Bermuda Residential Care Home

Type of visit: Required - 1 Year

On 06/30/26 at 09:25 am Licensing Program Analysts (LPA) J. Clancy-Czuleger arrived unannounced to do an annual inspection. LPA meet with Administrator Charmaine Collado and explained the purpose of the visit. LPA inspected the facility inside out. There is no body of water. Physical plant is consistent with the facility sketch received by Central Application Bureau (CAB) and approved by the fire department. LPA inspected the living room, dining area, kitchen, bedrooms, hallways, bathrooms, side and backyards. Bedrooms were observed appropriately furnished with adequate lighting and drawers. Facility has sufficient towels, extra bed sheets and comforters. Equipment and supplies for residents' personal hygiene are available and on site. Dinner and silver wares were observed sufficient for residents' use. Food supplies checked and observed good for seven days of non-perishables. Facility was observed equipped with refrigerator, microwave, dishwasher, washer and dryer. Cabinet for knives, cleaning supplies, and central storage for medications were observed with locks. Activity supplies were available. Outdoor activity space was observed furnished with tables, chairs and shade. The facility has a mitigation plan. Fire extinguishers were observed fully charge and tags showed serviced 06/03/2026. At 10:02 am LPA reviewed 6 residents records. At 10:30 am, LPA reviewed 3 staff records and 3 of 3 were fingerprint cleared and associated to the facility. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jun 30, 2026

Allegation investigated: Staff did not notify resident's responsible party of change in condition.

On 9/28/2025 at 10:30AM, Licensing Program Analysts (LPAs) J. Clancy-Czuleger arrived unannounced to deliver the findings for the above allegations. LPA explained the purpose of the visit with Staff Natasha Reyes. Administrator Charmaine C was called and informed of the visit. Collado. During the course of the investigation, LPA J. Clancy-Czuleger interviewed the administrator and residents, and reviewed records. On the allegation:Staff did not notify the residents responsible party of change in condition. RP stated that they were only informed of stage 3-4 wounds from hospice and were never informed by anyone at the home. When asked S1 stated that from what they understood, hospice was in charge of all aspects of wound care and thought that included notifying the resident’s responsible party. Based on LPA’s interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. The California Code of Regulations, Title 22 has been cited. Exit interview conducted. A copy appeal rights, and this report provided. Substantiated Continued from LIC9099A... On the allegation: Staff did not ensure resident's hygiene needs are being met. Based on interviews staff were offering showers to R1 but R1 would deny a shower. S1 stated that staff would offer to bring R1 to the shower but R1 would refuse, and staff would then offer bed baths which R1 would sometimes accept and sometimes deny. S1 said they did what they could, but they were not going to force R1 to shower/bath as it was R1’s personal right to deny. On the allegation: Staff do not ensure that residents have clean bedding. Based on interviews the facility has stained pillows. S1 stated that the bedding will sometimes discolor over time and after use. S1 stated that they reuse pillows, but they will clean and sanitize between different residents. S1 said that if a pillow or other bedding is too dirty or destroyed, they will toss it and replace it with new bedding but will do what they can to clean an item before making that decision. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 28, 2025 · control 15-AS-20250403131419

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(8) · Plan of correction due date: Sep 11, 2025

Residents in all residential care facilities for the elderly shall have all of the following personal rights: To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs. This requirement was not met as evidenced by: Based on interviews and observations the facility did not communicate R1's change of condition with familythe state’s words, verbatim · CDSS document, Aug 28, 2025

Plan of correction: The facility agrees to review the regulation and create a plan of communication for informing families of residents change of condition and submit it to CCLD by POC date.

Type of visit: Required - 1 Year

On 04/04/25 at 09:10 am Licensing Program Analysts (LPA) J. Clancy-Czuleger arrived unannounced to do an annual inspection. LPA meet with Administrator Charmaine C. Collado and explained the purpose of the visit. LPA inspected the facility inside out. There is no body of water. Physical plant is consistent with the facility sketch received by Central Application Bureau (CAB) and approved by the fire department. LPA inspected the living room, dining area, kitchen, bedrooms, hallways, bathrooms, side and backyards. Bedrooms were observed appropriately furnished with adequate lighting and drawers. Facility has sufficient towels, extra bed sheets and comforters. Equipment and supplies for residents' personal hygiene are available and on site. Dinner and silver wares were observed sufficient for residents' use. Food supplies checked. Facility was observed equipped with refrigerator, microwave, dishwasher, washer and dryer. Cabinet for knives, cleaning supplies, and central storage for medications were observed with locks. Activity supplies were available. Outdoor activity space was observed furnished with tables, chairs and shade. The facility has a mitigation plan. Fire extinguishers were observed fully charge and tags showed serviced 11/12/2024. Continued on 809C... ...Continued from 809 The following deficiency was observed during the visit: Fence in yard has fallen over The facility does not have a one week supply of nonperishable food The facility does not have hospice care plan for R2 The facility has not been reporting incidents to CCLD 4 of 6 residents do not have admissions agreements in their file 3 of 6 residents do not have personal property and valuables list in their file 6 of 6 residents do not have a reappraisal document in their file 2 of 2 staff files checked did not have a health screening The Facility was cited, and citations can be found on the LIC 809-D. Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Apr 4, 2025

Type of visit: Required - 1 Year

On 5/8/2024 at 11:35 am Licensing Program Analysts (LPAs) J. Clancy-Czuleger and A Gharachorloo arrived unannounced to do an annual inspection. LPA meet with Administrator Charmaine C. Collado and explained the purpose of the visit. LPA inspected the facility inside out. There is no body of water. Physical plant is consistent with the facility sketch received by Central Application Bureau (CAB) and approved by the fire department. LPA inspected the living room, dining area, kitchen, bedrooms, hallways, bathrooms, side and backyards. Bedrooms were observed appropriately furnished with adequate lighting and drawers. Facility has sufficient towels, extra bed sheets and comforters. Equipment and supplies for residents' personal hygiene are available and on site. Dinner and silver wares were observed sufficient for residents' use. Food supplies checked and observed good for seven days of non-perishables. Facility was observed equipped with refrigerator, microwave, dishwasher, washer and dryer. Cabinet for knives, cleaning supplies, and central storage for medications were observed with locks. Activity supplies were available. Outdoor activity space was observed furnished with tables, chairs and shade. The facility has a mitigation plan. Fire extinguishers were observed fully charge and tags showed purchased on 02/14/2024. At 12:02 pm LPA reviewed 6 residents records. At 12:45 pm, LPA reviewed 3 staff records and 3 of 3 were fingerprint cleared and associated to the facility. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, May 8, 2024