Happy Home Care for Elderly

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Bennette Pena and Gabriela Castro conducted an unannounced Required- 1 year visit. LPAs were met by Rosa Lee, Care Staff and John Kim, Registered Nurse (RN) and explained the purpose of the visit. Shortly after, Administrator Eunice Kim arrived and assisted LPAs with the inspection. The facility is approved to serve elderly residents, age 60 and over, (6) ambulatory of which (3) may be non ambulatory, Facility has approved hospice waiver for (2). LPAs utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were maintained. Bathroom has hygiene items such as hand soap and toilet paper. Operational Requirements: A fire clearance is in place. Fire Drill is conducted monthly and the last drill was conducted in July 2025. Facility has working signal systems in exit points. Facility maintains liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate and expires on 07/14/2026. Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood which consists of (4) resident bedrooms, (1) staff bedroom (not on sketch), (2) bathrooms, living room with covered fireplace, kitchen, dining area, laundry area in the attached garage and backyard with shaded patio area. There are currently (3) residents, 60 years and older residing in the facility, of which (1) is bedridden and no one is under hospice care. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, linen, light, chair and sufficient closet space. LPAs observed cameras in the common areas with no audio. Backyard was inspected and has a shaded area and sitting area. There is (1) fire extinguisher in the facility which was purchased on 09/08/2025. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility. Water temperature reading measured within the required 105 - 120 degrees Fahrenheit.*****REPORT CONTINUED ON LIC809-C***** Staffing: A total of (5) caregivers including the Administrator provide care and supervision to the residents. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have the required training and associated to the facility. Personnel Records-Training: Four (4) staff files were reviewed for criminal background clearance and training. Personnel records have health/TB screenings. Current Administrator's certificate is pending, expires on 05/15/2026. Resident Rights-Information: Resident personal rights are posted. Visiting policy is posted at a location that is visible and accessible to residents and families. Facility provides internet services to all residents and have access to the facility phone. Planned Activities: Information regarding Dementia is part of training for direct care staff and is included in the Plan of Operation. The facility provides sufficient space to accommodate both indoor and outdoor activities. Food Service: The kitchen was inspected and did not have sufficient supply of 2 day perishable & 7 day non-perishable food. Pesticides and cleaning supplies are kept away from the food preparation areas. Incidental Medical Services: All (3) residents' medications were reviewed during the visit. The facility uses the Medication Administration Record (MAR) log to document medications given. Medications were stored in a locked cabinet and inaccessible to residents. First-aid supplies along with a manual are maintained in the facility. Resident Records-Incident Reports: Three (3) resident files were reviewed containing admission agreements, Physician's Report, Medical/Functional assessments, Needs and Services Plans, TB clearance, Personal rights, Medical Consent, Medication Records. Disaster Preparedness: The facility has a complete Emergency Disaster and Mass Casualty Plan containing emergency evacuation, storage and preservation of medications, operation of manual assist devices. The facility conducts emergency drill on a monthly basis. Last fire drill was conducted in July 2025. Residents with SHN: None of the residents is under hospice care. Physician orders for use of half bed rails were reviewed in (2) residents files. (1) out of (3) residents is bedridden without the fire clearance. Deficiencies cited, Technical Assistance issued and Civil Penalty of Immediate $500 was assessed. Exit interview and a copy of this report along with the appeal rights was provided to the Administrator, Eunice Kim.the state’s words, verbatim · CDSS document, Oct 2, 2025

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Allegation investigated: Staff suffocated residents resulting in death of residents. Resident sustained an unexplained injury while in care. Facility staff not fingerprinted.

On 10/17/24, Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit. The purpose of the visit is to add additional information not included on the reported dated 9/5/24 and to issue an additional deficiency observed during the course of the investigation. The investigation consisted of: Interviews with staff and the alleged perpetrator and record reviews including but not limited to, police reports and 911 calls conducted by DSS Investigation Branch (IB) Investigator Ryan Miles and Community Care Licensing (CCL) staff. Allegations: Staff suffocated residents resulting in death of residents. Resident sustained an unexplained injury while in care. Facility staff not fingerprinted. It was alleged: Staff 1 (S1) suffocated the resident by placing a plastic bag over the Resident 1 (R1) head and taping around the R1’s neck. Injury was observed on R1’s head. Substantiated Reporting Party (RP) reported that the S1 member also placed a bag over Residents 2 (R2) head as well and placed tape around the neck also murdering R2. RP reported that the residents were found in the bathroom of the facility by Staff 2 (S2). RP also reported that the S1 was not fingerprinted. The investigation revealed the following: On 06/24/2023 at approximately 8AM, S2 found two residents R1 and R2 inside the restroom on the floor, unresponsive, and dead upon arrival in the morning. S2 immediately called 911. According to the Los Angeles Sheriff’s Department (LASD), S2 observed that bags were placed over the R1’s and R2’s face by S1. S1 placed bags over the two residents (R1 and R2) heads, and possibly killed them. Per LASD report, S1 contacted 911 at 7:52AM and self-reported the incident before S2 called 911. S1 admitted to the dispatcher that S1 just killed two residents. On 6/25/23, Regional Manager Araceli Ramirez and LPA Kimberly Ramirez conducted a health and safety check at the facility and gathered documents pertaining to R1, R2, S1, and S2. During the visit on 06/25/23, it was discovered that S1 was arrested for the murder of two residents of the facility. The investigation revealed that S1 started working and residing at the facility on 06/01/23. However, S1’s background clearance did not clear until 06/16/23. Therefore, the licensee allowed S1 to begin working and residing at the facility prior to obtaining a criminal record clearance. A case management visit was conducted on 6/30/23 by Licensing Program Analyst (LPA) Kimberly Ramirez and a $500 civil penalty was issued for Section 87355(e)(1) Criminal Record Clearance for failure to obtain a required criminal record clearance prior to working and/or residing in the facility. Therefore, the preponderance of evidence standard had been met and the allegation was SUBSTANTIATED. On 08/08/23, Investigator Miles interviewed the licensee/administrator and S2. Investigator also obtained the L.A. County Sherriff’s report and 911 calls made to the Walnut Sheriff’s Station. On 8/24/23, Investigator interviewed S1 while in custody. S1 admitted to the murder of R1 and R2 but did not want to go into further details of how the incident occurred. On 10/10/23, Licensing Program Analyst (LPA) Cynthia Chan conducted a Case Management visit. Based on the interviews conducted and supporting documents provided, there was sufficient evidence to support the allegation of Conduct Inimical. A $500 civil penalty was issued for Section 87468.2(a)(4) Additional Personal Rights of Residents in Privately Operated Facilities for the facility’s failure to provide the residents in placement with care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. Therefore, the preponderance of evidence standard had been met and the allegation was SUBSTANTIATED. On 06/05/24 CCLD received this complaint alleging the following personal rights violations: Staff suffocated residents resulting in death of residents, resident sustained an unexplained injury while in care and facility staff was not fingerprinted. On 6/7/24, LPA Ramirez conducted a Health & Safety Check tour with the Administrator and obtained staff and residents’ roster. On 09/04/24 during an office meeting at the Monterey Park Adult and Senior Care Regional Office, Enhanced Civil Penalty (ECP) was issued by Licensing Program Analyst (LPA) Cynthia Chan per Health and Safety Code 1569.49(e) for a violation that the Department determines resulted in the death of two residents in the amount of $30,000 ($15,000 for each death of a resident). However, since an immediate civil penalty of $500 was previously issued on October 10, 2023, the amount of the ECP will be $29,500. Reports were given to the licensee Jung Hyun Kim and originals were signed. Based on interviews conducted and record review, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED, however, deficiencies were previously issued during a case management visit on 6/30/23 for not obtaining a criminal record clearance and on 10/10/23 for conduct inimical. The remaining deficiency for personnel requirements will be cited on today’s report. Exit interview was conducted and the copy of this report along with appeal rights were provided to the Administrator.the state’s words, verbatim · CDSS document, Oct 17, 2024 · control 28-AS-20240605153844

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87411(a) · Plan of correction due date: Oct 18, 2024

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement is not met as evidenced by: Staff #1 did not have the competency to provide care to meet the needs of the residents which poses an immediate health, safety, and personal rights to residents in care.the state’s words, verbatim · CDSS document, Oct 17, 2024

Plan of correction: The licensee shall ensure all employees have related job experience and sufficient training to work with this population. A statement acknowledging this regulation has been read and understood will be submitted to LPA by 10/18/24.

Allegation investigated: Staff suffocated residents resulting in death of residents. Resident sustained an unexplained injury while in care. Facility staff not fingerprinted.

Licensing Program Analyst (LPA) Nune Margaryan conducted a subsequent visit to deliver findings on above allegations. LPA met with Kim Gi Soung. Shortly after Kim Eunice, Administrator arrived. LPA explained the purpose of the visit. The investigation consisted of: Interviews and record reviews conducted by DSS Investigation Branch (IB) Investigator and Community Care Licensing (CCL) staff. Allegations: Staff suffocated residents resulting in death of residents and Resident sustained an unexplained injury while in care. Facility staff not fingerprinted. It was alleged: Staff 1 (S1) suffocated the resident by placing a plastic bag over the Resident 1 (R1) head and taping around the R1’s neck. Injury was observed on R1’s head. Reporting Party (RP) reported that the S1 member also placed a bag over Residents 2 (R2) head as well and placed tape around the neck also murdering R2. RP reported that the residents were found in the bathroom of the facility by Staff 2 (S2). RP also reported that the S1 was not fingerprinted. Continue on 9099C Substantiated The investigation revealed the following: On 06/24/2023, in the morning, upon arrival at the facility, S2 found two residents R1 and R2 inside the restroom on the floor, unresponsive, and dead upon arrival. S2 immediately called 911. According to the Los Angeles Sheriff’s Department (LASD) S2 observed that “bags were placed over the R1’s and R2’s face by S1. S1 placed bags over the two residents (R1 and R2) heads, and possibly killed them.” Per LASD report before S2 contacting 911, at approximately 7:52 pm. S1 contacted 911 and self-reported the incident. Per S1 911 call, S1 admitted to the dispatcher that S1 just killed two residents / elderly people. On 6/25/23, Regional Manager Araceli Ramirez and LPA Kimberly Ramirez conducted a health and safety check at the facility and gathered documents pertaining to R1, R2, S1, and S2. During the visit on 06/25/23, it was discovered that S1 was arrested for the murder of two residents of the facility. On 06/30/23, Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Case Management Visit and an immediate civil penalty of $500 were issued for allowing S1 to work in the facility prior to obtaining a background clearance. Investigations Branch (IB) investigator conducted the investigation. On 08/08/24 Investigator interviewed the licensee/administrator and S2. Investigator also obtained the L.A. County Sherriff’s report and 911 calls made to the Walnut Sheriff’s Station. On 8/24/23, Investigator interviewed S1 while in custody. S1 admitted to the murder of R1 and R2 but did not want to go into further details of how the incident occurred. The investigation revealed that S1 started working and residing at the facility on 06/01/23. However, S1’s background clearance did not clear until 06/16/23. Therefore, the licensee allowed S1 to begin working and residing at the facility prior to obtaining a criminal record clearance. On 10/10/23, Licensing Program Analyst (LPA) Cynthia Chan conducted Case Management visit and another immediate civil penalty of $500 was issued due to neglect. On 06/05/24 CCLD received a complaint alleging neglect. Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced initial complaint investigation visit on 06/07/2024 regarding the above allegations. LPA Ramirez conducted a Health & Safety Check tour with Administrator and obtained staff and residents’ roster. Continue 9099C On 09/04/24, Enhanced Civil Penalty (ECP) was issued by Licensing Program Analyst (LPA) Cynthia Chan due to a civil penalty per Health and Safety Code 1569.49(e) for a violation that the Department determines resulted in the death of two residents in the amount of $30,000 ($15,000 for each death of a resident). However, since an immediate civil penalty of $500 was previously issued on October 10, 2023, the amount of the civil penalty will be $29,500. Based on interviews conducted and record review, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED, however deficiencies previously issued during case management and office visits. Exit interview was conducted and the copy of this report along with appeal rights were provided to Kim Eunice, Administrator.the state’s words, verbatim · CDSS document, Sep 5, 2024 · control 28-AS-20240605153844

Type of visit: Office

On September 4, 2024, Licensing Program Manager (LPM) Tony Vasallo and Licensing Program Analysts (LPAs) Cynthia Chan and Kimberly Ramirez held an office meeting to follow up on the concluded investigation of the double homicide that occurred at the facility on June 24, 2023. The investigation revealed that on June 25, 2023, the news media broadcasted a report of a double homicide at the facility. On the same day, licensing staff conducted an initial visit to obtain staff and resident records. Licensing staff also conducted interviews with two staff and attempted to interview the four remaining residents who were not able to respond due to cognitive impairment. Staff 1 (S1) was not available for interview as S1 was detained by the police. On August 24, 2023, Investigator Ryan Miles and LPA Christine Wong interviewed S1 at the jail. S1 spoke about their previous job experience that was not related to caregiving; how they obtained the job on the spot as a live-in caregiver; training they received; and the living environment at the facility. S1 acknowledged the killing of resident 1 (R1) and resident 2 (R2) but did not want to discuss details of what transpired. At the time of the case management visit conducted on October 10, 2023, an immediate civil penalty of $500 was issued for Section 87468.2 Additional Personal Rights for failure to provide care, supervision, and services. The licensee was informed that an additional civil penalty might be assessed based on Health and Safety Code 1569.49(e). The Department has concluded an analysis and has determined that an additional civil penalty is warranted for a violation that the Department determined resulted in the death of R1 and R2. This is evidenced by the licensee’s failure to protect the safety of two residents who were killed on site while under the care and supervision of a licensed residential care facility for the elderly. In addition, the licensee did not train staff adequately or obtain a criminal record clearance prior to S1 working and residing at the facility. Today, September 4, 2024, the Department will be issuing a civil penalty per Health and Safety Code 1569.49(e) for a violation that the Department determines resulted in the death of two residents in the amount of $30,000 ($15,000 for each death of a resident). However, since an immediate civil penalty of $500 was previously issued on October 10, 2023, the amount of the civil penalty today will be $29,500. Copies of the 421D were provided to Jung Hyun Kim and originals were signed. Exit interview conducted. A copy of the report issued. Appeal rights provided to Jung Hyun Kim, and signature on this report acknowledges receipt of the Appeal Rights, which is found on page 2 of the LIC421D.the state’s words, verbatim · CDSS document, Sep 4, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met with Administrator, Jung Hyun Kim, who assisted with the visit. The facility is licensed to serve six (6) residents of which three (3) may be non-ambulatory, ages 60 and above. No bedridden allowed. Hospice waiver approved for two (2) residents. During the visit, CARE tool was used, a tour of the facility was conducted, food supply/medication / staff/ residents records were reviewed, and staff/residents were interviewed. The facility was located in a residential neighborhood. The facility consisted of four (4) bedrooms (including 2 shared bedrooms and 2 private bedrooms), two (2) bathrooms, kitchen, dining room, laundry room, garage, and living room with a TV. All the rooms were furnished with appropriate furniture for residents’ comfort. The bathrooms were furnished with grab bars and nonskid surfaces. Common areas were observed for the ability to safely serve the needs of the residents. Hot water temperature was 107.4 degrees Fahrenheit. Adequate linen and personal hygiene supplies were observed. No pools and bodies of water on the premises. Facility maintained a comfortable temperature of 75 degree F for residents. Sufficient supplies of perishable and nonperishable foods were observed. Knives, tools, sharp items were inaccessible to residents. Smoke detectors and carbon monoxide detectors were operable. Fire extinguishers were fully charged. Medication, residents’/ staff’s records were centrally stored in a locked cabinet and inaccessible to residents. Toxic substances were inaccessible to residents. No deficiencies were observed and cited per California Code of Regulations, Title 22. An exit interview was conducted. This report was discussed and provided to Administrator.the state’s words, verbatim · CDSS document, Aug 27, 2024

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Kimberly Ramirez met with Licensee Jung Hyun Kim and Staff John Kim at Monterey Park Regional office to discuss validity of CPR/First Aid training of Staff#1 (S1). On 6/25/23, LPA Ramirez conducted Case management visit in regards to a homicide that took place at the facility on 6/24/23. During staff file review, LPA Ramirez observed S1's CPR/First Aid training certificate. LPA Ramirez contacted the CPR/First Aid vendor and it was revealed the CPR/First Aid certificate for S1 was issued on 6/25/23. S1 was already in police custody on 6/24/23. CPR/First Aid certificate LPA Ramirez observed on 6/25/23, was not authentic according to the National CPRFoundation. One deficiency is being cited. See 809-D. Exit interview was conducted. A copy of this report and appeals rights was provided.the state’s words, verbatim · CDSS document, Jul 3, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87405(h)(8) · Plan of correction due date: Jul 4, 2024

(h) The administrator shall have the responsibility to:(8) Have the personal characteristics, physical energy and competence to provide care and supervision and, where applicable, to work effectively with social agencies. This requirement was not met as evidence by: Licensee provided unauthentic CPR/First Aid training for S1.the state’s words, verbatim · CDSS document, Jul 3, 2024

Plan of correction: Licensee will certify all training will be authenticated and verified.

Allegation investigated: Facility failed to provide resident's records.

On 02/07/2024 at 9:43 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an initial complaint visit to investigate the above listed allegation. Upon arrival, LPA met with Staff #2. Shortly after the licensee Eunice Kim arrived and the purpose of the visit was discussed. During today’s visit, LPA Baptiste obtained a copy of the staff roster, resident roster, formal request from R1’s legal representative, and a copy of the receipt with a date the documents was sent to R1’s legal representative. LPA conducted a tour of the buildings and grounds with Staff #1. LPA Baptiste interviewed the licensee and a total of one (1) staff, who shall be referred to as staff #1(S1). LPA also interviewed R1’s legal representative who shall be referred to as witness #1. Report continued on 9099c Unsubstantiated The investigation reveals the following: Regarding “Facility failed to provide resident's records”. It is alleged the facility received a formal request to make R1’s documentation’s available on January 29th, 2024. The request was sent by R1’s legal representative and asked not to exceed two business days. According to the licensee the request arrived on January 30th, 2024, and the documents was sent out January 31st, 2024. S1 corroborated the statement, by adding they received the request and shipped the documents no later than the next day. Witness #1 confirmed they received the documents on February 1st, 2024. LPA reviewed the receipt and confirmed the facility shipped the documents on January 31st and R1’s legal representative was due to receive the documents no later than February 1st, 2024, at 6:00 pm. Based on LPA's interviews, investigation revealed: 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. Exit interview conducted with Eunice Kim and a copy of this record provided.the state’s words, verbatim · CDSS document, Feb 7, 2024 · control 28-AS-20240131160707

Allegation investigated: Facility failed to provide resident records.

Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation for the allegation listed above. LPA was granted entry by staff, Yun Kim. Licensee, Eunice Kim, arrived shortly after to assist with the visit. LPA toured the facility, interviewed the licensee, and reviewed Resident #1’s (R-1) file. Regarding allegation – Facility failed to provide resident records. It is alleged on November 13, 2023, the facility was sent a formal request via federal express to make available the records of Resident #1 (R-1). The formal request was made by R-1’s legal representative to arrange for photocopies within 2 working days. As of today, the documents had not been provided. Substantiated LPA interviewed the licensee who stated she did not sign any federal express delivery this week nor received any mail via federal express. She stated she will check with staff and the mailbox again. LPA verified with legal representative that they did not receive any returned mail and confirmed that the federal express package was left at the facility’s front door on 11/14/23. Based on information gathered, the licensee did not provide the records promptly. Therefore, there is sufficient evidence to corroborate the allegation. Based on interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiency is being cited according to Title 22, Division 6 Health and Safety Code, Chapter 3.2 Residential Care Facilities for the Elderly Article 02.5 Resident's Bill of Rights. An exit interview was held. A copy of this report along with appeal rights were given to the licensee.the state’s words, verbatim · CDSS document, Nov 17, 2023 · control 28-AS-20231115131734

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.269(a)(21) · Plan of correction due date: Dec 1, 2023

1569.269 Enumerated rights; severability (a) Residents of residential care facilities for the elderly shall have...(21)To have prompt access to review all of their records...not to exceed two business days... This requirement is not met as evidenced by: The licensee did not provide Resident #1's record to legal representative within 2 working days which poses a potential personal rights risk to resident in care.the state’s words, verbatim · CDSS document, Nov 17, 2023

Plan of correction: The licensee shall develop a plan to get the records to the legal representative and provide proof to show records were given to them. This POC is due 12/1/23.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Cynthia Chan conducted a case management visit regarding the death of two Residents. LPA met with Licensee/Administrator, Jung “Eunice” Kim and explained the purpose of the visit. On 6/24/23, The News reported a double homicide that occurred at the facility. A facility staff arrived in the morning and found 2 residents inside the restroom floor and were unresponsive. The staff immediately called 911 to report the incident. This prompted the department to conduct a visit to the facility. On 6/25/23, Regional Manager Araceli Ramirez and LPA Kimberly Ramirez conducted a health and safety check at the facility and gathered documents pertaining to Resident #1 (R1), Resident #2 (R2), Staff #1 (S1), and Staff #2 (S2). During the visit on 06/25/23, it was discovered that S1 was arrested for the murder of two residents of the facility. Due to the nature of the deaths, the Department of Social Services Community Care Licensing Division Investigation Branch (IB) Investigator, Ryan Miles conducted a further investigation. Investigator Miles interviewed the licensee/administrator, Jung Kim, S1 and S2. Investigator also obtained the L.A. County Sherriff’s report and 911 calls made to the Walnut Sheriff’s Station. On 8/24/23, Investigator Miles interviewed the suspect while in custody and admitted to the murder of both residents but did not want to go into further details of how the incident occurred. The investigation revealed that S1 started working and residing at the facility on 06/01/23. However, S1’s background clearance did not clear until 06/16/23. Therefore, the licensee allowed S1 to begin working and residing at the facility prior to completing a criminal record clearance. On 06/30/23, the licensee was issued an immediate civil penalty of $500 for allowing S1 to work in the facility prior to obtaining a background clearance. Based on the interviews conducted and supporting documents provided, there is sufficient evidence to support the allegation of Conduct Inimical, therefore, the finding is substantiated. An Immediate Civil Penalty of $500 is being issued today. Refer to LIC421IM. The issuance of an additional Civil Penalty is being assessed based on health and safety code 1569.49(e) if the department determines the death of the client is due to neglect. An exit interview was held. A copy of this report, LIC421IM, and appeal rights were given to the licensee.the state’s words, verbatim · CDSS document, Oct 10, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(a)(4) · Plan of correction due date: Oct 11, 2023

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) (4) To care, supervision, and services that meet their individual needs...delivered by staff... This requirement is not met as evidenced by: Based on interviews, the licensee did not ensure that the residents are provided with care, supervision, and services that meet their needs which poses an immediate health, safety, and personal rights to residents in care.the state’s words, verbatim · CDSS document, Oct 10, 2023

Plan of correction: The licensee shall ensure each staff member is qualified to provide care and supervision to all residents. The licensee shall provide in-service training to all staff regarding the care plan for each resident and ensuring there is sufficient staffing to meet their needs. This POC is due by 10/11/23.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Cynthia Chan conducted a case management visit to interview staff. LPA met with administrator, Eunice Kim, to explain the reason for the visit. LPA obtained a copy of the personnel report and interviewed Staff #1 who was on duty. No deficiencies issued. A copy of this report was given to the staff.the state’s words, verbatim · CDSS document, Oct 10, 2023