Ahau Boarding Care Home

Type of visit: Required - 1 Year

On December 30, 2025 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with the administrator and explained the purpose of today's visit. LPA toured the facility inside and out and inspected the living room, dining area, kitchen, bedrooms, bathrooms, and backyard. The indoor and outdoor passageways were free of obstruction. The facility has 3 resident rooms (2 shared and 1 private). Furniture and furnishings were observed to be sufficient. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Toilet, hand washing and bathing areas in operating condition. Showers were observed equipped with non-skid mats and grab bars. Comfortable temperature is maintained and lighting is sufficient for comfort Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time. Central storage for medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. Hot water temperature in the kitchen and bathroom were measured at 108-114 degrees Fahrenheit. Fire extinguishers were inspected on 12/11/2025. A review of (5) resident files was conducted and noted on the LIC 858. A review of (1) staff files was conducted and noted on the LIC 859. During the tour of the facility, LPA observed a storage unit in the back yard that was observed as a living space during last annual is currently being used as a storage unit. The administrator stated that they are still working with the city of San Bruno to make the unit legalize. No deficiency is cited today. This report is reviewed and discussed with administrator. A copy of this report is provided.the state’s words, verbatim · CDSS document, Dec 30, 2025

Type of visit: Required - 1 Year

On November 19, 2024 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with the administrator and explained the purpose of today's visit. LPA toured the facility inside and out and inspected the living room, dining area, kitchen, bedrooms, bathrooms, and backyard. The indoor and outdoor passageways were free of obstruction. The facility has 3 resident rooms (2 shared and 1 private). Furniture and furnishings were observed to be sufficient. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Toilet, hand washing and bathing areas in operating condition. Showers were observed equipped with non-skid mats and grab bars. Comfortable temperature is maintained and lighting is sufficient for comfort Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time. Central storage for medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. Hot water temperature in the kitchen and bathroom were measured at 108-111 degrees Fahrenheit. Fire extinguishers were checked. A review of (4) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. During today's visit, LPA observed the administrator was the only staff at the facility and when she was providing a shower for resident #1 (R1), the other 3 residents were in the dining room unattended and resident #2 (R2) called out several times for assistance before he/she was attended to. During the tour of the facility, LPA observed a storage unit in the back yard was converted into a living space and according to the administrator, this is a living space for the caregiver and the facility did not have any documents to proof that this is an approved habitable space. Civil penalty in the amount of $250 is being assessed today for repeat violation. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in an additional civil penalties. This report is reviewed and discussed with administrator. A copy of this report and the appeal rights were provided.the state’s words, verbatim · CDSS document, Nov 19, 2024

Type of visit: Required - 1 Year

On December 12, 2023 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by staff, Emily Latu and LPA explained the purpose of today's visit. Administrator, Temaleti Latu arrived shortly thereafter and assisted with the annual inspection LPA toured the facility and ground. No accessible bodies of water of fire safety hazards observed. During the visit there were 5 residents. This is a one story facility with 3 bedrooms (2 shared rooms and 1 private room) and 2 bathrooms. The facility observed to comfortable. Bedrooms are equipped with required furniture for residents to use. Bathrooms are equipped with grab bars, and nonskid mats. Facility temperature is comfortable. Hot water temperature was measured at 106- 108 degrees F. Central stored medication were observed to be locked and inaccessible to residents. However, expired medications were identified. Food supplies were observed to be adequate. LPA observed chemicals in the storage room next to the bathroom was not locked and accessible to residents. In regards to facility drills, facility was not able to provide documents that they were completed. LPA reviewed 5 residents records and all of them contained identification and emergency information, admission agreement, medical assessment, and LIC 602 (Physician Order), however, 5 out of 5 residents did not have a pre-appraisal plan and an appraisal service/plan. LPA reviewed 2 staff files and all of them contained personnel records, health screening, job description, First Aide and CPR, criminal record clearance and all 2 staff are associated. However, LPA did not observed training records for staff #1 (S1). Facility does not handle resident's P & I. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with administrator. A copy of this report and the appeal rights were provided.the state’s words, verbatim · CDSS document, Dec 12, 2023

Type of visit: POC

On November 16, 2023, Licensing Program Analyst (LPA) conducted an unannounced Plan of Correction (POC) visit to follow up on deficiencies cited on November 1, 2023 during a complaint visit. Upon arrival, administrator, LPA met with Temaleti Latu and caregiver, Emily Latu and explained the purpose of today's visit. Administrator provided a tour of the facility and LPA observed medicine cabinets were locked and inaccessible to residents in care, sharps and chemicals were locked and inaccessible to residents in care, new dining room furniture was purchased, living room appeared to be cleaned, no soiled clothes on the laundry room floor and no dirty dishes in the sink. The following deficiencies are cleared: Section: 87465 Incidental Medical and Dental Care..(h) The following requirements shall apply to medications which are centrally stored:..2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons... Section:§1569.49 Civil penalties; regulations setting forth appeal procedures for deficiencies..(c) The department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues after citation for any of the following serious violations:.. 87309 Storage Space..(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. 87303 Maintenance and Operation..(a) The facility shall be clean, safe, sanitary and in good repair at all times. Report is reviewed with administrator; POC letter is generated and provided on this day.the state’s words, verbatim · CDSS document, Nov 16, 2023

Allegation investigated: Due to staff negligence, medications were accessible to residents

On 11/1/2023, Licensing Program Analyst (LPA) Murial Han conducted a 10-day complaint visit. LPA met with administrator and explained the purpose of today's visit. Regarding to allegation of- due to staff negligence, medications were accessible to residents, the reporting party report that one cabinet lock was broken and accessible to resident and another cabinet was closed with a lock, however, the key is permanently in the lock. During the visit, LPA observed the medicine cabinet with two doors, the doors were closed, however, 2 keys were in the lock and both were not lock. In addition, LPA observed resident's medication placed on the counter below the medicine cabinet. Above observations were acknowledged by the administrator. In addition, LPA also made other observations during the visit, see LIC 809 and LIC 809 D under case management for the details. Based on observations, and interviews during the investigation, the preponderance of evidence standard has been met. Therefore, this allegation is determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with Administrator, and Appeal Rights provided. Substantiatedthe state’s words, verbatim · CDSS document, Nov 1, 2023 · control 14-AS-20231027125651

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87565(h)(2) · Plan of correction due date: Nov 2, 2023

87465 Incidental Medical and Dental Care..(h) The following requirements shall apply to medications which are centrally stored:..2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons... This requirement is not met as evidenced by LPA observed medicine cabinet was not locked and resident medications left unattended on the counter below the medicine cabinet which poses an immediate health risk to residents in care.the state’s words, verbatim · CDSS document, Nov 1, 2023

Plan of correction: The administrator/licensee will provide a plan to ensure medicine cabinet is lock and inaccessible to residents at all times and will provide a copy of the plan to CCL by 11/2/2023.

Type of visit: Case Management - Deficiencies

On November 1, 2023 Licensing Program Analyst (LPA) Murial Han conducted a 10-day complaint visit in reference to complaint # 14- AS- 20231027125651, and during the visit, LPA make the following observations. At 10:30AM, LPA arrived at the facility, and rang the door bell twice but no one answered. After 10 minutes of waiting, resident # 1( R1) who was watching TV in the living room noted from the window that LPA was waiting outside and opened the door for LPA. As R1 was opening the door, a dog ran out to the street from the facility. LPA proceed to enter the facility and did not observe any facility staff was present. LPA interviewed R1 in the living room and R1 stated that he/she did not know where the staff was. LPA observed resident #2 (R2) who was eating breakfast in the dining room and also reported that he/she did not know where the staff was. LPA waited by the front door / living area and yelled for assistance for about 8 minutes and no one responded. LPA proceed to called and spoke to the administrator via cell phone and after a few minutes, the administrator came out and stated that she was taking a shower and she was the only staff at the facility. During the tour of the facility, LPA observed a knife was placed on the counter next to the stove, dirty dishes were in the sink cover with dirty water, big pile of soiled clothes on the floor in the laundry room, big soiled towel on the living room floor, in front of the fire place, fruits were placed next to big piles of paper and clothes in the kitchen counter, several piles of clothes in front of the staff room area, and a thick layer of white dust on top of the unused paper towel dispenser in the bathroom. Deficiency was observed during the visit and cited from the California Code of Regulations, Title 22 and Health and Safety Code. See LIC809-D. An immediate civil penalty was assessed for Absence of supervision. Failure to correct the deficiency may result in additional civil penalty. Appeal Rights provided. This report was reviewed and discussed with administrator at the end of the inspection.the state’s words, verbatim · CDSS document, Nov 1, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 1569.0822(c)(3) · Plan of correction due date: Nov 2, 2023

§1569.49 Civil penalties; regulations setting forth appeal procedures for deficiencies..(c) The department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues after citation for any of the following serious violations:.. (3) Absence of supervision as required by statute or regulation. This requirement is not met as evidenced by there was absence of supervision when LPA arrived at the facility as the only staff (administrator) was taking a shower which poses an immediate health risks for residents in care.the state’s words, verbatim · CDSS document, Nov 1, 2023

Plan of correction: The administrator/licensee will develop a plan to ensure residents are being supervised at all times. Administrator/licensee will provide a copy of the plan to CCL by 11/2/2023. Immediate Civil Penalty is being assessed today (11/1/2023) for absence of supervision.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87309(a) · Plan of correction due date: Nov 2, 2023

87309 Storage Space..(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidence by LPA observed a knife on the counter next to the stove which poses an immediate health risks to residents in care.the state’s words, verbatim · CDSS document, Nov 1, 2023

Plan of correction: The administrator/licensee will develop a plan to ensure all items that could pose a danger is inaccessible to residents at all times. The administrator/licensee will submit a copy of this plan to CCL by 11/2/2023.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(a) · Plan of correction due date: Nov 2, 2023

87303 Maintenance and Operation..(a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by LPA observed dirty dishes in the sink, big pile of soiled clothes on the laundry room floor, fruits were stored on the counter with piles of paper, the unused towel paper dispenser in the bathroom was covered a white layer of dust etc. which poses an immediate health risk to residents in care.the state’s words, verbatim · CDSS document, Nov 1, 2023

Plan of correction: The administrator/licensee will provide proof that facility is clean, safe, sanitary and submit a copy of the proof (photos) to CCL by 11/2/2023. Administrator/Licensee will submit a plan on how the facility will maintain and sustain a clean, safe, and sanitary environment for resident. Administrator/Licensee will submit a copy of the plan to CCL by 11/2/2023.