Emerald Home Care

Type of visit: Required - 1 Year

On 04/24/2026 at 9:50 AM AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Bintia Loznianu, Care Staff and explained the purpose of the visit. Administrator Carmen Nica was not available during the visit. LPA called the Administrator to explain the purpose of the visit. Administrator Carmen Nica Authorized care giver Bintia Loznianu to sign the report. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 73 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 117.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 07/16/2025. Emergency Disaster Plan was last reviewed on 01/03/2026. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 02/02/2026. LPA reviewed 1 resident records and 3 staff records; all were complete. LPA also reviewed a sample of 1 resident’s medications.The following documents were reviewed during the visit: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan, Liability Insurance, and Current Administrator’s Certificate. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Apr 24, 2026

Allegation investigated: -Resident (R1) not provided call equipment/buzzer. -Staff is charging for services not received. -Staff did not follow admission agreement. -Resident (R1) did not receive medication as prescribed. -Staff did not meet resident's (R1) hygiene needs. -Staff did not properly dress a resident (R1) while in care. -Staff made an unauthorized diagnosis of a resident (R1) while in care. -Staff denied visits to resident (R1) while in care.

On this day, May 13, 2025 at 1:25 pm, Licensing Program Analyst (LPA) Delmundo conducted an unannounced visit to continue the investigation of the above allegations and close the complaint. LPA met with Carmen Nica, licensee, and informed the reason for visit. John Nica, administrator (ADM) arrived at around 2:10 pm. On 11/10/21, LPA conducted inspection and interviewed staff (S1 and S2) and resident (R2). R1’s family member (FM) was also interviewed on 11/08/21. Licensee was also interviewed. R1 had moved out from Emerald Care Home when complaint was received by the Department. LPA obtained copies of R1’s following documents from the facility where R1 moved-in: LIC601 Identification and Emergency Contact Information and LIC602A Physician’s Report facility Staff. On 11/10/21, LPA interviewed witness (W1) and R1. .......continued on 9099C (page 2) Unsubstantiated Page 2 Allegation: Resident (R1) not provided call equipment/buzzer. FM stated R1 was not provided call buzzer/call pendant. The 2 staff interviewed stated R1 had call bell which LPA observed in the vacant room used by R1 when R1 was at the facility. R1 stated she had buzzer. Due to medical diagnosis, LPA was not able to obtain information from another resident (R2). Therefore, the allegation is unsubstantiated. Allegations: · Staff is charging for services not received. · Staff did not follow admission agreement. FM stated the contract states residents would be bathed 2 times per week and that was not adhered to even after the family brought this issue to the licensee, they found R1 lacking proper hygiene with greasy matted hair and dressed in the same blouse 3 days in the same week. Review of Admission Agreement for R1 showed bathing twice a week. LIC602A Physician’s Report showed substantial assistance with bathing and partial to substantial assistance with dressing and grooming. S1 stated residents are given bath on Wednesdays and Saturdays. S1 denied missing giving bath to R1 and stated that she remembers giving R1 a bath 3x in a week, because R1 had an accident. S1 further stated that FM came one time and said something about R1's hair being dirty and that was day after R1 was given the scheduled bathing, so S1 gave R1 a shower that day. S2 stated all residents get a bath Wednesdays and Saturdays but R1 sometimes refused but at the end of the day, R1 still get bathe. She and S1 give bath to R1 because of R1’s medical condition and cannot take care of own bathing needs. R1 stated not remembering how many times staff gave R1 a bath, however, R1 told LPA regarding R1's medical condition. S1 stated R1 loves wearing dress sleep wear and that she changed R1's dress every day. S1 further stated she cleaned and wiped R1’s underarm and body with warm cloth every single day. S2 stated she changes all residents clothes every day. R1 stated that it never happened that R1 wore the same clothing for days. Licensee stated residents are changed everyday when they get up and before they go to bed ...continued 9099C (page 3) Page 3 During inspection, LPA observed R2 wearing clean clothing; however, due to R2’s medical condition, LPA was not able to obtain information regarding the allegations. Therefore, the allegations are unsubstantiated. Allegation: Resident did not receive medication as prescribed. FM stated that licensee, told FM that the Milk of Magnesia had not been stated and gave the FM the medication to administer to R1. Licensee denied the allegation and that she and ADM are the one who administers medications to residents. S1 stated she does know if licensee asked FM to administer the said medication. S2 stated not hearing the licensee asked FM to administer the said medication. R1 stated she does not believe she was taking Milk of Magnesia while at the facility, but list of medications showed R1 has order for this medication. Therefore, the allegation is unsubstantiated. Allegation: Staff did not meet resident's (R1) hygiene needs. FM stated that R1 would be bathe twice a week per contract which facility failed to provide. FM further stated that R1 was lacking proper hygiene with greasy, matted hair. Review of Admission Agreement for R1 showed bathing twice a week. S1 and S2, stated they gave R1 bath two times a week. S1 also stated she R1 a bath 3x a week when R1 had accident while S1 stated R1 sometimes refused but at the end of the day, R1 gets bathe. S1 further stated that when FM came and observed R1’s hair, R1 was given a bathe day prior. Licensee stated residents are given bath 2 to 3 times a week as agreed and given sponge bath on days residents are not scheduled for bathing; however, residents are given bath when they have accidents. R1 was not able to provide information regarding the frequency of bathing provided to R1. Due to R2’s medical diagnosis, LPA was not able to obtain information. Therefore, the allegation is unsubstantiated. Allegation: Staff did not properly dress a resident (R1) while in care. FM stated that R1’s lower half was not dressed for facility’s convenience and instead wrap a pad and blanket around R1’s lower extremities. S1 stated R1 loves wearing pajama. Both S1 and S2 stated they change residents’ clothes every day. Licensee denied the allegation and stated the residents' clothing are changed when they get up and before they are put to bed. ....continued on 9099C (page 4) Page 4 R1 stated care staff has taken good care of her. W1 stated observing R1 has blanket from waist down when she assessed R1, however, W1 was not able to tell if R1 was wearing something from waist down or if R1 was wearing a full dress. Due to R2’s medical diagnosis, LPA was not able to obtain information whether R2 observed R1 not dressed from waist down. Therefore, the allegation is unsubstantiated. Allegation: Staff made an unauthorized diagnosis of a resident (R1) while in care. FM stated the licensee repeatedly described R1 as having dementia. Review of LIC602A did not show R1 has dementia diagnosis. The licensee denied the allegation and stated that she never told the FM that R1 has dementia but mentioned that it could be mild cognitive impairment. S1 and S2 stated not hearing the licensee saying R1 has dementia. Due to R2’s medical diagnosis, LPA was not able to obtain information pertaining to the allegation. Therefore, the allegation is unsubstantiated. Allegation: Staff denied visits to resident (R1) while in care. FM stated that licensee told R1’s family leave R1 there for some time after admission meaning not visiting regularly R1 so R1 would fall into line with the house rules. The licensee …… . S1 and S2 stated R1’s family member came to the facility every day and was allowed to visit R1 and the visitation took place in the backyard. Residents’ visitations were allowed inside the facility after weeks and visitors wore mask. R1 was not able to provide information. Due to R2’s medical diagnosis, LPA was not able to obtain information. Therefore, the allegation is unsubstantiated. Based on interviews, observation and records review, there is not a preponderance of evidence standard to prove that violation occurred. No deficiency cited. Exit interview conducted and copy of this report provided.the state’s words, verbatim · CDSS document, May 13, 2025 · control 15-AS-20211105095643

Type of visit: Case Management - Deficiencies

While investigating a complaint (Control # 15-AS-20211105095643), Licensing Program Analyst (LPA) Delmundo requested for resident’s (R1) documents to be submitted by 11/12/21. LPA did not receive the requested documents. On 8/14/24, LPA called and requested again for the documents and licensee stated R1’s documents were already in the attic and if she cannot find them in her computer, she will not get to the attic to retrieve the documents. On August 27, 2024, LPA called and left an urgent message on licensee’s voicemail and requested to submit the documents by August 30, 2024. Licensee did not submit the documents. LPA reviewed the documents that were received via fax by the Department's Regional Office for October 2021, November 2021 and December 2021 and didn’t observe any documents for R1 from the facility. On this day, 5/13/25, LPA learned that the staff (S1) is not fingerprinted. LPA asked S1 who stated she started working Monday, May 5, 2025. The above were discussed with Carmen Nica, licensee, and John Nica, administrator (ADM). Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. A $500.00 civil penalty is assessed for S1 who is not fingerprinted and will continue for $100.00/day until corrected. Failure to submit proof of correction by plan of correction due date for the other deficiency may also result in civil penalty. Deficiencies and plan and proof of corrections were discussed. Exit interview conducted. Appeal Rights, LIC421BG Civil Penalty, LIC9098 Proof of Correction form and copy if this report provided to ADM.the state’s words, verbatim · CDSS document, May 13, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: May 14, 2025

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review ... 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.... -This requirement is not met as evidenced by: -Based on interview, and LPA checking of the Department's Guardian Portal, the licensee did not comply with the section in S1 not having fingerprint clearance which posed an immediate safety and/or personal rights risks to person in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee accompanied the staff for fingerprinting while LPA was at the facility. Staff will not be allowed to work until fingerprinted and associated. Proof to be submitted by 5/14/25, A $500.00 civil penalty is assessed.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87506(a) · Plan of correction due date: May 27, 2025

87506 Resident Records: (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. -This requirement is not met as evidenced by -Based on interviews, the licensee did not comply with the section above in not providing the requested documents which posed a potential personal rights risk to person in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee and administrator to read the Regulations and self-certify compliance. Proof to be submitted by 5/27/25.

Type of visit: Required - 1 Year

On 04/02/2025 at 12:05 PM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with caregiver, Bintia Loznianu and explained the purpose of the visit. Facility Manager, Carmen Nica arrived at 12:35 PM. LPA explained the purpose of the visit to the facility manager. At 12:10 PM, LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 109 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 07/01/2024. Emergency Disaster Plan was last posted on 07/21/2017. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 02/10/2025. At 1:10 PM, LPA reviewed 3 residents records and 3 staff records; all were complete. LPA also reviewed a sample of resident’s medications. The following documents were observed during the inspection: LIC 500 Personnel Report, LIC 610E Emergency Disaster Plan, and Liability Insurance. The current Administrator’s Certificate expires on 10/26/2026. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Apr 2, 2025

Type of visit: Required - 1 Year

On 5/21/2024 at 2:00PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with caregiver, Merlene Sulph and explained the purpose of the visit. Manager, Carmen Nica arrived an hour later, but was unable to stay until the end of inspection. The facility’s fire clearance was approved for 1 ambulatory and 5 non-ambulatory residents of which 2 residents maybe under hospice care. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide combination detectors were observed. Fire extinguisher was observed to be full. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 111.6 degrees F in the hallway bathroom. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. Last fire drill was conducted on 3/15/2024. LPA reviewed resident and 3 staff files starting at 2:50PM. LPA reviewed a sample of resident's medications during inspection. LPA interviewed resident and staff starting at around 5:15PM. At 2:20PM, LPA observed unlocked cleaning supplies in the staff room, unlocked knives in the kitchen, and unlocked gardening tools in the backyard. Staff locked up the cleaning supplies, knives, and gardening tools during inspection. At 2:30PM, LPA observed unlocked medications in the staff room, refrigerator, and kitchen drawer. Staff locked up the medications during inspection. (Continue on LIC809C...) At 3:00PM, LPA observed R1 does not have a current medical assessment and appraisal needs & service plan on file. At 5:30PM, LPA was informed that staff does not document resident's changes in condition. LPA did not observe facility notes or care notes for resident. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties. Exit interview conducted with Merlene Sulph. A copy of this report and appeal rights was provided.the state’s words, verbatim · CDSS document, May 21, 2024

The state marks this report as 8 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.