to adjust caregiver schedule and to have OnCall caregiver close by the facility available in case on emergencys. A statement of understanding on this regukation is required before POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 09:30 A.M. The LPA was greeted by caregivers Felicidad Portugal and Celso Espiritu. LPA informed the reason for the visit. At 9:40 A.M., Caregiver Portugal contacted the Administrator by phone, Margarita Colon. Administrator was unavailable during today's visit, but authorized Celso Espiritu to sign today's report. Entrance interview conducted. Beginning at 10:15 A.M., the LPA, along with caregiver Celso Espiritu toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: A fire extinguisher is fully charged and purchased on 12/25/2025. Between 10:40 A.M. and 10:57 A.M. smoke detectors and two (2) Carbon Monoxide detectors were tested and functional at the time of the visit. KITCHEN: The LPA observed the kitchen to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of seven (7) days non-perishable and two (2) days perishable food. Cleaning supplies and sharps are located in a locked cabinet under the kitchen sink. LPA conducted a review of expiration dates on product labels. At 10:53 A.M. hot water temperature was tested and measured at 112.5 degrees Fahrenheit. Continued on LIC 809-C Continued from LIC 809 COMMON AREAS: This includes the living room, family room, and dining room areas. LPA observed common area to be clean and properly furnished at the time of the visit. An adequately screened fireplace was noted in the living room. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. The facility maintained a temperature of 71 degrees. LPA observed a working phone available for residents use whenever needed. Facility provides sufficient space to accommodate indoor activities. BATHROOMS: There are two (2) bathrooms which are designated for shared use. Restrooms were observed to be equipped with slip-resistant surfaces and contain slip-resistant mats. Grab bars were observed in the bathrooms. LPA observed all bathrooms were clean, properly supplied and had functional fixtures. Residents have sufficient amounts of supplies for personal hygiene. Hot water temperature was measured in both shared bathrooms and measured within the required range of 105-120 degrees Fahrenheit. BEDROOMS: There are five (5) total bedrooms in the facility; 1 (one) is designated as a shared room and 4 (four) are designated as private resident rooms. Occupied rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There is an additional bedroom for staff use. GARAGE: Garage was observed locked and inaccessible to the residents in care. Garage contained laundry area, extra food, PPE and incontinence supplies, 1st aid kit and emergency food and water. LPA observed a low supply of emergency water. Technical assistance (TA) issued. OUTDOOR SPACE: The backyard has a covered patio area with patio furniture for residents’ use. All passageways were observed to be clear. There were no bodies of water on the premises at the time of the visit. Facility has a side gate which was observed to be self-closing and self-latching with clear passageways for emergency exit use. LPA observed cameras throughout the outside of the property only. Facility provides sufficient space to accommodate outdoor activities. LPA observed two (2) sheds containing holiday decorations, extra PPE and incontinence supplies, mobility devices and gardening tools. The property has two (2) homes with different house numbers/address. The homes are separated by a fence. Continued on LIC 809-C Continued on LIC 809-C RECORD REVIEW: Starting at 11:15 A.M. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. All 2 (two) resident files observed were missing the Personal Rights form (LIC 613). Technical Violation (TV) issued. All other forms were inside their files. During this visit, LPA requested two (2) staff files and the administrator’s file for review. The administrator’s file was reportedly maintained offsite and was not available at the time of the visit. Review of the two (2) caregiver files revealed missing documentation that had been available during the previous year’s visit. Missing documents included updated CPR and as personnel record or job application for Staff #1 and personnel record or job application and health screening for Staff #2. MEDICATION REVIEW: At 12:45 P.M. medications for 2 (two) residents were observed by the LPA. Medications are maintained locked in a hallway cabinet leading to the garage and they are inaccessible to residents. All medications observed were labeled and stored properly. However, discrepancies were identified on both residents during the medication count. The following was observed: Resident’s 1 Metroprolol Succ ER 100 MG, 1 tab twice a day, with a start date of November, 9, 2025 containing 180 pills, had 25 left. Eliquis 2.5 mg, 1 tab twice a day, with a start date of January 4, 2025 containing 60 pills, had 37 pills left. Resident’s 2 Atrovastatin 40 MG take, 1 tab a day, with start date of December 15, 2025 containing 100 pills had 59 pills left. LPA requested the following documents during today’s visit; Personnel Report (LIC 500), Resident Roster, Liability Insurance. Emergency disaster drills are conducted quarterly, with the last drill conducted on 12/28/2025. Additionally, LPA observed emergency disaster plan to be complete and updated annually, as required. INTERVIEWS: During today's visit, LPA interviewed 2 (two) staff members and 2 (two) residents. Pursuant to Title 22 CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D) and civil penalty issued. Exit interview conducted. Today's reports and appeal rights were discussed, and copy will be email to the Licensee.the state’s words, verbatim · CDSS document, Jan 23, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 09:40 A.M. LPA met with Licensee/Administrator, Margarita Colon. Entrance interview conducted. Beginning at 10:05 A.M., the LPA, along with Licensee/Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: Fire extinguisher is fully charged and purchased on 01/01/2025. Smoke detectors were tested at 1:52 P.M. and functional at the time of the visit. At 1:54 P.M. two (2) Carbon Monoxide detectors were tested. During the inspection it was observed that both detectors were missing batteries and were non-functional. Staff replaced batteries in both detectors, and they were retested. Following the replacement, both carbon monoxide detectors were confirmed to be functional. No fire clearance concerns were observed. KITCHEN: The LPA observed the kitchen to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of seven (7) days non-perishable and two (2) days perishable food. Cleaning supplies and sharps are located in a locked cabinet under the kitchen sink. LPA conducted a review of expiration dates on product labels. At 10:30 A.M. hot water temperature was tested and measured at 124.5 degrees Fahrenheit. Continued on LIC 809-C Continued from LIC 809 COMMON AREAS: This includes the living room, family room, and dining room areas. LPA observed common area to be clean and properly furnished at the time of the visit. An adequately screened fireplace was noted in the living room. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. The facility maintained a comfortable temperature of 71 degrees. LPA observed a working phone available for residents use whenever needed. Facility provides sufficient space to accommodate indoor activities. BATHROOMS: There are two (2) bathrooms for resident use. Both are designated for shared resident use. Restrooms were observed to be equipped with slip resistant surfaces and contain slip resistant mats. Grab bars were observed in the bathrooms. LPA observed all bathrooms were clean, properly supplied and had functional fixtures. Residents have sufficient amounts of supplies for personal hygiene. At 10:48 A.M. hot water temperature was measured in one shared resident bathroom and measured at 118.2 degrees Fahrenheit. BEDROOMS: There are five (5) total bedrooms in the facility; 1 (one) is designated as a shared room and 4 (four) are designated as private resident rooms. Occupied rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There is an additional bedroom for staff use. GARAGE: Garage was observed locked and inaccessible to the residents in care. Garage contained laundry area, extra food, PPE and incontinence supplies, and emergency food and water. Continued on LIC 809-C Continued from LIC 809-C OUTDOOR SPACE: The backyard has a covered patio area with patio furniture including a table and chairs for resident use. All passageways were observed to be clear. There were no bodies of water on the premises at the time of the visit. Facility has a side gate which was observed to be self-closing and self-latching with clear passageways for emergency exit use. LPA observed cameras throughout the outside of the property only. Facility provides sufficient space to accommodate outdoor activities. LPA observed two (2) sheds containing holiday decorations, extra PPE and incontinence supplies, mobility devices and gardening tools. The property has two (2) homes with different house numbers/address. The homes are separated by a fence. RECORD REVIEW: Began at 11:00 A.M. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. All 2 (two) resident files observed were in compliance with regulation. LPA reviewed three (3) staff files including Administrator’s. LPA observed Staff #1 (S1) and Staff #2 (S2) were missing proof of valid 1st AID/CPR certification. During today’s visit S1 and S2 were able to renew 1st AID/CPR certificate online. All other personnel files were reviewed and found to be complete, with no missing documentation or deficiencies noted. MEDICATION REVIEW: At 12:29 P.M. medications for 2 (two) residents were observed by the LPA. Medications are maintained locked in a hallway cabinet leading to the garage and they are inaccessible to residents. All medications observed were labeled and stored properly. However, discrepancies were identified in Resident’s 1 (R1) medication records during a medication count. The following was observed: Cyclobenzaprine 5 ML and Melatonin 3 MG were missing a dosage and Gabapentin 300 MG contained 3 extra capsules. Staff stated that R1 occasionally refuses to take medication. However, refusals were not documented in the centrally stored medication log nor the “end of date” staff notebook. Continued on LIC 809-C Continued from LIC 809-C LPA requested the following documents during today’s visit; Personnel Report (LIC 500), Handwritten Resident Roster, Liability Insurance. Emergency disaster drills are conducted quarterly, with the last drill conducted on 10/15/2024. Additionally, LPA observed emergency disaster plan to be complete and updated annually, as required. INTERVIEWS: During today's visit, LPA interviewed 1 (one) staff and 1 (one) resident. Pursuant to Title 22 CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D) and civil penalty issued. Exit interview conducted. Today's reports and appeal rights were discussed and copy was provided to Licensee.the state’s words, verbatim · CDSS document, Jan 7, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 08:50AM. LPA met with Licensee/Administrator Margarita Colon. Entrance interview conducted. Beginning at 10:17AM, the LPA, along with Licensee/Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: Fire extinguisher is fully charged and purchased on 12/11/2023. Carbon Monoxide detector was tested at 12:24PM, smoke detectors were tested at 12:25PM and all were functional at the time of the visit. No fire clearance concerns were observed. KITCHEN: The LPA observed the kitchen to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of seven (7) days non-perishable and two (2) days perishable food. Cleaning supplies and sharps are located in a locked cabinet under the kitchen sink. COMMON AREAS: This includes the living room, family room, and dining room areas. LPA observed common area to be clean and properly furnished at the time of the visit. An adequately screened fireplace was noted in the living room. Exit doors contain alarms and were functional at the time of the visit. BATHROOMS: There are two (2) bathrooms for resident use. Both are designated for shared resident use. Restrooms were observed to be equipped with nonskid surfaces and contain nonskid mats. Grab bars were observed in the bathrooms. The water temperature was measured in one shared resident bathroom and Report Continued on LIC 809-C initially measured at 100.8 degrees Fahrenheit; water heater temperature was adjusted during the visit. BEDROOMS: There are five (5) total bedrooms in the facility; 1 (one) is designated as a shared room and 4 (four) are designated as private resident rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. GARAGE: Garage was observed locked and contained laundry area, extra food, PPE and incontinence supplies, and emergency food and water. OUTDOOR SPACE: The backyard has a covered patio area with patio furniture including a table and chairs for resident use. All passageways were observed to be clear. There were no bodies of water on the premises. RECORD REVIEW: Began at 09:00AM. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. All 3 (three) resident files observed were in compliance with regulation. 2 (two) staff files were reviewed; 1 (one) staff file had an incomplete fingerprint background clearance, but a printed clearance letter issued. Licensee is working with LPA & Guardian to ensure additional background clearance is completed timely. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills are conducted quarterly, with the last drill conducted on 12/02/2023. Emergency disaster plan was observed to be complete and updated annually, as required. MEDICATION REVIEW: Medications for 2 (two) residents were observed. All medications observed were labeled, stored, and properly documented at the time of the visit. INTERVIEWS: During today's visit, LPA interviewed 1 (one) staff and 1 (one) resident. No deficiencies cited. Exit interview conducted. A copy of today's report was provided.the state’s words, verbatim · CDSS document, Jan 5, 2024