Clarissa's Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrator Jose Jr. Casimiro and was granted entry to the facility. Licensed capacity is (6) current census (4). LPA was accompanied by Administrator Jose Jr. Casimiro to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated spac for resident/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for residents. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (4) resident files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed (4) resident medications and (2) hospice files. During the medication audit, LPA Rico observed that PRN medications for residents R1 and R2 did not have documentation regarding dosage, administration date, and resident response. Additionally, LPA Rico noted an overflow of resident medications. Staff member S1 stated that the overflow medications had been discontinued; however, the facility did not have a physician’s discontinuation order on file. LPA observed that medications had been transferred from their original packaging into a clear container. LPA Rico also found five loose pills in the medication bins. Furthermore, the facility did not have a copy of its Plan of Operation available for review. Facility phone was out of service.LPA also reviewed (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. Based on the observations made during today’s visit, five deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809)(LIC809D) (APPEAL RIGHTS) was discussed and provided to Administrator Jose Jr. Casimirothe state’s words, verbatim · CDSS document, Sep 3, 2025

Type of visit: Required - 1 Year

On 09/26/2024 at 2:10 PM, Licensing Program Analyst (LPAs) Melody Brown and Becky Mann made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPAs Brown and Mann met with a staff and was granted entry to the facility. At the time of the visit there was one (1) staff present, and five (5) residents present. Licensee/Administrator Casimiro Jose was contacted and informed of the visit. Licensee/Administrator Jose arrived during the visit. LPAs Brown and Mann explained the purpose of the visit to Licensee/Administrator Jose. The facility is a 4 bedroom, 2 bathroom home with a kitchen/dining area, living room, activity room and laundry area. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) residents of which one (1) maybe bedridden. The facility has four (4) Hospice Waiver. The current census is five (5) residents. LPAs Brown and Mann was accompanied by Staff #2 (S2) to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). LPAs Brown and Mann observed no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 70 degrees Fahrenheit. LPAs Brown and Mann inspected resident bedrooms; they are equipped with required furniture such as: mattresses, lamps and storage space. LPAs Brown and Mann observed sufficient lightning. Moreover, LPAs Brown and Mann observed that bathrooms were clean, and appliances were operating appropriately. LPAs Brown and Mann observed grab bars and non-skid mat in the resident bathrooms. During the tour of the facility, LPAs observed the multiple cans of paints, chemicals and nails in the outside cabinet were not locked and accessible to residents in care. Deficiency will be issued. ***Continuation in LIC 809C*** ***Continuation from LIC809 *** Also, LPAs Brown and Mann observed Resident #1 (R1) with half bed rails. Licensee/Administrator Casimiro reported to LPAs Brown and Mann that R1 does not have written order from R1 physician indicating the need for half bed rail for mobility. Deficiency will be issued. LPAs Brown and Mann observed sufficient furniture and lighting throughout the facility. LPA Brown and Mann measured and observed the water temperatures in the bathroom to be at 118 degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCLD complaint poster, Ombudsman Poster and the Emergency Disaster plan were posted in a common area. There was a designated storage space for resident/staff files. There is a cabinet with the resident’s medications locked in the medication room. Food Service: Seven (7) days non-perishable and three (3) days perishable food supply observed at the facility. Care & Supervision: The facility has an administrator present in the facility. LPAs Brown and Mann observed no sufficient number of staff to provide care and supervision to the residents in care due to no staff is scheduled to work the night shift as required for facility with Dementia residents. Deficiency will be issued. Record Review: LPA reviewed three (3) resident files for admission agreements, updated medical assessment/physician reports, preplacement appraisals. The files were complete with updated physician’s reports, admissions agreements, and preadmissions appraisals. LPAs observed resident #1 (R1) and resident #3 (R3) do not have Preplacement Appraisal maintained in their facility file. Deficiency will be issued. Also, LPAs observed no completed Medical Assessment/Physician Report for resident #2 (R2). Deficiency will be issued. In addition, LPAs reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with tuberculosis (TB) test results. LPAs observed that files reviewed were complete. Furthermore, medications were audited for two (2) residents and LPAs observed resident #1 (R1) and resident #2 (R2) medications were not given per R1 and R2 physician's order. Deficiency will be issued. An exit interview was conducted where this report LIC809, LIC809D, and Appeal Rights were discussed and provided to Licensee/Administrator Casimiro Jose.the state’s words, verbatim · CDSS document, Sep 26, 2024