Golden Nest Assisted Living

Type of visit: Required - 1 Year

On 01/06/2026 at 11:25am, Licensing Program Analyst (LPA) L. Hall conducted an unannounced required annual inspection. LPA met with Frances Bacus, Caregiver. Licensee, Pramod Balanandan, arrived at 12:10pm, and explained the purpose of the visit. The Administrator currently holds a certificate (#7016877740) that expires on 7/20/2026. The facility’s fire clearance was approved for four (4) non-ambulatory and 2 bedridden resident. LPAs toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms and three (3) bathrooms. All outdoor and indoor passageways are kept free of obstruction. No bodies of water observed. A comfortable temperature is maintained at 72 degrees F. LPAs 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 137.3 degrees F. Residents’ bathrooms are equipped with grab bars and non-skid mats. Smoke detectors/ carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 0813/2025. First aid kit was observed to be complete. Fire drill was last conducted on 08/15/2025. Continued on LIC809. Continued from LIC809. LPA reviewed five (5) staff records and all were current and complete. All six (6) resident records were reviewed and complete. LPA also reviewed residents medications. LPA requested the following documents to be submitted to CCLD by 01/13/2026. LIC 308 Designation of Administrative Responsibility LIC 610E Emergency Disaster Plan (9 pages) Liability Insurance LIC500 (Personnel Report) LPA observed the following deficiencies: At 11:30am, LPA observed the hot water in the shared residents' bathroom measured at 137.3 degrees F. At 1:30pm, LPA observed R2, R3, and R4 was being given the wrong dosage of medication. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of the appeal rights and this report provided.the state’s words, verbatim · CDSS document, Jan 6, 2026

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 01/08/2025 at 10:18AM, Licensing Program Analyst (LPA) T. Syess-Gibson arrived unannounced to conduct a 1-Year Required inspection. LPA met with Caregiver, Frances Bacus and explained the purpose of the visit. Frances called the Administrator, Kavitha Pramod via telephone. At approximately 11:15AM Administrator, Kavitha Pramod arrived. Administrator, Kavitha Pramod had to leave and gave authorization for Caregiver, Estrella Bumanglag to sign the reports. The facility’s fire clearance was approved for four (4) non-ambulatory and two (2) bedridden residents. LPA toured the facility with Caregiver, Frances Bacus including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms. and three (3) bathrooms. All outdoor and indoor passageways are kept free of obstruction. LPA did not observe any bodies of water. A comfortable temperature is maintained at 73 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 146.0 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 08/03/2024. Emergency Disaster Plan was last posted on 01/02/2025. First aid kit was observed to be complete. Fire drill was last conducted on 08/26/2024. Continued on LIC809C. Continued from LIC809. Five (5) staff records were reviewed and five (5) out of five (5) were first aid certified, and one (1) staff was not fingerprint cleared and associated to facility. LPA reviewed all five (5) resident records which were complete. LPA requested the following documents to be submitted to CCLD by 01/15/2025: · LIC 308 Designation of Administrative Responsibility · LIC 309 Administrative Organization · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan · Liability Insurance LPA observed the following deficiencies: · At 10:26AM LPA observed water temperature in the shared bathroom measured at 146.0 degree Fahrenheit. · At 10:33AM, LPA observed unlocked kitchen cabinet with medications. · At 10:35AM LPA observed unlocked kitchen cabinet knives and a lighter. · At 11:02AM LPA observed a broken window located in the living room area. · At 11:05AM LPA observed an exit gate in disrepair in the backyard. · At 12:37PM LPA observed during record review and interview S1 was not fingerprint cleared and associated to the facility Continue on LIC809C Continued from LIC809C. *The total amount of civil penalties assessed on today's date is $1000.00. $500.00 for staff not being fingerprint cleared, $250.00 for repeat violation of regulation 87705(f)(1) and $250.00 for a repeat violation of regulation 87303(2). Deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy the appeal rights, LIC421IM, LIC421FC and this report provided to Estrella Bumanglag.the state’s words, verbatim · CDSS document, Jan 8, 2025

Type of visit: Case Management - Legal/Non-compliance

On 11/12/2024 at 1:26PM, Licensing Program Analyst (LPA) T. Syess-Gibson arrived unannounced to conduct a Case Management Legal/ Non-compliance visit. LPA met with care staff, Francis Bucas. Francis contacted Administrator via telephone, LPA was informed by Kavitha Administrator, of being at work and gave authorization to Francis Bucas, care staff to sign reports. LPA observed that care staff was sitting with two residents watching television when LPA entered the facility. LPA did a walk through the facility including bathrooms, kitchen, living room, and outdoor area. LPA observed two (2) residents sitting in the common area watching television and two (2) residents in their bedroom in the bed with television on. LPA requested staff files for review, care staff stated she didn’t have the key and contacted Kavitha Pramod via telephone. Kavitha explained that the key is with her and that she will leave the key tomorrow with staff. LPA explained to Administrator, the importance of files being readily accessible to Licensing for review during all visits. Continue on LIC809C Continue from LIC809 LPA couldn’t review and confirm if the facility conducted two (2) hours of staff training on each of the topics below: 1. Observation of resident(s) on recognizing signs and symptoms of residents change of condition 2. When to call 9-1-1 after resident/s unusual incident and properly responding to residents' emergencies. 3. Training on reporting requirement to timely inform appropriate parties such as but not limited to; CCLD, residents’ responsible parties, Ombudsman, etc. 4. Training for recognizing non-verbal cues of pain for residents in care. At 2:00PM LPA observed staff and residents’ files were inaccessible for review due to being locked in a cabinet during visit. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview conducted with Francis Bucas. A copy of this report and appeal rights provided.the state’s words, verbatim · CDSS document, Nov 12, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87412(f) · Plan of correction due date: Nov 19, 2024

87412 Personnel Records f) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements: This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above in having Personnel Records available to licensing agency to inspect, audit, and copy upon demand during normal business hours. which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Nov 12, 2024

Plan of correction: Administrator agreed to send a self certifying email to CCLD stating keys to all files will be available at the facility at all times by POC date

From the deficiency page — Deficiency type: Type B · Section cited: CCR87506(d) · Plan of correction due date: Nov 19, 2024

87506 Resident Records (d) All resident records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above in having Residents Records available to licensing agency to inspect, audit, and copy upon demand during business hours which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Nov 12, 2024

Plan of correction: Administrator agreed to send a self certifying email to CCLD stating keys to all files will be available at the facility at all times by POC date

Type of visit: Required - 1 Year

On 1/30/2024 at 3:30PM, Licensing Program Analysts (LPAs) L. Hall and T. Syess-Gibson conducted an unannounced 1-Year Required inspection. LPAs met with Caregiver Estrella Bumanglag, and explained the purpose of the visit. LPAs spoke with Administrator Kavitha Pramod via telephone. At 4:35PM the Licensee Pramod Balanandan arrived. The facility’s fire clearance was approved for four (4) non-ambulatory and two (2) bedridden residents. LPAs toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms and three (3) bathrooms. All outdoor and indoor passageways are kept free of obstruction. LPAs did not observe any bodies of water. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPAs 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 132.6 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 8/30/2023. Emergency Disaster Plan was last posted on 02/2019. First aid kit was observed to be complete. Fire drill was last conducted on 01/15/2024. Continued on LIC809. Continued from LIC809. Five (5) staff records were reviewed and four (4) our of five (5) were not first aid certified, and one (1) staff was not associated or had a file to review. LPAs reviewed all six (6) resident records. LPA requested the following documents to be submitted to CCLD by 02/06/2024. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 610E Emergency Disaster Plan Liability Insurance LPA observed the following deficiencies: At 3:35pm, LPAs observed during record review and interview S1 was not associated to the facility. At 3:44pm LPAs observed unlocked kitchen cabinet with medication. At 3:45pm LPAs observed unlocked kitchen drawer with knives. At 3:54pm LPAs observed water temperature in shared restroom to be 132.6 Fahrenheit. At 5:28pm LPAs observed bedridden resident located in room number four(4). Per fire clearance bedridden should reside in either bedroom #2 or #3. At 5:56pm LPAs observed during record review four (4) staff were not first aid certified. Continued on LIC809C. Continued from LIC809C. *The total amount of civil penalties assessed on today's date is $100.00 for staff not being associated.* Deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy the appeal rights, LIC421BG, and the report provided.the state’s words, verbatim · CDSS document, Jan 30, 2024