Brighten Cottages - Parkcrest

Type of visit: Required - 1 Year

On 10/27/2025 at 12:45pm, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one year inspection. LPA met with Jose Umana , Administrator and the purpose of the visit was discussed. The facility is licensed to serve 6 non- ambulatory of which 1 may be bedridden (bedroom #5 approved for bedridden) and approved for two (2) hospice waivers. The facility has four (4) of the residents are diagnosed with dementia, one (1) hospice, zero (0) home health resident and zero (0) bedridden resident. The facility does not handle any of the residents’ money. The facility has a current administrator Jose Umana has a certificate 7001004740 (valid 07/06/2025 - 07/05/2027). The last fire drill was conducted on 09/10/2025 The facility has liability insurance with James River Insurance Company (NAIC#12203) with an effective date as of 08/01/2025 - 08/01/2026 with each occurrence at $1,000,000 and general aggregate at $3,000,000 (Policy #001200934). The home is a single story home consisting of: (6) resident bedrooms, (4) full bathrooms, living room, kitchen with dining area, laundry room (located in the hallway) and an outdoor shaded patio area. Between the hours of 1:22pm - 3:00pm LPA reviewed (6) resident records, (6) staff records (1) Hospice Care Plan and and (6) Client Medication Administration Records. The last disaster drill was conducted on 09/10/2025. Report continues on LIC 809-C Between the hours of 12:55pm - 1:20pm, LPA Zina Brown conducted a toured with Jose Umana (administrator) the inside and outside of the facility. All client room were checked. Resident bedrooms had the required furniture had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured at 118.5°F, 117.6 °F, 118.7°F . Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly, and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did observe deficiencies such as missing TB Test Results for Resident #4, missing LIC 503 Health Screening for Staff #4 and Physician Order for half-bed rails for Resident #2, Resident #3 and Resident #6. Citations were issued at this time. An exit interview conducted, appeal rights explained, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 27, 2025

Type of visit: Case Management - Deficiencies

On 10/09/2024, LPA Zina Brown made an unannounced case management deficiency visit and met with Carl Beboso, Caregiver during today visit and explained the purpose of today's visit. LPA Brown conducted an annual inspection on Monday, September 30, 2024. During the inspection, based on an interview, Administrator Jose Umana indicated that the resident was not bedridden, despite the physician's report stating otherwise. On Tuesday, October 8, 2024, Administrator Jose Umana sent an email clarifying that the resident he previously told LPA was not bedridden is, in fact, bedridden, based on further clarification from the doctor. He also stated that the resident is currently located in bedroom #6, which has an exit sliding door near the garage. Based on interview, record review, and observation, Resident #1 (bedridden) is currently in bedroom #6, instead of bedroom #5, which is the room cleared for bedridden residents per the fire clearance. This presents an immediate health and safety risk to the resident. As a result, an immediate $500 civil penalty has been issued today, Wednesday, October 9, 2024. Deficiency cited under California Code of Regulation Title 22, Division 6, Chapter 8. An exit interview was conducted, with a copy of appeal rights, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 9, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a) · Plan of correction due date: Oct 10, 2024

Fire Clearance 87202(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district . . . This requirement is not met as evidence by: Based on interview, record review & observation bedridden resident #1 is currently in bedroom # 6 & is not bedroom #5 which is cleared for bedridden resident per the fire clearance assigned for bedridden resident. This poses as a immediately health & safety risk in care.the state’s words, verbatim · CDSS document, Oct 9, 2024

Plan of correction: The administrator stated he will contact the families of residence who resided in bedroom #5 and bedroom #6 to get approve of switch the bedridden client in the clear room based on fire clearance. Administrator state he will send pictures within 24 hours of POC date.

Type of visit: Required - 1 Year

On 09/30/2024 at 09:11am, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one year inspection. LPA met with Jose Urmana , Administrator and the purpose of the visit was discussed. The facility is licensed to serve 6 non- ambulatory of which 1 may be bedridden (bedroom #5 approved for bedridden) and approved for two (2) hospice waivers. The two (2) of the residents are diagnosed with dementia, two (2) hospice, one (1) home health resident and zero (0) bedridden resident. The facility does not handle any of the residents’ money. The facility have a balance of $0 for annual fees. The last fire drill was conducted on 03/13/2024. The Certificate of Liability is valid from 08/01/2024 - 08/01/2025. The home is a single story home consisting of: (6) resident bedrooms, (4) full bathrooms, living room, kitchen with dining area, laundry room (located in the hallway) and an outdoor shaded patio area. LPA Brown toured the resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured in kitchen at 111.3F and bathrooms #1 - # 4 at 115.1 F. 111.4, 109.9 F, 110.0 F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly, and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. Discrepancies were observed and documented on 809-D page . An exit interview conducted, appeal rights explained, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 30, 2024

Type of visit: Required - 1 Year

On 11/30/2023 at 01:30 AM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Brighten Cottages Parkcrest Facility. LPA Calderon was allowed entry into the facility by Administrator Elsa Roman. Administrator Elsa Roman asked infection control questions and took LPA Calderon temperature prior to entrance into the facility. The facility is licensed to operate age range 60 and over six (6) non-ambulatory of which 1 may be bedridden and hospice waiver for 2. Currently, there are six (6) residents residing in the facility 60 year or older. LPA Calderon explained to Administrator Elsa Roman, the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: three (3) resident service records, three (3) resident medication records, two (2) staff records. LPA Calderon interviewed three (3) residents and two (2) staff members for visit and inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 11/22/2023. The one-story residential home consists of six (6) resident bedrooms, four (4) resident bathrooms, living room, dining room, family room, kitchen, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A two-day (2) supply perishable and seven-day (7) supply of non-perishable foods are present in the facility. Emergency Water supply is found in the garage. During the visit, LPA Calderon observed the facility infection control practices. LPA Calderon observed screening protocols for visitors, staff, and residents, sanitizing stations (Located in common areas and restrooms). LPA Calderon observed staff and residents were NOT wearing face coverings. LPA Calderon noted required postings throughout the facility. LPA Calderon observed the facility has a thirty-day supply of Personal Protective Equipment (PPE). LPA Calderon advised the Administrator Elsa Roman to continuously monitor the Centers for Disease Control (CDC) website and Community Care Likening Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Calderon did not observe any deficiencies therefore NO citations were issued at this time. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Elsa Roman. LPA Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Calderon observed the following during inspection of resident’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Calderon observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats. LPA Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 109 degrees Fahrenheit, and bathroom #2 hot water temperature properly measured at 108 degrees Fahrenheit. Bathroom #3 hot water temperature properly measured at 107 degrees Fahrenheit, and bathroom #4 hot water temperature properly measured at 109 degrees Fahrenheit. Kitchen hot water temperature properly measured at 112 degrees Fahrenheit. Facility (2) carbon Monoxide and (8) Smoke Detectors hard wired and connected were tested and are working properly. The facility two (2) Fire Extinguishers were checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. All toxins and knifes are locked/secured and inaccessible to residents. Medications are centrally stored and in a locked storage cabinet. Facility first aid kit is fully stocked with manual was checked and in order. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Front patio accessible to residents. Three (3) resident files were reviewed and found to be complete. LPA Calderon reviewed three (3) resident medications and they were all found to be administered according to doctor's orders. Two (2) staff files were checked and have the required documents. LPA Calderon noted the Administrator Elsa Roman # 6040880740 expiration date of 06/23/2024 was valid at time of visit. The facility does NOT handle resident's money/cash resources and no Surety bond is needed. General Liability Policy #001200932 policy period from 08/01/2023 to 08/01/2024 underwritten by James Rivers Insurance Company Inc, coverage 1,000,000/3,000,000 is valid at time of inspection. LPA Calderon spoke to Administrator Elsa Roman who will email copy insurance contact to LPA Calderon on 12/12/2023. All the required documents are posted in the facility in a clearly visible area. LPA During the visit, LPA Calderon observed the facility infection control practices. LPA Calderon observed screening protocols for visitors, staff, and residents, sanitizing stations (Located in common areas and restrooms). LPA Calderon observed staff and residents were NOT wearing face coverings. LPA Calderon noted required postings throughout the facility. LPA Calderon observed the facility has a thirty-day supply of Personal Protective Equipment (PPE).the state’s words, verbatim · CDSS document, Nov 30, 2023