Hollister Care Home

Allegation investigated: Facility staff performed g-tube feedings for resident without training or supervision from a skilled professional Staff are not adequately trained to safely assist residents with prescribed medications Staff conduct poses a risk to residents in care

Licensed Program Analyst (LPA) Cassandra Mikkelson arrived at the facility unannounced and met with Okki Kim to deliver findings for the above complaint allegation. During the investigation, LPA conducted interviews, conducted a tour of the facility, and reviewed documentation pertinent to the investigation. The results of the investigation are as follows: *** Report continued on 9099-C*** Unfounded Facility staff performed g-tube feedings for resident without training or supervision from a skilled professional Interviews conducted indicated that staff were properly trained on g-tube feedings both using videos and in person visual trainings. Staff were not conducting feedings by themselves, staff were only assisting resident R1 in the feedings as R1 was still able to do most of the preparation and feeding themselves. Records reviewed indicated that feedings were documented and were done appropriately based on R1’s physician orders. All training for g-tube feedings were documented. Therefore, the allegation facility staff performed g-tube feedings for resident without training or supervision from a skilled professional is unfounded. Staff are not adequately trained to safely assist residents with prescribed medications Interviews conducted indicated that all staff are trained on how to properly dispense medications to residents. Staff are able to have hands on training as well to help ensure ability. Facility has procedures in place for medication passes to ensure that all medications are documented and given to the correct resident at the correct time of day. Records reviewed indicated that all staff have proper initial medication training and continuing education on dispensing medications. Staff understand the importance of properly giving medication and show their knowledge in the written question sheets in their training files. Therefore, the allegation staff are not adequately trained to safely assist residents with prescribed medications is unfounded. Staff conduct poses a risk to residents in care Interview with Administrator and assistant Administrator indicated that there have been no altercations between staff to their knowledge. There also has not been any altercations between the residents or staff and residents. Interviews with Resident R2 and Staff member S1 indicated there have no altercations between staff or staff and residents. Therefore, the allegation staff conduct poses a risk to residents in care is unfounded. Based on records reviewed and interviews, LPA finds the above allegations to be UNFOUNDED- meaning that the allegations were false, could not have happened and/or is without reasonable basis. Exit interview conducted with the Administrator. Copy of report was given to facility.the state’s words, verbatim · CDSS document, Apr 9, 2026 · control 59-AS-20260212170248

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cassandra Mikkelson arrived unannounced and met with Administrator Okki Kim to conduct an annual inspection utilizing the inspection tool. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA observed resident rooms, common area bathrooms, kitchen, and perimeter of care home. LPA observed rooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition, properly maintained, and the hot water temperature was observed to be 105.0 degrees F. LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two day perishable and (7) seven day non-perishable food supply on hand. Smoke detectors and carbon monoxide detectors are operational in the care home. Fire extinguishers and first aid kit are maintained and ready for emergency use. LPA checked medication storage and found medications to be locked away and inaccessible to the residents. LPA reviewed three (3) resident files, three (3) staff files and resident medications. Facility has a current copy of certificate of liability insurance and LPA requested a copy. As a result of this visit, no deficiencies were cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Exit interview was conducted with Administrator.the state’s words, verbatim · CDSS document, Oct 28, 2025

Type of visit: Post Licensing

On November 21, 2024, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced to conduct a required annual inspection. LPA met with Administrator and explained the purpose of the visit. LPA is conducting an annual inspection today but this report is being generated to clear the Post-Licensing inspection in the system. There are no citations issued on this report. Exit interview conducted. Signature on this form acknowledges receipt of report.the state’s words, verbatim · CDSS document, Nov 21, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a required annual inspection utilizing the inspection care tool. LPA met with Administrator and explained the purpose of the visit. Today's census is five (5) residents in care with three (3) residents on hospice services. Facility is licensed for six (6) non-ambulatory and hospice waiver for 6. Facility is compliance to licensure. During today's inspection, LPA conducted an inspection of six residents rooms, two bathrooms, kitchen and the common areas. LPA observed outside to be free of obstructions. Based on the areas toured, LPA observed no health, safety and personal rights violation. LPA observed facility to have sharps, toxins and medications to be locked and inaccessible to other residents in care. LPA observed license and Administrator Certificate to be posted in a conspicuous space. LPA observed Administrator Certificate #7027603740 to be active with expiration date of 2/28/2026. File review was conducted for five residents and five personnel records. LPA observed initial training completed. LPA observed documentation of annual training to be pending. LPA was informed partial training has not been inputted on file for S1 and S2. Care tool completed and facility was found to be in compliance. Exit interview conducted. Signature on this form acknowledges receipt of report.the state’s words, verbatim · CDSS document, Nov 21, 2024