La Concepcion Residential Care Home

Allegation investigated: Staff inappropriately restrain resident. Staff are not addressing resident's fall risk.

On 07/28/2026 at 8:25 AM, Licensing Program Analyst (LPA) P.Manalo arrived unannounced to conduct the initial 10-day visit and delivered the findings on the above allegations. LPA met with Administrator (ADM), Cristina Concepcion and explained the purpose of the visit. During the visit, LPA interviewed ADM, 2 residents, and 2 staff members. LPA reviewed and obtained the following documents included but not limited to physician report (LIC602A), appraisal needs and services plan (LIC625), preplacement appraisal information (LIC603) dated 07/06/2026, and admission agreement dated 07/06/2026. Allegation: Staff inappropriately restrain resident. Continue to LIC9099-C... Substantiated Continued from LIC9099… Allegation: Staff do not provide activities for residents. It was alleged that staff do not provide activities for residents. During the tour of the facility, LPA observed R2 listening to music on their radio. R2 stated that they like to listen to music and sit on the porch by the door. Interview with R3 stated that R3 likes to watch tv and walk around the backyard. R3 stated that staff will offer things such as Bingo, but R3 will decline because R3 is not interested in it. Interview with ADM, S1, and S2 stated that they will offer activities to residents but sometimes the residents don’t want to do activities. ADM and S2 stated that R1 would be offered to do activities or watch tv in the living room, however, ADM and S2 stated that R1 did not want to do that and would stay in R1’s room. Based on interviews conducted, the above allegation that staff do not provide activities for residents unsubstantiated. 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 allegations are unsubstantiated. Allegation: Staff leave resident in soiled diaper for extended period of time. It was alleged that staff leave resident in soiled diaper for extended period of time. During the visit, R2 stated that when R2 needs to use the bathroom, R2 can ask the staff for help. R2 stated that they do not use the bathroom on their own, and staff will help them. R3 stated that they do not need assistance with using the bathroom and R3 is able to use the bathroom on their own. ADM, S1, and S2 stated that residents will be changed more than 3 times a day and will be changed if residents are wet or has a bowel movement. Based on interviews conducted, the above allegation that staff leave resident in soiled diaper for extended period of time is unsubstantiated. 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 allegations are unsubstantiated. No deficiencies noted. Exit interview conducted and a copy of this report provided. Continued from LIC9099... It was alleged that staff inappropriately restrain resident. ADM stated that because R1 would slide down their bed, ADM placed two big chairs along with R1’s wheelchair in front of R1’s bed to prevent R1 from sliding down. Interview with S1 and S2 stated that sometimes they would place a chair in front of the residents' bed so that it could prevent the residents from falling. During the visit, LPA conducted a tour of the facility and observed a chair on the side of R2’s bed. ADM stated that we put the chair there so that R2 does not fall. R2 stated that R2 thinks that staff put a chair there so R2 does not get up by themselves. Based on interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation that staff inappropriately restrain a resident is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099D. Allegation: Staff are not addressing resident’s fall risk. It was alleged that staff are not addressing resident’s fall risk. ADM stated that R1 has had two falls since the beginning of the month when R1 moved to the facility but did not sustain any bruises or fracture. ADM stated that R1 would slide from their bed and paramedics needed to be contacted for lift support. LPA reviewed R1’s documents and did not observe an Appraisal Needs and Services Plan that addressed R1’s fall risk. LPA reviewed R1’s Preplacement Appraisal Information dated 07/06/2026 in which it did not state R1 being a fall risk. Interview with ADM, S1, and S2 stated that if a resident was a fall risk, staff would put chairs in front of their bed so that residents don't fall. Based on interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation that staff are not addressing resident’s fall risk is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099D. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted with Administrator. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 28, 2026 · control 15-AS-20260723170950

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(4) · Plan of correction due date: Aug 11, 2026

87468.2(a)(4)Additional Personal Rights of Residents in Privately Operated Facilities (4)To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidenced by: Based on observation and interviews, the licensee did not comply with the section cited above by placing chairs in residents room to prevent falls which posed a potential safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 28, 2026

Plan of correction: By POC date, Administrator agrees to contact the residents' physicians to come up with a plan to address the falls. Administrator removed the chairs during today's visit.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87463(b) · Plan of correction due date: Aug 11, 2026

87463(b)Reappraisals (b)The reappraisal shall document significant changes in the resident's physical, mental..functional condition, including those required to be documented as specified in Section 87466, Observation of the Resident. This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not comply with the section cited above when ADM did not address R1's fall risk which posed a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Jul 28, 2026

Plan of correction: By POC date, Administrator agrees to review the regulation and self certify. Administrator agrees to update residents' appraisal when there is a change in condition.

Type of visit: Required - 1 Year

On 03/13/2026 at 9:00 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Cristina Concepcion and explained the purpose of the visit. Administrator certificate is current. LPA toured the facility inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 4 bedrooms are occupied by the residents and 2 bedroom is occupied by staff. There are no bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms is adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 120 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 03/31/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 09/15/2025. At 9:53 AM, LPA reviewed 4 residents records. At 10:21 AM, LPA reviewed 3 staff records and 2 of 3 have current first aid training and 2 of 3 are associated with the facility. At 12:00 PM, LPA reviewed a sample of resident’s medications. Continue to LIC809-C… Continued from LIC809… Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 03/27/2026: LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 9:15 AM, LPA observed knife and scissors unlocked in the kitchen. At 9:22 AM, LPA observed Tylenol, Robitussin, Hydrocortisone Cream, Scissors, etc in R3's room. At 9:30 AM, LPA observed the garage unlocked with disinfectants. At 9:36 AM, LPA observed that one of the side gates is locked with a screw and the other side gate is locked with a screwdriver. At 9:45 AM, record review and observation revealed that the physical plant does not match the approved sketch on file. At 10:59 AM, LPA observed that the residents' files are incomplete such as their Appraisal Needs and Services Plan (LIC625, Identification and Emergency Information (LIC601), and Physician Report (LIC602A) for R3. At 11:13 AM, LPA observed that S2 is not associated with the facility. At 11:19 AM, LPA observed that the staff records are incomplete. S1 is missing First Aid Certification, S2 and S3 are missing Health Screening and TB Test. Continue to LIC809-C... Continued from LIC809-C... At 11:44 AM, LPA observed that R1, R2, and R4 have half bed rails without a doctor's order. At 12:05 PM, record review revealed that for R1 there is no discontinued order for the Melatonin and doctor’s order for sodium, docusate sodium, smartrx, blood sugar monitoring, etc. At 12:26 PM, record review revealed that the facility has not conducted a fire drill since September 15, 2025. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties.the state’s words, verbatim · CDSS document, Mar 13, 2026

The state marks this report as 12 pages; the online copy we transcribed has 8. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

On 05/28/2025 at 3:05 PM, Licensing Program Analysts (LPAs) P.Manalo and L. Fontanilla arrived unannounced to conduct a case management visit. LPAs met with Administrator, Cristina Concepcion, and explained the purpose of the visit. The facility sent an updated Physician's Report for Resident 1 (R1) on 04/11/2025 which indicated that R1 was bed bound. Medical assessment also indicates R1 is non ambulatory. Based on interview conducted with the Administrator, R1 is unable to turn from side to side independently. Staff need to reposition R1. Administrator added that R1 has been bedridden since the time R1 was admitted to the facility. The facility's fire clearance is approved for four (4) may be non ambulatory. Deficiency is cited per Title 22 California Code of Regulations (refer to Lic 809D). Civil penalty of $500 is being assessed for today's visit. Exit interview was conducted with the Administrator. Appeal Rights and a copy of this report were provided.the state’s words, verbatim · CDSS document, May 28, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87606(c) · Plan of correction due date: May 29, 2025

87606(c) Care of Bedridden ResidentsTo accept or retain a person who is bedridden...a licensee shall obtain and maintain an appropriate fire clearance as specified in Section 87202, Fire Clearance. This requirement is not met as evidenced by: Based on interview and record review, the facility admitted a bed bound resident without an approved fire clearance which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, May 28, 2025

Plan of correction: Within 24 hours, the Administrator will notify the local fire department about the bedridden resident and send proof to CCLD. Then, the facility will send the LIC200 and the updated facility sketch by 06/18/2025 to apply for a bedridden fire clearance.

Type of visit: Required - 1 Year

On 03/07/2025 at 11:30 AM, Licensing Program Analysts (LPAs) P. Manalo and L. Fontanilla arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Administrator, Cristina Concepcion, and explained the purpose of the visit. Administrator certificate is current and expires on 12/10/2026. The facility’s fire clearance was approved for only four (4) may be non-ambulatory and hospice waiver of three (3) . LPAs toured facility with Administrator inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 4 bedrooms are occupied by the residents and 2 bedroom is occupied by staff. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the resident's bathroom was measured at 129.1 degrees Fahrenheit. Both residents’ bathrooms are equipped with grab bars, non-skid mats, and non-skid shower pans. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 03/25/2024. First aid kit was observed to be complete. At 12:16 PM, LPAs reviewed 4 residents records. At 12:42 PM, LPA reviewed 4 staff records. At 2:00 PM, LPA reviewed two sample of residents' medications. Continue to LIC809-C... Continue from LIC809... THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 11:50 AM, LPA observed the hot water temperature measured at 129.1 degrees Fahrenheit. At 12:02 PM, LPA observed oxygen tanks, portable oxygen machine, crutches, commode, bbq pit, etc in the backyard that needs to be removed. At 12:04 PM, LPA observed that the self closing latch was tied with the string to keep it locked. At 12:15 PM, LPA observed a knife in one of the kitchen drawers. At 1:12 PM, LPA observed that 24 have incomplete staff files in record. At 1:13 PM, LPA observed the Emergency Disaster Plan incomplete and not filled out. At 1:24 PM, LPA observed that S4 did not have a TB test on file. At 1:30 PM, during record review, LPA observed no drills conducted. At 1:32 PM, LPA observed that S2 to S4 does not have a First Aid Certification. At 1:33 PM, LPA did not observe a complaint poster. At 1:42 PM, LPA observed that S4 was not associated to the facility. At 1:44 PM, LPA observed that R2 and R4 have half bed rail and did not have doctor's order on file. At 1:45 PM, LPA observed that R3 have full bed rails. At 1:47 PM, LPA observed that R1 to R4's files was incomplete on file. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Civil Penalties Assessed for today's visit. Exit interview conducted with Licensee. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Mar 7, 2025

The state marks this report as 12 pages; the online copy we transcribed has 11. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct annual required inspection and met with Administrator Cristina Concepcion. LPA explained to the Administrator the purpose of the visit. During the visit, LPA inspected the facility inside and out including but not limited to resident rooms, bathrooms, kitchen, dining, garage and backyard. Hot water measured at 138.5 Fahrenheit. There was sufficient supply of perishable and non perishable foods. LPA observed sufficient supply of warm blankets, sheets and towels available for use of the residents. Smoke detectors and carbon monoxide were tested and observed functional. First aid kit was observed to be complete. LPA reviewed 2 resident and 2 staff files. LPA interviewed 2 staff and one resident. The following deficiencies were observed: hot water measured at 135 degrees Fahrenheit Both staff on duty did not have any first aid training window screen/screen door observed taped and with holes no proof of staff training on file unused equipment, commodes, wood planks, etc were observed on the side fire extinguisher was last inspected on 7/8/2021 R2 has dementia and last medical assessment was made in 2022 missing staff and resident records were observed S2 does not have TB test and health screening on file The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code. Failure to correct deficiencies by POC date may result in additional Civil Penalties.the state’s words, verbatim · CDSS document, Mar 20, 2024

The state marks this report as 16 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.