Emerald Retirement Residence

Type of visit: Required - 1 Year

On 10/14/2025, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by Assistant Administrator, Kristine Tan and Caregiver, Ronaldo Marcos. LPA explained the purpose of today's 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 and 7-day non-perishables, Facility has 5 resident bedrooms (4 private rooms and 1 shared room), 1 staff room, 2 full- bathrooms, kitchen, and common areas. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and nonskid mats. Facility temperature is comfortable. Hot water temperature was measured at 106-116 degrees F. The emergency drills were reviewed. Central stored medication, toxins and sharps objects were locked and inaccessible to residents. Staff training records were reviewed to be adequate. Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time. A review of (5) resident files was conducted and noted on the LIC 858. A review of (3) staff files was conducted and noted on the LIC 859. LPA requested for a copy of the LIC 400- Affidavit Regarding Client/Resident Cash Resources to be submitted to CCL by 10/16/2025. No deficient is cite today. This report is reviewed and discussed with the asst. administrator and a copy is provided.the state’s words, verbatim · CDSS document, Oct 14, 2025

Type of visit: Required - 1 Year

On September 12, 2024 Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregivers, Maria Burgos and Ronaldo Marcos and LPA explained the purpose of today's visit. The administrator, Isabelle Gil arrived shortly thereafter and assisted with the 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 and 7-day non-perishables, Facility has 5 resident bedrooms (4 private rooms and 1 shared room), 1 staff room, 2 full- bathrooms, kitchen, and common areas. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and nonskid mats. Facility temperature is comfortable. Hot water temperature was measured at 108- 119 degrees F. The emergency drills were reviewed. Central stored medication, toxins and sharps objects were locked and inaccessible to residents. Staff training records were reviewed to be adequate. Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time. A review of (5) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. During today's inspection, there are 3 residents present and 2 were attending the adult day program. During the tour, LPA observed a storage unit in the yard and inside the storage unit, there were 2 beds, TV, a chair, exercise equipment, and personal items such as clothing, medications, shoes, etc. Civil Penalty is being assessed today in the amount of $100 as the facility did not complete the Criminal Background Clearance Transfer Request for staff #1. LPA requested for a copy of the Liability Insurance to be submitted to CCL on 9/16/2024. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with administrator. A copy of this report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Sep 12, 2024

Type of visit: Required - 1 Year

On October 19, 2023 Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregivers, Luisa Dizon and Maria Burgos and LPA explained the purpose of today's 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 and 7-day non-perishables, Facility has 5 resident bedrooms (4 private rooms and 1 shared room), 1 staff room, 2 full- bathrooms, kitchen, and common areas. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and nonskid mats. Facility temperature is comfortable. Hot water temperature was measured at 108- 112 degrees F. The most recent emergency drill was conducted on June 24, 2023. Fire extinguisher(s), smoke and carbon monoxide detectors in the facility. Central stored medication, toxins and sharps objects were locked and inaccessible to residents. Staff training records were reviewed to be adequate. LPA reviewed 6 resident files and all of them contained medical assessment, and GGRC/IPP. However, 3 out of 3 resident's file did not contain a facility Admission Agreement, and 4 out of 6 residents did not have an Appraisal Needs and Service Plan. This observation was presented to the caregivers. LPA reviewed 3 staff files that contained personnel records, health screening, Job Description, Abuse Statement, First Aide and CPR, Criminal Record Statement. During today's inspection, there are 4 residents present and 2 were attending the adult day program. LPA requested for a copy of the Liability Insurance, and Control of Property to be submitted to CCL by 10/20/2023 Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with caregivers. A copy of this report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Oct 19, 2023