Jasmine's Home Care

Type of visit: Office

An informal conference was held at the Monterey Park Adult and Senior Care Program Regional Office on 06/17/2026. Attendees included: · Fernando Fierros, Licensing Program Manager · Kimberly Ramirez, Licensing Program Analyst · Levita Maghirang, Administrator/Licensee · Lesile Lantano, Administrator Assistant SEE 809-C Continuation Page Purpose: The conference was held to discuss the issues of noncompliance for the past three years. The following regulations were discussed and a copy of the regulations was provided. I. Health and Safety Code 1569.605 Liability insurance; coverage requirements. II. 87468- Personal Rights. III. 87303- Maintenance and Operation. IV. 87309- Storage Space and Access. V. 87465- Incidental Medical and Dental Care. VI. 87412- Personnel Records. VII. 87608- Postural Supports. VIII. 87633- Hospice Care of Terminally ill Residents IX. 87355- Criminal Record Clearance Background: Within the last three years the facility has received one (1) complaint, and this complaint was documented as “Unsubstantiated”, four (4) Type A citations and eight (8) Type B citations were issued. Six (6) out of the eight (8) citations are still outstanding as of 06/17/2026. Conference Discussion: During the conference, the licensee revealed that she updated the facility resident Admissions checklist tool and staffing tool. The licensee revealed that she will utilize these updated checklists when admitting new residents and when hiring new staff. The licensee revealed that the facility maintains a contract with PIH hospital to accept residents that need temporary placement. The licensee was reminded that the facility license is for a Long Term Community, not transitional or temporary housing. The licensee agreed to provide LPA Ramirez with a copy of the contract between PIH and the facility by 06/19/2026. The licensee agreed to draft a plan that acknowledges the licensee shall not operate a facility beyond the conditions and limitations specified on the license, by 06/19/2026. The licensee agreed to send picture proof of corrected citations that are outstanding for 87468(c)(2)(A) & 87506(a) by 06/19/2026. The licensee provided a copy of her current Administrator's Certificate (7033445740) expires on 10/16/2027. Exit interview conducted. A copy of this report was provided.the state’s words, verbatim · CDSS document, Jun 17, 2026

Allegation investigated: Facility staff are not meeting resident diapering needs. Staff do not treat resident with dignity or respect.

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced subsequent complaint investigation visit on 04/14/2026 regarding the above allegations. On 03/12/2026, LPA Ramirez conducted an unannounced initoal complaint investigation and a need further investigation was documented. During today’s visit LPA Ramirez was greeted by Jasmin Del and explained the purpose of the visit. The investigation consisted of the following: LPA Ramirez requested and obtained copies of Resident/Client Roster, Staff#1-3 interview (S1-S3), Resident#1-6 interviews (R1-R6), Interview with R2's familiy, Medical Assessment for residents#1- 6 (R1-R6), and physical plant tour. SEE 9099-c Unsubstantiated The investigation revealed the following: regarding the allegation “Facility staff are not meeting resident diapering needs.” It is alleged the facility staff are not assisting R1 with diapering needs. Three (3) out of the three (3) staff interviewed denied the allegation. Four (4) out of the six (6) residents interviewed denied this allegation. Due to cognitive impairments, R2’s interview was not reliable. Staff interviews revealed that all residents that require assistance with toileting are checked on every 2 hours or sooner if the resident request assistance. S1 revealed that R1 does not require assistance with toileting per their medical assessment. S2 revealed that R1 asks for assistance with toileting and staff assist R1 with toileting. During record review of R1’s medical assessment, LPA observed that per R1’s physician, R1 does not require assistance with toileting, does not suffer from bowel or bladder incontinence. 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. “Staff do not treat resident with dignity or respect.” It is alleged that staff do not treat R1 with dignity or respect. Three (3) out of the three (3) staff interviewed denied the allegation. Four (4) out of the six (6) residents interviewed denied this allegation. Due to cognitive impairments, R2’s interview was not reliable. Resident interviews with R3- R6 revealed that staff treat residents with respect and are professional. During record review of personnel records. LPA did not observe disciplinary records that indicate staff were reprimanded for not treating residents with dignity or respect. Interview with R2’s family revealed that R2’s family is in the facility every day for several hours and they have never heard staff being disrespectful to any residents. R2’s family revealed R1 and R2 are roommates and they have witnessed interactions between R1 and staff and those interactions have always been professional. 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. Exit interview was conducted. A copy of this report was provided.the state’s words, verbatim · CDSS document, Apr 18, 2026 · control 28-AS-20260310082758

Type of visit: Annual/Random

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced annual inspection visit on 04/16/2026 and was greeted by Caregiver Benjamin Aguila. Administrator Levita Maghirang arrived shortly after. 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: LPA Ramirez discovered one (1) accessible 2liter bottle of liquid drain opener, in a unlocked bathroom cabinet. Staff immediately removed the liquid sink drainer and placed them in a location inaccessible to residents. LPA Ramirez observed carbon monoxide detectors and smoke alarms in hallways. LPA Ramirez inspected three (3) resident rooms. LPA did observe Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) near dining room table; however, the poster was not 20" x 26" as required and was not posted in the main entryway of the facility. LPA issued one (1) deficiency based on this observation. All resident bedrooms contained required furniture, linens and lighting. LPA tested/measured faucets in bathroom#1 and #2 to read 144.5 F degrees. LPA Ramirez issued one (1) deficiency based on this observation. LPA Ramirez observed grab bars near toilets and inside shower. LPA Ramirez observed no-slip mat in showers. SEE 809-C 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: personal rights, and nondiscrimination notice. LPA Ramirez observed facility land line. Disaster Preparedness: Administrator Maghirang was unable to provide documentation of emergency drills. LPA will issue one (1) deficiency based on this observation and staff interview. Emergency Disaster Plan was not available when requested. According to Administrator Maghirang, she maintains these documents at her home. LPA will issue one (1) deficiency based on staff interview. LPA Ramirez observed facility sketches with exits and emergency exits routes throughout various locations of the facility. LPA Ramirez observed emergency food supply located in pantry. Residents with Special Needs: No large bodies of water were observed. LPA Ramirez observed R4's bed had full bed rails during inspection. During record review, LPA did not observe documents indicating R4 was receiving hospice care. Interview with staff revealed R4 is no longer on hospice. Based on observations and staff interviews, LPA issued one (1) deficiency. During facility inspection, LPA observed R6 & R7 in a shared room. R6 is currently receiving hospice care. During record review, LPA did not observe a signed statement by R7 indicating their acknowledgment that R6 intends to receive hospice care in the facility for the remainder of R6's life, and the roommate's voluntary agreement to grant access to the shared living space to hospice caregivers, and the resident's support network of family members, friends, clergy, and others. Health Related Services/Incidental Medical Services: The medications are centrally stored in the medication closet and in bubble packs and/or original containers. The facility provides incidental medical services. Staffing: Administrator Certificate for Levita Maghirang is pending renewal. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. SEE 809-C Personnel Records Training: Staff files are maintained at the facility. LPA Ramirez observed required CPR and First Aid for three (3) out of the three (3) personnel record reviewed. LPA Ramirez observed TB testing results, Health screening, fingerprint clearance and job application for three (3) out of the three (3) personnel record reviewed. During personnel record review, LPA did not observe completed documented proof of S1 & S2 annual and initial training. Staff interviews revealed initial & annual training sessions were completed and documented, however, the documented proof was not placed in S1 & S2's files. LPA issued one (1) deficiency based on this observation and staff interview. 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. Operational Requirements: The fire clearance is approved for six (6) non ambulatory residents of which three (3) may be bedridden. The facility may retain four (4) hospice residents. There is currently one (1) resident on hospice care. Resident Records/Incident Reports: During record review, LPA Ramirez observed R7's medical assessment was incomplete and not endorsed by the physician that conducted R7's assessment. LPA Ramirez did not observe a signed original admission agreement for R7. California Code of Regulations, Title 22, eleven (11) deficiencies are being cited. Exit interview was conducted. A copy of this report and appeals rights were providedthe state’s words, verbatim · CDSS document, Apr 16, 2026

Type of visit: Required - 1 Year

On 03/12/2026, LPA Ramirez was conducting a staff record review and it revealed that staff#3 (S3) did not have transfer of criminal clearance in their personnel file. Interview with Administrator Maghirang revealed that S3 worked at another facility and is cleared criminally however, S3 has not been associated with this facility. Interview with S3 revealed that they do have criminal clearance, but they did not submit a request for transfer of criminal clearance record. Based on interviews and records reviewed, LPA will issue one (1) deficiency and will assess a civil penalty of $500. Exit interview was conducted and a copy of this report, 809-D, LIC 421BG, and appeals rights was provided.the state’s words, verbatim · CDSS document, Mar 12, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2)(3) · Plan of correction due date: Mar 13, 2026

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility:(2)Obtain a California clearance or a criminal record exemption as required by the Department or (3)Request a transfer of a criminal record clearance as specified in Section 87355(c). This requirement was not met as evidenced by: S3's personnel record did not have proof of criminal clearance or proof of request of transfer of criminal record clearance.the state’s words, verbatim · CDSS document, Mar 12, 2026

Plan of correction: Administrator Maghirang will submit a plan on when S3's criminal clearance or transfer of criminal record clearance. Plan must be received by 03/13/2026. Administrator Maghirang agreed that S3 will return to the facility once S3's criminal clearance is received in their file.

Type of visit: Required - 1 Year

Licensing Program Analyst(LPA) Nicol Wesley conducted a required 1 year visit with inspection and met with Levita Maghirang. There were (3) residents in care during the time of this visit. The facility phone number is 562 693 9608. The Compliance and Regulatory Enforcement (CARE) tools was used for the visit today. LPA Wesley toured the facility and observed the following: 4 bedrooms, 2 bathrooms, 1 living room, kitchen, laundry area, and a detached garage. Hot water was tested and the temperature measured at 110.4 degrees F. Medications, medication records, and first aid kit with manual will be centrally stored in a locked kitchen cabinet, toxins, detergents, and sharps, are stored in locked cabinets. The smoke detectors/carbon monoxide detectors were tested and are operable. 1 fully charged fire extinguishers(1 in the laundry area). LPA Wesley observed an adequate supply of perishable and non perishable food items. There are no deficiencies cited. LPA Wesley interviewed 1 resident and 1 staff. Exit interview conducted.the state’s words, verbatim · CDSS document, Jun 3, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angelica Rea conducted an unannounced visit for the purpose of conducting the required annual inspection. On today's visit LPA met with Administrator, Levita Maghrang, who allowed entry into the facility and assisted with the visit. LPA and Ms. Maghrang toured the facility inside and out, reviewed food supply, reviewed staff files, reviewed resident files, and reviewed resident medications. Bedrooms have the required furniture including bedframes, dressers, lamps and chairs. Beds have the required linen and the linen is in good condition. Passageways and exits are free of obstruction. The front and backyard are well maintained. The resident bathrooms are clean, and showers have non-skid materials. The hot water temperature measured between 105 degrees F and 120 degrees F in kitchen and bathroom sinks. The facility temperature at the time the visit was comfortable. There is sufficient lighting throughout the facility. There are smoke detectors located throughout the facility, tested and operational. Carbon monoxide detector was also observed, tested and operational. LPA observed a sufficient supply of PPE. Infection control signs were observed throughout the facility. Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview held and a copy of the report were provided to Ms. Maghrang.the state’s words, verbatim · CDSS document, May 28, 2024