Berland Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jose De La Cruz made an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with S1, and Licensee May Paraiso. The facility's license shows a maximum capacity of 6 non-ambulatory residents, ages 60 and above. During today’s inspection there were 6 residents in care. LPA arrived at 7:20 am, facility looks clean and in good repair and decorated for the Holidays. At 7:35 am LPA reviewed requested residents files where he found that a resident in the facility appears as bedridden according to their records. LPA and Licensee toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC809] The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. One deficiency was cited per California Code of Regulations, Title 22 (refer to the LIC809-D page). A Civil Penalty was assessed (refer to the LIC421IM page). Plan of Correction was jointly developed with the Licensee. An exit interview was conducted with Licensee May Paraiso, to whom a copy of this report, the LIC 809-D and LIC421IM pages, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.the state’s words, verbatim · CDSS document, Oct 28, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to continue a Required Annual Inspection which began on 11-21-2024. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Thea Capili. LPA then met with Co-Administrator May Paraiso, who arrived shortly after. According to the facility’s license, the facility has a maximum capacity of six (6) residents, of whom all may be ambulatory or non-ambulatory, but none may be bedridden. According to care records, staff interviews, and LPA observation: During this annual inspection, there were a total of six (6) residents in care [Resident #1 (R1), Resident #2 (R2), Resident #3 (R3), Resident #4 (R4), Resident #5 (R5), and Resident #6 (R6)], of whom all were non-ambulatory, per their respective doctors. [See LIC811 Confidential Names list pages for a description of select person identifiers used in this report.] The facility’s license did not include endorsements for delayed-egress doors or secured perimeter, and neither of these were present. During this inspection, LPA interviewed multiple residents and multiple staff. LPA reviewed the care records for all residents and the personnel and training files for all staff. LPA also toured the interior and exterior of the facility, and inspected all common areas and bedrooms. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were working. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. [CONTINUED ON LIC 809-C, 1 of 3] [CONTINUED FROM LIC 809] The facility’s ambient internal temperature was complaint at 74 F. Hot water at taps accessible to residents were also compliant in temperature: Kitchen Sink was 115.3 F, Bathroom #1 Sink was 105 F, and Bathroom #2 Sink was 110.8 F. Appliances to preserve perishable food were compliant in temperature: Kitchen Refrigerator was 39 F, and Kitchen Freezer was 0 F. There were at least (2) days of perishable food and at least seven (7) days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. No pools or bodies of water observed on the premises. The facility's fireplace was screened. There were no open-faced heaters accessible to residents. Smoke detectors, carbon monoxide detector, emergency lighting, night lights, and facility telephone were all working. Confidential records were stored in locked areas. Required licensing postings were observed in visible areas of the facility. Per the Licensee, no firearms or ammunition were kept at the facility. Licensee presented proof of current business liability insurance. R1’s doctor wrote that they were sometimes “forgetful. R3’s doctor diagnosed them with Mild Cognitive Impairment (MCI). R2, R3, R5, and R6 were each diagnosed with Dementia, per their respective doctors. For all residents in care, their doctor determined that each required staff assistance with storing and taking their prescribed medications, and that each was not able to safely leave the facility unassisted. Inside the facility was a cabinet which contained centrally stored medications. Early on during LPA’s visit, the doors of this cabinet were closed but a caregiver’s keys were left inside the lock. Without the direct care staff noticing, LPA was able to open this cabinet and access the centrally stored medications. [LPA immediately secured/locked the cabinet, and the keys were returned to staff.] Inside the facility was a separate cabinet which contained over fifteen (15) bottles of cleaning chemicals, which would have been hazardous to residents diagnosed with Dementia. The doors to this cabinet were initially unlocked. Without the direct care staff noticing, LPA was able to open this cabinet and access the chemicals. [LPA immediately notified staff and with their help, relocked the cabinet.] In the facility’s backyard, LPA observed unlocked/accessible the following “tools and items that could constitute a danger to residents”: one (1) full-length pole saw with serrated metal blade, one (1) full-length scraper tool with sharp metal blade, three (3) full-length shovels with metal spades, one (1) half-length shovel with metal spade, and one (1) full-length bow rake tool with rigid metal teeth. [Facility staff immediately moved these tools to a locked area.] [CONTINUED ON LIC 809-C, 2 of 3] [CONTINUED FROM LIC 809-C, 1 of 3] During the visit, LPA observed, and manager interview confirmed: Licensee did not ensure the facility’s three (3) fire extinguishers had been professionally inspected and serviced within the last twelve (12) months, which was needed to remain in ongoing compliance with the facility’s prior-approved fire clearance. Also, Licensee did not ensure that a working “auditory device or other staff-alert feature to monitor exits” was present on two (2) of the four (4) exterior exit-doors which residents had access to (which is required when caring for persons with Dementia). During a review of client records, LPA observed, and manager interview confirmed: R4’s doctor wrote that on their LIC602 Physician’s Report (dated 06-08-2023) that they did not have Tuberculosis (TB). However, Licensee did not have written proof of a negative TB test result or chest X-ray for R4, which was required before R4 moved-in. [During the inspection, R4 did not show signs/symptoms, observable to the layperson, of active TB infection] For R2, R4, R5, and R6, Licensee did not ensure they had a LIC602 Physician’s Report (or equivalent Medical Assessment) updated within the last year, which was required for residents diagnosed with Dementia. For R1 through R6, Licensee did not complete a Functional Capabilities Assessment (or equivalent determination of the resident's ability to perform specified activities of daily living), as required. For R1 through R6, Licensee did not complete a Needs and Services/Care Plan (or equivalent “written record of care the resident will receive in the facility [and] the resident’s preferences regarding the services provided at the facility”), as required. There was also no evidence that Licensee held a care conference meeting with the respective responsible persons (RPs) for R1 through R6, within the last twelve (12) months, as was required. For R1 through R6, Licensee did not ensure their care records contained the name, address, and telephone number of a dentist to be called in an emergency, as required. For R1 through R6, Licensee did maintain a Personal Property Inventory, which was required to be completed with the resident and/or their representative at time of move-in. For R2, R3, R4, and R6, Licensee did not maintain a copy of the Resident’s Personal Rights, signed by the resident and/or their representative, in the resident’s record, as required. For R1 and R5, there was a copy of signed Resident’s Personal Rights, but the version of the form used was outdated/obsolete, and thus incomplete. For R1 through R6, Licensee did not maintain a Telecommunications Device Notification form, signed by the resident and/or their representative, as required. Also, Licensee did not maintain a record of body weights for R1 through R6. (Regulation required Licensee to “regularly observe” clients for changes in physical condition, to include “unusual weight gains or losses.”) [CONTINUED ON LIC 809-C, 3 of 3] [CONTINUED FROM LIC 809-C, 2 of 3] During a review of personnel and training records, LPA observed, and manager interview confirmed: Licensee did not maintain at the facility a personnel file on Staff #1 (S1), as required. Staff #2 (S2), who had worked at the facility since 2022, possessed an active background clearance from CCLD to work in care facilities, per a check of CCLD’s Guardian database. However, Licensee did not ensure that S2 was associated to the facility’s roster of staff, as required. Licensee did not ensure S2 and Staff #3 (S3) had a completed and signed Health Screening (or equivalent pre-employment physical), as required. Licensee did maintain proof that Staff #4 (S4) and Staff #5 (S5), both of whom provided direct care to residents, had current First Aid Training from a qualified agency, as required. Interview of S4 confirmed they were missing this training. R1, R3, and R4 were current hospice care patients. However, Licensee did not have proof that S1 through Staff #9 (S9) were trained by each residents’ hospice agency on the resident’s “current and ongoing needs,” as required. Licensee did not have proof that S1 through S9 had received training on the facility’s written Emergency Disaster Plan within the last year, as was required. Also, Licensee did not have proof that S1 through S9 had received training on Personal Protective Equipment (PPE) within the last year, as was required. Licensee did not have proof of completion of disaster drills within the last two (2) years. Interview of manager confirmed disaster drills were not conducted. (Regulation required Licensee to drill each shift at least once per quarter). Nineteen (19) deficiencies were cited per California Code of Regulations, Title 22, and three (3) deficiencies were cited per California Health and Safety Code (refer to the LIC 809-D pages). Plans of Correction were jointly developed with the Licensee. LPA also issued one (1) Technical Violation (TV) regarding a needed Hospice Exception Request for R1 (refer to the LIC9102-TV page). An exit interview was conducted with Administrator May Paraiso, to whom a copy of this report, the LIC 809-D pages, the LIC9102-TV page, the LIC811 Confidential Names List pages, and the Licensee/Appeal Rights (LIC9058 03/22) were provided to Licensee during today's visit.the state’s words, verbatim · CDSS document, Nov 22, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Thea Capili. LPA then met with Co-Administrator May Paraiso, who arrived later during the visit. During today’s visit, LPA toured the facility, reviewed staff and resident records, and interviewed staff and residents. No deficiencies were cited during today’s visit. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection. An exit interview was conducted with Paraiso, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Nov 21, 2024

Allegation investigated: Licensee did not seek medical attention for resident. Licensee did not meet resident's grooming needs. Licensee did not maintain a comfortable temperature for residents in care.

Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced complaint investigation visit to continue investigating for the above mentioned allegations and deliver findings of the investigation. LPA gained access to the facility, identified herself, and met with Care Giver Beth Barbarose to discuss purpose of today's visit. LPA also spoke Administrator May Paraiso on the phone. LPA's visit consisted of reviewing resident records, Observations, welfare check and delivering findings of the complaint investigation. LPA's investigation consisted of staff interviews, resident record review, observations, and outside source interviews. Continued on 9099-C Unsubstantiated Continued from 90999 Regarding the allegation of Licensee did not meet resident's grooming needs, evidence obtained from residents Physician's Report (dated March 2023 ) indicates that Resident #1(R1) required assistance with oral care and dressing and bathing. Based on evidence obtained from R1s records, it is revealed that as part of their behavior, as a result of their medical diagnosis, consisted of resisting assistance from staff when it came to hygiene care. Interviews with outside sources confirm combative behavior when assisting R1 with ADL's.. The facility “resident Care notes” documented on numerous occasions how R1 would be aggressive and resistant to staff attempting to provide hygiene and oral care. Under regulations, residents of RCFE’s have the right to be free from “interference, coercion, discrimination, and retaliation in exercising their rights,” rights of which include “daily living functions” with the Department. Regarding the allegation of Licensee did not maintain a comfortable temperature for residents in care. LPA observation on 6/13/2024 and on 7/18/2024 individual room temperatures in a range of 70 degrees Fahrenheit to 75 degrees Fahrenheit. Under regulations, residents of RCFE’s shall provide a comfortable temperature for residents. Regarding the allegation Licensee did not seek medical attention for resident. Interviews with OS1 and staff reveal R1 was with outside the RCFE’s physical house when OS1 felt R1 was not responding well. Staff assisted R1 back inside facility and followed protocol for medical assistance.. Based on LPA's interviews, record reviews, and observation there is not a preponderance of evidence to prove alleged violations occurred, therefore the allegations are unsubstantiated. An exit interview was conducted with Care Giver Beth Barbarose to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.the state’s words, verbatim · CDSS document, Jul 18, 2024 · control 08-AS-20240604093115

Allegation investigated: Licensee's neglect of resident resulted in malnourishment Licensee's neglect of resident resulted in dehydration Licensee did not assist resident with incontinence care Licensee neglect resulted in resident wearing dirty clothing

Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced complaint visit to deliver findings regarding the above-mentioned allegations. LPA identified herself to, was greeted by, and explained the purpose of the visit to Administrator May Paraiso. The Department’s investigation consisted of interviews with staff and outside sources and a virtual tour of the facility. It was alleged that the Licensee’s neglect of resident resulted in malnourishment and dehydration, Licensee did not assist resident with incontinence care, and Licensee’s neglect resulted in resident wearing dirty clothing. Interviews with staff and outside sources revealed that in 2020, the facility cared for residents with major cognitive impairments and several residents required assistance with all activities of daily living, including Resident 1 (R1). Interviews with staff and outside sources described R1 as having a diagnosis of major cognitive impairment, received hospice services, required assistance with ambulation, grooming, dressing, and showering, and used incontinence briefs. Continued on LIC9099-C page... Unsubstantiated Interviews with staff revealed that staff assisted residents with showers or bed baths two to three times a week unless the resident was receiving hospice services. In that event, the hospice agency would be responsible for providing showers or bed baths. Staff stated that residents were changed from sleeping clothing into daytime clothing in the morning and staff changed resident clothing as necessary if the clothing became wet, soiled, or dirty. Interviews did not reveal that any residents had a pattern of consistently refusing showers. Residents who wore incontinence briefs were checked by staff multiple times a day and were changed as needed. During an on-site visit in January 2024, LPA Ruiz did not detect any smell of urine or other foul odors. Interviews with staff and outside sources indicated that staff assisted residents with eating meals and encouraged hydration by providing all residents with a cup for water that was kept near the resident. Staff verbally encouraged residents to drink water and finish eating their meals and would notify the Administrator if a resident did not finish all of a meal multiple days in a row. Interviews confirmed that R1 required encouragement to eat meals but did not experience any decline in meal portions eaten. Interviews revealed that staff did not regularly weigh residents at the facility unless a resident had a doctor’s order but would document a resident’s weight from medical records. Interviews with outside sources described staff as attentive, compassionate, and patient, and did not voice any concerns regarding resident cleanliness, observations in changes of conditions, or staff to resident interactions. Interviews with outside sources did not reveal any concerns regarding the care and supervision provided by the facility and did not support the validity of the allegations. The Department was unable to interview R1 due to R1 passing away and the Department was unable to secure facility records for 2020 due to the requirement that facilities must maintain records for 3 years only. The Department has investigated the above-mentioned allegations and based on interviews, the preponderance of the evidence has not been met, therefore, these allegations are deemed unsubstantiated. An exit interview was conducted with Administrator May Paraiso, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 01/16).the state’s words, verbatim · CDSS document, Feb 14, 2024 · control 08-AS-20201201112638