Golden Home Extended Care

Allegation investigated: Staff spoke inappropriately to resident in care

At approximately 9:00AM, Licensing Program Analyst (LPA) Felias arrived unannounced to deliver findings for a complaint investigation regarding the above allegation, and met with Staff Members, Shirik Sochanngan, and Angel Socito. Administrator, Rufus Zingkhai arrived during visit at approximately 9:30AM. During the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. The following allegation was investigated, “Staff spoke inappropriately to resident in care.” Complaint alleged that Resident 1 (R1) had a conversation with Staff Member 1 (S1) about their cultural heritage where S1 asked R1, "what kind of food does a German person eat for breakfast, and what does a German person drink for breakfast?" R1 stated” Schwarez Brot,” or dark bread, and I don't know." Per complaint, S1 stated “Jews.” Per report, S1 did not apologize to R1 for their comments and R1 felt extremely offended. Continued on LIC9099C Substantiated Continued from LIC9099 LPA conducted interviews. Interview with Resident 1 (R1) stated that they had a conversation with S1. Per R1, the conversation was about their cultural heritage and was in a joking manner. In the interview, R1 stated that they were from Germany and that S1 asked them questions about what they ate and drank in Germany for breakfast. R1 stated that they answered that Germans eat “Schwarzbrot” or “dark bread” and that they did not know what Germans drank for breakfast. S1 then responded, “Yews,” in a joking manner. R1 stated that you had to listen hard to know if it was the drink “juice” or the race of people. R1 stated that they joked back with S1 and that they did not feel offended or disrespected by S1’s comments. R1 further stated that S1 apologized to them and they told S1 that there was no reason to apologize. Interview conducted with Staff Member 1 (S1) stated that they spoke with R1 a lot. Per interview, they had a conversation with R1 about their cultures and they told R1 some jokes they had heard on Youtube. S1 stated that they heard later that their conversation had been reported and they were instructed to apologize to R1. Per S1, when they went to apologize, R1 was surprised and told them to forget about it and that it was nothing. Based on interviews conducted, this allegation is Substantiated. A finding that the complaint allegation is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiencies, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC9099D (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Apr 15, 2026 · control 21-AS-20260129164044

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Apr 27, 2026

87468.1 Personal Rights of Residents in All Facilities:(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by: based on interviews conducted, Licensee did not comply with the section cited above and did not ensure R1’s personal rights. This poses a potential health, safety, and/or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Apr 15, 2026

Plan of correction: Licensee to conduct inservice-training on Personal Rights and Cultural Competency. Training to include the following: Date, Topic, Name/Job Role, and Signatures. In-Service and supporting documents to be submitted to CCL for review and approval by POC due date of 04/27/2026.

Type of visit: Case Management - Annual Continuation

At approximately 11:40 AM Licensing Program Analyst (LPA) Elias Magdaleno arrived unannounced to conduct an Annual Continuation of a 1-year required annual inspection that was started on 9/29/2025 and was greeted by MedTech Angel Socito. Physical Plant inspection was completed during previous visit. At approximately 11:50 AM LPA conducted a review of five (5) resident records. All required documentation present. At approximately 12:30 PM LPA conducted review of six (6) staff records. All required documentation present. At approximately 1:30 PM LPA and MedTech conducted a spot check of medication and medication records. Medication is centrally stored and locked. Updated copies of the following documents shall be submitted to CCL by 10/29/2025: Lease agreement Annual inspection has been completed. No deficiencies cited. Exit interview conducted with MedTech, whose signature on form confirms receipt.the state’s words, verbatim · CDSS document, Oct 13, 2025

Type of visit: Required - 1 Year

At approximately 10:45 AM, Licensing Program Analyst (LPA) Elias Magdaleno arrived unannounced to conduct a required 1-year annual inspection and was greeted by Administrator Rufus Zingkhai. Facility is a Residential Care Facility for the Elderly (RCFE) with eighteen (18) residents in care. Facility is approved for twenty-seven (27) non-ambulatory residents with one (1) bedridden. At approximately 10:55 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one (1) story home, was a comfortable temperature, and passageways were free from obstructions. Fire extinguishers were last inspected 8/25. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Water temperature measured 105.1 degrees F, which is within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, hygiene, incontinent care, and paper products available for residents. LPA conducted a spot check of residents' bedrooms and observed them to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. LPA observed at least a two (2) day supply of perishable and seven (7) day supply of non-perishable food, as well as an emergency water supply. Food was found to be stored in a safe manner with open items covered. Facility has an internet access device and internet available to residents in care, and the phone was tested and operational during today's inspection. Continued LIC809C... Facility conducts monthly disaster drills, and the most recent drill was conducted 9/25. LPA observed facility's emergency disaster plan which was last updated 1/25. LPA observed a supply of PPE, emergency supplies, two (2) first aid cabinets, and flashlights. Rufus Zingkhai Administrator Certificate 7033932740 expires 8/15/2027. All fees are current as of this time. Updated copies of the following documents were gathered during this visit: Liability Insurance LIC500 - Personnel Report LIC308 - Designation of Responsibility LIC610E - Emergency Disaster Plan Updated copies of the following documents shall be submitted to CCL within 30 days of this visit: Lease agreement The annual inspection will be completed by the Department at a later date. No deficiencies cited. Exit interview conducted with Administrator, whose signature on form confirms receipt.the state’s words, verbatim · CDSS document, Sep 29, 2025

Type of visit: Case Management - Annual Continuation

At approximately 8:55AM, Licensing Program Analyst (LPA) Felias arrived unannounced to continue a 1-Year Required Visit and met with Staff Member, Sandra Lopez. Administrator, Rufus Zingkhai arrived during visit at approximately 9:30AM. Facility serves residents with dementia and has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and total capacity for 28 non-ambulatory residents and has an approved hospice waiver for 6 individuals. Upon arrival, LPA was informed that there were 16 Residents in care and 4 staff members on-site. At approximately 9:05AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 9:15AM, LPA reviewed staff files, resident files and resident medication. All files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid and CPR certification. Medication was observed to be centrally stored and secure. Administrator's Certificate for Rufus Zingkhai (7033932740) was current with an expiration date of 08/15/2025. LPA requested the following documents to update facility file: Designation of Facility Responsibility (LIC 308) Emergency Disaster Plan (LIC 610D) Updated Personnel Report (LIC 500) Register of Clients/Residents (LIC 9020) Updated Liability Insurance Active and Current Administrator Certificate Documents to be submitted to Community Care Licensing (CCL) by due date of 11/11/2024. No Deficiencies Cited during Visit. Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Oct 11, 2024

Type of visit: Required - 1 Year

At approximately 1:40PM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a 1-Year Required Visit and met with Staff Member, Angel Socito. Administrator, Rufus Zingkhai arrived during visit at approximately 2:00PM. Facility serves residents with dementia and has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and total capacity for 30 non-ambulatory residents and has an approved hospice waiver for 6 individuals. Upon arrival, LPA was informed that there were 16 Residents in care and 3 staff members on-site. At approximately 1:50PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 1:55PM, LPA conducted a walk-though of the facility with Staff Member. LPA observed the following: The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a 1 story building with 15 Resident bedrooms, 8 bathrooms, and common spaces. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Mattress pads were in place or available for Resident use. Toxins were observed to be stored inaccessible to residents. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. Hot water temperatures for a sample size of 4 sinks were within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility's last emergency/disaster drill was conducted September 2024. Facility's fire extinguishers were last inspected August 2024. Facility has a hard wired fire alarm and sprinkler system that is directly connected to the local Fire Department. Facility's smoke detectors and sprinkler system were last inspected August 2024. Facility's carbon monoxide detectors were tested and operational. Continued on LIC809C Continued from LIC809 During walkthrough, LPA was informed that Facility currently has 1 resident with bedridden status. Facility currently does not have a clearance to admit residents with bedridden status. Licensee to submit a new LIC200 and updated facility sketch to Community Care Licensing (CCL) so a new fire clearance can be requested (deficiency cited, see LIC809D, regulation 87202(a)(2)). Licensee understands that if a new fire clearance is not granted by the local Fire Department, the resident will have to be relocated due to requiring a higher level of care. LPA unable to complete Annual Inspection. Annual Continuation Visit to be conducted at a later date. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC-809D (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Sep 23, 2024

Type of visit: Case Management - Incident

At approximately 9:40AM, Licensing Program Analysts (LPAs) Felias and Florio arrived unannounced to conduct a Case Management - Incident Visit and met with Administrator, Rufus Zingkhai. The purpose of today's visit is to follow up on self-reported incidents that were submitted to Community Care Licensing (CCL). Incident Report 1: CCL received an incident report on 02/26/2024. Report stated that on 02/21/2024, Facility observed an anal fissure on Resident 1 (R1). Facility contacted 911 and Home Health Nurse and R1 was transported to the hospital for evaluation. Facility made all appropriate notifications per regulation. Incident Report 2/SOC-341: CCL received an incident report and SOC-341 on 03/12/2024. Reports stated that on 03/11/2024, R1's Responsible Party reported to staff that R1 could have had forced trauma injuries to their rectal area. Facility made all appropriate notifications per regulation. LPAs requested and reviewed documents. No Deficiencies cited during visit. Exit interview conducted. Copy of report and LIC811 (Confidential Names) discussed and provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Mar 18, 2024