Lotus Hearts Home Care

Type of visit: Required - 1 Year

On 08/18/26 at 1PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. LPA observed ADM has a current administrator certificate# 7036900740 which expires 04/04/2028. At 1:25PM, LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, clients and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizer were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 75 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. Two fire extinguishers were observed fully charged and purchased on 08/10/26. LPA reviewed 2 staff and 1 resident files. Updated copies of the following documents were obtained from administrator:  LIC500 - Personnel Report  LIC9020 - Resident Roster  LIC308 - Designation of Facility Responsibility  LIC610E - Emergency/Disaster Plan including infection control plans  Evidence of Liability Insurance No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 18, 2026

Type of visit: Required - 1 Year

On 08/12/25 at 1PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with staff (ADM) and explained the purpose of the visit. ADM has a current RCFE certificate # 6068864740 which expires on 04/04/2026. LPA observed no residents living at the facility. At 1:10PM, LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. Emergency Disaster Plan, Personal rights were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 78 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. Fire extinguisher was observed fully charged and last inspected on 08/20/23. LPA observed the following deficiencies during visit: Expired fire extinguisher (last inspected 08/20/23) MIssing Infection Control plans Continued on next page, LIC 809-C 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 dates and/or any repeat deficiencies within a 12-month period may result in civil penalties. Updated copies of the following documents were obtained for facility file:  LIC500- Personnel Report LIC9020- Resident Roster  LIC308- Designation of Facility Responsibility  LIC610E- Emergency/Disaster Plan including infection control plans Exit interview conducted, appeal rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 12, 2025

From the deficiency page — Deficiency type: Type B · Plan of correction due date: Sep 5, 2025

All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement was not met as evidenced by expired fire extinguisher last inspected on 08/20/23 which posed a potential health & safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 12, 2025

From the deficiency page — Deficiency type: Type B · Plan of correction due date: Sep 5, 2025

An Infection Control Plan shall be developed by the licensee and shall be included in the Plan of Operation required by Section 87208. This requirement was not met as evidenced by missing infection control plan which poses a potential health & safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 12, 2025

Type of visit: Prelicensing

On 07/16/24 at 11:30AM. Licensing Program Analyst (LPA) Daisy Panlilio arrived unannounced to conduct a pre-licensing inspection. LPA met with Administrator/Applicant (ADM) and explained the purpose of the visit. ADM has a current administrator certificate # 6068864740 which expires 04/04/26. Fire clearance was granted on 11/07/23 for 6 non-ambulatory residents. Facility currently has no residents. LPA toured the facility with ADM including but not limited to the residents' bedrooms, common areas, kitchen, and outdoor area. LPA observed a screening station near the front entrance with a no touch temperature probe, visitors' log and hand sanitizer. Facility has adequate lighting. Indoor and outdoor passageways were observed free of obstruction. LPA observed hot water temperature at 119 degrees F. LPA observed 2 days supply of perishable and one week supply of non-perishable foods. Towels, sheets, activity supplies and hygiene products were observed available. The facility has 2 full bathrooms. LPA observed the shower area has non-skid floor tiles. There are activity materials observed in the living room. Facility has flashlights available for emergency use. LPA observed sufficient emergency supplies stored inside the garage. There is sufficient lighting throughout facility. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was observed fully charged. Proper hand-washing signs, Emergency/Disaster plans/contact information, personal rights were observed posted in common areas. LPA observed no deficiencies during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 16, 2024

Type of visit: Case Management - Other

On 07/16/24 while at the facility for another reason, Licensing Program Analyst (LPA) D Panlilio conducted a component III presentation with administrator (ADM)/ applicant. LPA discussed the common deficiencies that residential facilities for the elderly are cited on, Title 22 regulations on infection control, physical plant, personnel requirements on clearances and associations, training, emergency/disaster/food requirements, etc. ADM agrees to comply with Title 22 regulations. ADM was reminded of the statute that requires CCL to be notified within 5 business days of admitting their first resident. This notification may be done by phone, by mail, or by fax. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 16, 2024

Type of visit: Office

COMP II by CAB successfully completed Method: Phone Call at CAB Applicant/administrator participated in COMP II at CAB telephone call with analyst at CAB. Identification of the applicant and administrator was verified by presenting photo ID via phone. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, May 22, 2024