Coastside Senior Home

Type of visit: POC

On July 29, 2026, Licensing Program Analysts (LPAs) Brandon Lopez and Tran Nguyen made an unannounced visit to the facility to conduct a Plan of Correction visit. LPAs were greeted and granted entry into the facility by staff after explaining the purpose for the visit. Administrator (AD) Joselito Rivera was present and assisted on today's visit. LPAs are conducting the visit to follow up on the citations that were issued during the facility's annual inspection conducted on July 8, 2026. During today's visit, LPAs, accompanied by the AD, conducted a tour of the interior portions of the facility. LPAs observed the stove was fixed and all four burners of the stove are now operational. LPAs observed the lights in each resident bathroom were fixed and is now in operational order. LPAs observed the toilets in each of the resident bathrooms were cleared and to be in sanitary condition. LPAs also observed the exterior passageways to be free of any hazards or obstructions. The Administrator submitted all of the required documents to LPA for the plans of corrections within the required time frame. Based on the observations made during today's visit, no deficiencies are being cited per Title 22 of the California Code of Regulations. All citations that were issued during the annual inspection conducted on July 8, 2026, were cleared at time of visit. An exit interview was conducted with Administrator Joselito Rivera and a copy of the report was provided at time of visit.the state’s words, verbatim · CDSS document, Jul 29, 2026

Type of visit: Required - 1 Year

On July 8, 2026, Licensing Program Analysts (LPAs) Brandon Lopez and Taylor Simerly made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPAs were greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Joselito Rivera was present and assisted with today's inspection. LPAs observed that Joselito Rivera has a valid administrator certificate which expires on October 3, 2026. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for four. The facility is a two story home. The first floor consist of four resident bedrooms, two of which are shared, two shared resident bathrooms, a staff bedroom, two living rooms, a dining room, a kitchen, and an attached two car garage. The second story is for staff use only and has three staff bedrooms and one bathroom. LPAs, accompanied by the AD, conducted a tour of the interior portion of the facility. On today's visit, LPAs observed four residents in care. LPAs observed the See Something, Say Something poster (PUB 475) mounted on the wall in a living room. LPAs inspected the four resident bedrooms and they were observed to be free of hazards. LPAs observed residents bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPAs observed resident beds had clean linens and blankets. LPAs observed additional linens to be stored in a hallway closets. LPAs inspected the two resident bathrooms. Resident bathrooms were equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. LPAs observed the toilets in each of the resident bathrooms to be yellow and to have rust present. LPAs observed two of the lights, in each of the two resident bathrooms were not operational. Hot water temperature measured between 112.2 and 113.1 degrees Fahrenheit. CONTINUED ON LIC809-C LPAs observed the kitchen has a two day perishable and a seven day nonperishable food supply on hand. LPAs observed one of the burners, from the four burner gas stove was not operational. LPAs observed six expired food condiments and one expired condensed milk in the refrigerator. LPAs also observed four medications to be unsecured in the refrigerator where they can be accessible by residents in care. LPAs observed a total of forty three expired food items in the kitchen pantry including sweet potatoes, pasta sauce, canned beans, and condensed milk. LPAs also observed prepared food such as spaghetti and rice to be left in the open and not refrigerated. LPAs observed an unsecured bleach container on the kitchen floor. LPAs observed kitchen knives and sharps to be stocked in a locked kitchen cabinet. LPAs observed a fire extinguishers to be mounted in the kitchen and it was observed to be charged and serviced as of June 10. 2025. LPAs tested the individual smoke detectors and individual carbon monoxide detector which tested operational. LPAs observed the facility conducted their last emergency disaster drill on May 10, 2026. LPAs observed the centrally stored medication to be kept in a locked cabinet in the kitchen. LPAs observed the facility has a first aid kit stored in the resident hallway and it had all the required components. LPAs observed an unsecured disinfectant on the staircase. LPAs observed the garage door to be kept locked and inaccessible to residents in care. LPAs observed the garage to be used for storage and laundry. LPAs observed additional chemicals and toxins to be stored in the garage. LPAs, accompanied by the AD, conducted a tour of the exterior portion of the facility. LPAs observed two mattresses blocking the passageway on the north side of the facility. LPAs also observed multiple items including chairs, a couch, suitcases, boxes, and trash, to be obstructing the passageway of the southside of the facility. LPAs observed a shaded outdoor seating area with furniture for resident use. LPAs observed the perimeter gates of the facility to be self latching and can be opened in an evacuation. There are no bodies of water on the premises. LPAs reviewed all four resident files. LPAs observed that the facility did not have a Reappraisal on file for Resident #1 (R1). LPAs reviewed residents' medication and medication records. LPAs observed that the facility has not provided R1's prescribed Senna 8.6 MG routine medication in July 2026, despite R1 having a prescribed order for it to be given twice daily. LPAs observed that the facility has not provided Resident #2 (R2) prescribed Cyclosporine routine medication in July 2026, despite R2 having a prescribed order for it to be given twice daily. LPAs also observed the facility did not have Resident #4 (R4) as needed Albuterol inhaler, despite R4 currently having an active order for the medication. CONTINUED ON LIC809-C LPAs reviewed four staff files. LPAs observed that Staff #3 (S3) and Staff #4 (S4) did not complete any the required annual training for the year of 2025. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, deficiencies are being cited on the attached LIC809-D page. An exit interview was conducted with Administrator Joselito Rivera. A copy of the report and appeal rights were provided at time of visit.the state’s words, verbatim · CDSS document, Jul 8, 2026

Type of visit: POC

Licensing Program Analyst (LPA) Fred Arias made an unannounced visit for the purpose of conducting a Plan of Corrections Inspection for deficiencies issued on 06/25/2025 during the required annual inspection. LPA was greeted and granted entry by Administrator (AD) Joselito Rivera. LPA discussed the purpose of the inspection with AD. LPA toured the facility to check the deficiencies has been corrected with AD. LPA observed corrections completed including auditory alarms being operational, cleaned bathroom, repaired shower chair, furniture relocation, and clutter/overgrowth removed from the backyard. Fire drill was completed on 06/28/2025. Based on LPA's observation on today's visit, the Plan of Corrections has been fulfilled by the assigned POC due date of 07/09/2025, thus clearing the Type B deficiencies CCR 87303(a) and HSC 1569.695(c). An exit interview was conducted with AD and a copy of this report was provided to the facility representative.the state’s words, verbatim · CDSS document, Aug 19, 2025

Type of visit: Required - 1 Year

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents. Facility has an approved hospice waiver for 4 residents and the home currently has 2 residents, with 1 resident on hospice. Administrator (AD) Joselito Rivera arrived shortly to conduct facility tour. AD provided updated liability insurance that expires on 2/16/2026. AD certificate expires on 10/3/2026. LPA along with AD toured the facility at 9:05 AM. LPA toured the physical plant, checked food service, and facility documentation. The home consists of 4 resident bedrooms, living room, dining room, staff room and kitchen as well as 2 bathrooms on the first floor. The second floor consists of 3 bedrooms and living room used by the AD. 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. At 9:30 AM, LPA observed shower floor dirty with stains, transfer chair with rusted wheel brackets, and cleaning power in unlocked cabinet in resident bathroom. Water temperature measured 115.7 degrees F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. At 9:45 AM, LPA observed furniture blocking sliding door exit access in rooms 3 and 4. Three auditory exit alarms were non-operational. LPA toured the kitchen and observed sharps locked in a cabinet during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Smoke detectors tested operational during today's visit. Fire extinguishers were fully charged. Outside grounds were toured. At 10:00 AM, LPA observed clutter in the backyard including an old mattress, other large items designated for removal as stated by AD, and various small items stacked around the house which can be difficult to navigate through. There is plant overgrowth along one of the exit paths covering a large portion of concrete. Continued on LIC809-C Exit gates are unlocked and operational. First aid kit contained all required items including tweezers, scissors and thermometer. LPA observed the emergency food supply. LPA reviewed emergency disaster plan. There was no infection control plan to review. There is no evidence of disaster drills being completed this year. LPA reviewed two resident files and two staff files. All resident files contained required documentation including admission agreements, physician reports, and resident appraisals. Staff files reviewed contained required documentation including medical assessment/ TB, criminal record clearance and proof of CPR training. One out of two staff files contained proof of required training. LPA reviewed medication storage and administration. Medications are stored in a locked closet. Medication is not being administered as prescribed for resident 1 (R1). Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided along with appeal rights.the state’s words, verbatim · CDSS document, Jun 25, 2025

The state marks this report as 10 pages; the online copy we transcribed has 8. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by staff. LPA met with Joselito Rivera, Administrator and explained the nature of the visit. There are three residents at the facility and there is two residents receiving hospice services currently. LPA accompanied with 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. There is a minimum of one week of non-perishables foods and two days of perishables foods available. There is additional food storage in pantry located in the garage. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked cabinet located in the kitchen. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA inspected the bathroom and LPA measured the hot water temperature which measured 107.7 Fahrenheit degrees. Bathroom 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 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 laundry toxins are locked in the garage by laundry unit. The facility has an available clean supply of linens. LPA inspected residents’ bedrooms which has sufficient lighting to ensure the safety and comfort. All bedrooms observed to have all required components. Storage space is provided for residents in their bedroom. Smoke 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 Continued on LIC809-C for residents’ enjoyment. LPA observed a fire extinguisher with service date of July 18, 2024, in the kitchen. LPA began review of records. LPA reviewed three resident records. All the required documentation was present and current in the residents’ files reviewed. LPA reviewed three employee records. All employees present have a criminal record clearance and are associated to 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, Jul 23, 2024