Constantin's Care Home

Type of visit: Required - 1 Year

On 03/10/2026, Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced required 1 year inspection. LPA met with Constantin Lapustea administrator and stated the purpose of the visit. The facility has a current census of 6 residents. The facility serves adults 60 and over who are elderly and has neurocognitive disorder. 3 may be non-ambulatory and subject to the terms of dementia and hospice waiver. 4 Out of 6 residents was in the facility and 2 of 6 residents were attending the day program at the time of the visit and 2 staff was present. LPA toured the facility inside and outside including the living room, kitchen, dining room, 2.5 restrooms, 5 resident bedrooms and 1 staff room, backyard and side emergency exits. LPA observed hallways and walkways to be free from obstructions. LPA observed the kitchen, dining, resident bedrooms, and staff room be organized and sanitary, the restrooms are equipped with anti skid mat and grab bars. Residents room has sufficient storage for their personal belongings. LPA inspected food storage and observed 2 days of perishable and 7 days of nonperishable food supplies. LPA observed the medication, chemicals and knives were locked and not easily accessible to residents. The room temperature is at 70 degrees F, and hot water temperature was measured with a digital thermometer at 117.5 to 119.3 degrees F. Facility is equipped with 2 fire extinguisher and was last inspected on 01/13/2026. The facility is equipped with wall fire alarm system, carbon monoxide and smoke detectors and were observed to be in good working condition. page 1 of 2 LPA observed facility first aid kit were complete and were accessible to staff. LPA reviewed 3 residents records such as centrally stored medication, physician's report (LIC 602), appraisal needs and services plan (LIC 624), admission agreement and more . LPA reviewed 3 staff records and found them to be complete and up to date. 3 out of 3 staff have a fingerprint and criminal background clearance and valid First aid certificates. Disaster training was administered on 01/20/2026 and 01/07/2026 for fire, earthquake and other disaster training. Dementia care training was administered on 01/15/2026. Adult and Elder Abuse training (Mandated Reporter) was administered on 1/14/2026. Staff training was up to date and complete. No deficiencies were cited based on California Code of Regulation (CCR) Title 22. An exit interview was conducted with administrator Constantin Lapustea and a copy of the report was provided. page 2 of 2 end of reportthe state’s words, verbatim · CDSS document, Mar 10, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management visit and met with staff Netta Carroll. The purpose of the visit was to conduct a wellness check at the facility. No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Netta Carroll and a copy of this report was provided.the state’s words, verbatim · CDSS document, Apr 22, 2025

Type of visit: Required - 1 Year

On 4/2/2025 Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced required 1 year inspection. LPA met with Constantin Lapustea administrator and stated the purpose of the visit. The facility has a current census of 5 residents and serves 60 and over who are elderly and has neurocognitive disorder. 3 may be non-ambulatory and subject to the terms of dementia and hospice waiver. 2 of 5 was in the facility and 1 of 5 arrived during the visit. 2 of 5 were out with family. LPA toured the facility inside and outside including the living room, kitchen, dining room, 3 restrooms, 5 resident bedrooms and staff room, backyard and side emergency exits. LPA observed hallways and walkways to be free from obstructions. LPA observed the kitchen, dining, resident bedrooms, and staff room be organized and sanitary, the restrooms are equipped with anti skid mat and grab bars. Residents room has ample storage for their personal belongings. LPA inspected food storage and observed 2 days of perishable and 7 days of nonperishable food supplies. LPA observed the medication, chemicals and knives were locked and not easily accessible to residents. The room temperature is at 70 degrees F, and hot water temperature was measured at 111.7 to 112.2 degrees F. Fire extinguisher was last inspected on 1/22/2025. The facility is equipped with carbon monoxide and smoke detectors and were observed to be in good working condition when tested. page 1 of 2 See LIC 809C LPA requested updated copies of LIC 500 personnel report, control of property, and LIC 308 (designation of facility administrator). LPA observed facility first aid kit were complete and were accessible to staff. LPA reviewed 3 residents record and 2 staff records and found them to be complete and up to date. Disaster training was administered on 1/08/2025 and 1/23/2025 respectively (fire, disaster & earthquake) Dementia care training was administered on 1/16/2025. Adult and Elder Abuse training (Mandated Reporter) was administered on 1/24/2025. Staff training was up to date and complete. No deficiencies were cited based on California Code of Regulation (CCR) Title 22. An exit interview was conducted with administrator Constantin Lapustea and a copy of the report was provided. page 2 of 2 end of reportthe state’s words, verbatim · CDSS document, Apr 2, 2025

Allegation investigated: Questionable death Staff is physically abusive to residents Staff made inappropriate comment(s) to resident Staff does not change resident's clothes Facility smells of urine Staff serves expired food Staff did not seek timely medical attention to residents

Licensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannounced visit to deliver the findings of the above allegations. LPA met with licensee/administrator (LIC/ADM) Constantin Lapustea and stated the purpose of the visit. On 4/30/2024 - The department received a complaint alleging that there was questionable death, staff was physically abusive to residents, staff made inappropriate comment(s) to resident, staff serves expired food, staff did not provide meal to resident and staff did not seek timely medical attention to residents. This allegation is connected to complaint filed on 4/29/2024 referencing complaint #26-AS-20240429110546 On 5/1/2024, the Department conducted an investigation of the allegation(s). page 1 of 4 see LIC 9099C Unsubstantiated Questionable death Based on record review, and interviews - Physician (MD) stated that the resident (R7) had a medical condition that is "not very common and does not have exact statistics." Physician stated depending on the cause it could be prevented and it can also not be prevented. It can happen for different reasons..." Based on record review, R7s condition has unknown etiology. Staff is physically abusive to residents On 4/29/2024 - LPAs interviewed R1 to R6, they did not witness staff physically abuse a resident. R1 did not engage in conversation with LPAs R1 spouse was in the facility visiting at the time of the visit and stated will not let anyone get in trouble. R2 stated staff are friendly, however, R2 stated there was a time when a staff was rough with resident, but does not remember when it happened. R3 stated, "it's not abusive, the situation was difficult because it's not easy to care for R1." R4 stated no issues with staff. R5 stated did not observed being rough to a resident, staff are fine. R6 stated staff are good. On 5/1/2024 - LPA interviewed S1. S1 stated R1 became very lethargic at one time and it scared S1. S1 tried to wake R1 and put cold towel to wake R1. S1 demonstrated the tapping to LPA to wake R1. Staff made inappropriate comment(s) to resident On 4/29/2024 - LPA interviewed W1, and stated he/she heard LIC/ADM call R4 stupid, over and over again. W1 stated no one else witnessed the incident because everyone was in the kitchen. R1 does not want to engage in conversation, R2 stated staff are friendly. R4 stated no issues with staff. R5 stated no comment to add. R6 stated he doesn't know. Based on the written statement of W1 dated 8/19/2024. W1 did not state the date and time when the incident happened. page 2 of 4 Staff does not change resident's clothes On 4/30/2024 LPA interviewed W1 who stated "unless R6 clothes are super filthy that's the only time staff will change R6. R6 uses the same sweats during the weekend, R6 is not allowed to wear clothes that R6 wants to wear. R6 can say no and can refuse." On 5/1/2024 LPA interviewed LIC/ADM, and stated that resident do not change clothes everyday but every other day. On 5/1/2024 LPA interviewed S2 and stated "we wash their clothes, they change clothes, but if they don't want to change we cannot force them." LPA Partoza visited and inspected the facility on the following dates 4/28/24, 4/29/24 5/1/24 and 5/29/2024. During the visit LPA observed R1 had different clothes 3 occasions. On 4/29/24 R1s spouse was present and stated R1 has few clothes. On 4/29/2024 LPA observed R6 was wearing the clothing worn on 4/28. On 5/1/2024 LPA observed R6 changed 3 times. R3 has clothes on bed and R3 stated he likes to choose his clothes. R2 stated he/she changes clothes everyday. LIC/ADM stated that they assist residence with showering and changing clothes. Facility smells of urine On 5/1/2024 LPA Interviewed LIC/ADM and S2. LIC/ADM stated diapers are changed all the time or when wet, they do not leave the resident wet or soaking especially when it's getting hot, the bedding is changed every week, sheets are changed everyday if necessary, specially if it's wet. S2, we do once a week bedsheet change. On 5/1/2024 LPA interviewed R2 and R3. R2 stated sheets are washed every week. R3 stated they put pads and washes the sheet each week. LPA Partoza, visited the facility on 4/28/24, 4/29/24, 5/1/24 and 5/29/24. LPA inspected the facility and residents room (R1 to R6). R1 and R3 shares a bedroom and a bathroom. LPA inspected 2 bathrooms and R2, R3, R4, R5, and R6 room and observed rooms to be organized and sanitary. page 3 of 4 Staff serves expired food On 4/28/24, 4/29/24, 5/1/24 and 5/29/24. LPA inspected the pantry and refrigerator. LPA observed fruits and vegetables. Bread that was recently bought. LPA observed 2 days of non-perishable food and 7 days of non-perishable food. On 5/1/2024 - LPA interviewed R2, R3 and R4. R2 stated there's food fruits for snacks, healthy dinner made and cooked by S1. R3 stated there's always food. R5 no expired food served. On 5/1/2024, LPA interviewed S1, S2 and ADM. S1 stated,"I have eggs for breakfast or I go by preference of the resident. I make jams from scratch." S2 stated, S1 takes care of meals and do grocery shopping at least once a week. Staff did not seek timely medical attention to residents. Based on document review and interview, MD stated "it would be difficult to judge how severe symptoms are, especially if R7 cannot clearly express the discomfort. It could happen quickly depending on what's happening leading up to R7's condition." On 7/9/2024 - S1 was interviewed and stated that on 12/14/2023 there was a delay because the family was attempting to arrange a respite or hospice evaluation. S1 stated they (S1 and ADM) grew concerned and prompted them to take R7 to the hospital. On 7/9/2024 - Responsible Party (RP) was interviewed, and stated that staff called on 12/13/2023 and asked what they should do. RP does not remember instructing to take R7 to the hospital. RP stated there was communication issues with the hospital and the facility on the next steps. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. No deficiencies were cited during today's visit based on California Code of Regulations (CCR) Title 22. An exit interview was conducted with Licensee/administrator Constantin Lapustea and a copy of the report was provided. page 4 of 4 End of reportthe state’s words, verbatim · CDSS document, Sep 30, 2024 · control 26-AS-20240430100728

Allegation investigated: Staff forced resident to wear denture

Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannouced complaint investigation of the above allegation and met with licensee/administrator (ADM) Constantin Lapustea and stated the purpose of the visit. On 4/29/2024 - The department received a complaint alleging staff forced resident to wear dentures. LPAs Partoza and Monter conducted an initial investigation on the same day the complaint was received and interviewed witness 1 (W1), residents (R1 to R6) and staff (S1 to S2), ADM, and visitor (W2) of R1. page 1 of 2, See LIC 9099C Unsubstantiated On 4/29/2024 LPA interviewed residents 1 to 6 (R1 to R6), based on interview, R1 did not respond to questions, W2 however, spoke in behalf of R1. W2 stated that he/she visits R1 on a regular basis at least 2 to 3 times a week at random days and time and R1 will not say anything, R1 does not like anyone to get in trouble, R1s spouse stated he/she did not see any visible sign of abuse. R2 stated S1 used the right hand to open R1s mouth to put in the denture, R2 stated "I can't describe how hard or forceful it was but, R1 is bigger than S1." R2 does not recall when the incident occurred. R3 stated he/she seen the staff put the dentures in, "but it was not abusive." R4 stated he/she did not see staff forcefully put dentures inside a resident's mouth. R5 stated he/she did not see staff forcing a resident to wear dentures. R6 stated no, and doesn't know. S1 stated sometimes they request for the dentures, and R1 will refuse. S1 stated R1 has been able to manage dentures for a long time. ADM stated they cannot force R1, if R1 refuses to wear dentures. S2 stated, R1 will sometimes refuse to put on dentures. On 5/1/2024 - LPA Partoza conducted an interview with W1. W1 stated they told S1 not to force R1 to wear dentures if R1 doesn't want to. S1 stopped and no longer forced R1 to use dentures. W1 stated that he/she could not remember when it happened. Based on the written statement of R2 dated 4/29/2024, R2 did not state the date and time of the incident and if there was any visible sign of physical injury to R1. Based on the written statement of W1 dated 8/19/2024. W1 did not state the date, time of the incident and if there was any visible sign of physical injury to R1. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. No deficiencies were cited during today's visit based on California Code of Regulations (CCR) Title 22. An exit interview was conducted with licensee/administrator (LIC/ADM) Constantin Lapustea and a copy of the report was provided. page 2 of 2 end of reportthe state’s words, verbatim · CDSS document, Sep 30, 2024 · control 26-AS-20240429110546

Allegation investigated: Facility did not submit incident / death report

Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannouced complaint investigation of the above allegation and met with licensee/administrator (ADM) Constantin Lapustea and stated the purpose of the visit. At the time of the visit LPA observed 4 out of 6 residents are in the facility, 1out of 6 is attending day program, 1 out of 6 is at a skilled nursing facility (SNF), 2 staff (S1 and S2) and LIC/ADM. LPA continued with the complaint investigation for the following allegation facility did not submit incident / death report when a resident was taken to the hospital and passed away. LIC/ADM stated that he did not know and is not aware that death and other incidents needs to be reported when a resident is taken to the hospital, by family or paramedics. LIC/ADM stated he only reports if it is a fall or accident, or altercations between staff and resident, resident to resident and staff to staff. page 1 continued to page 2 LIC 9099C Substantiated Based on LPAs observations, interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (CCR) Title 22, Division 6, Chapter 8, being cited on the attached LIC 9099D. LIC/ADM submitted a written statement of understanding for reporting requirement. An exit interview was conducted with LIC/ADM Constantin Lapustea. A copy of the report and appeal's rights were provided. page 2 End of Report.the state’s words, verbatim · CDSS document, May 29, 2024 · control 26-AS-20240430100728

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87211(a)(1)(A) · Plan of correction due date: May 30, 2024

87211 Reporting Requirement (a) Each licensee shall furnish to the licensing agency ... reports (1)A written report shall be submitted to the licensing agency... within seven days of the occurrence of any of the events specified in (A) Death of any resident. This requirement was not met as evidenced by: Based on document review and as stated by LIC/ADM he/she did not submit a death report because the resident passed away in the hospital and not in the facility.the state’s words, verbatim · CDSS document, May 29, 2024

Plan of correction: LIC/ADM gave a written statement to LPA during today's visit that he/she will comply with Title 22 reporting requirement. con't LIC/ADM stated he/she is not aware that any death should be reported regardless of where it occurred.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87405(d)(2) · Plan of correction due date: May 30, 2024

Administrator Qualification (d) administrator shall have the qualifications (2) knowledge of and ability to conform to the applicable laws and regulations. This requirement was not met as evidenced by: Based on record review and interview. LIC/ADM did not conform to the applicable laws and regulations. LIC/ADM stated he/she was not aware of the reporting requirements for unusual incidents and death of a resident.the state’s words, verbatim · CDSS document, May 29, 2024

Plan of correction: LIC/ADM stated that he/whe will submit a statement of understanding for reporting requirements and will conform to the applicable laws and regulations for Title 22

Allegation investigated: Facility staff beats up resident

The report was amended based on additional information received by the department. Licensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannouced visit to the facility to deliver the findings on the above allegation. LPA met with LIcensee/Administrator (ADM) Constantin Lapustea and stated the purpose of the visit. On 3/29/2022, the department received the complaint and conducted an initial investigation on 4/7/2022. LPA Dolores, requested documents and interviewed staff on 4/7/2022. On 4/5/2024, LPA Partoza continued with the investigations, requested and reviewed additional documentations, interviwed staff and residents. page 1 continued to page 2 - LIC 9099C Unfounded This report is being amended based on additional information received by the department. Based on interviews of residents (R2 to R4), they are not aware of any staff hurting or beating on residents. Based on R2s account of events of 3/28/2022, resident 1 (R1) has aggressive behavior. and he/she would leave the room for safety. R3 stated that staff are not hurting residents in care. R4 recently moved in to the facility and have not experienced, heard or witness a staff hurting a resident. Based on interview and documented statement of staff (S1 to S3). S1 wrote and stated that R1 was the aggressor and physically assaulted S1. S1 stated on the day of the incident, S1 was assisting R1 to prepare for R1s appointment, as soon as the sweater came off, R1 pushed S1 hard and started to scream and accused S1 of hitting him/her. S2 on a written statement stated, that he/she heard the yelling and ran to the room to assess the situation and witnessed R1 hitting S1 and asked R1 to take medication to calm R1 down, but R1 knocked the pills off S2s hand and refused to take the medication. S3 in a written statement stated that law enforcement was called on the day of the incident 3/28/2022 and interviewed staff. Based on law enforcement (LE) report review, Law enforcement interviewed R1 and S3, R1 could not provide details of the incident due to neurocognitive disorder. S3 stated that he/she held R1 to prevent R1 from hitting S1. Based on the police report R1 did not have visible marks or bruising and R1 stated he/she did not have any marks or bruising. This agency investigated the complaint alleging that a staff beat the resident. We have found that the complaint was unfounded, meaning that the allegations was false, could not have happened and/or is without reasonable basis. No deficiency was cited during today's visit. An exit interview was conducted with LIC/ADM Constantin Lapustea. A copy of the signed report was provided. end of report page 2the state’s words, verbatim · CDSS document, Apr 28, 2024 · control 26-AS-20220329113337

Type of visit: Case Management - Deficiencies

On 4/28/2024, Licensing Program Analysts (LPA) Maria (Mita) Partoza and Simi Rai conducted an unannounced visit to the facility. LPA stated that the purpose of the visit is to continue the case management-deficiencies observed from 4/27/2024, and to deliver the deficiency citations based on observation and interview from 4/27/2024. LPAs were met by a care giver (S2) and S2 called the licensee/administrator (LIC/ADM) Constantin Lapustea and LIC/ADM arrived at the facility within 30 minutes. LIC/ADM stated he was attending church. On 4/27/2024 LPA Partoza conducted an unannounced complaint visit to the facility and was greeted by the staff's (S1) child who is a minor (M1). LPA was able to confirm that M1 is under the age of 18. LPA arrived at 9:00 a.m. on 4/27/2024 and requested to see LIC/ADM or the designated administrator. M1 stated that the licensee/administrator (LIC/ADM) Constantin Lapustea and caregiver (S2) was out. M1 stated he/she is the child of the staff (S1) who is currently accompanying and assisting 3 residents with their walk and will be back in 15 minutes. LPA observed that M1 was alone with 2 residents for more than 15 minutes with 2 out of 2 residents that are diagnosed with dementia and are ambulatory. During visit on 4/27/2024, LPA observed the following: 3 residents with the staff (S1) came in after their walk around the neighborhood. LPA observed that 2 out of 3 residents uses assistive device such as cane and walker. 1 out of 3 uses assistive device as needed (walker). S1 introduced self and stated that he/she is the caregiver at the facility and LIC/ADM are not in the facility during the time of visit of 4/27/2024. LPA conducted a facility inspection and observed that 5 out 6 residents were present in the facility. 1 out of 6 went out to a day program. continued to page 2 - LIC 809C During the visit of 4/27/2024, LPA interviewed S1. S1 stated that he/she is not fingerprinted and not background cleared. S1 stated that he/she has been working at the facility since September 2023 and works at the facility every other weekends. LPA observed that S1 is not associated and listed on the facility roster and on the department's record under the facility personnel summary report. S1 stated that he/she does not have criminal background clearance and have not completed livescan for fingerprint clearance. During today's visit, LPAs interviewed LIC/ADM. LIC/ADM admitted that he did not have S1 fingerprinted and have a criminal background clearance prior to working in the facility. On 4/27/2024, LPA toured the facility and checked bathroom, kitchen and residents' room and observed that the drawer for knives were unlocked and key was located in the key hole. The cabinet under the sink has chemicals and the cabinet was unlocked. LPA observed that the medications for the day in the upper kitchen cabinet, such as Nyquil, Robitussin, Centrum, Magnesium and resident's prescription medications were unlocked and easily accessible to residents in care. The medication was also accessible to staff who is not responsible to administer and supervise medication to residents in care. LPA inspected the bathrooms and 3 out of 3 bathroom sink cabinets was unlocked and contains chemicals, such as Lysol cleaning solutions, bar counter cleaner, were easily accessible to residents in care. LPA reviewed records for 2 out of 2 residents were diagnosed with dementia and are ambulatory. During today's visit, LPAs observed 3 out of 6 resident walking around the facility. Deficiencies is being cited during today's visit based on California Code of Regulation, Title 22, please see LIC809-D. A civil penalty is being assessed for the amount of $500 ($100 per day x 5 days) for staff (S1) working at the facility without fingerprint clearance. See LIC 421BG. An exit interview was conducted with LIC/ADM Constantin Lapustea and a copy of the report was provided. Appeal rights was also provided. End of Reportthe state’s words, verbatim · CDSS document, Apr 28, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(1) · Plan of correction due date: Apr 29, 2024

87355 All individuals...pursuant to Health and Safety Code Section 1569.17(b) shall prior to working... in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidenced by Based on interview Licensee/ADM stated that he hired a staff that does not have a fingerprint or criminal background clearance prior to working at the facility, which pose/poses an immediate health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Apr 28, 2024

Plan of correction: Licensee/ADM stated that all staff prior to working at the facility have criminal background and fingerprint clearance prior to working at the facility. Licensee will have staff fingerprinted and ensure that residents are protected from any harm. Licensee/ADM will provide a written plan of action by POC due date. LIC/ADM agreed and understood.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87468.2(a)(4) · Plan of correction due date: Apr 29, 2024

87468.2 Additional Personal Rights of Residents in privately owned facilities (a)(4)To care, supervision...that meet their..needs and are delivered by staff that are sufficient in qualifications...This requirement is not met as evidenced by: Based on interview and observation, Licensee/ADM did not provide care & supervision to residents by leaving the resident unattended and with a person who is a minor, which pose/poses an immediate health, safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 28, 2024

Plan of correction: Licensee/ADM stated that staff will have sufficient qualification to provide care & supervision that meets the needs of the persons in care, by providing training and guidance to staff. Licensee/ADM will provide a written plan of action by POC due date. LIC/ADM agreed and understood.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(f) · Plan of correction due date: Apr 29, 2024

87705 Care of Person with dementia. (f) The following shall be stored inaccessible to residents with dementia: (1) Knives...(2)Over-the counter medication... supplements... toxics... such as... cleaning supplies...This requirement was not met as evidenced by: Based on observation, Licensee/ADM did not ensure that toxics, medications & knives located in the kitchen and three bathroom sink cabinets are inaccessible to persons with dementia, which pose/poses an immediate health, safety and personal right risk to persons in care.the state’s words, verbatim · CDSS document, Apr 28, 2024

Plan of correction: Licensee/ADM stated to ensure that cleaning supplies and knives are locked at all times to ensure the safety of persons in care. Licensee/ADM will submit a written plan of action by the POC due date. Licensee/ADM agreed and understood.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87465(h)(2) · Plan of correction due date: Apr 29, 2024

87465 Incidental Medical and Dental Care Services (h)(2) Centrally stored medications shall be kept in a safe locked place that is not accessible to persons other than employees responsible for the supervision of the medication. This requirement is not met as evidenced by: Based on observation Licensee/ADM did not lock the upper kitchen cabinet and resident's prescription medication were accessible, which pose/poses an immediate health, safety and personal risks to persons in care.the state’s words, verbatim · CDSS document, Apr 28, 2024

Plan of correction: Licensee/ADM stated that prescription and over-the counter medications is not accessible to persons in care. Licensee/ADM will submit a written plan of action by the POC due date. Licensee/ADM agreed and understood.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87405(d)(1)* · Plan of correction due date: Apr 29, 2024

87405 Administrator - Qualifications and Duties (d)The administrator shall have the qualifications specified in Sections 87405(d) (1) through (7) If the licensee is also the administrator, all requirements for an administrator shall apply. This requirement is not met as evidenced by: Based on observation, interview & record review, Licensee/ADM did not provide, care and supervision, did not ensure knives,toxics and medication are inaccessible to residents with dementia, and did not ensure staff has obtained a California criminal record clearance before providing direct carethe state’s words, verbatim · CDSS document, Apr 28, 2024

Plan of correction: LIcensee/ADM stated that a letter of understanding regarding Title 22 regulation by POC due date. Licensee/ADM agreed and undestood. (con't) to residents, which pose/poses an immediate health, safety and personal risks to persons in care. *87405(d)(1-7)

Type of visit: Case Management - Deficiencies

On 4/27/2024 - Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced visit to the facility. LPA stated the purpose of the visit is to deliver a finding for a complaint that was received by the department on 3/29/2022. LPA was greeted by the staff's (S1) child who is a minor (M1). LPA conducted a case management based on today's visit. LPA arrived at 9:00 a.m. M1 stated that the licensee/administrator (LIC/ADM) Constantin Lapustea and caregiver was out. M1 stated he/she is the child of the staff who is currently accompanying and assisting residents with their walk and will be back in 15 minutes. LPA observed that M1 was alone with 2 residents (R1 to R2) and feeding one of the resident (R1). At 9:30 a.m. 3 residents (R3 to R5) with the staff (S1) came in after their walk around the neighborhood. One of the resident (R3) approached LPA and made their introduction. S1 introduced self and stated that he/she is the caregiver for today and LIC/ADM are not in the facility at the moment and are currently at church. LPA conducted a facility inspection and observed that 5 out 6 residents were present in the facility. During the visit LPA interviewed S1. S1 stated that she is not fingerprinted and not background cleared. S1 stated that she has been working at the facility since September 2023 and works at the facility every other weekends from 6:00 a.m. to 2:30 p.m. LPA - checked Guardian and found that S1 is not associated with the facility and does not have background clearance. LPA interviewed residents (R3 and R4). Continued on page 2 LIC 809C LPA toured the facility and checked bathroom, kitchen and residents' room. LPA observed that the drawer for knives were unlocked and key was in the key hole. The cabinet under the sink was unlocked with chemicals that are accessible to residents. 3 out of 3 bathroom under the sink cabinet is not locked and chemicals were easily accessible. LPA observed that the medications for the day was in the cabinet and are easily accessible. No staff is trained to administer medication and administer first aid to residents. On 4/27/2024 at 11:04 a.m. S1 stated that he/she is not authorized and is not comfortable to sign the report. A citation will be issued at a later date. The licensee/administrator was not present in the facility at the time of the visit. A copy of the report was left with S1 and an exit interview was conducted.the state’s words, verbatim · CDSS document, Apr 27, 2024

Type of visit: Required - 1 Year

On 4/5/2025 at 10:45 a.m. Licensing Program Analyst (LPA) Maria (Mita) Partoza arrived unannounced to conduct an annual required inspection. LPA met with Rodica Lapustea staff and caregiver. Administrator (ADM) Constantin Lapustea was currently unavailable. Staff called ADM and stated that he was picking up a guest from Romania and will be in the facility in 45 minutes. ADM stated staff is authorized to sign reports and accompany LPA when touring the facility. ADM arrived at around 12:15 p.m. The facility has a current census of 6 residents. During the time of the visit 4 out 6 resident were out on a day program. LPA observed the facility temperature measured at 70 degrees F. The hot water temperature measured at 109 to 112 degrees F. There were working lights in each room. There are grab bars for each toilet and shower. Bathrooms had non-skid mats. Supplies of personal hygiene items were available. The facility had combination smoke and carbon monoxide detectors that were tested and functioning properly. Fire Extinguishers were inspected on 1/28/2024. The last emergency disaster drill was on 1/29/2024. Medications are stored in a locked cabinet in the office. Knives are locked in a drawer in the kitchen. Toxins and cleaning supplies are locked in a cabinet in the garage. LPA observed 2 days of perishable food and 7 days of non-perishable food. LPA observed the emergency plan, exit plan, Long-Term Care Ombudsman, posted on the wall. Residents and staff records were reviewed. Resident records have the following admission agreement, medical assessment with TB test information, updated needs and services plan, and personal rights, the centrally stored medication record were up to date. Advisory note was given to the administrator. page 1 continued to page 2 LIC 809C. Facility staff all have criminal record clearance to work at the facility and are associated to the facility. Staff records have the following personnel record, health screening with TB test information, criminal record statement, and current first aid certificate. Administrator certificate renewal was sent on 10/18/2023 with appropriate training requirement. The following forms to be updated and submitted to CCL 4/15/2024 LIC 500 Personnel Record LIC 610E Emergency Disaster Plan Limited Liability Insurance During today's visit no deficiency was cited. An exit interview was conducted with the administrator Constantin Lapustea. end or reportthe state’s words, verbatim · CDSS document, Apr 5, 2024