Bruiz Carehome

Allegation investigated: Staff illegally evicted a resident in care.

On 04/23/206 at 9:48AM, Licensing Program Analyst (LPA), T. Syess-Gibson arrived unannounced to conduct an investigation and deliver complaint findings for the above allegations. LPA met with Cherry Corazon, caregiver and explained the reason for the visit. Marilou Intog, House Manager arrived at approximately 10:10AM, LPA explained the purpose of visit. During the investigation, LPA interviewed W1, W2, S1, S2 and S3. LPA reviewed and obtained the following documents: staff roster, staff contact information, residents’ roster, resident (R1) emergency information, admission agreement, appraisal needs and service plan, physician’s report, daily behavior notes and all incidents’ reports. Continue on LIC9099C... Substantiated Continued from LIC9099 Allegation: Staff illegally evicted a resident in care. Interview with W1 revealed, W1 called S1 to advise R1 was ready to be picked up from the hospital, S1 stated would not allow R1 back into the home, R1 needs could not be met at the facility. Interview with W2 revealed, W2 called S1 a couple of times for R1’s discharge planning, S1 informed W2 of not be taking R1 back. Interview with S1 revealed R1’s behavior was impacting the other residents at the facility and R1 was no longer a good for the facility due to behaviors. Interview with S1 also revealed, S1 refused to accept R1 back without the proper eviction notice. Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D. Exit interview conducted and a copy of this report and appeal rights were given.the state’s words, verbatim · CDSS document, Apr 23, 2026 · control 15-AS-20251222101326

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(a) · Plan of correction due date: Apr 3, 2026

87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5) This requirement is not met as evidenced by: Based on interviews, licensee did not comply with the section cited above by refusing to accept a R1 back without an eviction notice which poses a potential health and safety risk to the persons in care.the state’s words, verbatim · CDSS document, Apr 23, 2026

Plan of correction: By POC date. Administrator has agreed to review the eviction procedures and submit self-certification email to CCLD.

Type of visit: Required - 1 Year

On 01/22/2026 at 11:23AM, Licensing Program Analyst (LPA) T. Syess-Gibson arrived unannounced to conduct Required 1 Year Annual inspection. LPA met with Perla Aplasia, Caregiver and explained the purpose of the visit. Administrator, Jamie Bernardino-Ruiz arrived at 11:58AM. Administrator currently holds certificate #7035384740 that expires on 10/04/2027. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden resident. LPA toured facility with Marilou Intog, caregiver, including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of seven (7) total bedrooms, one (1) bedroom occupied by staff and two and half (2 1/2) bathrooms. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms is adequate for the comfort and safety of the residents. The hot water temperature in the resident’s shared bathroom was measured at 112.1 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum 7-day supply of nonperishable and 2 days of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced 01/13/2026. First aid kit was observed to be complete. Fire drill was last conducted on 10/25/2025. Emergency disaster plan updated 01/21/2026. Continues on LIC809C Continued from LIC809. LPA reviewed all five (5) resident records, and they were complete. LPA reviewed Five (5) staff records were reviewed; all five (5) staff were associated and has FirstAid. LPA requested the following documents to be submitted to CCLD by 01/29/2026. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (last page) Liability Insurance Updated Facility Sketch LPA observed no deficiencies during visit. Exit interview conducted a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 22, 2026

Type of visit: Required - 1 Year

On 01/30/2024 at 2:08PM, Licensing Program Analyst (LPA) T. Syess-Gibson arrived unannounced to conduct Required 1 Year Annual inspection. LPA met with Caregiver, Brian Llagas and explained the purpose of the visit. Administrator, Jamie Bernardino-Ruiz arrived at 2:41PM. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden resident. LPA toured facility with Brian and Jamie including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of seven (7) total bedrooms, one (1) bedroom occupied by staff and two and half (2 1/2) bathrooms. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 112.1 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7 day supply of nonperishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced 12/17/2024. First aid kit was observed to be complete. Fire drill last conducted on 01/05/2025 . Emergency disaster plan updated 12/16/2024. Continues on LIC809C Continued from LIC809. Five (5) staff records were reviewed, all five (5) staff were associated and had FirstAid. LPA reviewed all five (5) resident records, and they were complete. LPA requested the following documents to be submitted to CCLD by 02/04/2025. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (last page) Liability Insurance Updated Facility Sketch LPA observed no deficiencies during visit. Exit interview conducted a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 28, 2025

Type of visit: Required - 1 Year

On 01/30/2024 at 9:00 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct Required 1 Year Annual inspection. LPA met with Administrator, Jamie Bernardino-Ruiz and explained the purpose of the visit. The facility’s fire clearance was approved for 6 Non-Ambulatory. LPA toured facility with Jamie including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which all 6 bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 71 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 107.3 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7 day supply of nonperishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced 7/19/2023. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 12/08/2023 . Emergency disaster plan updated 7/15/2023. At 9:30 AM, LPA reviewed 5 residents records. At 10:04 AM, LPA reviewed 5 staff records 5 of 5 are associated to the facility. At 11:00 AM, LPA reviewed a sample of resident’s medications. Continues to 809 C The following Deficiencies were Observed during Visit During File review LPA observed that R5's physician report states that they are bedridden and not on Hospice. Facility is not cleared for bedridden. Updated copies of the following documents were requested for facility file and are to be submitted to CCLD by 02/13/2024: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Updated Facility Sketch Updated Fire Clearance The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code. Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 30, 2024

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.