Helping Hands

Type of visit: Required - 1 Year

On 04/01/2026 at 10:05 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Luciana Arellano and explained the purpose of the visit. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 116.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 03/11/2026. Emergency Disaster Plan was last posted on 01/30/2026. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 01/30/2026. LPA reviewed 3 residents records and 2 staff records; all were complete. LPA also reviewed a sample of resident’s medications. The following documents were reviewed during the visit: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan, Liability Insurance, and Current Administrator’s Certificate No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Apr 1, 2026

Type of visit: Required - 1 Year

On 03/11/2025 at 1:22 PM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Luciana Arellano and explained the purpose of the visit. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 111 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 11/25/2024. Emergency Disaster Plan was last posted on 01/01/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 02/20/2025. At 2:10 PM, LPA reviewed staff records. At 2:30 PM, LPA reviewed residents records. LPA also reviewed a sample of resident's medications. The following documents were requested and reviewed during the visit :LIC 500 Personnel Report LIC 610E Emergency Disaster Plan, Liability Insurance, and Current Administrator’s Certificate. ***CONTINUE ON 809 C*** ***CONTINUE FROM 809*** During the inspection, the following deficiency was observed: At 2:10 PM, during the staff file review, LPA observed LIC503 ( Health Screening) records were not available and were not on file. The above deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health & Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted with Luciana Arellano. A copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Mar 11, 2025

Type of visit: Required - 1 Year

On 4/18/2024 at 8:45 AM, Licensing Program Analysts (LPA) K. Nguyen and G. Luk arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with facility Administrator, Elena Mihale and explained the purpose of the visit. Licensee, Luciana Arellano arrived 30 minutes later. LPAs toured facility with Elena including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 7 total bedrooms which 3 bedrooms are occupied by the residents and 2 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 68 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 116 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. At 11:00 AM, LPAs reviewed 3 clients records. At 11:30AM, LPAs reviewed 2 staff records. At 1:00PM, LPAs reviewed a sample of resident’s medications. During the inspection deficiency was observed: At 9:20AM, LPAs observed unlocked knifes in the sink and cabinet, unlocked cleaning supplies under sink and bug spray on the side of the refrigerator. Administrator locked up the knives, cleaning supplies and bug spray during inspection. At 9:25AM, LPAs observed unlocked medications in the refrigerator and cabinet. Administrator locked up the medications during inspection. At 9:30AM, LPAs observed window screen in staff room and bathroom fan is in disrepair. LPAs also observed dog feces in the side and back yard. Administrator cleaned up the dog feces during inspection. Report continued on LIC 809c... At 9:45AM, LPAs observed expired can goods in cabinets. Administrator threw away expired can goods during inspection. At 9:55AM, LPAs observed video baby monitor in all resident's rooms. Administrator removed the baby cameras during inspection and will start using call buttons. At 11:30AM, LPAs observed residents do not have preplacement appraisals and needs & service plans. At 12:00PM, LPAs observed liability insurance policy in 2023 was TBD. LPAs were informed by licensee that policy was canceled at the end of 2023 and is in the process of obtaining liability current insurance. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health & Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted with Luciana Arellano. A copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Apr 18, 2024

The state marks this report as 10 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Allegation investigated: Staff, who is not a skilled professional, gave resident morphone

On 2/29/2024 at 10:05am, Licensing Program Analyst (LPA) K. Nguyen to conduct an complaint visit for the allegation above. LPA met with Luciana Arellano Licensee and explained the purpose of the visit. During the course of investigation, LPA conducted reviewed files, and conducted interviews. Based on the information obtained, the above allegations are SUBSTANTIATED. Licensee admitted to LPA that facility do not have a skill professional to administer morphine to R1. R1 cannot self-administer, but POA and hospice agency is aware and gave us permission to administer the medication. Report continues on LIC 9099C... Substantiated Deficiencies are being cited in violation of Title 22 California Code of Regulations. Failure to submit proof of corrections (POC's) by plan of correction due dates along with the LIC9098 Proof of Correction may result in civil penalties. Exit interview conducted. Appeal Rights and copy of this report provided to Licensee via email at the conclusion of interview.the state’s words, verbatim · CDSS document, Feb 29, 2024 · control 15-AS-20240226143104

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87633(4)(B) · Plan of correction due date: Mar 7, 2024

Hospice Care of Terminally Ill Residents (4) A description of the area of licensee’s responsibility for implementing the plan including, but not limited to, facility staff duties; record keeping; and communication with the hospice agency, resident’s physician, and the resident’s responsible person(s), if any. This description shall include the type and frequency of the tasks to be performed by the facility. (B) The plan shall specify, by name or job function, the licensed health care professional on the hospice agency staff who will control and supervise the storage and administration of all controlled drugs (Schedule II - V) for the hospice client. Facility staff can assist hospice residents with self-medications without hospice personnel being present. This requirement is not met as evidence by: Based on investigation, licensee did not comply with the section cited above by not having a skill professional to administer morphine to R1.the state’s words, verbatim · CDSS document, Feb 29, 2024

Plan of correction: Licensee agree to submit a self-certified indicating the understanding of the regulation by 3/7/2024.