Corina Elderly Home

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Sommer Hayes arrived unannounced to conduct a health and safety visit. LPA Hayes spoke with caregiver and explained the purpose of the visit. The caregiver called Beatrice Clark to let her know the LPA was there for health and safety checks of the resident. Beatrice Clark said caregiver Ariany Velasquez could sign this report in her absence. This location is considered unlicensed. A notice of violation of law was delivered on July 17, 2025, informing the operators that the previously existing license at this location had been forfeited. Clark currently has an application pending for a new license. LPA Hayes inspected the property and checked in with the resident of this operation to ensure their health and safety. An exit interview was held and a copy of this report was left with Ariany Velasquez.the state’s words, verbatim · CDSS document, Sep 25, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Sommer Hayes arrived unannounced to conduct a health and safety visit. LPA Hayes spoke with caregiver Lavender Mule and explained the purpose of the visit. Caregiver called Beatrice Clark to let her know LPA was there for health and safety of the resident(s). Beatrice Clark said caregiver Lavender Mule could sign this report in her absence. This location is considered unlicensed. A notice of violation of law was delivered on July 17, 2025, informing the operators that the previously existing license at this location had been forfeited. Clark currently has an application pending for a new license. LPA Hayes inspected the property and checked in with the resident of this operation to ensure their health and safety. An exit interview was held and a copy of this report was left with Mule.the state’s words, verbatim · CDSS document, Sep 15, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Sommer Hayes arrived unannounced to conduct a health and safety visit. LPA Hayes spoke with operator Beatrice Clark and explained the purpose of the visit. Beatrice Clark said caregiver Brenda Bryan could sign this report in her absence. This location is considered unlicensed. A notice of violation of law was delivered on July 17, 2025, informing the operators that the previously existing license at this location had been forfeited. Clark currently has an application pending for a new license. LPA Hayes inspected the property and checked in with the residents of this facility to ensure their health and safety. An exit interview was held and a copy of this report was left with Bryan.the state’s words, verbatim · CDSS document, Sep 3, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Sommer Hayes arrived unannounced to conduct a health and safety visit. LPA Hayes spoke with operator Beatrice Clark over the phone and explained the purpose of the visit. Beatrice Clark said caregiver Anna McKreith could sign this report in her absence. This location is considered unlicensed. A notice of violation of law was delivered on July 17, 2025, informing the operators that the previously existing license at this location had been forfeited. Clark currently has an application pending for a new license. LPA Hayes inspected the property and checked in with the residents of this facility to ensure their health and safety. An exit interview was held and a copy of this report was left with McKreith.the state’s words, verbatim · CDSS document, Jul 31, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a health and safety visit. LPA Moleski spoke with operator Beatrice Clark over the phone and explained the purpose of the visit. Clark said caregiver Anna McKreith could sign this report in her absence. This location is considered unlicensed. A notice of violation of law was delivered on July 17, 2025, informing the operators that the previously existing license at this location had been forfeited. Clark currently has an application pending for a new license. LPA Moleski inspected the property and checked in with the residents of this facility to ensure their health and safety. An exit interview was held and a copy of this report was left with McKreith.the state’s words, verbatim · CDSS document, Jul 25, 2025

Allegation investigated: Facility failed to provide reimbursement for a deceased resident.

Licensing Program Analyst (LPA) Vincent Moleski and Licensing Program Manager (LPM) Stephen Richardson arrived unannounced to open this complaint investigation. LPA Moleski and LPM Richardson met with operator Corina Dragnea and explained the purpose of the visit. These allegations are determined to be UNFOUNDED because at the time of this visit and at the time the complaint was received by the California Department of Social Services (CDSS), this facility's license has been forfeited. The CDSS Community Care Licensing Division (CCLD) does not have the authority to investigate allegations made at unlicensed locations, as they are outside of departmental jurisdiction. An exit interview was held and a copy of this report was left with Dragnea. Unfoundedthe state’s words, verbatim · CDSS document, Jul 16, 2025 · control 27-AS-20250710135002

Allegation investigated: Administrator is making false statements. Facility is not adequately staffed. Administrator changed pharmacy without the authorization of the POA/Executor. Administrator is talking about residents in a disrespectful manner. Administrator refuse to transport resident from medical facility.

Licensing Program Analyst (LPA) Vincent Moleski and Licensing Program Manager (LPM) Stephen Richardson arrived unannounced to open this complaint investigation. LPA Moleski and LPM Richardson met with operator Corina Dragnea and explained the purpose of the visit. These allegations are determined to be UNFOUNDED because at the time of this visit and at the time the complaint was received by the California Department of Social Services (CDSS), this facility's license has been forfeited. The CDSS Community Care Licensing Division (CCLD) does not have the authority to investigate allegations made at unlicensed locations, as they are outside of departmental jurisdiction. An exit interview was held and a copy of this report was left with Dragnea. Unfoundedthe state’s words, verbatim · CDSS document, Jul 16, 2025 · control 27-AS-20250715155616

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Vincent Moleski and Licensing Program Manager (LPM) Stephen Richardson arrived unannounced to conduct a case management visit. LPA Moleski and LPM Richardson met with licensee Corina Dragnea and explained the purpose of the visit. LPM Richardson reviewed a business agreement made between the licensee of Corina Elderly Home, Corina Dragnea, and the current administrator, Beatrice Clark. According to the business agreement, facility business assets were transferred to Clark as of March 22, 2025. Per Health and Safety Code (HSC) Section 1569.191, the prospective buyer of a facility must submit an application for licensure within five days of acceptance of the buyer's offer. However, an application was not received by the California Department of Social Services (CDSS) Centralized Applications Bureau (CAB) until May 15, 2025. HSC Section 1569.19 states that a facility license is effectively forfeited when "the licensee sells or otherwise transfers the facility or facility property..." Due to this unlawful transfer of facility business assets, this facility's license is considered forfeited. LPA Moleski and LPM Richardson provided Dragnea a notice of violation of law (NOVL). Continued operation of this facility without a license is unlawful, and may result in the assessment of civil penalties and/or department-initiated administrative actions, pursuant to applicable sections of HSC. An exit interview was held with Dragnea. A copy of the NOVL, appeal rights, and this report were left with Dragnea.the state’s words, verbatim · CDSS document, Jul 16, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sommer Hayes and Licensing Program Manager (LPM), Stephen Richardson arrived unannounced to conduct a Case Management visit 07/09/25 at 08:30am to follow up on a recent death report from 07/01/2025. LPA and LPM were met by caregivers, S1 and S2. Beatrice Clark was contacted and arrived at 9:45am and LPA and LPM stated the purpose of today’s visit. The facility is licensed for a capacity of 6 residents. There are currently 5 residents. The purpose of this visit is to follow up on the death of Resident. (R1) occurred on 07/01/25. The Department received a death report on 07/07/25 at 6:05pm. Per review of the death report, the cause of death is unknown. Additionally, R1 was receiving hospice care services beginning sometime in June 2025. Through documentation review of staff and resident files, LPA and LPM learned there have been changes to facility documentation from the Administrator who is in the process of a change of ownership and have not been licensed yet. Some resident and staff files are not kept at the facility based on an interview with the facility administrator. LPM and LPA observed an admission agreement for R2 from Providential Senior Care, which is not a licensed facility but in the application process with Centralized Application Bureau (CAB). Additionally, LPA and LPM observed that the facility does not document routine medication administration on a Medication Administration Record (MAR) and confirmed that through interview with S1 medication is not being recorded when dispensed, but visually confirmed. Continued on 809-C LPM and LPA interviewed S1 and S2 to obtain their names and observed that S2 was not cleared in Guardian to work in this home. Both caregivers admitted that they do work in other homes. S2 notified LPM that they had their identification in their car. LPM followed S2 to their car, where they said they could not find their ID and stated they had to leave to go to their next job, then left the facility grounds. Per California Code of Regulations, Title 22, 3 deficiencies were observed during today’s visit. Exit interview was conducted. A copy of this report was provided to Administrator Beatrice Clark. .the state’s words, verbatim · CDSS document, Jul 9, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Jul 9, 2025

Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Obtain a California clearance or a criminal record exemption as required by the Department or This requirement was not met as evidenced by staff interviews and LPA/LPM observations. The Licensee failed to ensure staff was fingerprint cleared prior to providing services to a resident in care. This poses an immediate health and safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jul 9, 2025

Plan of correction: No plan of correction provided by Administrator.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87412(f) · Plan of correction due date: Jul 9, 2025

87412(f) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements: This regulation was not met as evidence by: The Licensee failed to ensure personnel records were available for inspection by LPA Hayes and LPM Richardson during an case management visit. This poses a potential health and safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jul 9, 2025

Plan of correction: Administrator states they will keep staff and resident files in facility.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(d)(2) · Plan of correction due date: Jul 9, 2025

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. (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement was not met as evidenced by staff interviews and record reviews. LPA/LPM reviewed resident records and observed there to be 2 admission agreements for 2 separate residents in care for a facility that is in the application process and not licensed. This poses a potential health safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jul 9, 2025

Type of visit: Office

Licensing Program Analyst (LPA) Sommer Hayes and Licensing Program Manager (LPM) Stephen Richardson met with Corina Dragnea, Licensee of Corina Elderly Care (347005547) via TEAMS virtually on 07/07/25 at 10:00am to discuss the transition of ownership for the above-named Residential Care Facility for the Elderly (RCFE). Corina Dragnea is the Licensee of Corina Elderly Care (#347005547). A change of ownership (CHOW) is currently in process. The purpose of this meeting is to review the status of the ownership change and address concerns. The licensee, Corina Dragnea submitted a “Notification of intent to sell the business” to the Community Care Licensing on 03/25/25. The notification stated that the new buyer would obtain their own license. This notice stated that Corina Dragnea would continue to operate Corina Elderly Home as Licensee until the qualified buyer gets their license. The licensee stated that she has concerns that the buyer (also the Administrator of this facility) has minimal involvement with the facility and is spending very little time at the facility. Staff and families are concerned, questioning her visibility and participation. The licensee had existing agreements (per the admissions agreement) with families to handle medical appointments, and the buyer made changes to this agreement and is refusing to assist residents with medical appointments. The licensee stated that they have concerns about the buyer’s creditability. Continued on 809-C LPA/LPM Recommendations Licensee, Corina Dragnea was reminded that she is responsible for this facility as the Licensee until the CHOW is completed. Provide a copy of the agreement between Licensee Corina Dragnea and the Buyer to LPA, Sommer Hayes. No changes to facility policies, procedures, or agreements until buyer officially has their license and CHOW is approved by Community Care Licensing Division (CCLD). Clarify to families that the facility is still under Corina’s license, and she remains responsible for all resident care and financial oversight. Refund any overpayments to the affected families and document all actions taken. Consider terminating the arrangement if trust, care continuity, or compliance cannot be ensured. Licensee, Corina Dragnea is to follow up with CCLD with any questions or concerns.the state’s words, verbatim · CDSS document, Jul 7, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sommer Hayes arrived unannounced to conduct a Required - 1 Year visit on 06/13/25 at 8:40am. LPA met with Beatrice Clark, Designated Administrator and stated the purpose of today’s visit. The facility is licensed for a capacity of 6 non-ambulatory residents. The current census is 5. LPA toured with the DFA and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed 2-day perishables and 7-day non-perishables. LPA Hayes observed one (1) pair of scissors with a grey handle in an unlocked kitchen drawer. The temperature inside the facility was observed to be at 72 degrees F which is within the required range of 68-85 F. The hot water temperature was measured at 117 F which is within the required range of 105-120*F. LPA observed a fire extinguisher, smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed the centrally stored medications area to be locked and inaccessible to residents. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. LPA reviewed 2 resident records; staff records were not available for review. The garage is not accessible to clients. There was an outdoor refrigerator, non-perishables and emergency food supply. LPA observed the backyard of the facility. There was a shaded area for residents to enjoy. Fencing was in good repair. There were no bodies of water. Continued on LIC 809 C The facility living room was clean and free of obstruction. The seating is efficient seating for the number of residents in this facility. Per California Code of Regulations, Title 22, 2 (two) deficiencies were observed during today’s visit. Exit interview was conducted. A copy of this report was provided to DFA, Beatrice Clark.the state’s words, verbatim · CDSS document, Jun 13, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87412(f) · Plan of correction due date: Jun 13, 2025

87412(f) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements: This regulation was not met as evidence by: The Licensee failed to ensure personnel records were available for inspection by LPA Hayes during an annual inspection.the state’s words, verbatim · CDSS document, Jun 13, 2025

Plan of correction: The licensee agrees to read the Title 22 Regulation 87412(f) and provide a signed statement of acknowledgement to the Department by 06/20/25 via email to LPA Sommer Hayes.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87309(a) · Plan of correction due date: Jun 13, 2025

87309(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, ... could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This regulation was not met as evidence by: The Licensee failed to ensure sharps were secured and inaccessible to residents in care.the state’s words, verbatim · CDSS document, Jun 13, 2025

Plan of correction: The licensee agrees to read the Title 22 Regulation 87309(a) and provide a signed statement of acknowledgement to the Department by 06/20/25 via email to LPA Sommer Hayes.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct a Required - 1 Year visit on 7/2/24 at 9:30am. LPA met with Corina Dragnea, Administrator and stated the purpose of todays visit. LPA observed the Administrator Certificate for Corina Dragnea expires 9/2/25. License fees are current. The most current emergency drill was conducted on 6/20/24. The facility is licensed for a capacity of 6 non-ambulatory residents of which 4 may receive hospice care services. There is 1 residents receiving hospice care services during this visit. LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed 2-day perishables but not a 7-day non-perishables. The temperature inside the facility was observed to be at 75*F which is within the required range of 68-85*F. The hot water temperature was measured at 115.6*F which is within the required range of 105-120*F. LPA observed fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed the centrally stored medications area to be locked and inaccessible to residents. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. LPA reviewed 1 staff and 5 resident files during this visit. Upon a file review the following items were discussed to be submitted with any changes annually: Licensing fees-Current Criminal Record Clearances LIS536-Current Administrative Organization LIC309-Current Designation of Administrative Responsibility LIC308-Submit Personnel Report LIC500-Submit Affidavit Regarding Client/Resident Cash Resources LIC400-NA Surety Bond LIC402-NA Emergency Disaster Plan LIC610E-Submit Facility Floor Plan/Plot Plan LIC999-Current Fire Clearance (consistent with terms and limitations of license)-NA Qualifications of Administrator/Facility Manager-Submit Articles of Incorporation/Organization, Constitution and bylaws-NA Partnership Agreement-NA Control of Property-Submit Plan of Operation (Restricted Health Care Plan)-NA Admission Policies and Procedures-NA Health Screening Report-Facility Personnel LIC503-NA Bacteriological Analysis of Private Water Supply-NA In-service Training Program-NA Medication Procedures-NA Transportation Procedures-NA Job Description/Personnel Policies-NA Exemptions/Waivers and Exceptions-Current First aid/CPR certificates-Current Liability Insurance-Submit Infection Control Plan-Submit Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, the following deficiencies are being cited on the attached 809D during this visit. If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed. The Licensee was provided a copy of their rights (LIC9058) and their signature on this form acknowledges receipt of these rights. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 2, 2024