Diamond Manor 2

Type of visit: Required - 1 Year

On today's date Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual inspection. Upon arrival LPA Vanegas was greeted and granted entry to the facility by the home owner. After explaining the purpose of the visit home owner explained to LPA that the facility is no longer operating, and the home was sold to him by his brother who was the administrator of this faciltiy. Home owner explained that the facility is no longer in operation due to the administrator/licensee unexpectedly passing away. LPA conducted a tour of the facility and observed that there are no residents in care. Home owner explained that the last resident they had was relocated to another facility at the time of the facility ceasing to operate. Home owner explained that the facility ceased operation in June of 2025. The home is now used as a residential facility and facility will now be processed for closure. An exit interview was conducted and a copy of this report was provided to the home owner.the state’s words, verbatim · CDSS document, Mar 26, 2026

Type of visit: POC

On February 19th, 2025 Licensing Program Analyst (LPA) William Vanegas made an unannounced visit to conduct a plan of correction visit. Upon arrival LPA Vanegas was greeted and granted entry by Care Giver (CG) Samah Elmathena. LPA Vanegas explained the nature of the visit and observed the following. Administrator (AD) made the following corrections. AD ensured that all staff files were up to date, and had all required documentation, and training completed. AD made sure that all centrally stored medications were documented, and are now up to date with accurate medications that are being taken. AD hung up all required postings such as personal rights, ombudsman, and PUB 475 see something say something. Based on observations made during today's visit no deficiencies will be cited per title 22 chapter six of the California Code Of Regulations. An exit interview was conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Feb 19, 2025

Type of visit: Required - 1 Year

On February 4th, 2025 Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual visit. Upon arrival LPA Vanegas was greeted and granted entry by Care Giver (CG) and explained the purpose of the visit. Upon entry LPA Vanegas set up equipment and began a tour of the facility and observed the following. This a two storied home with seven bedrooms, four of which are resident bedrooms and three of which are staff bedrooms. There is three bathrooms two of which are resident bathrooms and one of which is staff bathroom the facility also has an attached two car garage. LPA Vanegas observed the kitchen to be clean and free of debris. LPA Vanegas observed kitchen to have a microwave, dishwasher, gas stove and refrigerator all tested to be operational and in good repair. LPA Vanegas observed a 2 day supply of perishable food and a 7 day supply of non-perishable food with a sufficient amount of emergency water. LPA Vanegas observed all client bedrooms to have required furniture such as a bed, closet space, a lamp, chest drawers, and clean linens in good repair meaning no strains or tears. LPA Vanegas observed all resident bathrooms to be clean and free of debris and mildew. Toilet and water faucet tested operational. Water tested in between 110.8 and 111.0 degrees. All bathrooms consisted of the required furnishings such as functional grab bars slip resistant floor matts and shower chair. LPA Vanegas observed fire extinguisher to be fully charged, LPA Vanegas observed smoke and carbon monoxide detectors to be functional and in good repair. LPA Vanegas observed first aid kit to contain all required material such as tweezers, scissors, adhesive tape, a thermometer, and clean bandages. LPA Vanegas observed outside of the facility and noted no obstructions along exit routes or ramps or inclines. Side doors are unlocked and self latching. Backyard is big enough to participate an outdoor activities and contains an outdoor shaded seating area. CONTINUED ON LIC809C LPA Vanegas observed medications to be locked and inaccessible to residents in care. LPA Vanegas observed toxins and sharps to be inaccessible to clients in care and locked away. Toxins are stored separately from food items. LPA Vanegas reviewed emergency disaster plan, and infection control plan. Both items contained all required documentation. LPA Vanegas was unable to review staff records due to facility staff not having it available for review. A deficiency was cited on today's date. LPA Vanegas reviewed three client records. All client records contained all the required documentation. LPA Vanegas reviewed medication administration record and medications with Administrator (AD) Basyouny Elsayed. Per LPA Vanegas review medications are not being documented correctly and medications are being transferred from one bottle to another a deficiency was cited on today's date. Based on the observations made during today’s inspection, deficiencies are not being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights were left at the facility.the state’s words, verbatim · CDSS document, Feb 4, 2025

Allegation investigated: Licensee Corporation is not in good standing

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an uannounced visit to conduct a complaint investigation. LPA was greeted and granted entry into the facility by Basyouny Elsayed and explained the reason for the visit. The Department recieved a complaint on 12/20/2024 and the initial 10 day visit was conducted on 12/30/2024. During the visit LPA Mendivil reviewed files and interviewed staff. Regarding the allegations that icensee corporation is not in good standing the investigation revealed the follwing: It was alleged that the licensee's corporation Diamnond Manor 2 LLC is not in good standing with the Secretary of State. LPA Mendivil reviewed California Secretary of State Business Search website, based on information provided on the website the licensee Diamond Manor 2 LLC is in good standing. Unfounded Therefore based on preponderance of evidence through records reviewed and interviews the allegation that Licensee Corporation is not in good standing is determined to be UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. An exit was conducted and a copy of this report was provided to facility representative. Therefore based on the preponderance of evidence through interviews the allegation facility lacks liability insurance is determined to be SUBSTANTIATED, meaning the complaint allegation was valid and that a violation has occurred The following is being cited per California Code of Regulations Title 22 Division 6 Chapter 8. An exit interview was conducted and a copy of this report and appeal rights were provided to Licensee.the state’s words, verbatim · CDSS document, Dec 30, 2024 · control 22-AS-20241220165902

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.605 · Plan of correction due date: Jan 6, 2025

all residential care facilities for the elderly … shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee. This requirement was not met as evidence by Licensee stated they did not pay renewal for liability insurance. This poses a potential safety risk to those in care.the state’s words, verbatim · CDSS document, Dec 30, 2024

Plan of correction: Licensee obtained liability insurance within the parameters of HSC while LPA Mendivil was at the facility. POC cleared as of 12/30/2024.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Ruth Martinez conducted an announced visit to the facility for purpose of a pre-licensing evaluation. LPA arrived at the facility was greeted and granted entry. A change of ownership application to operate an Adult Residential Facility for the Elderly, age 60 years and over, for (6) capacity, (1) ambulatory, (4) non-ambulatory, and (1) bedridden residents was submitted to CCL on 10/25/22. Structure: The facility is a two-story house with an attached garage with 4 resident bedrooms, 1 staff bedroom, 2 full bathrooms, a living room, a dining room, a family room, and a kitchen on the first floor of the facility. The second floor is occupied by applicants and there are no resident bedrooms on the second floor. The resident’s bedrooms are spacious and will easily accommodate the resident’s furnishings. There is a large back yard with an exit walkway on both sides of the house with covered seating for the residents. Air/Heating: Central air/heating system installed with a central panel to control entire house. Bedrooms Residents: Bedrooms will accommodate 6 residents with 2 private rooms and 2 shared room accommodating two residents. Bedrooms Staff: Bedroom #5 designated for awake staff. Bathrooms: All bathrooms have a working toilet, wash basin, walk in shower. Linens & Hygiene Supplies: Adequate supply of linen stored in hallway storage. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed. Menus posted and available. Menus prepared one week prior and listed for food serve for one week. Food Service: Adequate supply of 7-day non-perishable and 2-day perishables are stored in the kitchen. Smoke Detectors: Smoke detectors and carbon monoxide alert systems are hardwired, were tested, and Continued on LIC809-C found operational. Appliances: Gas six-burner stove/grill, single oven, 2 refrigerator (kitchen & garage), microwave, washer, and dryer are clean and noted to be operational. Toxins: All and any toxic chemicals, cleaning solutions and disinfectants are inaccessible to residents are stored and locked in garage. Water Temperature: Tested and recorded maintained at a comfortable temperature and the water temperature measures 105.9 Fahrenheit degrees in facility bathrooms. Medications, First-Aid Kit & Book: Medication and first aid kit/book are stored and locked in a storage cabinet located kitchen. Resident & Staff Files: Records will be kept locked in the medication cabinet. Reading Material, Games, Equipment & Materials: The facility has board games, books, and other recreational materials for the residents’ use, commensurate with the plan of operation. Fire clearance: Was approved on 06/09/2023. Component III: Component three waived during visit. Applicant is Licensee/Administrator of other licensed facilities. The applicant has met all pre-licensing requirements. LPA will submit notification to CAB in Sacramento for final review prior to license being issued. Exit interview was conducted with applicant and a copy of this report was left with the applicant.the state’s words, verbatim · CDSS document, Mar 7, 2024