Care and Care Residence II

Allegation investigated: -Facility staff are not properly addressing bed bugs in the facility

On 04/02/2026, Licensing Program Analyst (LPA) Yi Sam Jian conducted an unannounced complaint investigation visit. LPA met with Michelle Perez, Caregiver. LPA explained the purpose of the visit. During the visit, resident R2 directed the LPA to a bed where the LPA observed a live bed bug crawling, confirming the presence of a bed bug on the resident’s bed. Administrator denied having a bed bug issue. Based on LPA observation, interviews and file reviews during the course of the investigation it was determined that the preponderance of evidence standard has been met, therefore the allegations above are found to be SUBSTANTIATED. The deficiency is cited in accordance with California Code of Regulations, Title 22 Division 6, Chapter 8 and is noted on the attached LIC 9099-D. Report was reviewed with caregiver. A copy of this report and Appeal Rights was provided to facility. Substantiatedthe state’s words, verbatim · CDSS document, Apr 2, 2026 · control 14-AS-20260224064215

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(a) · Plan of correction due date: Apr 3, 2026

87303 Maintenance and Operation..(a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by: Based on observation, record review and interview, facility has bedbugs which poses an immediate health and safety risks to residents in care.the state’s words, verbatim · CDSS document, Apr 2, 2026

Plan of correction: The licensee shall develop a plan to ensure the facility is cleaned, safe and sanitary to all residents. The plan shall have a different intervention as the current plan is not working. The licensee will submit a copy of the plan to CCL by POC due date.

Type of visit: Required - 1 Year

On 03/03/2026 Licensing Program Analyst(LPA) Yi Sam Jian arrived at the facility to conduct the Annual 1-year required visit. LPA was greeted by Lucila Panganiban, Caregiver and explained the purpose of the visit. LPA toured the physical plant. This is a 2-story building which consists of a kitchen, living room, dining room, 3 bedrooms, a staff bedroom downstairs, backyard, and 2 full bathrooms. All hallways, passageways, and the backyard were observed to be free of hazards and obstructions. The kitchen was inspected, and a sufficient supply of food was observed. Infection control practices were reviewed. Medications, toxins, and sharps were stored appropriately and kept inaccessible to clients. A comfortable temperature was maintained throughout the facility, with hot water temperature inspected to be in compliant. Furnishings and lighting were adequate for comfort and safety. The carbon monoxide and smoke detection systems were inspected and meet required standards. The fire extinguisher was checked and is fully charged. The first-aid kit was inspected and is complete. Technical violations were provided for not having documentation for annual appraisal for clients and not having documentation for personal property for clients. Deficiencies of the California Code of Regulations, Title 22 are cited on LIC809-D. This report was reviewed with Lucila Panganiban, Caretaker and a copy of the report along with Appeal Rights left at the facility.the state’s words, verbatim · CDSS document, Mar 3, 2026

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 04/17/2025 Licensing Program Analyst(LPA) Yi Sam Jian arrived at the facility to conduct the Annual 1-year required visit. LPA was greeted by Lucila Panganiban, Caregiver and explained the purpose of the visit. LPA toured the physical plant. This is a 2-story building which consists of a kitchen, living room, dining room, 3 bedrooms, a staff bedroom downstairs, backyard, and 2 full bathrooms. All hallways, passageways, and the backyard were observed to be free of hazards and obstructions. The kitchen was inspected, and a sufficient supply of food was observed. Infection control practices were reviewed. Medications, toxins, and sharps were stored appropriately and kept inaccessible to clients. A comfortable temperature was maintained throughout the facility, with hot water temperature inspected to be in compliant. Furnishings and lighting were adequate for comfort and safety. The carbon monoxide and smoke detection systems were inspected and meet required standards. The fire extinguisher was checked and is fully charged. The first-aid kit was inspected and is complete. Type B Violations were provided for incomplete Physician's reports and administrator certificate not available for review at the time of visit. A Technical violations were provided for not having documentation for emergency drills and emergency plan. Deficiencies are cited under California Code of Regulations, Title 22, cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report was reviewed with Lucila Panganiban, Caretaker and a copy of the report along with Appeal Rights left at the facility.the state’s words, verbatim · CDSS document, Apr 17, 2025

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On May 9, 2024, at 8:45 AM, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the Annual 1-year required visit. LPA Calandra was greeted by Lucila Panganiban, Caregiver and explained the purpose of the visit. LPA Calandra toured the physical plant. This is a 3-story building which consists of a kitchen, living room, dining room, 3 bedrooms, a staff bedroom downstairs, backyard, and 2 full bathrooms. All hallways, passageways, and the backyard were observed to be free of hazards and obstructions. All bedrooms had the required furniture and sufficient lighting. The facility was maintained at a comfortable temperature of 74 degrees Fahrenheit. Hot water temperature in all bathrooms was measured between the required 105-120 degrees Fahrenheit. Bathrooms were equipped with the required grab bars and floor mats. Fire Alarms and Carbon Monoxide detectors in the facility were observed to be in working condition. Fire extinguishers were observed to be fully charged and a copy of the purchase receipt was provided to the LPA by caregiver, Lucila Panganiban. All food was observed to be in good condition. No food was expired. The facility had the required 7 days of non-perishables and 2 days of perishables on site. The washer and dryer were observed to be in working condition. All soap, detergent, and cleaning supplies were observed to be locked and in-accessible to persons in care. All knives and sharp objects were observed to be locked and in-accessible to persons in care. LPA Calandra reviewed 4 client records and 5 staff records. All client records were observed to have incomplete LIC 602-Physician's reports that were unsigned. LPA Calandra interviewed 2 residents and 1 staff member. A review of Centrally stored medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication records(CSMR) kept at the facility. LPA Calandra requested the following documents be sent to the department: -The facility's Liability Insurance -The facility's current lease agreement -Updated LIC 500 -LIC 503/Health Screening Reports for all staff Type B Violations were provided for incomplete Physician's reports and dressers in resident bedrooms that were in disrepair. A Technical violation was provided for not having a facility sketch that shows evacuation routes. Deficiencies are cited under California Code of Regulations, Title 22, cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report was reviewed with Lucila Panganiban, Caretaker and a copy of the report along with Appeal Rights left at the facility.the state’s words, verbatim · CDSS document, May 9, 2024

Type of visit: Required - 1 Year

On 1/26/24, LPA Grace Donato made an unannounced annual visit to the facility. LPA met with Caregiver Lucila Panganiban. LPA explained the purpose of the visit. LPA toured the facility inside and outside including all of resident rooms, garage/storage area, and kitchen area. Residents are currently resting in their rooms resting and others are watching. It was observed that the room temperature was 68 deg F. Hot water was also tested in the bathrooms and the temperature was 108 deg F. The facility is observed to be clean, odorless, and well maintained. Residents’ bedrooms were observed to be organized and fully furnished with adequate lighting. Sharps and toxic materials were observed to be locked. Food supply was observed with an adequate two-day perishable and seven-day non-perishable food supply. Carbon monoxide/smoke detectors, and fire extinguisher were present throughout the facility. The facility has an updated log for emergency drill which is done every quarter. Four resident records and four staff records were reviewed. Staff have criminal record and fingerprint clearances on file. Staff have current First Aid/CPR certifications on file. Resident records were reviewed and were observed to be complete. All medication logs are complete and updated. LPA requested the following documents: LIC 308, Certificate of Liability Insurance, LIC 500, Control of Property. No deficiencies are cited at this time. Report is reviewed and a copy is provided.the state’s words, verbatim · CDSS document, Jan 26, 2024