Gem's Senior Living II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit for a required annual inspection. The LPA was greeted by Caregiver Glenn Gutierrez, notified them of the purpose for the visit and was allowed to enter the facility to conduct the inspection. Licensee Gerlita Higa joined the visit at a later time. Facility Overview: The facility is a single story building with five(5) residents bedrooms, 1 staff room/Office, two (3) bathrooms, a dinning room, a kitchen and a garage. There is no gated pool and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department's requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in the kitchen under the sink and inaccessible to residents. The smoke detectors were in good working condition. Water temperature was measured at 117.8 meeting the department's requirement. LPA observed three fire extinguishers not in compliance with the department's requirements. The fire extinguishers were last inspected on June 25, 2021. Citation will be issued. Continued 809-C...... Care & Supervision/Administration: Adequate staff were present to supervise residents during the visit. The administrator holds a current administrator’s certificate with expiration date of March 30, 2026 and a CPR certification with the expiration date of May 21, 2026 Record Review and Resident/Staff Files: LPA reviewed files for one(1) staff member, confirming criminal clearance, updated training, and CPR/First Aid certification. No health screening was found for S1, citation will be issued. Two (2) residents' files were reviewed and contained all required documentation. LPA observed first kit to be available. The residents and staff files were kept locked and inaccessible to unauthorized individuals. Health-Related Services/Incidental Medical Services: All residents' medications were securely locked in a cabinet and located in the Office area. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, and did not observe documentation of the last emergency drill. A technical violation will be issued. All facility exits were clear of obstructions. An exit interview was conducted where a copy of this report 809C, 809D, LIC421IM and appeal rights, was reviewed and provided to Licensee Gerlita Higathe state’s words, verbatim · CDSS document, Jun 27, 2025

From the deficiency page — Deficiency type: Type A · Plan of correction due date: Jun 28, 2025

FIRE SAFETY: All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshall for the protection of life and property against fire and panic. This requirement is not met as evidenced by: Based observation and interview, the licensee did not comply with the section cited above in four fire extinguisher last inspected on 06-25-2021, which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 27, 2025

From the deficiency page — Deficiency type: Type A · Plan of correction due date: Jun 28, 2025

87205: Accountability of Licensee Governing Body (b) If the licensee is a corporation or an association, the governing body shall be active, and functioning in order to assure accountability Based observation, record review and interview, the licensee did not comply with the section cited above. Licensee does not have an active governing body, which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 27, 2025

Plan of correction: Licensee agreed to have an active governing body by July 18, 2025

From the deficiency page — Deficiency type: Type B · Plan of correction due date: Jul 25, 2025

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening as specified in Section 87411(d) This requirement is not met as evidenced by Based on observation, interview, and record review, the licensee did not comply with the section cited above in S1 not having a health screening, which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 27, 2025

Type of visit: Required - 1 Year

On June 05, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the Required Annual Inspection and met with Gerlita Higa, the Licensee. The facility file review was conducted in the Regional Office and additional forms were reviewed and requested on site. LPA Mixson toured the facility along with the Licensee and inspected the facility inside and outside, and there was no debris or obstructions to the indoor or outdoor passageways at the time of this visit. The facility is a single-story home located at 28291 Portsmouth Drive, Sun City, CA. 92586. Physical Plant: The facility phone number is (951) 301-4134. The LPA observed the residents’ bedrooms. Each bedroom was equipped with required furniture as per Title 22. LPA Mixson inspected facility bathrooms, and the hot water temperature tested within regulations. The bathrooms were clean, appliances were operating appropriately currently at the time of this visit, and exit signs were observed. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. LPA Mixson observed required postings such as "If you See Something, Say Something" the "Personal Rights" and the Ombudsman postings. The cleaning supplies and sharp items were locked and inaccessible to the residents in care at the time of this visit. A designated storage space for the residents and staff files was observed, and it was locked and inaccessible to residents in care currently at the time of this visit. The overall facility is clean, the furniture is in good condition. The facility cooling system and other appliances were operable currently at the time of this visit. There were safety lights for night. Medications: The medications were locked and inaccessible to residents in care. There is a sufficient supply of medication for each resident currently. Food Service: Non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for residents. Dishes and utensils were in sufficient supply and stored properly, and sharps are locked. Care & Supervision: Facility has sufficient staff, two staff on site at the time of this visit, and the staff were engaging the residents with morning meals and medications. Records Review: LPA Mixson reviewed resident files, along with staff files, conducted staff interviews. Residents were occupied with morning meal and medication management. Previous Community Care Licensing forms were reviewed. There were no Title 22, Division 6 Regulation violations observed or cited during today’s visit. An exit interview was conducted, and a copy of this report was given to the Licensee, Gerlita Higathe state’s words, verbatim · CDSS document, Jun 5, 2024

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.