Las Palmas Home Care

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Martha Serna and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 3:00PM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 6-bedroom, 4-bathroom, one-story house with an attached garage that is used for storage. There is a back yard with a patio cover for the residents. LPA observed 1 staff and 5 residents present at the facility in addition to AD. Resident Bedrooms: the 5 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the 1 staff bedroom. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested 118 degrees F in the 3 resident bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the laundry room and garage. Medication cabinet: observed to be locked, after corrections. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees have been paid. At about 12:30PM, LPA reviewed 5 resident files and 5 staff files, interviewed 2 residents and 2 staff, and inspected medications for 5 residents. Facility does not handle resident money. During the inspection, LPA and AD observed the following: based on observation, the medication cabinet lock was not functioning leaving medications accessible; based on documents, R2's physician's report does not document a TB test and there is no other documentation of a TB test in R2's file; based on documents, the facility's emergency disaster drill logs show drills conducted every 6 months and not quarterly as required. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Civil penalties for repeat violations are being assessed. See LIC421FC. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, Jul 6, 2026

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On July 11, 2025, at 10:15 AM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator Martha Serna and explained the purpose of the visit. The facility is licensed to operate for six (6) non-ambulatory, of which one (1) can be bedridden and has a hospice waiver for six (6) residents. The facility is a single-story building located in a residential neighborhood. It consists of the following: five (5) residents bedrooms, one (1) staff bedroom, four (4) bathrooms, an attached 3-car garage, living area, outdoor pool, dining area, kitchen, and an outdoor covered seating area. LPA Kim toured inside and outside of the physical plant. The outdoor pool is fenced and inaccessible. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident room 1, resident room 2, resident room 3, resident room 4, and resident room 5. Bathrooms were found to be clean and operational. The water temperature measured between 107.7 degrees F and 128.8 degrees F. A comfortable temperature of 74 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, residents, and sanitizing stations in common areas. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, emergency water and emergency supplies are stored in the garage. All mandated inspection control posters were posted. The facility has smoke detectors and carbon monoxide detectors that were operable. The Certificate of Liability Insurance is effective from June 20, 2025, to June 20, 2026. The facility has not conducted any Fire/Safety Drills. One (1) fire extinguisher was mounted in the kitchen. A working telephone (714-773-0055) remains available. First Aid Kit contained all the necessary elements. LPA Kim conducted an audit of six (6) residents (R1-R6) files, and four (4) staff (S1-S4) personnel files, and medication and medication administration records. S1 was missing a LIC503 that was filled out. LPA conducted interviews for two (2) resident interviews and one (1) staff interview. Based on today’s visit, deficiencies are being cited as per Title 22 Division 6 Chapter 8 of California Code of Regulations (CCR). LPA observed the water temperature in shared resident bathroom measured at 126.5 degrees F and the resident room #5 private bathroom measured at 128.8 degrees F. An exit interview was conducted, and a copy of this report, appeal rights, and LIC811 were provided to Administrator Martha Serna.the state’s words, verbatim · CDSS document, Jul 11, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Administrator Martha Serna and explained the reason for the visit. LPA and the Administrator toured the facility. LPA observed the PUB 475 poster was posted in the entry way of the facility but was 8 1/2 by 11 inches. The facility is a single story house with 6 bedrooms, living room, dining room, kitchen, laundry room, 4 bathrooms and an attached 3 car garage. The garage is used for storage and kept locked. LPA observed the fire extinguisher in the kitchen is fully charged. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. LPA observed the knives and cleaning supplies are kept in the kitchen inaccessible to residents secured under the sink and in a kitchen drawer. LPA observed a seating area in the living room for residents to have visitors or to watch TV. The fireplace in the living is screened. LPA and the administrator toured the resident bedrooms. There are 6 bedrooms, 1 is for staff the rest are for residents. 1 of the resident bedrooms (the master bedrooms) can be shared. LPA observed all residents rooms had the required furnishings and bed linens. LPA observed all 4 bathrooms are clean and operational. How water measured between 105.0 degrees Fahrenheit and 108.1 degrees Fahrenheit. The smoke detectors/carbon monoxide detector tested operational. LPA and the Administrator toured the backyard. LPA observed there is a pool in the backyard. The patio area is fenced which makes the pool inaccessible to anyone in the house. The patio has a shaded seated area for the resident. The exit gate is operational. No obstacles or hazards observed in the backyard. The garage is kept locked and used for storage. LPA reviewed 4 resident records, no discrepancies observed. LPA reviewed 4 resident medications, no discrepancies observed. LPA reviewed 2 staff files. LPA observed staff 1 did not have the required 20 hours of annual training. Both staff members had current CPR training. LPA observed the first aid kit not have a current edition first aid manual. Deficiencies are being cited per title 22 Division 6 of the California Code of Regulations on the attached LIC 809D. An exit interview was conducted with the Executive Director and a copy of the report provided along with appeal rights.the state’s words, verbatim · CDSS document, Jul 1, 2024

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.