European Home Care III

Allegation investigated: Staff consume liquor while on shift. Staff do not have fingerprint clearance. Staff lock facility doors to prevent residents from leaving. Staff refuse to call an ambulance for residents in care. Staff insert suppositories to residents in care. Staff facility records are falsified. Staff did not maintain resident records. Residents are not provided proper food service.

Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility Administrator Iren Ceighton and explained the purpose of the visit. The investigation consisted of interviews and review of records. First allegation, staff consume liquor while on shift. During the facility visit, the Licensing Program Analyst (LPA) conducted a comprehensive walkthrough, inspecting the kitchen cabinets, appliances, and pantry, and noted no liquor present. Additionally, the LPA interviewed facility residents, all of whom reported never witnessing staff consume alcohol while on duty or detecting any odor of liquor on them. Three(3) out of Three Staff denied consuming or storing alcohol at the facility, as well as witnessing any coworkers drinking while providing resident care. Unsubstantiated Second allegation, Staff did not inform resident’s physician of resident’s change of condition. Regarding the allegation “Staff did not inform resident’s physician of resident’s change of condition” LPA conducted interviews with residents pertaining to the allegation Staff did not inform resident’s physician of resident’s change of condition. Six(6) out of six(6) residents denied the allegation and stated that staff do inform their physician/Innovage, if there is any change in condition. Staff#1 told LPA Singh that staff calls Innovage and informs innovage and all the medical care has been provided through Innovage. Residents goes to Innovage for their weekly checkups. Third Allegation: Staff did not provide adequate medication assistance to residents in care. Staff did not provide adequate medication assistance to residents in care, Regarding the alleged allegation. LPA conducted interviews with residents and six out of six residents stated that they receive medication on a timely manner. In addition, all residents stated that medication is always given and not withheld by staff. LPA conducted a file review of residents MAR records and observed that all medication is being distributed and managed correctly by staff. Fourth Allegation: Staff threatened residents in care. Staff threatened residents in care. Regarding the allegation “Staff threatened residents in care” LPA conducted interviews with residents pertaining to the alleged allegation and six out of six residents denied being threatened or mistreated by staff. In addition, all residents denied witnessing staff threat other residents in care. LPA conducted interviews with staff regarding the allegation stated above, all staff denied threatening or mistreating residents in care. In addition, staff also denied witnessing other staff threat or mistreat residents in care. Fifth Allegation: Staff did not ensure sufficient food items were available at the facility for residents in care. Staff did not ensure sufficient food items were available at the facility for residents in care. Regarding the allegation stated above. LPA conducted an inspection on facilities food supply. During the inspection LPA discovered that the facility had adequate amount of food supply to meet resident needs. LPA conducted interviews with residents and six out of six residents stated that the food provided is fulfilling and have no issues with food or snack supply. Sixth Allegation: Staff did not prevent residents from engaging in inappropriate interactions. Regarding the allegation “Staff did not prevent residents from engaging in inappropriate interactions.” LPA conducted interviews with residents pertaining to the allegation Staff did not prevent residents from engaging in inappropriate interactions. Six(6) out of six(6) residents denied the allegation and stated that staff do prevent any inappropriate interaction and supervises the residents in their care. Seventh Allegation: Staff yelled at residents in care. Staff yelled at residents in care. Regarding the allegation “Staff yelled at residents in care” LPA conducted interviews with residents pertaining to the allegation stated above and six out of six residents denied being yelled at by staff. In addition, all residents denied witnessing staff yell at residents in care. LPA conducted interviews with staff regarding the allegation stated above, all staff denied yelling at residents in care. In addition, staff also denied witnessing other staff yell at residents in care. Eighth Allegation: Staff did not assist residents that sustained falls. Staff did not assist residents that sustained falls. Regarding the allegation” Staff did not assist residents that sustained falls” LPA conducted interviews with residents, and all denied staff not assisting residents with transfers. All residents also stated that caregivers are very involved with helping residents who are non-ambulatory. Furthermore, during interviews residents denied witnessing residents sustain falls and not being assisted by staff Ninth Allegation: Centrally stored medications are accessible to residents in care. Centrally stored medications are accessible to residents in care. Regarding the allegation “Centrally stored medications are accessible to residents in care” LPA conducted a walkthrough of the facility during the walkthrough LPA discovered a black metal cabined located across bedroom #6 that was locked and secure. LPA checked cabinet to ensure that the cabinet was locked and secured. During the inspection facility staff opened the cabinet with a key (no magnet) and demonstrated to LPA that medication cabinet remains locked and inaccessible to residents in care. The investigation did not provide any evidence or witnesses that indicated that these Allegations listed above Staff did not ensure resident’s diapering needs were met, Staff did not inform resident’s physician of resident’s change of condition, Staff did not provide adequate medication assistance to residents in care, Staff threatened residents in care, Staff did not ensure sufficient food items were available at the facility for residents in care, Staff did not prevent residents from engaging in inappropriate interactions, Staff yelled at residents in care, Staff did not assist residents that sustained falls and Centrally stored medications are accessible to residents in care Therefore, based on the evidence gathered during the investigation, the allegations listed above is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Based on corroborating evidence obtained during the course of the investigation, LPA has determined that the above allegations are Unsubstantiated. Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Administrator Iren Ceighton Second Allegation: Staff left residents unattended. Staff left residents unattended. Regarding the allegation “Staff left residents unattended” LPA conducted interviews with residents regarding the allegation stated above all six residents denied being left alone or unattended at the facility. LPA conducted interviews with regarding the alleged allegation all staff denied leaving residents in care unattended or unsupervised. Third Allegation: Staff do not have an infection control plan at the facility. Staff do not have an infection control plan at the facility. Regarding the allegation “Staff do not have an infection control plan at the facility” LPA conducted a record review and observed that facility had an infection control plan in place that was current. In addition, LPA observed proper postings throughout the facility that indicated the preventions and the spreads of infections and illnesses. The investigation did not provide any evidence or witnesses that indicated that these Allegations listed above Staff do not have a fire evacuation plan at the facility, Staff left residents unattended and Staff do not have an infection control plan at the facility. Therefore, based on the evidence gathered during the investigation, the allegations listed above is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Based on corroborating evidence obtained during the course of the investigation, LPA has determined that the above allegations are Unsubstantiated. Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Administrator Iren Ceighton Second allegation, Staff do not have fingerprint clearance. Regarding the allegation “Staff do not have fingerprint clearance” LPA retrieved a facility roster via Guardian Background System, and observed that Staff #1, Staff#2, and Staff#3, that were currently working at the facility all were eligibly cleared. LPA conducted a file review for Staff 1-3 and discovered that all clearance records were on file. Third allegation, Staff lock facility doors to prevent residents from leaving. Regarding the allegation “Staff lock facility doors to prevent residents from leaving” LPA conducted a walk through of the facility and inspected six out of six resident’s bedrooms along with resident’s doorknobs and observed that no doors have locks in place. In addition, LPA conducted an inspection on all doors along with emergency exists and witnessed that no doors have locks in place. LPA conducted interviews with residents regarding the allegation “Staff locking facility doors to prevent residents from leaving” all residents denied being locked or prevented from leaving the facility. LPA conducted interviews with staff regarding the alleged allegation, and all denied locking or preventing residents from leaving the facility. Fourth allegation, Staff insert suppositories to residents in care. Regarding the allegation” Staff insert suppositories to residents in care” LPA conducted interviews with staff and all staff denied utilizing or inserting suppositories to residents. LPA conducted interviews with residents, and all denied having suppositories inserted by staff. LPA conducted a medication inspection and discovered that no suppositories are being stored. Fifth Allegation: Staff facility records are falsified. Regarding the allegation “Staff facility records are falsified” LPA conducted a file review of all staff and residents records and discovered that all required documentation for six out of six residents and Three out of there staff were on file based on Title 22 Residential Care Facility for Elderly (RCFE) and no records were falsified. Sixth allegation, Staff did not maintain resident records. Regarding the allegation “Staff did not maintain resident records” LPA conducted a file review of all resident records and discovered that all required documentation for six out of six residents were on file based on Title 22 Residential Care Facility for Elderly (RCFE). Based on the evidence gathered during the investigation, the above allegations Staff did not complete required training and Staff are not following reporting requirements are Substantiated. Substantiated: A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Title 22 regulations, from division 6, chapter, article 6, is being cited on the attached LIC 9099 D. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided, along with a copy of the appeal rights to Facility Seventh allegation, Residents are not provided proper food service. During the inspection LPA discovered that the facility had adequate amount of food supply to meet resident needs. In addition, LPA observed that all food including canned goods sustained current shelf life. LPA conducted interviews with residents where five out of six residents stated that that the food is good and have no concerns. The investigation did not provide any evidence or witnesses that indicated these Allegations listed above Staff consume liquor while on shift, Staff do not have fingerprint clearance, Staff lock facility doors to prevent residents from leaving, Staff refuse to call an ambulance for residents in care, Staff insert suppositories to residents in care, Staff facility records are falsified, Staff did not maintain resident records and Residents are not provided proper food service. Therefore, based on the evidence gathered during the investigation, the allegations listed above is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, LPA has determined that the above allegations are Unsubstantiated. Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Administrator Iren Ceightonthe state’s words, verbatim · CDSS document, Aug 14, 2026 · control 56-AS-20241120134233

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87705(a)(b)(1) · Plan of correction due date: Aug 28, 2026

(b) Licensees shall be responsible for the following:(1) Ensuring staff receive the following training as part of the training requirements specified in Section 87208 Plan of Operation:(A) Dementia care, including, but not limited to, knowledge about hydration, nutrition, skin care, communication, therapeutic activities, behavioral challenges, the environment, and assisting with ADL's; (B)Recognizing symptoms that may create or aggravate behavioral expression, as defined in Section 87101, Definitions, including, but not limited to, dehydration, UTI, and problems with swallowing; and(C)Recognizing the effects of medications commonly used to reduce behavioral expression. Based on observation and record review, the licensee did not comply with the section cited above by not completing Staff#1 and Staff#2 training in Dementia which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 14, 2026

Plan of correction: Licensee to train staff#1 and Staff#2 and provide the copies of the Dementia training completed for all staff shifts to LPA by POC via email.

From the deficiency page — Deficiency type: Type B · Section cited: HSC 87411(c)(3) · Plan of correction due date: Aug 28, 2026

87411 Personnel Requirements-General (c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 (3) The training shall include, but not be limited to, the following:(A)The aging process and physical limitations and special needs of the elderly(B)Importance and techniques of personal care services, including but not limited to, bathing, grooming, dressing, feeding, toileting, and infection control, as specified in Section 87470, Infection Control Requirements.(C) Residents rights, as specified in Section 87468, Personal Rights. (D) Policies and procedures regarding medications, including the knowledge in Section 87411(d)(4). Any on-the-job training provided for the requirements in Section 87411(d)(4) may also count towards the requirement in this subsection. (E) Psychosocial needs of the elderly, such as recreation, companionship, independence, etc.(F) Recognizing signs and symptoms of dementia in individual Based on observation and record review, the licensee did not comply with the section cited above by not completing Staff#1 and Staff#2 training in Training which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 14, 2026

Plan of correction: Licensee to train staff#1 and Staff#2 and provide the copies of the Medicationtraining completed for all staff shifts to LPA by POC via email.

From the deficiency page — Deficiency type: Type B · Section cited: HSC 87211(a)(b) · Plan of correction due date: Aug 28, 2026

87211Reporting Requirements(a) Each licensee .. the Department may require, including, but not limited to, the following:(1)A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case.(A) Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, en route to or from a hospital, or visiting away from the facility.(B)Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision...Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents,...(2) Occurrences, such as epidemic outbreaks ... which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate.(3) Fires or explosions which occur in or on the premises shall be reported.., within 24 hours to the State Fire Marshal; and no later than the next working day to the licensing agency.(b)Any known, suspected, or alleged abuse of an elder ... with dementia diagnosed by a licensed physician and there was no serious bodily injury, the local law enforcement agency as required by Welfare and Institutions Code Section 15630(b)(1). Based on observation and record review, the licensee did not comply with the section cited above by not reporting to CCLD since last year 2025, which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 14, 2026

Plan of correction: Licensee to train/read Title 22 reporting requirements to all staff on reporting requirements and provide the copies of the training completed for all staff to LPA by POC via email.

Allegation investigated: Staff engaged in an inappropriately relationship with resident Staff inappropriately had resident sign a document giving staff legal decision making over resident

Licensing Program Analyst (LPA) E. Conchas conducted an unannounced visit to deliver findings on the allegation listed above. LPA met with caregiver Desiree DuBois and explained the purpose of the visit. The investigation consisted of staff interviews, resident interview and document review. Staff engaged in an inappropriately relationship with resident. Interveiws conducted of 3 staff and 1 resident. 3 out of the 3 staff stated there is no inappropraitely realtionship with the resident. Resident 1(R1) stated no, they are not engaged in an inappropraitely realtionship with any staff. This is unsubstantiated. Staff inappropriately had resident sign a document giving staff legal decision making over resident. Interveiws conducted of 3 staff and 1 resident. 3 out of 3 staff interviews stated staff have not inappropriately had resident sign a document giving staff legal decision making over resident. R1 stated there are no staff who have any authorization to make any legal desicion over resident. This is unsubstantiated Continue to LIC 9099-C Unsubstantiated Based on the evidence gathered during today’s investigation, the allegation listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. During today’s visit, pertaining to the allegations listed, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to caregiver Desiree DuBois.the state’s words, verbatim · CDSS document, May 14, 2026 · control 56-AS-20260416123134

Type of visit: Required - 1 Year

On 5/14/2026 Licensing Program Analyst (LPA) E. Conchas made an unannounced visit to the facility to conduct an annual required inspection. LPA was greeted and granted entry by the caregiver Desiree DuBois and accompanied LPA throughout today's inspection. LPA verified contact information for the facility and will update the land line accordingly. A file review was conducted, and the facility annual fees are due in this upcoming month of June. Below are the observations made during today's visit: The facility was observed to have the required postings: CCL complaint poster, license and emergency disaster plan. LPA observed for the facility to possess signed acknowledgment forms. The facility was observed to be clean and clutter free. The food supply was observed to be adequate, with a 2-day supply of perishable and a 7-day supply of non-perishable food items. The facility was observed to have fully charged fire extinguisher with the tag intact and was last serviced on 07/17/25. The emergency disaster drills was last conducted on February 2026. There are no guns and ammunition on the premises. The smoke and carbon monoxide detectors were tested and found to be operable. The sharps, chemicals and medications were observed to be locked and inaccessible to clients in care. The hot water temperature was tested and measured to be between 116.9- 122.1 degrees Fahrenheit. The client bedrooms were observed to have the required furniture (chair, bed, lamp). File review was conducted of staff and client files, and the staff were in possession of valid CPR certification, and the administrator on record, Iren Creighton, was observed to possess a valid certification that expires on 10/29/2026. Continue to LIC809-C The client bedrooms were observed to have the required furniture (chair, bed, lamp). File review was conducted of staff and client files, and the staff were in possession of valid CPR certification, and the administrator on record, Iren Creighton, was observed to possess a valid certification that expires on 10/29/2026. The following was observed and cited. · LPA did not observe training completed for staff in file. · LPA observed the carbon monoxide detector was not functioning correctly. · No designated facility manager or representative on site · LPA observed prescription list for R3 and compared it to the MAR revealing it was not being followed according to physician orders. · LPA observed resident records to be incomplete. · LPA observed the last drill to be completed on February 2026 for the 1st shift only with only 3 staff who signed. · LPA observed an outdated roster of residents. Based on today's inspection where the facility was evaluated in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 6), there were several deficiencies and technical issued. An exit interview was conducted where a copy of this report was reviewed and provided to caregiver Desiree DuBois.the state’s words, verbatim · CDSS document, May 14, 2026

The state marks this report as 12 pages; the online copy we transcribed has 9. You can request the full file from the county licensing office.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Edith Conchas made an unannounced visit to initiate a complaint investigation for the complaint control number 56-AS-20260416123134. LPA met with Adelaida Dy -Support staff. During LPA visit, LPA verified staff on premises. LPA revealed staff 1 did not have clearance background and no personnel file at facility available for view. LPA requested staff 1 to leave. A civil penalty was issued.the state’s words, verbatim · CDSS document, Apr 21, 2026

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.17 · Plan of correction due date: Apr 21, 2026

1569.17 Fingerprints and criminal records...clearances. The ... individual shall be required to obtain either a criminal record clearance or a criminal record exemption... before their initial presence in a residential care facility for the elderly.This is not met by: Based on LPA observation it was revealed staff 1 was working in the facility providing care and has been at the facility 6 different days. Staff 1 is not finger print cleared or associated to the facility or has a personnel file which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 21, 2026

Plan of correction: Care staff to immedialty leave facility. Staff 1 Is not able to return until clearance is aqcuired.

Allegation investigated: Staff handle resident in a rough manner

Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Caregiver Adelaida Dy and explained the purpose of the visit regarding the allegations stated above. First allegation: Staff handle resident in a rough manner. Regarding the allegation stated above, LPA conducted an interview with Staff #1 regarding the alleged allegation Staff #1 denied the allegation pertaining to staff handling resident in a rough manner and reported to LPA that Staff #1 has not witnessed other staff mistreat or handling residents in a rough manner. LPA conducted interviews with R#2, R#3, R#4, and R#5, regarding the alleged allegation and R#2-5 reported to LPA that staff treat residents well and have not experienced or witness staff mistreating residents or handling residents in a rough manner. In addition, R#2-5 informed LPA that they like the facility and staff and feel safe. Unsubstantiated Based on corroborating evidence LPA has determined that the above allegation is Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Caregiver Adelaida Dy.the state’s words, verbatim · CDSS document, Apr 18, 2026 · control 56-AS-20241112083112

Allegation investigated: Sexual Abuse

On 3/30/2026, at 9:10 am, Licensing Program Analyst (LPA) E. Conchas conducted an unannounced visit to the facility to deliver the findings of the above allegation. LPA met and explained the purpose of the visit to Aida Dy, Caregiver . The investigation was conducted by the Department. The investigation consisted of records review and interviews with relevant parties. On November 18, 2025, The Department received a complaint alleging sexual abuse of a resident. The investigation consisted of interviews with outside parties and staff, and review of pertinent documents. On 11/15/2025 Resident 1 (R1) was admitted to the hospital for general weakness. Continue LIC 9099-C. Unsubstantiated Interview with W1 revealed that they had received blood results that were conducted while R1 was in the Emergency room that revealed a diagnosis of a sexual transmitted disease (STD). W1 revealed prior medical records were reviewed and did not indicate any history of STD diagnosis. It could not be determined what prompted the blood test to be conducted, there were no physical symptoms documented that would prompt the test to be run. Interviews revealed no rash or signs of sexual abuse were present. Interview with W1 revealed that lab work may have been conducted so the doctor could gain a better understanding of R1 declining so quickly during the stay in the Emergency room. Interview with W1 explained the condition can be present for many years without producing symptoms. The test performed is not part of standard panel and requires specific screening. Department staff reviewed resident facility files which did not indicate any results like R1. Department staff was unable to interview R1 due to R1 being deceased at time of investigation. Interview with staff 1 and staff 2 revealed there were no rashes or unusual observations made of R1 while under their care. Staff reveal there is no awareness of similar lab results among the residents. Interview with staff revealed that there was an all-female staff and R1 did not engage with any residents in the facility. Although there are male residents, interview revealed most residents are non-ambulatory or stay in their room. Based on interviews with relevant parties, there was not sufficient corroborating evidence to confirm sexual abuse. Based on the evidence, the allegations mentioned above are UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time. No deficiencies were cited. An exit interview was conducted where a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 30, 2026 · control 56-AS-20251118110559

Type of visit: Case Management - Other

On 3/19/2026, Licensing program analysts A. Martinez and E. Conchas made an unannounced Case Management Visit regarding complaint 56-AS-20251118110559. LPA met with Irene Creighton, Administrator, and explained the reason for the visit. LPAs conducted a facility tour and collected pertinent documents. LPAs observed the staff did not have air conditioning on in the facility. LPAs observed caregiver place fans in dining and living rooms after mentioning malfunctioning air conditioning equipment. Interview with Staff 1 (S1) revealed yesterday, 3/18/2026, at approximately 8:00 PM, another staff member observed a leak in the restroom and called management to make them aware of the problem. According to S1, licensee contacted a contractor to repair the air conditioner and will schedule a visit to fix the problem. LPAs observed inside facility temperature to be 78- 81 degrees Fahrenheit. LPAs advised staff that the air conditioning unit needs to be repaired expeditiously and to provide fans to all residents to ensure facility temperature does not exceed 85 degrees Fahrenheit. Upon LPAs visual inspection of the restroom of the ceiling reveals a hole, approximately 4ft by 2.5ft wide, with localized speckled patches of black growth on wood substructure. LPAs did observe a maintenance man arrived at the facility to fix the AC. Based on observation, record review a deficiency was cited by Title 22, Division 6 of The California Code of Regulations. An exit interview was conducted where the Licensing reports were discussed, and copies of the report were provided to Irene Creighton.the state’s words, verbatim · CDSS document, Mar 19, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(a) · Plan of correction due date: Mar 20, 2026

Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services...for the safety and well-being of residents, employees and visitors.This requirement is not met as evidenced by: Based on observation and interview, the licensee did not comply with the section cited above by not fully inspecting the spotted black growth on the exposed wood and insulation which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 19, 2026

Plan of correction: Administrator will contct a specialist to verify there is no mold that is at risk for the resdients and will provide an invoce to LPA via email by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA’s) Bernadette Allen and LaVette Farlow made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA’s met with Iren Creighton Assistant Administrator who granted entry into the facility. The facility is a six (6) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, secured pool, and attached garage. The facility is a Residential Care Elderly (RCFE) licensed for a capacity of (6) non-ambulatory residents ages 60 and up. LPA’s conducted 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 indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA’s inspected client bedrooms: they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. The hot water temperature tested within regulation at 104-124 degrees F. The facility is equipped with operating smoke detectors, carbon monoxide alarms and fully charge fire extinguishers. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. All sharps are locked inaccessible to clients in care. There was a designated place for client/staff files. Overall, the facility appeared to be clean, in good repair, and operating in safe conditions for clients in care. Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA's reviewed two (2) client files for admission agreements, updated physician reports, and Medication Administration Records (MAR’s) which appeared to be administered as prescribed by their physicians. LPA’s also reviewed five (5) staff files for First Aid/CPR certification, training's, and health screenings and which appeared to be current. Based on the observations made during today’s visit, no deficiencies were cited. An exit interview was conducted, and this report was discussed and provided to Iren Creighton Assistant Administrator at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jul 26, 2024