Agape Collins' Carehome

Type of visit: Case Management - Other

At approximately 11:45AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct a case management visit in regards to the closure of this facility. Upon arrival, LPA was greeted by the property owner who wished to remain annomoyos. The property owner allowed LPA entry to conduct a walkthrough of the building. LPA observed the home to be empty of furnishing and there were no residents or belongings present. LPA was not able to secure a signature. Based on observation, there are no residents present and no one is receiving care or supervision. Facility is closed as of 08/26/2025.the state’s words, verbatim · CDSS document, Aug 26, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Stevenson arrived unannounced to continue a required annual inspection at approximately 1:45 PM and met with caregiver Annie Marjorie Vinluan. Four staff were present and found to be background cleared and associated to the house through Guardian. At approximately 2:30PM record review began Five (5) staff files were reviewed and it was observed that four (4) of five (5) staff files did not have evidence of 20 hours annual training, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696 (Technical Deficiency issued) Five (5) client files were reviewed and five of (5) client files were found to have all required documentation. Medicines were found to be centrally stored and locked. Last disaster Drill was conducted January 8th. 2025 Deficiencies cited from Title 22 Regulations and/or the California Health and Safety Code. Updated Certificate of Liability Insurance was obtained Licensee is asked to submit a copy of her updated lease agreement. An exit interview was conducted, and Plans of Corrections were reviewed and developed collaboratively. A copy of this report, LIC 809-D, and Appeal Rights were discussed and providedthe state’s words, verbatim · CDSS document, Mar 27, 2025

Type of visit: Required - 1 Year

On 02/20/2025, at approximately 2:55PM, Licensing Program Analyst (LPA) Star Stevenson and Licensing Program Manager (LPM) Kimberly Mota, arrived at the facility unannounced to conduct a 1-Year Required Annual Inspection. LPA and LPM met with Annie-Majorie Vinluan-caregiver and explained the purpose of the visit. Facility has an approved Hospice Care Waiver for three (3). Clearance is approved for six (6) non-ambulatory of which one (1) can be bedridden in bedroom #1. At approximately 3:00PM , LPA Stevenson and LPM Mota and caregiver toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, backyard, shed, and common restrooms. LPA and LPM observed the facility to be clean, in good repair and odor-free. Water faucets accessible to clients were measured and found to have temperatures of 130.6F in Kitchen and 131.1F and 127.4F in back bathrooms (pictures taken) LPA and LPM observed each bathroom to have the necessary grab bars, non-skid flooring or shower chair, paper towels, trash can with tight fitting lid. LPA and LPM observed each bedroom to have all the required furnishings, with working lights and windows with screens. One back bathroom was noted to have mold on the shower ceiling (photos taken) Smoke detectors and carbon monoxide sensors were tested and observed to be in working order. Fire extinguisher were observed to last be inspected 12/2024 and charged. Last emergency drills were performed 10/2024 Last fire department inspection was on 01/21/2025. Facility has extra PPE and generator. At approximately 3:30 PM the personnel roster (LIC500) was observed and all employees were deemed eligible to work at the site. Facility has a 2-day perishable and a 7-day non-perishable amount of food. Facility medications are locked and inaccessible to residents in care. Repacked meets were not labeled, and bottom of freezer was dirty (photos taken)All toxins are locked and inaccessible to residents in care. LPA observed the first aid kit complete and ready for use. Continued on LIC809-C. Continued from LIC809 Deficiencies cited from Title 22 Regulations and or the California Health and Safety Code. An exit interview was conducted, and Plans of Corrections were reviewed and developed collaboratively. A copy of this report, LIC 809-D, and Appeal Rights were discussed and provided Due to time constraints the annual inspection will need to be continued at a later date.the state’s words, verbatim · CDSS document, Feb 20, 2025

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Allegation investigated: Personal rights

Licensing Program Analyst (LPA), Araceli Canela arrived unannounced, for the purpose of continuing complaint investigation and delivering findings, regarding the above listed allegations. In the course of the investigation LPA conducted several interviews, made observations and reviewed records. It was alleged residents personal rights were violated in that resident R1 was being changed by staff S2, with the door closed, and R1 was heard yelling out. LPA took statements and R1 likes living in the home and the staff working are nice. Staff expressed they close the door when they change R1 because R1's room is accross from the hallway bathroom and for the residents privacy when other residents walk by. Staff expressed R1 is ok most of the time when changing and they are never rough when changing or assisting any resident. Although the allegation may be valid, based on statements and document reviews, there is not a preponderance of evidence to prove or, disprove, the allegation. Therefore, the allegation is UNSUBSTANTIATED. No citations issued today. Unsubstantiated LPA noticed that all bedrooms were free of odors and no urine smell. It was also alleged the facility is not clean, safe, sanitary and is in disrepair. More specifically, that there are rats, roaches and the heat does not work. LPA opened all kitchen cabinets, inspected all floors, other cabinets and LPA did not observe any droppings. The home was free of vermin. The home was also observed, clean and clutter free. Staff stated they have no issues with rodents and residents interviewed also stated they have not seen any. Residents and staff interviewed stated the home is at a comfortable temperature, they are not cold or hot, if they needed the heater turned on, the staff will turn it on. LPA was able to notice the home was at a very comfortable temperature during the previous visits and not cold and during today's visit, upon arrival LPA observed the home had the central air conditioning on to maintain the home comfortable, as the temperature outside was about 94 degrees. Based on information received during staff and resident interviews, and LPA observations, the following allegations for Residents care needs are not being met. Facility is not clean, safe, and sanitary and Facility is in disrepair, are all found to be UNFOUNDED, meaning that the allegation is false and/or, without a reasonable basis. The above allegations are DISMISSED. No citations issued.the state’s words, verbatim · CDSS document, Jul 5, 2024 · control 21-AS-20240402125621

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced and met with Samantha Ephraim, Licensee. During a complaint investigation LPA discovered staff (S1) who was fingerprinted earlier in the day and had not yet obtained a clearance to this facility as required. LPA and licensee went over info to change the Administrator and LPA will email info. LPA also went over staff training and how to document it properly. A civil penalty was assessed for $100.00 for staff S1 not having a fingerprint clearance to this facility. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.the state’s words, verbatim · CDSS document, Apr 5, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(1) · Plan of correction due date: Apr 6, 2024

87355(e)(1) Criminal Record Clearance. Prior to working, residing or volunteering in a licensed facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. This requirement was not met as evidenced by: During today's inspection LPA found staff S1 who was fingerprinted just today and results have not been received . This is an immidiate risk to the health and safety of residents in care.the state’s words, verbatim · CDSS document, Apr 5, 2024

Plan of correction: Facility to send in written statement they understand regulation and how they will ensure they stay in compliance. Facility to self certify staff S1 will not be present until proper clearance and association is received. POC due date 4/9/2024 attention LPA Canela Civil Penalty issued for 100.00

Type of visit: Required - 1 Year

On 01/25/2024, Licensing Program Analyst (LPA) Jaynae Boyles, arrived at the facility unannounced to conduct a 1-Year Required Annual Inspection. LPA met with Facility Administrator, Samanth Raty, and explained the purpose of the visit. Facility has an approved Hospice Care Waiver for three(3). Facility has submitted the required Infection Control Plan. Fire clearance is approved for six (6) non-ambulatory of which one(1) can be bedridden in bedroom #1. LPA Boyles and Administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, backyard, shed, and common restrooms. LPA observed the facility to be clean, in good repair and odor-free. LPA observed each bathroom to have the necessary grab bars, non-skid flooring or shower chair, paper towels, trash can with lids and 20-second hand-washing poster. LPA observed each bedroom to have all the required furnishings, with working lights and windows with screens. Facility has a 2-day perishable and a 7-day non-perishable amount of food. Facility medications are locked and inaccessible to residents in care. All toxins are locked and inaccessible to residents in care. Hot water temperature was measured above regulation. LPA observed the first aid kit complete and ready for use. LPA reviewed a total of six (6) residents' files and three (3) staff files. Three of three staff files observed did not have completed TB testing. Several topics were discussed. Deficiencies cited from Title 22 Regulations and or the California Health and Safety Code. An exit interview was conducted, and Plans of Corrections were reviewed and developed collaboratively. A copy of this report, LIC 809-D, and Appeal Rights were discussed and provided.the state’s words, verbatim · CDSS document, Jan 25, 2024