Comfort Keepers Home Care II

Type of visit: Required - 1 Year

On September 19, 2025, at 10:00 AM, 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 Administrator (ADMIN) Constantin Mitrica and explained the purpose of the visit. The facility is licensed to operate for six (6) nonambulatory residents and have a hospice waiver for six (6) residents. The facility is a single-story building located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, one (1) Staff Bedroom, three (3) bathrooms, one (1) living area, dining area, kitchen, outdoor patio area, and an attached two car garage. LPA Kim toured inside and outside of the physical plant with ADMIN Mitrica. There were 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 resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, and Resident Room 5. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 113.0 degrees F to 115.8 degrees F. A comfortable temperature of 79 degrees F was maintained in the facility. LPA 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 residents. 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. Emergency food, emergency water, and emergency supplies were stored in the garage. Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed a staff bedroom inside of a closet. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were operable. A working telephone (714-602-6529) remains available. First Aid kit had all the necessary elements. The facility has one (1) fire extinguisher that was charged and mounted in the kitchen that was serviced on June 23,2025. Emergency drills are conducted quarterly and were last conducted on September 12, 2025. Evidence of liability insurance effective September 15, 2025, to September 15, 2026. LPA Kim conducted an audit of resident files (R1-R6), staff files (S1-S5), and medication and medication administration record that were all in order and complete. LPA Kim conducted interviews with two (2) staff and three (3) residents. A deficiency was cited during this inspection visit according to the California Code of Regulations (Title 22, Division 6, Chapter 8). LPA observed a closet being utilized as a staff bedroom. An exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator Constantin Mitrica.the state’s words, verbatim · CDSS document, Sep 19, 2025

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA was greeted and granted entry by facility administrator Constantin Mitrica after introducing himself and stating the purpose of the visit. There are currently six residents in care, five of which are receiving hospice care at the time of the visit. LPA accompanied by facility staff conducted a tour of the physical plant and observed the following: the facility is a one-story home with an attached garage accessible from the side yard and secured with a locking doorknob. The facility has four private and one shared bedrooms along with one shared bathroom and a secure bathroom used by staff. The second bathroom has a digital lock on the knob and is locked with a code. The bathroom in use by residents is observed to be equipped with grab bars and slip mats. All resident bedrooms have the required furnishings and linen present. Bathrooms faucets and toilets are operational. Water temperature was measured at 113.3F in the bathroom used for personal hygiene. LPA observed all beds have linen and blankets. There are full rails used for postural supports on five of the beds. Hospice plan of care reviewed for all five residents on hospice. Hospice staff had initially forgotten to include the bed rails on four of the five plans of care reviewed. Updated plans of care were however obtained during the visit and reviewed by LPA. A consultation of the required documentation for postural supports was provided to the licensee. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. Drills are conducted and documented. Three drills are verified to have been conducted in 2024. LPA provided licensee with a consultation on the frequency of drills and licensee confirmed a fourth drill would be conducted before the end of the year. Smoke and carbon monoxide detectors tested operational. The fire extinguisher present is fully charged and has been maintained in 2024. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 There is adequately shaded outside space with outdoor furniture present. There are self-latching gates on each side of the property. The routes of egress are free of obstructions. There are no bodies of water on the premises. The kitchen is clean and equipped with operational appliances. Facility staff was observed cooking the evening meal during the visit. A sufficient supply of perishable and non-perishable food is observed to be stocked in the kitchen refrigerator and freezer, as well as in the pantry and additional refrigerator and freezer in the locked garage. Cleaning products are observed to be secure throughout the physical plant, both under the kitchen sink in a locked cabinet as well as in the locked garage where the laundry area is located. Sharp items are verified to be stored in a drawer secured by a magnetic lock. The medication central storage was also observed to be secure and reviewed to be accurate and up to date with the resident's prescription orders. LPA reviewed six resident files along with five staff files. Resident records include all necessary components. One admission agreement is electronically signed and will be signed physically upon the next visit from the resident's responsible party. Consultation provided. All staff members on the facility's roster are confirmed to be cleared and associated with this particular licensed location. Training and CPR training verified to be up to date. Health screenings are on file for all staff members. One resident interview was conducted during the visit. Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. Three Technical Assistance Advisory Notes and consultations are provided to the licensee. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Nov 15, 2024

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.