Hesperia Senior Care

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Magda Malcore and Rima Corona made an unannounced visit to conduct a required comprehensive annual inspection. LPAs met with Facility Manager, Raeann Rios and informed the purpose of the visit. The facility is Residential Care Facility for Elderly (RCFE). The facility's license capacity is (18) with a current census of (10). LPAs conducted a general inspection of the facility, which included, but was not limited to, the following: Physical Plant: The facility has no obstructions to indoor and outdoor passageways. The facility is maintained at a 72 degrees Fahrenheit (F). The facility's outdoor activity area is enclosed with a latching gate. The facility is equipped with operating smoke/carbon monoxide alarms, two (2) fully charge fire extinguishers, laundry equipment, and telephone service. The facility has posted in a common area: Community Care Licensing Complaint poster, Ombudsman poster, emergency telephone numbers, facility menu, activities, theft and loss policy, and "Oxygen in use" signs. Cleaning supplies, toxins, and sharps were kept inaccessible to residents in care. LPAs inspected five (5) resident bedrooms which were equipped with beds, bed linen, night stands, chairs and sufficient lighting. LPAs inspected five (5) resident bathrooms which were equipped with grab rails and slip mats. Bathroom hot water temperatures measured 106 degrees (F). Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. The facility has sufficient cups, plates, and utensils for residents in care. The facility's refrigerators and freezers were operating in a healthful manner. Care & Supervision: The facility's staff schedule reflects care coverage 24 hours a day, 7 days a week. All staff working in the facility have criminal record clearance through the department. Health Related Services: The facility maintains record of resident’s medications and first aid kit. Medications were centrally store in a locked room. Record Review: Five (5) resident files reviewed had admission agreements, medical assessments, and appraisals. Five (5) staff files reviewed had First Aid/CPR certifications, criminal record clearances, training, and health screenings. The facility had a emergency disaster plan, infection control plan, liability insurance and staff disaster drill training for review. No deficiencies were issued during today's visit. An exit interview was conducted, where this report was discussed and a copy provided to Facility Manager Rios.the state’s words, verbatim · CDSS document, Jan 16, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrator Jin Wang and informed the purpose of the visit. The facility is an 8 bedroom, Residential Care Facility for Elderly (RCFE) facility. The facility's license capacity is (18) with a current census of (9) . LPA conducted a general inspection of the facility, which included, but was not limited to, the following: Physical Plant: The facility has no obstructions to indoor and outdoor passageways. The facility is maintained at a 75 degrees F. The facility's outdoor activity area is enclosed with latching gate. The facility is equipped with operating smoke/carbon monoxide alarms, telephone service, and call button system. The facility has posted Community Care Licensing Complaint poster, Ombudsman poster, emergency telephone numbers, facility menu, activities, theft and loss policy, and "Oxygen in use" signs. Cleaning supplies, toxins, and sharps were kept inaccessible to residents in care. LPA inspected five (5) resident bedrooms which were equipped with beds, bed linen, night stands and sufficient lighting. LPA inspected five (5) resident bathrooms which were equipped with grab rails and slip mats. LPA observed the bathroom hot water temperature in the following bedrooms tested as follows: bedroom#103 tested 132 degrees F, bedroom#104 tested 139 degrees F, bedroom #107 tested 133 degrees F, and bedroom #106 tested at 139 degrees F. Deficiency cited. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. The facility's two (2) refrigerators were operating properly at 43 degrees F. Care & Supervision: The facility's staff schedule reflects care staff coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed three (3) resident files for admission agreements, physician reports, assessments, needs and services plans. LPA reviewed three (3) staff files for First Aid/CPR certifications, criminal record clearances, trainings, and health screenings. Resident medications were kept inaccessible to residents in care. LPA review of resident #1 (R1), resident #2 (R2) , resident #3 (R3) medication records reveals staff did not document on 1/7/25 when the medication was given for all three residents. Deficiency cited. Deficiencies were cited and technical advisories were issued per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, where reports (LIC809, LIC809-C, LIC809-D, LIC9102) and were discussed. Copies of the reports were provided with appeal rights to the Administrator at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jan 8, 2025

The state marks this report as 10 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 01/25/24, Licensing Program Analyst (LPA) Michelle Echeverria arrived unannounced to conduct the required annual visit to the facility. LPA met with caregiver, Crystal Taylor and introduced self and stated purpose of the visit. LPA was informed that there are currently 6 residents in the facility and 2 residents in day program. The facility has 8 resident bedrooms with bathrooms included, 1 staff office with bathroom, kitchen, dining area, reception area, and shaded patio. LPA completed a walk through of facility and of review of records. Medication not audited due to timing. Physical Plant: The facility is approved for 18 ambulatory which 18 can also be nonambulatory and hospice waiver increased from 6 to 12. There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 71 degrees fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and sufficient lighting. LPA inspected resident bathroom; bathroom was clean and appliances were found functional. Water temperatures tested at 110 degrees fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarms, fire extinguisher and first aid kit. Posters such as; the personal rights, ombudsman and emergency disaster plans were posted in a common area. LPA also observed cleaning supplies, toxins, sharps, and other dangerous items locked made inaccessible to residents. There was a designated storage space for resident/staff files. Medications were observed secured and inaccessible to residents. There are no guns or ammunition in the facility. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a wide variety of food available for residents. Dishes, cups, and utensils were also stored properly. Yards/Outside: One shaded patio, a side gate with self-latching handle on the front side of the facility that leads into the back patio. All outdoor pathways were free of obstructions. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed 3 resident files for admission agreements, updated physician reports, and needs and services plans. LPA discovered the facility is providing care for two (2) bedridden residents which are not approved per the facility's license. Deficiency issued with civil penalty. LPA also reviewed staff and administrator's file for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. The facility last conducted a fire drill on 12/04/2023. LPA observed that the Emergency Disaster Plan does not have a signature and date. Deficiency issued. Deficiencies were cited during this visit. An exit interview was conducted where this report LIC809, LIC809C, LIC809D, LIC412IM and appeal rights were discussed and copies were provided to Grabriella Taylor.the state’s words, verbatim · CDSS document, Jan 25, 2024