L & S Gentle Care

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst arrived unannounced to complete a required Annual Continuation. LPA was greeted by Staff Designee/Caregiver Luz Torres. LPA reviewed all 5 resident records. All required documentation was present. LPA reviewed 3 staff records. All required documentation was present. Training records not in file but completed for one staff., Admin to send to LPA certificates. LPA conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. Centrally Stored Medication Log up to date. No deficiencies Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility Liability Insurance No deficiencies given in today's visit. Report read with Designee. Printer malfunction, LPA to send copy of report to Admin. Exit interview conducted.the state’s words, verbatim · CDSS document, Sep 17, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Contreras arrived unannounced to conduct a required annual inspection visit. LPA was greeted by caregiver Luz Torres . Facility is a Residential Care Facility for the Elderly that has a fire clearance approved for six residents. There are currently 5 residents in care. LPA and staff toured the building and grounds which was found to be clean and in good repair. Facility was clean and at a comfortable temperature. LPA observed all walkways and exits to be unobstructed. All required postings were in a highly visible area. Fire extinguishers were charged and last inspected 7/01/2026. Fire alarms and carbon monoxide detector were tested and operational. Outdoor emergency exit clear from obstruction. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable foods. Facility kitchen, refrigerators and freezers were clean, and food was stored properly with expiration dates noted. Toxins are stored in a locked cabinet and inaccessible to residents. Sharps and knives were locked in kitchen drawer. Emergency water and food supply was stored in garage. Facility had an ample supply of linens, towels and extra hygiene products for residents. All bedrooms were equipped with lighting, a night stand and chest of drawers. All bedrooms were clean and in good repair. Resident bathroom had required bath mat and grab bar. Water temperature measured within the allowable range of 105 to 120 degrees F per Title 22. Disaster drills are conducted quarterly. LPA will return to complete visit at another date. No deficiencies or advisories given during today's visit. Exit interview conducted and report given to staff.the state’s words, verbatim · CDSS document, Sep 10, 2026

Type of visit: Required - 1 Year

At approximately 12:15 PM Licensing Program Analyst (LPA) Contreras conducted an unannounced Annual Required inspection to this facility and met with administrator Imelda Padama. Facility is a Residential Care Facility for the Elderly that has a fire clearance approved for two ambulatory residents, 3 non ambulatory and 1 bedridden with an approved hospice waiver for 2. LPA toured the building and grounds which was found to be clean and in good repair. Facility was clean and at a comfortable temperature. LPA observed all walkways and exits to be unobstructed. All required postings were in a highly visible area. Fire extinguishers were charged and last inspected 6/30/2025. Fire alarms and carbon monoxide detector were tested and operational. Disaster drills are conducted quarterly with the last drill conducted on 6/22/2025. All signal systems were operational. Outdoor emergency exit clear from obstruction. LPA observed there to not be at least a 2 day supply of perishable food enough for 5 residents. It was observed there to be a 7 day supply of non-perishable foods. Admin stated grocery food shopping is done every Thursday or Friday of the week. Facility kitchen, refrigerators and freezers were clean, and food was stored properly with expiration dates noted. Toxins and chemicals were locked and inaccessible to residents. Sharps and knives were locked in kitchen drawer. Emergency water and food supply was stored in garage. Facility had an ample supply of linens, towels and extra hygiene products for residents. All bedrooms were equipped with lighting, a night stand and chest of drawers. All bedrooms were clean and in good repair. Resident bathroom had required bath mat and grab bar. Continued onto 809C.... Continued from 809... Water temperature in sinks accessible to residents in care measured at 139.3, 139.2 and 137.8 degrees Fahrenheit which is not within the allowable range of 105 to 120 degrees F. Signs observed stating water will get above 125 degrees however, faucets used for personal care such as shaving and grooming of the residents including dementia residents in care was not measured within regulation. LPA reviewed 5 of 5 resident records. All required documentation was present. Physician reports were up to date. LPA reviewed 4 staff records. All required documentation was present. LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. No deficiencies Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308-Designation of Responsibility Liability Insurance Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Administrator. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Administrator left facility and report given to Designee Luz Torres. Exit interview conducted.the state’s words, verbatim · CDSS document, Aug 28, 2025

Type of visit: Required - 1 Year

On 10/11/2024, Licensing Program Analyst (LPA) Jill Nakagawa, arrived at the facility unannounced to conduct a 1-Year Required Annual Inspection. LPA met with Assistant Director Imelda Padama and explained the purpose of the visit. There were six (6) residents and two (2) caregivers at the time of inspection. LPA Nakagawa and Assistant Director toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, and common restrooms. LPA observed the facility to be clean, in good repair and odor-free. Each bathroom to have the necessary grab bars, non-skid flooring or shower chair, paper towels and hand soap. LPA observed each bedroom to have the necessary furnishings with working lights and windows with screens. Facility has a 2-day perishable and a 7-day non-perishable amount of food and sharps to be locked. Hot water temperature was measured within the required range. LPA observed 2 fire extinguishers, fire detectors, and carbon monoxide detectors throughout out the facility. LPA observed the first aid kit to be complete and ready for use. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA reviewed a total of five (5) residents' files and five (5) staff files which contained all the required documentation. Several topics were discussed. LPA requested: LIC500, Proof of Liability Insurance No deficiencies are being cited as a result of today’s inspection. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Oct 11, 2024

Allegation investigated: Staff did not ensure assistance was provided to resident in care Staff was asleep while at work Staff dispensed medication not as prescribed to resident in care Staff financially abused resident in care

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at L & S Gentle Care for the purpose of delivering complaint findings. LPA was greeted at the door by Caregiver, Luzviminda Torress. LPA was granted access into the facility. During the course of the investigation, LPA interviewed all residents in care and staff. In addition, LPA made observations of the Medication Administration Record (MAR) for Resident #1. Complaint alleges that staff did not ensure assistance was provided to resident in care. Based on interviews that were conducted with residents and staff, LPA could not corroborate the allegation. In addition, there were inconsistent information during interviewing. (Report continued on LIC 9099C) Unsubstantiated However, during an observation of documents, LPA observed that a FaceTime still photo was taken that depicted a Personal Rights violation. LPA learned that the facility was made aware about this incident in early October 2023 and failed to report to the Department of Social Services-Community Care Licensing Division (See LIC 809-Case Management-Deficiencies dated for November 21, 2023). Complaint alleges that staff was asleep while at work. Based on interviews that were conducted, LPA could not corroborate the allegation. Furthermore, LPA reviewed a photo that provided no additional details into the time, date and place that the alleged caregiver was sleeping. LPA observed the staff schedule for the alleged caregiver, and learned that the alleged caregiver does not work night shift at the facility. Complaint alleges that Staff dispensed medication not as prescribed to resident in care. Based on interviews conducted and observation, LPA could not corroborate the allegation. Furthermore, LPA reviewed the Medication Administration Record (MAR) for Resident #1 on November 7, 2023 and found no concerns during the MAR review. Complaint alleges that Staff financially abused resident in care. Based on interviews that were conducted, LPA could not corroborate the allegation. Residents were interviewed which yielded no additional supporting information. Furthermore, LPA received inconsistent statements during interviewing. A finding that the complaint allegation of Staff did not ensure assistance was provided to resident in care, Staff was asleep while at work, Staff dispensed medication not as prescribed to resident in care, Staff financially abused resident in care are unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview was conducted and a copy of this was report was signed and given to Caregiver, Luzviminda Torress.the state’s words, verbatim · CDSS document, Nov 21, 2023 · control 21-AS-20231101142046

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at L & S Gentle Care for the purpose of conducting a Case Management-Deficiencies inspection. LPA was greeted at the door by Caregiver, Luzviminda Torress. LPA was granted access into the facility. During the dates of November 7, 2023, November 17, 2023 and today, November 21, 2023, LPA observed that the Administrator and facility manager was not present and the only time that they made themselves available in-person was on November 17, 2023 (See LIC 9102-Technical Violation). During the course of an investigation that was initiated on November 7, 2023, LPA observed/reviewed photos of a FaceTime still photo that was taken when the resident was getting changed which is a Personal Rights violation (See LIC 809D). LPA conducted an interview with the alleged Caregiver (See LIC 812-Interview-Caregiver #2 dated for November 17, 2023). During the interview on November 17, 2023 at approximately 11:21 AM, Caregiver acknowledged that it was her in the photo and alleged that "someone set her up, and that a former caregiver was up on the small table taking that photo." While conducting an additional interview with the Assistant Facility Manager, (See LIC 812-Interview-Assistant Facility Manager dated for November 17, 2023) LPA learned that the facility was made aware about this incident in early October 2023 and failed to report to the Department of Social Services-Community Care Licensing Division (See LIC 809D). Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview was conducted, and a copy of this report was signed and given to Caregiver, Luzviminda Torress.the state’s words, verbatim · CDSS document, Nov 21, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(2) · Plan of correction due date: Nov 27, 2023

87468.1 Personal Rights of Residents in All Facilities: (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by: Based on an observation/review, LPA observed/reviewed photos of a FaceTime still photo that was taken when the resident was getting changed which is an immediate health, safety and personal rights risk to the residents in carethe state’s words, verbatim · CDSS document, Nov 21, 2023

Plan of correction: Licensee shall submit a an LIC 9098 understanding the regulation. Licensee shall submit a Plan for Future Compliance and how this plan will be implemented. Licensee shall retrain ALL staff that provide Care and Supervision regarding Personal Rights. Plan of Correction due on November 27, 2023.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87211(a)(1)(d) · Plan of correction due date: Nov 22, 2023

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement was not met as evidenced by: LPA learned that the facility was made aware about the incident in early October 2023 and failed to report to the Department of Social Services-Community Care Licensing Division which presents an immediate health, safety and personal rights risk to the residents in care.the state’s words, verbatim · CDSS document, Nov 21, 2023

Plan of correction: Licensee shall submit a an LIC 9098 understanding the regulation. Licensee shall submit a Plan for Future Compliance and how this plan will be implemented. Licensee shall retrain ALL staff that provide Care and Supervision regarding Reporting Requirements. Plan of Correction due on November 27, 2023.