Inspired Elderly Care Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA was met by Romeo Casimiro and Evangeline Casimiro, Caregivers and explained the purpose of the visit. At 1:15pm, administrator, Lauri Gallegos arrived and and assisted LPA with the inspection. The facility is approved to serve residents age range 60 and over, (5) non ambulatory, (1) bedridden in bedroom #5, hospice waiver for (6). LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were maintained. LPA observed that the infection control plan did not show that the administrator/licensee reviewed the procedures in 2025, no date nor signature on the form. Bathroom has hygiene items such as paper towel, hand soap and toilet paper. Operational Requirements: A fire clearance is in place. Facility has working signal systems in exit points. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is in place and expires 02/01/2027. Fire drill was last conducted on 10/16/2025. Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood which consists of (5) bedrooms, (4) of which are resident bedrooms, (1) staff bedroom, (3) bathrooms, living room with fireplace, kitchen, dining area, breakfast nook, laundry inside one of the bathrooms, attached garage and backyard with patio area. There are currently (6) residents, 60 years and older residing in the facility, (5) are under hospice care. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, linen, light, chair and sufficient closet space. Backyard was inspected. There are (2) fire extinguishers in the facility without proof of purchase provided. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility. Water temperature reading measured within the required 105 - 120 degrees Fahrenheit *****REPORT CONTINUED ON LIC809-C***** Staffing: A total of (6) caregivers including the Administrator provide care and supervision to the residents. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have the required training and associated to the facility. Administrator's CPR/First aid certificate expired in Nov. 2025 and a valid certificate will be emailed to LPA. Personnel Records-Training: Five (5) staff files were reviewed for criminal background clearance and training. Personnel records have health/TB screenings. Administrator has completed the required Administrator courses and certificate is valid through 09/05/2026. Resident Rights-Information: Resident personal rights are posted. Facility provides internet services to all residents and have access to the facility phone. Administrator provides initial and ongoing training for staff. Planned Activities: Information regarding Dementia is part of training for direct care staff and is included in the Plan of Operation. The facility provides sufficient space to accommodate both indoor and outdoor activities. Food Service: The kitchen was inspected and has sufficient supply of 2 day perishable & 7 day non-perishable food. Pesticides and cleaning supplies are kept away from the food preparation areas. Modified diets for (3) residents are provided. Incidental Medical Services: Residents' medications were reviewed during the visit. The facility uses the Medication Administration Record (MAR) log to document medications given. Medications are stored in a locked cabinet and inaccessible to residents. However, LPA observed that the staff are pre pouring medications (2) days in advance in order to have them ready for the following shift. Resident Records-Incident Reports: Five (5) resident files were reviewed containing admission agreements, Physician's Report, Medical/Functional assessments, Needs and Services Plans, TB clearance, Personal rights, Medical Consent, Medication Records. Disaster Preparedness: The facility has a complete Emergency Disaster and Mass Casualty Plan containing emergency evacuation, storage and preservation of medications, operation of manual assist devices. Administrator agreed to update the information on the temporary hotel location listed on the form. According to the administrator, they conduct emergency drill on a quarterly basis, however the last fire drill on file was conducted on 10/16/2025. Residents with SHN: (5) residents are under hospice care. Physician orders for bed rails were reviewed on the residents files'. No deficiency cited. Technical Violation and Technical Assistance issued. Exit interview and a copy of this report was provided to the Administrator, Laurie Gallegos.the state’s words, verbatim · CDSS document, Feb 5, 2026

The state marks this report as 7 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced subsequent annual inspection visit on 12/05/2024 and was greeted by Caregiver Lilibeth Alcala . Administrator Laurie Gallegos arrived shortly after to assist with tour. LPA Ramirez explained the purpose of the visit. The facility is located on a residential street and is a single store dwelling. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Residents with Special Needs: No large bodies of water were observed LPA Ramirez observed signs posted indicating “No smoking - Oxygen in Use” in various locations of the facility. LPA Ramirez observed several oxygen tanks in resident rooms secured in stands. Knives, sharps or other items that could pose a danger to residents with dementia, were observed to be inaccessible. Auditory devices were observed to be in working order. Health Related Services/Incidental Medical Services: The medications are centrally stored in the medication cabinet and in bubble packs and/or original containers. The facility uses the Medication Administration Record (MAR) log to document medications given. The facility provides incidental medical services. Staffing: Administrator Certificate for Laurie Gallegos expires 09/05/2026. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. Personnel Records Training: Staff files are maintained at the facility. LPA Ramirez observed required annual training, CPR and First Aid for three (3) out of the three (3) personnel records reviewed. LPA Ramirez observed TB testing results, Health screening, fingerprint clearance and job application for three (3) out of the three (3) personnel records reviewed. Infection Control: There are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has an Infection Control Plan in place. SEE 809-C. Operational Requirements: The fire clearance is approved for five (5) non-ambulatory of which one (1) may be bedridden in bedroom#5. This facility may retain no more than six (6) hospice residents. There were five (5) residents under hospice care during inspection. Resident Records/Incident Reports: LPA reviewed Resident files for six (6) residents in care. Resident files are maintained at the facility. Admission Agreement, Physician's Report (including T.B and Ambulatory Status), Consent for Medical Treatment, Preplacement Appraisal Information, Resident Pre-Appraisal, Care Plan/Appraisal/Needs and Services Plan, Resident Rights were observed. No deficiencies were observed during visit. Exit interview conducted. A copy of this report, and LIC 9120 was providedthe state’s words, verbatim · CDSS document, Dec 5, 2024

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced required annual inspection visit on 11/16/2024 and was greeted by Caregiver Lili Beth Alcala . LPA Ramirez explained the purpose of the visit. The facility is located on a residential street and is a single store dwelling. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Physical Plant and Environment safety: Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to residents, were observed to be inaccessible to residents. LPA Ramirez observed carbon monoxide detectors and smoke alarms in hallways. LPA Ramirez inspected four (4) resident rooms. All resident bedrooms contained required furniture, linens and lighting. Water temperatures in all grooming and bathing areas were measured to be with 105 – 120 degrees F. LPA Ramirez observed grab bars near toilets and inside showers. LPA Ramirez observed no-slip mat in showers. Food Service: LPA Ramirez observed sufficient supply of nonperishables for one week and perishable foods for a minimum of two days in the facility kitchen area. Soaps, detergents, and cleaning compounds were observed to be stored away from food supplies. Freezers and refrigerators were observed to be clean and within temperatures of 0-degree F (-17.7 degree C), and refrigerators with maximum temperature of 40-degree F. (4 degree C). Planned Activities: LPA Ramirez observed board games, magazines, and other activities for residents. Residents Rights-Information: LPA Ramirez observed the following postings in common areas throughout the facility: Complaint Poster (PUB 475), personal rights, and nondiscrimination notice. LPA Ramirez observed facility land line. Due to time constraints, LPA Ramirez will return at a later date to complete inspection. Exit interview was conducted. A copy of this report was provided. No violations were observed at this time.the state’s words, verbatim · CDSS document, Nov 16, 2024

Allegation investigated: Broken furniture not maintained by facility staff presents a hazard. Facility staff do not serve quality meals to resident(s). Facility staff did not make menus available upon request.

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced initial complaint investigation visit on 07/02/2024 regarding the above allegations. LPA Ramirez was met by Administrator Laurie Gallegos and explained the purpose of the visit. The investigation consisted of the following: LPA Ramirez requested and obtained copies of Resident/Client Roster (LIC 9020), Staff#1 - 3 interviews (S1 – S3), Attempted interview of Resident#6 (R6), Interview of Resident# 1-5 (R1-R5) copies of Resident#1-6 (R1-R6): Identification and Emergency Information form, Physician Report, Hospice Care plan, copy of facility sample menu, copy of grocery receipts dated 7/1/24 and 7/2/24 and physical plant tour. See 9099-C for continuation. Unsubstantiated The investigation revealed the following. Regarding Allegation(s): - Broken furniture not maintained by facility staff presents a hazard- It is alleged the facility allows residents to sit in broken recliners and does not repair them. Three (3) out of the three (3) staff interviewed deny this allegation. Five (5) out of the five (5) residents interviewed deny this allegation. R6 was unable to be interviewed at this time. R6 has relocated to another facility. On 7/2/2024, at 2:18pm, LPA Ramirez attempted to contact R6 but was unable to make contact. On 7/2/2024, at approximately 10:38 am, LPA Ramirez entered the facility. LPA Ramirez conducted physical plant inspection around 10:45 am and did not observe the facility to be in disrepair. LPA inspected living room area and observed six (6) recliners. Five (5) out of the six (6) recliners each had a resident’s first name taped to the top cushion of the recliner. LPA Ramirez observed the recliners to be in good repair and working to their original design. LPA Ramirez observed two (2) out of the five (5) residents resting in their own recliners during inspection. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Facility staff do not serve quality meals to resident(s)- It is alleged staff do not provide nutritious meals to residents based on their health needs. Three (3) out of the three (3) staff interviewed deny this allegation. Five (5) out of the five (5) residents interviewed deny this allegation. R6 was unable to be interviewed at this time. R6 has relocated to another facility. On 7/2/2024, at 2:18pm, LPA Ramirez attempted to contact R6 but was unable to make contact. During physical plant tour LPA Ramirez observed a supply of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days. All food was observed to be stored, prepared and served in a safe and healthful manner during inspection. At 11:10 am, LPA Ramirez observed Staff#1(S1) stuffing and rolling egg rolls and slicing onions to add to a noodle stir fry dish. LPA Ramirez observed various packaged frozen meats and seafood, pre-cooked frozen meats, frozen vegetables, various fresh fruits and vegetables, several cartons on eggs, several gallons of milk, several gallons of orange juice, and desserts. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. See 9099-C for continuation. Facility staff did not make menus available upon request- It is alleged staff did not make menu available for R6’s family upon request. Three (3) out of the three (3) staff interviewed deny this allegation. R6 was unable to be interviewed at this time. R6 has relocated to another facility. On 7/2/2024, at 2:18pm, LPA Ramirez attempted to contact R6 but was unable to make contact. Five (5) out of the five (5) residents interviewed deny this allegation. Per Title 22, Division 6, Chapter 8, Article 10. Food Service 87555 General Food Service (a)The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. (6) In facilities for sixteen (16) persons or more, menus shall be written at least one week in advance and copies of the menus as served shall be dated and kept on file for at least 30 days. Facilities licensed for less than sixteen (16) residents shall maintain a sample menu in their file. Menus shall be made available for review by the residents or their designated representatives and the licensing agency upon request. LPA Ramirez observed a sample menu in resident records during file review. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. No deficiencies were cited during this investigation. Exit interview was conducted. A copy of this report was provided via email due to printer problems.the state’s words, verbatim · CDSS document, Jul 2, 2024 · control 28-AS-20240625162907

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. The purpose of the visit was explained to caregiver Lilibeth Alcala. Administrator Laurie Gallegos arrived shortly after. The facility serves residents ages 59 and older. The following 12 (CARE) tool domains were utilized during the inspection: Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. There is a visitor sign-in station located in the main entrance. The facility has an Infection Control Plan. Operational Requirements: A current Plan of Operation was reviewed. A Dementia waiver and hospice waiver for six (6) is in place. A fire clearance for 6 non-ambulatory adults 60 and over. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is in place and expires 2/1/2024. A surety bond is not applicable. Facility does not handle resident's money. "Narrative continues next page.**** Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood. It consists of 5 bedrooms; 4 for residents [2 private & 2 shared) and 1 staff bedroom in room #5, 2 1/2 bathrooms, living room, dining room, game room, kitchen, outdoor patio area, laundry room in bathroom, and a 2 car attached garage. The interior and exterior physical plant was inspected. Exit doors are free of any obstruction. There is an inoperable small water fountain and jacuzzi in the backyard. The backyard cement walkway is cracked and lifted posing a tripping hazard. A citation was issued. The facility has two (2) fully charged fire extinguisher and a pull alarm Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Staffing: A total of 4 caregiver staff provide care and supervision to the clients. Personnel Records/Staff Training: Administrator certificates expires 9/5/2024. Personnel files/training were reviewed. Proof of staff training, health clearance, criminal background clearance and 1st Aid/CPR training were verified. Resident Records/Incident Reports: A total of six (6) resident files were reviewed. Files contained admission agreements, Physician's Reports, Appraisals, TB clearance, Functional Capability Assessment, and emergency information. RCFE complaint poster and Personal rights were observed posted in the facility entrance area. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. Indoor and outdoor activities are scheduled at least 3-4 times a week. The facility does not have a Resident Council. ***Narrative continues next page.*** Food Service: Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies. Physician orders for modified diets are in place. Incident Medical and Dental: Centrally stored resident medications were observed to have a 30-day supply of medications. Resident (R1) had 1 medication and 2 supplement medications in an unlocked drawer in the room. The supplements do not have physician orders. Citation was issued. Medical and dental transportation is provided by family members. Disaster Preparedness: Emergency and Disaster Plan LIC 610E is in place. The last emergency disaster drill was conducted on 11/16/2023. Residents with Special Health Needs: One (1) resident is receiving home health services and one (1) resident is enrolled in hospice care. Postural support physician orders are on file. Half bed rails for mobility assistance were observed in resident beds. A full bed rail was also observed for the resident enrolled in hospice services. Individual Service Plans and Appraisals were not observed in resident files. No residents have prohibited health conditions. Per California Code of Regulations, Title 22, deficiencies were cited. Exit interview was conducted with Administrator Laurie Gallegos. A copy of the report and appeal rights were issued.the state’s words, verbatim · CDSS document, Jan 30, 2024