Benie Lungan Care Home

Type of visit: Required - 1 Year

On 09/11/2025, Licensing Program Analyst (LPA) Pang Lee arrived at the facility to conduct an unannounced annual inspection. LPA Lee met with administrator Benilda Lungan and explained the purpose of the visit. The administrator, Lungan assisted with today’s visit. Administrator certificate # is 7036256740 and will expire on 05/04/2027. The current census is 4 with 3 facility staff. This facility is a single story building licensed to serve five (5) non-ambulatory residents or 4 non-ambulatory and 2 ambulatory residents. The northeast bedroom is approved for two ambulatory or 1 non-ambulatory resident. LPA Lee inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA Lee observed the facility to be free of odor, clean and in good repair. LPA Lee observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA Lee toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. Hot water temperature was measured at 105.1 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Grab bars and non-slip mat were observed to be stable and in good repair at this time. Smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in the dining area and was last serviced on 02/10/2025. CONTINUED LIC 809-C The last fire drill was conducted on 08/21/2025. LPA Lee observed the facility has a has a public telephone in the kitchen and the facility has the required posters posted. Facility thermostat was observed at 76 degrees Fahrenheit. LPA Lee observed toxins located in the garage cabinet and kept locked and inaccessible to residents. LPA Lee observed sharp knives kept locked in the kitchen cabinet and inaccessible to residents. LPA Lee checked medication storage and found medication to be locked away and inaccessible to residents. LPA reviewed 4 out of 4 resident medications and medication administration record (MAR) and it was complete. The first aid kit was checked and contained the required components. LPA Lee requested resident and staff files for review. LPA Lee reviewed 4 out of 4 resident files and they were complete. LPA Lee reviewed 2 staff files, and it was complete. LPA Lee reviewed staff criminal record clearances, and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared and associated with the facility. The following documents will be email to LPA by 09/11/2025 end of day 5:00 PM: (1) LIC 308 Designation of Administrative Responsibility (2) Copy of Administrator Certificate (4) LIC 610 Current Emergency Disaster Plan (5) Proof of Current Liability Insurance (6) LIC 500 Current Personnel Report As a result of this annual visit, the facility is in compliance with Title 22 Regulation. An exit interview was conducted with administrator Lungan , and a copy of these LIC 809 reports were provided to the facility.the state’s words, verbatim · CDSS document, Sep 11, 2025

Type of visit: Required - 1 Year

On 08/08/2024 at 12:22 PM, Licensing Program Analysts (LPAs) Pang Lee and Holly Williams arrived at the facility to conduct an unannounced annual inspection. LPAs met with Licensee Benilda Lungan. LPAs explained the purpose of today’s visit. Administrator Certificate # is 6003722740 and will expire on 05/04/2025. The current census is 5 with 3 facility staff. This facility is a single story building licensed to served 5 non-ambulatory resident or 4 non-ambulatory and 2 ambulatory residents. Residents’ northeast bedroom is approved for two ambulatory or 1 non-ambulatory residents. LPAs inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry room, staff room and outside courtyards of the facility to ensure compliance with Title 22 regulations. It was observed the facility was free of odor, clean and in good repair. LPAs observed client bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPAs toured the kitchen and observed the facility had sufficient seven-day non-perishable food supplies and 2 days perishable food supplies. Hot water temperature was measured at 112.8 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is in the kitchen and was last serviced on 02/08/2024. The last fire drill was conducted on 07/20/2024. LPAs observed the facility has a has a public telephone in the kitchen. Facility thermostat observed at 74 degrees Fahrenheit. LPAs observed sharp knives kept locked and inaccessible to resident. LPAs observed cleaning solution and disinfectants in the garage made accessible to residents in care. LPAs observed the administrator removed the cleaning solution and disinfectants and placed them in a locked cabinets in the garage. Grab bars were observed to be stable and in good repair at this time. Continued LIC 809-C LPAs did not observe the resident shower to have a non-slip mat. During today’s visit administrator went and purchased a new non-skid mat and placed it in the resident shower. LPAs also didn’t observe the facility to have Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) posted in the facility. LPAs checked medication storage and found medication to be locked away and inaccessible to residents. LPAs reviewed and compared 3 out of 5 medication administration record (MAR) along with residents’ medications and it was all complete. LPAs asked to inspect the facility’s first aid kit and it was complete. LPAs requested client and staff files for review. LPAs reviewed 5 out of 5 client files and they were complete. LPAs reviewed 3 staff files and they were complete. LPAs interviewed 2 facility staff and 1 clients during today’s visit. LPAs reviewed staff criminal record clearances and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared and associated to the facility. The following documents will be email to LPA Lee at pang.lee@dss.ca.gov by 08/12/2024 end of day 5:00 PM: (1) LIC 308 Designation of Administrative Responsibility (2) LIC 500 Personnel Report (3) LIC 610 Emergency Disaster Plan (4) Proof of Bond Insurance As a result of this annual visit, the facility is not in compliance with Title 22 Regulation, and the deficiencies can be found on the LIC 809 D page. An exit interview was conducted, and a copy of these LIC 809 reports, LIC 809-D page, Technical Assistance, Technical Violation and Appeals rights were provided to the facility.the state’s words, verbatim · CDSS document, Aug 8, 2024

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.