Bubbe and Zayde's Place

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Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez made an unannounced visit for the purpose of conducting the required annual inspection. LPA was greeted and granted entry by care staff and explained the purpose for the visit. Administrator Shimon Cagan arrived shortly after and met with LPA. LPA observed that Administrator Shimon Cagan has a valid Administrator certificate which expires November 21, 2027. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for six. There currently are four residents at the facility and there are two residents receiving hospice services currently. LPA accompanied by Administrator began the tour of the inside and outside of the facility. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. LPA observed residents to have just finished lunch and about to do activities. There is a minimum of one week of non-perishables foods and two days of perishables foods available. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage closet located in the living room. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA observed the first aid kit stores with medication. LPA inspected the facility bathrooms and LPA measured the hot water temperature which measured 111.3 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The Continued on LIC809-C facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. LPA observed that toxic chemicals, cleaning solutions and disinfectants are stored locked underneath kitchen sink and locked storage cabinet in the laundry unit. The facility has an available clean supply of linens stored in bedroom hallway cabinets. LPA inspected residents’ bedrooms which have sufficient lighting to ensure safety and comfort. All bedrooms observed to have all required components. Storage space is provided for residents in their bedroom. Smoke detectors/carbon monoxide detectors were tested and found to be operational. LPA toured the outside of the facility and observed outdoor passageways are free of obstructions. LPA observed there are shaded seating areas for residents’ enjoyment. LPA observed a fire extinguisher charge and mounted in the kitchen and bedroom hallway with service date of May 9, 2025. Fire drills are conducted every three months, LPA verified fire drill logs are kept and last drill was conducted April 8, 2025. LPA began reviewing records. LPA reviewed two resident records. All the required documentation was present and reviewed in the residents’ files. LPA reviewed two employee records. All employees present have a criminal record clearance and are associated with the facility. LPA observed records reviewed have a current First Aid certificate. Based on the observations made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator, and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Feb 18, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit for the purpose of conducting the required annual inspection. LPA was greeted and granted entry by care giving staff after explaining the purpose for the visit. Administrator (AD) Seth Curkin was notified via telephone but could not arrive to assist with the inspection. LPA observed that Administrator Seth Curkin has a valid Administrator certificate which expires August 21, 2026. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents, and has a hospice waiver for six. The facility is a single story home with three resident bedrooms, one of which is shared, two resident bathrooms, both are which are shared, a living room, a dining room, a kitchen, a laundry room, and an attached two car garage. LPA, accompanied by a care giving staff conducted a tour of the interior portion of the facility. On today's visit, LPA observed one resident in care and two care giving staff present. LPA observed the resident relaxing in a common area. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the entryway of the facility. LPA inspected all three resident bedrooms and they were observed to be free of any hazards. LPA observed the resident bedrooms had all the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds had clean linens and blankets. LPA observed additional linens and blankets are stored in a closet in the resident hallway. LPA inspected the two shared resident bathrooms. Resident bathrooms are clean. Resident bathrooms were equipped with grab bars and nonskid floor mats. Faucets and toilets were operational. Hot water temperature measured between 109.5 and 110.3 degrees Fahrenheit. LPA observed that the kitchen has a two day perishable and a seven day nonperishable food supply on hand. The kitchen is clean and appliances were operational. LPA observed the four top electric stove to be operational at the time of visit. LPA observed kitchen knives to be stored in a locked kitchen cabinet. LPA observed toxins and chemicals to be stored in a locked kitchen cabinet under the sink. CONTINUED ON LIC809-C A fire extinguisher is located in the kitchen and in the resident hallway. Fire extinguishers were observed to be charged and serviced as of March 12, 2024. LPA tested the dual smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on January 21, 2025. The centrally stored medication is kept in a locked closet in the living room. LPA observed a First Aid Kit to be stored in the locked closet and it was observed to have all the required components. LPA observed a fireplace in the living room and it was observed to be adequately fenced and not in operation at time of visit. LPA inspected the laundry room and observed chemicals and toxins to be stored in a locked cabinet. LPA observed the door leading to the attached two car garage is kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage. LPA observed the facility has a three day emergency food and water supply stored in the garage. LPA, accompanied by a care giving staff conduct a tour of the exterior portion of the facility. LPA observed the exterior portion of the facility to be free of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for resident use. The perimeter gate on the west side of the facility is self-latching and can be open in an evacuation. There are no bodies of water on the premises. LPA reviewed the one resident file. All the required documentation was present and current in the resident file reviewed. LPA reviewed the one residents' medication and medication record. LPA reviewed two staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, no deficiencies are being cited per Title 22 of the California Code of Regulations. LPA spoke with Administrator Seth Curkin via telephone who authorized Supervisor Juana Gonzalez to sign the report. An exit interview was conducted with Supervisor Juana Gonzalez and a copy of the report was provided.the state’s words, verbatim · CDSS document, Feb 14, 2025

Type of visit: Required - 1 Year

On May 31, 2024 at 1:15PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Supervisor (SV) Juana Gonzalez and explained the purpose of the visit. Administrator Shimon Cagan was contacted over the phone to explain he could not attend today's visit. The facility is licensed to operate for six (6) non-ambulatory and have a hospice waiver for six (6) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: three (3) resident bedrooms, two (2) bathrooms, living room, dining room, kitchen, an attached garage, and an outside covered patio area. LPA Kim toured indoor and outdoor of the physical plant with SV Gonzalez. There are no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each client’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident Room 1, Resident Room 2, and Resident Room 3. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 114.9 and 115.1 degrees F. A comfortable temperature of 73 degrees F was maintained in the facility. LPAs Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to clients. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. The facility has two (2) fire extinguishers that are charged and they were all serviced on March 12, 2024, smoke detectors, and carbon monoxide detectors were operable. A working telephone (657-210-4114) remains available. First Aid Kit contained all the necessary elements. Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA Kim reviewed the facility’s plan of operation, infection control plan, and emergency and disaster plan.. LPA Kim conducted an audit of all resident files (R1-R5), staff files (S1-S3), and medication and medication administration record. LPA Kim conducted 2 staff interviews and no residents because all residents were out in the community. A deficiency was cited during this inspection visit according to the California Code of Regulations (Title 22, Division 6). An exit interview was conducted, and a copy of this report was provided to Supervisor Juana Gonazalez.the state’s words, verbatim · CDSS document, May 31, 2024