Bethel Place Assisted Living 2

Allegation investigated: Staff did not reorder residents medications timely resulting in resident missing medications

On 8-12-2026 at 10:30am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to continue investigation for the allegation noted above. LPA met with Administrator Princewill Nwaogu and explained the purpose of the visit. During this investigation, LPA conducted interview with Administrator and reviewed facility file documentation including medication log sheets and physician's report for resident1 (R1). Allegation: Staff did not reorder residents medications timely resulting in resident missing medications. LPA conducted interview and record reviews as noted above. Based on interview and record reviews, it was determine that resident1 (R1) was admitted to facility on 4-13-2026 with orders for two diabetic medications. A review of medication log sheets indicated R1 was without one diabetic medication between 4/30/2026 to 6/9/2026 and filled on 6/10/2026. It was also revealed that R1 was without a second diabetic medication between 5/29/2026 and 6/8/2026 and filled on 6/9/2026. Interviews and record reviews further revealed that ordering of medication commenced on or about 6/2/2026. No further evidence existed to show earlier attempts at re-ordering medication. {Cont. on 9099C} Substantiated Additionally, interviews revealed that Licensee did not ensure R1 was seen for emergency services despite knowledge of medication not available for the time frames mentioned above. As a result, there is a preponderance of evidence to conclude that Licensee did not ensure the timely ordering of medication resulting in missed medication for R1, therefore this allegation is SUBSTANTIATED. Citation is issued under Title 22, Division 6, and noted on LIC 9099D. An exit interview was conducted with Administrator and a copy of this report was provided. Appeal rights and LIC 811 provided.the state’s words, verbatim · CDSS document, Aug 12, 2026 · control 27-AS-20260617111308

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(4) · Plan of correction due date: Aug 13, 2026

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility... (4) The licensee shall assist residents with self-administered medications as needed.This requirement was not met as evidence by: Based on interview and record review, Licensee did not ensure the assistance of medications for R1 in that R1 ran out of medications without the timely ordering to ensure availability. This posed an immediate health and safety risk to resident in care.the state’s words, verbatim · CDSS document, Aug 12, 2026

Plan of correction: Licensee will develop and submit a plan outlining procedures to ensure timely ordering of medication and overall assurance of medication availablity for residents in care. Plan to be submitted to LPA by POC due date.

Type of visit: Case Management - Other

On 8-12-2026 at 12:50pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management visit regarding medication needs for resident1 (R1). LPA met with Administrator and explained the purpose of the visit. LPA reviewed medication log sheet, physician's report, and medication orders for R1. Additionally, LPA conducted interview with staff1 (S1). Based on interviews and record reviews, it was revealed that R1 was admitted to facility on 4-13-2026 with supply of diabetic medication. It was further revealed that medication ran out and R1 did not receive medication from 4/30/2026 to 6/9/2026. An additional medication ran out and R1 did not receive this medication from 5/29/2026 to 6/8/2026. It was revealed through interviews, that Administrator attempted to re-order medication on or about 6-2-2026, however, prior to and after this date, did not make additional attempts for R1 to receive necessary medication such as seeking emergency and other services to ensure medication availability. As a result of this case management, citation is issued under Title 22, Division 6, and noted on LIC 809D. An exit interview was conducted with Administrator and a copy of this report was provided. Appeal rights provided.the state’s words, verbatim · CDSS document, Aug 12, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87405(d)(1) · Plan of correction due date: Aug 13, 2026

87405 Administrator Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7)...(1) Knowledge of the requirements for providing care... appropriate to the residents. This requirement was not met as evidence by: Based on interview and record review, Administrator did not provide additional necessary emergency attempts to ensure medication availability upon learning of two diabetic medications running out for R1. This posed an immediate health and safety risk to resident in care.the state’s words, verbatim · CDSS document, Aug 12, 2026

Plan of correction: Licensee and Licensee designee will read regulation 87405(d)(1) and submit a signed declaration of understanding to LPA by POC due date.

Type of visit: Required - 1 Year

On 3-18-2026 at 10:20 am, Licensing Program Analyst (LPA) Michael Bilger arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the administrator Princewill Nwaogu and explained the purpose of the visit. LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, common TV area, and outside of the facility to ensure compliance with Title 22 regulations. Facility is a residential facility for the elderly (RCFE) with a current census of 2. Facility has 3 bedrooms and 2 bathrooms for resident use. 1 extra bedroom is for staff use. Facility has a dining area off the kitchen and a formal living room. LPA also conducted the inspection using the CARE tool. Facility currently provides care for 0 ambulatory residents, 2 non ambulatory residents, 0 hospice, and 0 bedridden. The facility has an approved infection control plan in place. Water temperature reads 105*F to 120*F in the bathroom and room temperature reads 73*F. LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguisher was checked 2-2-26. Facility has an emergency food and water kit. All toxins and other dangerous items including sharp objects were locked and inaccessible to residents in care. Medication storage area was observed to be locked and inaccessible to residents in care. First aid kit was observed to have adequate supplies and accessible to staff. {Cont.on 809C} During this inspection 2 resident files and 3 staffing files were reviewed for regulatory compliance. All files contained required contents. LPA completed 0 resident interviews due to decline for interviews, and 2 staff interviews. Resident files reviewed contained all required contents including updated admission agreements, medical assessments, and updated appraisal forms as required. Facility does not contain any bodies of water. LPA observed personal rights and complaint information posted. Facility has appropriate internet access available for resident use. LPA observed facility’s activity calendar and sufficient equipment and supplies to meet activity program needs of residents in care. LPA reviewed facility’s disaster plan to ensure regulatory compliance. LPA requested an updated copy of LIC 308 and LIC 500. Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a report was given to Administrator.the state’s words, verbatim · CDSS document, Mar 18, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Kesha Lewis arrived at this facility unannounced to conduct a Required 1 Year Annual Inspection Visit. LPA was met by staff and administrator. LPA explained the purpose of the visit to Administrator and staff. LPA and administrator inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry area, living area and other common areas, as well as outside of the facility to ensure compliance with Title 22 regulations. Facility is a 6 bed facility with a current census of 3. There is entry door is leading to the living room, kitchen with a hallway to the bedrooms and bathrooms. Chemicals and medications noted to be locked to residents in care. LPA also conducted the care tool. No bodies of water were observed at the facility. Hot water temperature was measured at 112 F degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees Fahrenheit. All necessary documents were in place. LPA observed the following posted on the facility wall: Facility license, sketch, See Something Say Something poster, Ombudsman poster, Theft and Loss Policy, Resident Bill of Rights, Rights of Resident/Family Councils. The facility submitted a LIC 808 mitigation plan, which was approved. The facility has central entry point. LPA observed the facility to have adequate food supply of 7 days non-perishables and 2 days perishables in place. Resident rooms were sanitary and had the required furniture and furnishings. LPA observed, fire extinguishers was purchased on 02/03/2025 and current, smoke and carbon monoxide detectors, central heating and air in the facility. The first aid kit was found in compliance. LPA reviewed two (3) staff files. All staff is fingerprint cleared and associated to the facility and staff have current First Aid or CPR certifications on file. Facility is conducting initial and continuing training as required. LPA reviewed two (3) resident facility files, COVID-19 Plan, and survey binder. All necessary documents were in place. Exit interview held with staff and copies of reports left at conclusion of visit.the state’s words, verbatim · CDSS document, Feb 4, 2025

Type of visit: Post Licensing

On 7/23/24, Licensing Program Analyst (LPA) Kesha Lewis arrived at this facility unannounced to conduct a post-licensing inspection. LPA met with Administrator and explained the purpose of the visit. Administrator assisted LPA with today’s inspection. Administrator’s certificate is current and will expire on 10/24. This facility is three licensed for 2 ambulatory and 2 non-ambulatory client and hospice waiver for 3. Current census is 3. There were one direct care staff on duty during today’s visit. LPA toured and inspected the physical plant inside and outside to ensure there were no health and safety concerns. LPA observed the kitchen, bedrooms, bathrooms, medication, laundry area and common areas. LPA observed the facility is in good repair. LPA observed sufficient furniture and lighting throughout the facility. The hot water temperature was measured at 107*F which was within the required range of 105-120*F. The temperature inside the facility was observed to be at 75*F which was within the required range of 68-85*F. LPA observed the centrally stored medication areas to be locked and made inaccessible to the clients at this time. LPA observed the fire extinguisher(s) and first aid kits were up to date. LPA observed smoke and carbon monoxide detector(s) in the facility were in good repair. LPA reviewed staff and resident files. An exit interview was conducted and a copy of this report was given.the state’s words, verbatim · CDSS document, Jul 23, 2024

Type of visit: Prelicensing

On 03/05/2024, Licensing Program Analyst (LPA) Kesha Lewis arrived announced to conduct a Pre-Licensing visit. LPA was greeted by applicants,NWAOGU, PRINCEWILL and explained the purpose of the visit. The purpose of this visit was to conduct a Pre-Licensing Visit. This facility will be licensed to hold 6 residents, of which 4 may be non-ambulatory and 2 ambulatory. A tour of the facility was conducted. Smoke detectors and carbon monoxide detectors were tested and are in good repair. A tour of the kitchen area was done. A review of food supply was conducted to ensure a 2 day perishable and 7 day non-perishable food supply was available. This facility will have a locked medication cabinet located in the kitchen. A first aid kit was observed and had all the required components. Fire extinguisher was located in kitchen and was purchased on 10/30/2023. A tour of the family room was conducted. Furniture and furnishings were observed to be in good repair. A tour of the backyard was conducted with no hazards present. Perimeter gate was observed to be in good repair. A tour of garage was conducted. A washer and dryer was identified. Detergent, toxins and other cleaning supplies were observed to be locked and made inaccessible. A tour of the resident bedrooms were conducted. Furniture and furnishing were observed to meet the residents needs. A linen closet was located in hallway and was observed to have a sufficient amount of linen to meet the residents needs at this time. A tour of two resident restrooms were toured. Hot water temperature was taken to ensure that it was in within 105-120 degrees. Comp II was completedthe state’s words, verbatim · CDSS document, Mar 5, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Nwaogu, Princewill - Applicant/Administrator Interview Method: Telephone interview On 02/13/2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Feb 13, 2024