Happy Home Care II

Allegation investigated: Staff are not providing adequate care for residents due to not being properly qualified/trained.

Licensing Program Analyst (LPA) Erica Mosley conducted an unannounced initial 10-day complaint visit to investigate the above listed allegation. Upon arrival at approx.10 a.m. LPA was greeted by staff who called the Administrator and explained the reason for the visit. The LPA met with Designee Karina Antig and reason for the visit was explained. Entrance interview conducted. On 05/11/2026, the Department received a complaint regarding the following allegation, Staff are not providing adequate care for residents due to not being properly qualified/trained. During today's visit LPA and staff toured the physical plant areas inside and outside to ensure there are no immediate health and safety hazards, and facility is in compliance with Title 22 Regulations. Starting at 10:36 a.m. LPA conducted a file review on facility live in Staff #1 (S1) and Staff #2 (S2), Administrator, Assistant Administrator, Designee, conducted three (3) staff interviews including the Designee, S1, S2, two (2) resident interviews and attempted three (3) resident interviews and obtained copies of pertinent documents relevant to the investigation.Report continued on LIC 9099-C PAGE 2... Unsubstantiated (PAGE 2) Report continued from LIC 9099...On the allegation, Staff are not providing adequate care for residents due to not being properly qualified/trained it is the concern of the Reporting Party (RP) that the facility staff are not properly trained leading to poor care. To investigate this complaint, LPA conducted in person interviews, file and record review and obtained copies of pertinent documentation relevant to the investigation. Record review revealed that the facility has two primary live-in staff who work regular shifts from 7:00 a.m. to 7:00 p.m. Staff S1 and S2 have both been employed as caregivers since January 2012. Their CPR and First Aid certifications were verified by the LPA at 10:52 a.m. and confirmed to be valid and active as of 01/08/2026. LPA reviewed the facility’s 2025–2026 training logs and confirmed that both staff members have completed more than the required 20 hours of annual training. Documented trainings include: Elder Abuse (March 2025, 1 hour), Personal Rights (April 2025, 2 hours, videos and discussions noted), Acceptance and Retaining (May 2025, 1 hour), Responsibilities and Duties (June 2025, 4 hours), Fire Safety (July 2025, 1 hour), Calling 911 (August 2025, 1 hour), Dementia—Getting Through the Day (August 2025, 2 hours), Dementia—Communication (September 2025, 2 hours), Dementia—Behavior (October 2025, 4 hours, videos and situational discussions noted), Common Infectious Diseases (November 2025, 2 hours), Hospice Care—Restricted/Prohibited Conditions (December 2025, 4 hours), Medication Administration (January 2026, 2 hours), Activities of Daily Living (February 2026, 4 hours, including needs, reporting, cleanliness, and redirection), and Transfer Training and Body Mechanics (March 2026, 2 hours). Interviews with S1 and S2 revealed that both staff members are CPR and First Aid certified. Staff reported that they receive regular training, with the most recent conducted by the home health physical therapist on proper transferring techniques. Staff stated that "they believe they are qualified to care for their residents." Interview with Designee revealed the staff at the facility are well-trained and are considered some of the strongest caregivers within the Happy Home Care Company. It was noted that “Although some staff may be older, they are experienced, knowledgeable, and highly dedicated to providing quality care”. It was noted that staff receive formal training once a month, and additional reminders and refreshers are provided whenever the trainer visits the home. They also participate in Zoom training, phone consultations, and group discussions on current issues. Most recently, they reviewed elopement procedures. Training topics vary based on current needs, and staff consistently receive feedback to ensure they remain prepared and informed. Report continued on LIC 9099-C PAGE 3... (PAGE 3) Report continued from LIC 9099-C PAGE 2... Resident interviews revealed Residents were pleased with the quality of care they are provided by the facility staff specifically by S1 and S2. Residents state that the staff are helpful and have no complaints. Although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation of Staff are not providing adequate care for residents due to not being properly qualified/trained is deemed unsubstantiated at this time. No citations issued at this time. Exit interview conducted. Report was reviewed and a copy was provided.the state’s words, verbatim · CDSS document, May 12, 2026 · control 29-AS-20260511155110

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Erica Mosley arrived at the facility unannounced to conduct a required annual visit and entered the facility at 9:18 a.m. Upon arrival, LPA Mosley was greeted by staff who called the Administrator to inform them of the visit. The Designee, Karina Antig arrived shortly after and the reason for the visit was explained. Entrance interview. The LPA and staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The facility is a single-story home located in a residential neighborhood. COMMON AREAS: This includes the living room, and dining room. At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. At 12:48 p.m., hardwire combination of smoke / carbon monoxide detectors were tested and operational at the time of the visit. The fire extinguisher was observed and fully charged on 05/20/2025. The emergency exiting plans/sketch are posted. The emergency telephone numbers are posted in the common hallway. The LPA observed required postings throughout the common space. The last emergency disaster drill took place on 10/20/2025 and are conducted quarterly. Activities were observed in the common areas. The fireplace in the living room was adequately screened and noted to be non-functional. There is a functioning telephone on the premises. INTERVIEWS: Starting at 9:28 a.m. and throughout the visit two (2) staff and two (2) resident interviews were conducted. Staff interviews revealed that staff are knowledgeable in Resident rights, different forms of abuse, and reporting procedures. Resident interviews revealed that no concerns were noted or voiced at the time of the visit. Report Continued on LIC 809-C PAGE 2... (PAGE 2) Report Continued from LIC 809-C... BEDROOMS: There are six (6) total bedrooms in the facility; four (4) bedrooms are designated as private, single occupancy, resident rooms, one (1) shared, double occupancy resident room and one (1) staff rooms. The staff rooms are kept locked at all times and observed to be occupied by staff. Two (2) out of five (5) resident rooms have exits to the exterior. All passageways were observed to be clear of obstructions. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. RESTROOMS: There are two (2) total restrooms. One (1) is designated as a shared / common resident restroom, One (1) is designated as a private resident restroom. Resident restrooms were observed to be equipped with a slip resistant surface / mat. Grab bars were observed in the restrooms. The restrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured in all resident restrooms and ranged between 105.6-116.1 degrees Fahrenheit, all within the required range. LPA observed storage space closets in the hallway containing extra clean linens and towels for resident use. KITCHEN: The LPA inspected the kitchen/food service area. Knives and sharps were observed in a locked cabinet. Kitchen appliances were in operable condition. The facility has a sufficient supply of two (2) day perishable and seven (7) day non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. The kitchen faucet was measured for hot water temperature, and it measured 118.6 degrees Fahrenheit. Cleaning supplies and other chemicals are kept in the garage locked and inaccessible to residents in care. GARAGE: LPA observed the attached facility garage accessible through the kitchen, which was locked at the time of the visit. LPA observed emergency food and water, personal protection equipment (PPE) , incontinent supplies, laundry units including washer, dryer and detergent, an extra refrigerator and freezer that were checked for proper labels and expiration dates. BACKYARD: The entire property is fenced. The backyard has a covered patio area with shade, patio furniture including a table and chairs for resident use. LPA observed one (1) self-latching gate. There were no bodies of water noted at the time of the visit. Only one (1) pathway is used as an emergency exit which was free of obstructions at the time of the visit. Report Continued on LIC 809-C PAGE 3... (PAGE 3) Report Continued from LIC 809-C PAGE 2... RECORDS: Resident Records: Five (5) Resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. All records were in order. Personnel Records Five (5) Personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All records were in order. INFECTION CONTROL/ EMERGENCY DISASTER PLANNING: During today’s visit the LPA reviewed the facility’s infection control practices and the facilities emergency disaster plan. Both documents were observed to be complete and updated annually as required. The facilities policies and procedures, as they pertain to infection control and emergency planning meet the regulatory standard. MEDICATIONS: Medication review began at approximately 2:05 p.m. Medications are centrally stored and locked in a cabinet in the kitchen adjacent to the dining room. Medications for Three (3) residents were reviewed. Medications were properly documented on the centrally stored medications and destruction record. Medications are labeled and checked for expiration dates. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. Medications reviewed were found to be self administered as prescribed and documented on the centrally stored medication and destruction records. No errors observed during review. LPA observed the first aid supplies to be complete, including sterile first aid dressings, bandages, tweezer, a thermometer and a current version of a first aid manual. DOCUMENTS: Documents obtained during the visit include: LIC 500 facility roster and LIC 9020A Resident roster and copy of the Limited Liability insurance. During today's inspection, the facility is in compliance with Title 22 regulations. No citations issued. Exit interview conducted. Copy of report reviewed and provided.the state’s words, verbatim · CDSS document, Jan 9, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 10:00AM. The LPA was greeted by staff, Facility Designee Karina Antig arrived shortly thereafter and LPA informed them of the reason for the visit. Beginning at 10:13AM, the LPA and Facility Designee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: Combination smoke and carbon monoxide detectors were tested at 10:47AM and were operational at the time of the visit. The two (2) fire extinguishers were fully charged and last serviced 05/14/2024. KITCHEN: Knives and cleaning supplies are stored in locked cabinets inaccessible to residents at risk. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. There is a fireplace in the living room, which is screened and inaccessible. The facility maintained a comfortable temperature throughout the visit. The LPA observed required postings throughout the common space. BEDROOMS: There are 5 (five) designated resident rooms and 1 (one) staff room. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Extra linens are available as needed. LPA discussed with Facility Designee following up with the Fire Inspector related to a requested change in status from non-ambulatory to bedridden. Continued on LIC 809-C BATHROOMS: The facility contains 2 (two) resident bathrooms; 1 (one) is a common restroom and the other is a private resident restroom. Both restrooms were clean and sanitary and in operating condition with grab bars and slip-resistant surfaces. The bathrooms were sufficiently stocked with soap and paper towels and available hygiene products. The hot water temperature in the hallway bathroom measured within the required range. OUTDOOR AREA/GARAGE: The backyard has an outdoor area equipped with furniture and shade for resident use. There is a side gate for resident exit and is single latched. No bodies of water noted. The garage contains an additional refrigerator and freezer with perishable food items. Additional nonperishable food was observed along with emergency food and water. Cleaning supplies and disinfectants are stored in the locked garage. The laundry area is located in the locked garage. All laundry supplies are locked and inaccessible to residents in care. RECORDS: Records will be reviewed during the annual continuation visit. MEDICATIONS: Medications are stored locked in a cabinet in the eating area adjacent to the kitchen. First aid kit was observed to be complete. Medications will be reviewed during the annual continuation visit. INFECTION CONTROL/EMERGENCY DISASTER PLAN: Will be reviewed during the annual continuation visit. INTERVIEWS: During today's visit, LPA interviewed 2 (two) residents. No concerns were noted. Additional interviews will be conducted during the annual continuation visit. Due to time constraints, LPA will return at a later date to continue the annual inspection. No citations issued. Exit interview conducted. A copy of the report was provided to Facility Designee.the state’s words, verbatim · CDSS document, Jan 28, 2025

Allegation investigated: Resident room has ant infestation

Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced initial complaint visit to this facility. LPA initially met with facility staff and explained the reason for the visit. At 09:58AM, Assistant Administrator Karina Antig arrived at the facility. Entrance interview conducted. Starting at 09:55AM, the LPA conducted interviews with 2 (two) staff, the Assistant Administrator, and 3 (three) residents. At 10:39AM, the LPA along with the Assistant Administrator conducted a physical plant tour. The following was then determined: It was alleged that resident room has an ant infestation, as ants were observed on the wall, on the bed and in Resident #1 (R1)'s linens. 2 (two) residents interviewed (including R1) indicated they have seen no ants. R1 indicated that facility staff take good care of them and that R1 would notify staff if they observed any unwanted pests. 1 (one) other resident interviewed did indicate they had seen just a few ants a couple Report Continued on LIC 9099-C Unsubstantiated days ago and that staff had responded quickly to spray the ants and clean up the area. No ants have been observed since then. Staff interview revealed that last week during the heat wave, some ants had been observed in R1's room, but that staff had sprayed outside the home and did clean up the ants inside the resident's room. Staff stated there has not been a problem since then. During today's facility tour, LPA did not observe any ants in the facility, nor any evidence of any a prior infestation. All interviews indicated there were few ants in the facility and staff responded quickly and appropriately to maintain the facility in clean, safe condition. Based on observation and interview, although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore the allegation "resident room has ant infestation" is deemed UNSUBSTANTIATED at this time. No citations issued. Exit interview conducted with Assistant Administrator. A copy of today's report was provided.the state’s words, verbatim · CDSS document, Sep 12, 2024 · control 29-AS-20240911145548

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced Annual Continuation Visit to the facility to continue the annual inspection visit initiated on 01/19/2024. The LPA was greeted by staff and informed them of the reason for the visit. Administrator Karina Rosales Antig arrived shortly. Today the LPA conducted a medication audit, staff interviews and finished the record review initiated on 1/19/2024. Record Review: The LPA observed documentation for Disaster prevention and last fire drill (conducted on 12/18/2023). The LPA obtained Resident and Staff Rosters. The LPA observed five (5) out of (5) staff files. Two (2) out of five (5) staff were missing 6 hours of medication training, 4 hours of dementia training, 1 hour of general topics training and 2 hrs of Postural supports and and restricted health conditions. One (1) out of five (5) staff files was observed to be missing all annual training required. Medications: At 3:45 p.m. a medications review was initiated for two out of five residents. Medications are centrally stored and locked in a locked cabinet in the dining area; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted and copy of the report and appeal rights provided.the state’s words, verbatim · CDSS document, Feb 1, 2024

Type of visit: Required - 1 Year

At 09:00 a.m. Licensing Program Analyst (LPA) Esther Cortez arrived at the facility unannounced to conduct a required annual visit. The LPA was greeted by staff and informed them of the reason for the visit. Administrator Karina Rosales Antig arrived shortly. At 9:40 a.m. the LPA conducted a tour of the physical plant with the Administrator to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was noted: Facility is a single-story residence that consists of five (5) resident bedrooms, one (1) staff room, and two (2) restrooms. The LPA observed one (1) fire extinguisher which was fully charged and last purchased on 05/18/2023. All smoke alarms and carbon monoxide detectors were tested and functioned properly. The LPA observed all required postings in the hallway near the entrance area. Kitchen: The kitchen appeared clean and the appliances and fixtures functional during the time of visit. LPA observed a sufficient amount of perishable and non-perishable food at the facility. Food is prepared based on the menu. Snacks and beverages are always available for the residents. At 9:41 a.m. the LPA observed two knives in the unlocked dish washer machine. At 9:43 a.m. the LPA observed Robitussin cough+sore throat medication, Greri Tussin DM medication, and Nystatin 100,000 unit/ml medication in the kitchen refrigerator accessible to residents in care. Bedrooms: The resident bedrooms were properly furnished with at least one chair, nightstand and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding. At 10:01 a.m. the LPA did not observed a required “No Smoking-Oxygen in use” sign in room #2 due to use of oxygen equipment. Report will continue on LIC809-C. Bathrooms: The LPA observed all bathrooms, properly supplied and had functional fixtures. The LPA observed grab bars and non-skid mats in all bathrooms. At 10:14 a.m. water temperature in resident’s restroom was measured at 116.3 degrees Fahrenheit. The hot water measured was within the required limit of 105-120 degrees Fahrenheit. Common Areas: These included the living room and dining area. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. There is a fireplace in the living room, which is covered with a screen. There were no obstructions and/or tripping hazards throughout the facility. The garage: The LPA observed the garage where additional supplies and the emergency food and water is stored. Cleaning supplies and disinfectants are kept in the garage. The garage is locked. Surrounding Grounds (Outdoors): The LPA observed appropriate outdoor furniture, with a covered shaded area for residents. There are no bodies of water on the premises. The LPA observed paint buckets, nails, and equipment in the backyard. Upon observation the administrator stated maintenance will be picking up all items today. Record Review: At 11:13 a.m. a review of facility files was initiated. The LPA reviewed five (5) out of five (5) resident files. The following was observed: Two out five residents (R1, R2) did not have a pre-placement appraisal (LIC 603), or appraisal/needs and services plan (LIC625). Three out of five Residents (R3,R4,R5) did not have a required annually updated LIC625. At 10:20 a.m., the LPA observed R5 residing in room five (5), which is not an identified bedridden room. Per R5’s physician’s report, R5 is identified as bedridden. Per the fire clearance, the facility does not have a bedridden fire clearance at this time. Administrator could not verify if they a bedridden fire clearance. An immediate civil penalty of $500 is assessed, due to a violation of the fire clearance. The LPA obtained a Client Roster and Staff Roster. Interviews: The LPA conducted two (2) resident Interviews. No immediate concerns were voiced. Due to time constraints the LPA will return at a later date to complete the annual. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted and copy of the report and appeal rights provided to Administrator Karina Rosales Antig.the state’s words, verbatim · CDSS document, Jan 19, 2024