Crestview Senior Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Administrator Nimfa Ramos. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, of whom one (1) may be bedridden in bedroom #1. Hospice waiver for six (6). During today’s inspection there were five (5) residents in care. LPA with Administrator Ramos toured the interior and exterior of the facility and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to residents. Medications were labeled, as required, and stored in locked areas. LPA observed four (4) unlabeled weekly medication containers that were filled with residents medications poured in advance in a locked cabinet located in the kitchen. No pools or bodies of water exist on the premises. Per Administrator Ramos, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. First aid kits were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. One deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D). A plan of correction was jointly formulated, and an exit interview was conducted with Administrator Ramos, to whom a copy of this report, LIC809-C, LIC809-D and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to.the state’s words, verbatim · CDSS document, Oct 23, 2025

Type of visit: Required - 1 Year

On 11/13/2024 at 11:45 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. At the time of the visit there were three (3) staff present, and four (4) residents present. Licensee/Administrator Nimfa Ramos was informed of the visit. LPA Brown explained the purpose of the visit to Licensee/Administrator Ramos. The facility is a six (6) bedroom, four (4) bathroom home with a kitchen, two (2) dining areas, two (2) living rooms, and an attached garage. The facility is a Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) non-ambulatory residents and one (1) resident may be bedridden. The current census is four (4) resident. LPA Brown was accompanied by Licensee/Administrator Ramos 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). There are no obstructions to interior and exterior passageways. The facility is maintained at a comfortable temperature of 72 degrees Fahrenheit. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown observed sufficient furniture and lighting throughout the facility. LPA Brown measured and observed the water temperature in the residents/staffs shared bathroom to be at 110 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Postings such as the facility license, personal rights, the CCLD complaint poster, ombudsman poster, labor laws, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside the medication cabinet in the kitchen inaccessible to residents. Overall, the facility is clean, in good repair for residents in care. ***Continuation in LIC809C*** Food Service: Seven (7) days non-perishable and two (2) days perishable food supply observed at the facility. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed two (2) resident files for admission agreements, updated physician reports, pre-placement appraisals, needs and services plans and centrally stored medications list. LPA Brown observed Resident #2 (R2) Pre-Admission Appraisal was incomplete as evidenced of no resident/responsible person signature and licensee/facility representative signature. Deficiency will be issued. LPA Brown observed incomplete Resident #2 (R2) Preplacement Needs & Services Plan (LIC625) as evidenced of no resident/responsible person signature noted in R2 form LIC625. Deficiency will be issued. LPA reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with tuberculosis (TB) test results. LPA Brown observed Staff #3 (S3) did not complete the required training in First Aid from persons qualified by such agencies as the American Cross. Deficiency will be issued. In addition, LPA Brown observed that the facility admitted two (2) bedridden residents on 08/25/2024 and per R1 and R2 Admission Agreements and Physician Reports (LIC602) and documents review, the facility's licensed for one (1) bedridden resident. Deficiency will be issued and a immediate civil penalty of $500.00 will be issued today for zero tolerance violation. During Medication Audit, LPA Brown observed that staffs at the facility are not assisting Resident #1 (R1) with R1's one (1) medication per R1's Physician Order as evidenced of R1's one (1) medication was missing. Deficiency will be issued. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), LIC809D, LIC421IM and Appeal Rights were discussed and provided to Licensee/Administrator Nimfa Ramos.the state’s words, verbatim · CDSS document, Nov 13, 2024

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ryan Gardner made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Administrator Nimfa Ramos and was granted entry to the facility. At the time of the visit, there were two (2) staff present and one (1) resident present. The facility is a six (6) bedroom, four (4) bathroom home with a kitchen, two (2) dining areas, two (2) living rooms, and an attached garage. The facility is a Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) non-ambulatory residents and one (1) resident may be bedridden. The current census is one (1) resident. LPA was accompanied by Administrator 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 interior and exterior passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperature in the bathroom to be at 120 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Postings such as the facility license, personal rights, the CCL complaint poster, labor laws, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside the medication cabinet in the kitchen inaccessible to residents. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for the resident in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed one (1) resident file for admission agreement, updated physician report, and needs and services plan. LPA reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. Medications/MARs records were audited and appeared to be dispensed and logged appropriately. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Nimfa Ramos.the state’s words, verbatim · CDSS document, Nov 2, 2023