Lafayette Care Home

Type of visit: Required - 1 Year

On 07/20/2026 at 11:30 AM, Licensing Program Analysts (LPA) David Doidge arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator Linda Li Kurihara and explained the purpose of the visit. LPA toured the facility including, but not limited to, bedrooms, bathrooms, activity rooms, kitchen, and common area. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 72 degrees Fahrenheit. The hot water temperature in a common bathroom was measured at 105 degrees Fahrenheit. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medications, sharps are locked and inaccessible to residents in care. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last purchased on 06/30/2026. Emergency disaster drills are conducted quarterly with the last one conducted on 06/01/2026. First aid kit was observed to be complete. LPA reviewed four (4) resident records and three (3) staff records, all were complete. No deficiencies observed or cited during this visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 20, 2026

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Delmundo conducted a case management to ensure the health and safety of residents as a result of the Department receiving a Priority 2 complaint (Complaint Control # 15-AS-20260622132459). Upon arrival to the facility and review of records and conducting inspection, LPA observed and learned the following: staff (S1) left the facility at around 4:15 pm with only S1's friend (F1) at the facility with the four residents. F1 is not fingerprinted and stated she does not work at the facility. S1 arrived at 5:10 pm and Linda Kurihara, administrator (ADM) at 5:20 pm. unlocked kitchen cabinet where medications are stored. medication out in the open in the formal dining room. unlocked kitchen cabinet where cleaning supplies are kept. unlocked kitchen drawer where sharps are stored and knife in the dish drainer. unlocked cabinet in the bathroom where including but not limited to the following were stored: Drano clog remover; insect killer; shower and mirror glass cleaner; Ajax cleanser; Pledge spray. resident's (R1) was placed on hospice care on February 20, 2026 but R1's LIC625 Appraisal/Needs and Services not updated. LIC625 on file was dated February 20, 2020. R1 sustained bruises but ADM stated she did not submit LIC624 Unusual Incident Report, ....continued on 809C CONTINUED FROM PAGE 1: Deficiencies are cited from Title 22 California Code of Regulations, and listed on 809Ds. A $500.00 civil penalty is assessed for deficiency section 1569.312(a). Failure to submit proof of corrections by plan of correction due dates and any repeat violation within 12 month period may result in additional civil penalties. Deficiencies, plan and proof of corrections and civil penalty were with the administrator (ADM). Exit interview conducted. Appeal Rights, LIC421IM Civil Penalty Assessment, LIC9098 Proof of Correction form, and copy of this report provided.the state’s words, verbatim · CDSS document, Jun 25, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 1569.312(a) · Plan of correction due date: Jun 26, 2026

§1569.312 Basic services requirements: Every facility required to be licensed under this chapter shall provide at least the following basic services: (a) Care and supervision as defined in Section 1569.2. -This requirement is not met as evidenced by: -Based on observation and interviews, the licensee did not comply with the section above when the staff left the residents which posed an immediate health, safety and/or personal rights risks to persons in care,the state’s words, verbatim · CDSS document, Jun 25, 2026

Plan of correction: Administrator to in-service the staff and ensure there's always staff with the residents. Proof to be submitted by 6/26/26. A $500.00 civil penalty is assessed.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87309(a) · Plan of correction due date: Jun 26, 2026

87309 Storage Space and Access (a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage... ....and are not left unattended if outside the locked storage. -This requirement is not met as evidenced by; -Based on observation, the licensee did not comply with the section above in unlocked cabinets & drawers where cleaning supplies and sharps were kept & knife in the dish drainer.the state’s words, verbatim · CDSS document, Jun 25, 2026

Plan of correction: Staff locked the knife and cabinets. In addition, administrator to in-service the staff and submit copy of training topic with attendees signatures by 6/26/26.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(2) · Plan of correction due date: Jun 26, 2026

87465 Incidental Medical and Dental Care: (h) The following requirements shall apply to medications which are centrally stored:(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored.... .. medication. -This requirement is not met as evidenced by: -Based on observation, the licensee did not comply with the section above in unlocked central storage for medication and medication in the formal dining area which posed an immediate health and/or personal right risks to persons in care,the state’s words, verbatim · CDSS document, Jun 25, 2026

Plan of correction: Staff locked the cabinet. In addition, administrator to in-service the staff and submit copy of training topic with attendees signatures by 6/26/26.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1) · Plan of correction due date: Jul 9, 2026

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... -This requirement was not met as evidenced by: -Based on interview, the licensee did not comply with the section above when report was not submitted when R1 was observed with bruises.the state’s words, verbatim · CDSS document, Jun 25, 2026

Plan of correction: Resident is no longer at the facility. Administrator to do the following and submit proof by 7/09/26: 1. Read the Regulations and submit self-certifcation of understanding of timely reporting. 2. Submit LIC624

From the deficiency page — Deficiency type: Type B · Section cited: CCR87463(a) · Plan of correction due date: Jul 9, 2026

87463 Reappraisals: (a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions,... ... and to keep the appraisal accurate. -This requirement was not met as evidenced by: -Based on record review and interview, the licensee did not comply with the section above in not updating R1's LIC625 which posed a potential health, safety and/or personal rights risks to person in care,the state’s words, verbatim · CDSS document, Jun 25, 2026

Plan of correction: Resident is no longer at the facility. Administrator tp read the Regulations and submit self-certifcation of understanding by 7/09/26.

Type of visit: Required - 1 Year

On 07/09/2025 at 1:40 PM, Licensing Program Analysts (LPAs) David Doidge and Andrew Christy arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Administrator, Linda Li Kurihara and explained the purpose of the visit. Administrator had an appointment and left. LPAs finished tour with Caregiver Yuxiang (June) Guo LPAs toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 118.3 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 07/03/2025. Emergency Disaster Plan was last posted on 04/25/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 04/25/2025. LPAs reviewed five (5) residents records and five (5) staff records. No staff had current 1st Aid/CPRAED training. LPAs observed the following deficiencies: At 2:10 while doing staff file reviews, LPAs observed no staff had current CPR training. At 4:00 PM LPAs observed rodent droppings in both the living room and on the front porch. Continued on LIC809C. Continued from LIC809 The deficiency were observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted and a copy of this report and appeal rights provided.the state’s words, verbatim · CDSS document, Jul 9, 2025

Type of visit: Required - 1 Year

On 08/30/2024 at 11:55 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Linda Li Kurihara and explained the purpose of the visit. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 108 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 08/28/2024. Emergency Disaster Plan was last posted on 03/1/2018. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 01/06/2024. LPA reviewed 6 residents records and 5 staff records; all were complete. LPA also reviewed residents medications. As part of the annual inspection, the following documents were reviewed: LIC 500 Personnel Report, LIC 610E Emergency Disaster Plan, Liability Insurance, Current Administrator’s Certificate, and Infection control plan. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 30, 2024