Heritage Care Home

Type of visit: Required - 1 Year

On 12/4/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Simranpreet Mandair. LPA was granted entry. 6 clients were present during inspection. House Manager (HM) Jodhveer Singh and Manager (M1) Kamljit Kaur arrived shortly after LPA’s arrival. LPA toured facility with S1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at -5 degrees F and refrigerator temperature was maintained at 37 degrees F. Cleaning chemicals was observed stored and locked under kitchen sink. Fire extinguisher was observed with a purchase date of: 12/4/25. Fire drill last completed on 11/16/25. Clients' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 106.7 to 114.6 degrees F in 3 bathrooms. Outside of facility toured. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Medications were checked and observed kept locked in medication cart. Clients’ MARS was reviewed. Carbon monoxide and smoke detectors were tested and observed to be operational. Samples of clients’ files reviewed. 1 resident was missing the Consent for Medical Treatment and the Appraisal Needs and Services forms in resident’s files. Samples of staff files were reviewed and observed to have all the required documents. Deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents requested to be updated and submitted to Fresno CCL by 12/18/25: Lic 308, Lic 500, Lic 610D, and Lic 9020. LPA received a copy of current Administrator certificate. A copy of this report with appeal rights was provided to House Manager, whose signature on this form confirms receipt of these report.the state’s words, verbatim · CDSS document, Dec 4, 2025

Type of visit: Required - 1 Year

On 1/6/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Mehkapreet Kaur. LPA was granted entry. 6 clients were present during inspection. Administrator (A1) Manprit Singh arrived shortly after. Manager (M1) Kamaljit Kaur arrived with A1 during tour. LPA toured facility with A1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at -5 degrees F and refrigerator temperature was maintained at 34 degrees F. Cleaning chemicals was observed stored and locked under kitchen sink. Fire extinguisher was observed with a service date of: 1/30/24. Fire drill last completed on 12/21/24. Clients' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at 119.4 in bathroom 1, 117.5 in bathroom 2 and 116.2 degrees in bathroom 3. Outside of facility toured. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Medications were checked and observed kept locked in medication cart. Clients’ MARS was reviewed. Carbon monoxide and smoke detectors were tested and observed to be operational. All clients’ files reviewed to have all the required documents. Samples of staff files were reviewed and observed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. The following documents requested to be updated and submitted to Fresno CCL by 1/20/24: Lic 308, Lic 500, Lic 610D, Lic 9020 and a current Administrator certificate. A copy of this report was provided to Manager, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Jan 6, 2025

Type of visit: Required - 1 Year

On 1/6/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Mehkapreet Kaur. LPA was granted entry. 6 clients were present during inspection. Administrator (A1) Manprit Singh arrived shortly after. Manager (M1) Kamaljit Kaur arrived with A1 during tour. LPA toured facility with A1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at -5 degrees F and refrigerator temperature was maintained at 34 degrees F. Cleaning chemicals was observed stored and locked under kitchen sink. Fire extinguisher was observed with a service date of: 1/30/24. Fire drill last completed on 12/21/24. Clients' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at 119.4 in bathroom 1, 117.5 in bathroom 2 and 116.2 degrees in bathroom 3. Outside of facility toured. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Medications were checked and observed kept locked in medication cart. Clients’ MARS was reviewed. Carbon monoxide and smoke detectors were tested and observed to be operational. All clients’ files reviewed to have all the required documents. Samples of staff files were reviewed and observed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. The following documents requested to be updated and submitted to Fresno CCL by 1/20/24: Lic 308, Lic 500, Lic 610D, Lic 9020 and a current Administrator certificate. A copy of this report was provided to Manager, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Jan 6, 2025

Type of visit: Required - 1 Year

On 1/29/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. introduce self, stated the purpose of the visit and requested to meet with the Administrator. LPA met caregiver Ma Tersita Cabuhat. House Manager (HM) Phoeun Marez was called and arrived shortly. LPA toured facility with HM. Licensee Manprit Singh arrived later during tour. All four residents were present during inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. Extra linens were observed. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature is maintained at 33 degrees F and freezer at -5 degrees F. Medications were observed locked in hall closet. MARs were reviewed. Cleaning supplies and chemicals stored and locked in garage and laundry room. Fire extinguisher was observed with a purchased date of: 2/28/22. Alll bedrooms were observed to have the required furnishings and with adequate lightening. The bathrooms were toured and observed operational during inspection. Non-skid mat and grabbed bars were observed. Hot water temperature was tested at 125.2 degree F in the bathroom 1, and 106.2 degree F in bathroom 2. Outside of facility toured and observed to be free of debris. Side gate observed self-closing and self-latching. Adequate outdoor seatings available for residents. All residents’ and staff files were reviewed. Two out of four residents’ files were observed did not have all the required documents. Two out of three staff files were observed did not have all the required documents and not associated to the facility. A deficiency and an immediate Civil Penalty of $1000 was assessed. See Lic 421BG is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6 see attached 809D. Exit Interview conducted. LPA received a copy of Lic 9282. The requested documents are to be submitted to CCL by 02/05/24: Lic 308, Lic 500, Lic 610E, current liability insurance, and current Administrator certificate. A copy of this report and appeal rights were provided to Licensee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Jan 29, 2024

Allegation investigated: Staffing requirements not being met

An unannounced Complaint visit was conducted on the date & times indicated above by Licensing Program Analyst (LPA) K. McClurg. LPA was met @ door by caregiver, introduced self & asked is Administrator was available. Staff contacted Corporate Officer (CO) of Licensee Manpret Singh by telephone. LPA spoke with CO. CO stated that they would not be able to join LPA during visit, however Consulting House Manager (CHM) would be there shortly & is authorized to sign for receipt of report, as well & collaborate on Plan of Correction(s) (POC) for any citations/deficiencies issued. -LPA reviewed resident records & discussed resident behavior with staff. Per Physician Reports & staff, current residents do not wander & do not have needs that would require awake staff. All resident bedroom doors are kept open, including Staff room door. Staff will check on residents during the night. -The Department has investigated this allegation & determined it to be UNFOUNDED. -Exit interview conducted with CHM. Copy of reports provided. Unfoundedthe state’s words, verbatim · CDSS document, Dec 21, 2023 · control 24-AS-20231212104650

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(5) · Plan of correction due date: Dec 22, 2023

Incidental Medical...Care. A plan for incidental medical...care shall be developed by each facility. Facility staff...may assist persons with self-administration (of medication) as needed. Medication observed to be given past d/c date due to lack of plan. MARs not being signed at time Rx given, requiring a plan to ensure records are maintained correctly @ all times.the state’s words, verbatim · CDSS document, Dec 21, 2023

Plan of correction: CHM has agreed to submit a plan of how medication communication will be documented & handled in a timely manner, as well as maintaining correct med record keeping (MARs). Plan to include brief outline to be shared with staff & date(s) staff will be trained. Facility to maintain personnel training documents.. POC may be emailed to the LPA by date indicated.

Type of visit: Case Management - Deficiencies

During a Complaint visit on the date & times indicated above, Licensing Program Analyst (LPA) K. Mcclurg observed & reviewed the following violations with Consulting House Manager (CHM) Phoeun Marez. Magnetic key to open drawer in kitchen containing medications observed to be accessible on metal light switch opposite drawer. Key accessibility makes medication in locked drawer accessible posing an immediate risk to residents. Key was made inaccessible at time of visit. Staff currently working 24 hour days. Vacant resident room #1 currently being used a staff room. Rooms may not be used for any other purposes other than as designated as licensed. Room is designated as a resident room, not for use as a staff room. Alternatives are to: Have awake staff @ all times, including overnight, OR Request to change facility's license to designate a dedicated staff bedroom. To add a designated staff room: Licensee would need to request change of capacity to decrease capacity from 6 to 5. If want to retain license for 6 residents, room #1 will require fire clearance for 2 residents. Initially inspected only for 1 per licensee request @ time of application. Please submit a Letter of Intent of how issue will be addressed by due date of Plan of Correction (POC). If adding a staff room for the time being, please indicate if would like to decrease capacity to 5 or would like to have fire clearance for 2 non-ambulatory/bedridden residents in room #1. Please follow through with the Department to initiate desired changes by due date of (POC).the state’s words, verbatim · CDSS document, Dec 21, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(2) · Plan of correction due date: Dec 22, 2023

Incidental Medical and Dental Care. Centrally stored medicines shall be kept in a safe...locked place not accessible to persons other than employees responsible for the supervision of the centrally stored medication. Key to open locked drawer in facility kept on wall opposite locked drawer making contents accessible to residents.the state’s words, verbatim · CDSS document, Dec 21, 2023

Plan of correction: Key was made inaccessible @ time of visit.Facility will develope written plan how key will be made & maintained inaccessible to resients. Plan to include commitment to do training & date(s) of training. Copy of plan to be emailed to this LPA by due date. Failure to submit POC's by due date may result in Civil Penalties.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87208(a) · Plan of correction due date: Jan 5, 2024

Plan of Operation. Each facility shall have and maintain a current, written definitive plan of operation....including...plan that describes the capacities... (&)the uses intended and a designation of the rooms to be used. Vacant designated resident room being used as a staff bedroom.the state’s words, verbatim · CDSS document, Dec 21, 2023

Plan of correction: Licensee to determine if will have awake staff at all times or to designate a room for staff. Licensee to notify the Department by due date. Licensee to follow-up with Department on how to implement changes if needed. Licensee may email notification of decision to the LPA. Please reference facility by name & number. Include follow-up contact telephone number.