Elite Manor Amelia

Type of visit: Required - 1 Year

On 8/11/26, Licensing Program Analyst (LPA) Kyle Wellington arrived unannounced to conduct an annual inspection. LPA was greeted and granted entry by Caregiver, Karina Alvarez, who was informed of the purpose of the visit. LPA met with Administrator (Admin), William Lee, who arrived later and was also was informed of the purpose of the visit. LPA received a staff and resident roster from Admin. The census at the facility is five (5) residents. LPA toured the inside and outside of the facility with Admin. LPA conducted an observation and record review for the inspection Facility Overview: Facility is a one story house with six (6) resident bedrooms, three (3) resident bathrooms, living room, kitchen, dining room, family room, laundry room, storage rooms and attached garage. There are no pools, bodies of water or firearms at the facility. Infection Control: LPA observed cleaning equipment and supplies in the locked laundry room and in the locked storage room and available for regular facility maintenance. LPA reviewed the facility’s infection control plan which met the department’s requirements. Physical Plant: LPA observed the inside and outside of the facility to be clean, safe and well kept. The floors, windows and doors were clean and well maintained. The living room, family room and dining room furniture was in good repair. Clients' bedrooms were neat, organized and contained the required bedding, lighting and furniture. Clients' bathrooms were clean, tidy and had hot air hand dryers, soap, hand rails, non-slip mats in the showers and posted signs for water temperature over 120 F. Extra linen and towels were kept in a closet in the hall. Facility had night lights and was free of obstructions. Laundry equipment appeared to be in good working condition. Laundry supplies were kept in a cabinet in the locked laundry room. One (1) fire extinguisher was charged and available for use. LPA tested one (1) of the smoke and carbon monoxide detectors and found them to be hard-wired and operable. The backyard was free of hazards and had outdoor furniture and shaded area for the residents. Kitchen: LPA observed the kitchen to be sanitary, organized, and well maintained. The kitchen had the ability to prepare and store food in a safe and clean environment. Kitchen appliances appeared to be in good working condition. All sharp objects were kept in a locked drawer in the kitchen inaccessible to residents. Cleaning supplies were kept in a locked cabinet under the kitchen sink inaccessible to residents. Food in the refrigerator/freezer and cabinets were stored properly and not expired. Facility has over a two day supply of perishable foods and over a seven day supply of non-perishable foods. Care & Supervision: LPA observed two (2) staff and four (4) residents at the facility during the inspection. One (1) resident was in the hospital. Facility has sufficient staff to supervise the residents. Administration: LPA observed facility sketch, personal rights, emergency and disaster plan, complaint information & procedures, long-term care ombudsman information, facility license, business license and administrator certificates posted in the hall. Admin holds a current Administrator Certificate, Criminal Record Clearance and is associated with the facility. Client/Resident and Staff Files: LPA reviewed the records of three (3) staff files and five (5) residents' files. Staff have a current CPR/First Aid Certificate, Criminal Record Clearance and are associated with the facility. The files contained all the required documentation and paperwork. Resident files were kept in a locked cabinet in the kitchen and Staff files were kept at the office inaccessible to unauthorized individuals. Medication: LPA observed residents' medications were centrally stored in a locked cabinet in the kitchen inaccessible to residents. First aid kit was kept in a locked cabinet and it contained all the required items. LPA reviewed five (5) residents' medications to the facility’s medication log to make sure all medication was accounted for and dispensed correctly. Disaster & Emergency: LPA reviewed the facility’s emergency and disaster plan. It is current and up to date. Disaster drills are conducted quarterly with the last one done on 7/5/26. Facility's property and liability insurance is current and expires on 7/1/27. All facility exits were clear of blockage and contained signage. No deficiencies were cited during this visit. An exit interview was conducted with Administrator, William Lee, and a copy of this report was given to Administrator, William Lee.the state’s words, verbatim · CDSS document, Aug 11, 2026

Type of visit: Required - 1 Year

On 08/08/24 at 11:02am Licensing Program Analyst (LPA) Javina George made an unannounced visit for the purpose of conducting a 1 year required visit/annual inspection. LPA George met with Administrator William Lee and informed of the purpose of today's visit. The facility is licensed to serve residents age range 60 and over, of which 1 may be non ambulatory and 5 ambulatory residents. The facility has an approved hospice waiver for (1). There are currently (2) residents receiving hospice services. The Administrator will submit a hospice waiver increase. Below is a summary of what was observed during today’s inspection: Infection Control: LPA George observed that the facility has an updated Infection Control Plan on file and is demonstrating best practices in the facility to maintain a healthy environment for staff, residents and visitors. Physical Plant: LPA toured the interior and exterior of the facility and observed that there a sufficient bedrooms (6) and bathrooms (2.5) for resident use. The facility was observed to have the required furniture and linen to be present and in good condition in resident bedrooms. The exits are free from obstruction and that there is plenty of space for activities. In the backyard there is a covered patio, and a gazebo. There are no pools or bodies of water on the premises. LPA observed for the facility sketch to not match the physical lay out of the facility as the licensee added staff break rooms, that have beds inside. LPA observed for one room to have a green suitcase, however all staff and the Administrator William denied that there are live in caregivers. Staff Records: LPA observed that there are sufficient staff present to meet the needs of residents. LPA George confirmed that there is an Administrator present. LPA observed for the additional Administrator William Lee to not be associated to the facility, but has proper fingerprint clearance. Guardian information will be provided. However per the records review and confirmation from the Administrator William all staff present at the time of LPAs visit are volunteers. All volunteers are paid were observed to have criminal record clearance and were associated to the facility. The volunteers were included in the staffing plan and were left unattended without any supervision. Deficiency cited. Resident Records: LPA conducted a review of (2) resident files to confirm that they have the required information present in their files, including Physician's Report, Admissions Agreement, and current Needs & Services Plan. (1) resident was observed to not have a current medical assessment completed, as the last assessment was in May 2023. In addition LPA conducted a review of the resident roster as LPA observed for there to be more than one non ambulatory resident as 1 resident was observed using a walker, 1 was observed using a motorized wheelchair and the third resident was in a wheelchair. The facility fire clearance was granted for 1 non ambulatory and 5 ambulatory residents. Deficiency cited. Food Services: The kitchen and dining area to be maintained in a clean and healthful manner. Sufficient dishware and silverware were present for resident’s use. LPA George observed the facility to have the required amount of 7 day supply non-perishable and a two supply perishable food items. LPA observed for there to be 3 expired canned food items, which were discarded at the time of LPAs visit. Medication: Resident medication was observed to be locked in the cabinet inside the kitchen and inaccessible to residents. A review of medication revealed that there was (5) missing initials on the Medication Authorization Record MAR, however LPA was able to verify that the medication had been dispensed. The Administrator stated that a training will be given which will include reminders to sign off on the medication after it has been administered. Emergency Disaster Preparedness: The facility has an Emergency Disaster Plan on file and conducts regular disaster drills on a quarterly basis. The last drill was conducted on 07/31/24. The smoke and carbon monoxide detectors were tested and were found to be operable. The facility has a fully charged fire extinguishers. There are no known guns or ammunition on the premises. The hot water was tested and was found to be within regulatory limit measuring at 110-113.8 degrees Fahrenheit. The facility has emergency food and water supply. The sharps and hazardous chemicals were observed to be locked and inaccessible to residents in care. Based on today's inspection a citation will be issued in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted and a copy of this report, 809D, appeal rights, and Proof of Corrections form LIC 9098, were provided to William Lee, Administrator.the state’s words, verbatim · CDSS document, Aug 8, 2024