Lorraine Guest Home

Type of visit: Required - 1 Year

On June 16, 2026, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Administrator Teresita Lozano was contacted and notified about inspection visit. Caregiver Mary Jane Tan was available to assist with the facility inspection. Administrator Teresita Lozano arrived during middle of inspection tour and was able to finish assisting with visit. The facility is licensed for six (6) non-ambulatory residents with approved hospice waiver for two (2) residents. Currently, there is zero (0) residents on Hospice during today’s visit. This is a single story home with a detached garage facility. The facility has Six bedrooms (five private resident rooms and one staff room), dining room, living room, activity den, kitchen and four bathrooms. LPA conducted a tour of the physical plant accompanied by caregivers and the following was observed: Facility has a swimming pool with secured fence on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens and bath towels were available during the visit. Bathrooms were operational with water temperature measured between 105.2 to 111.5 degrees F. A comfortable temperature of 77 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for cleaning chemicals and sharps objects was observed. The kitchen was inspected, and sufficient two day perishable and Seven day non-perishable food was maintained adequately. CONTINUED ON 809C Facility had supply of emergency food and water. Facility has one fire extinguisher which was mounted and fully charged . During the visit, LPA observed screening protocols for visitors and sanitizing stations in common areas and restrooms. LPA observed the facility has supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. A working landline phone was operational. The facility had operational smoke and carbon monoxide detectors in bedrooms and common areas. The facility has current liability insurance on file effective 6/27/2025 – 6/27/2026. A review of five residents (R1-R5) service files and three staff (S1-S3) personnel files was observed. The facility has the current administrator's certification on file for Teresita Lozano # 7000177740 - Expiration 05/22/2027 Based on the observations made during today's visit, a deficiency is being cited as per the Title 22 Division 6 Chapter 2 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator Teresita Lozano.the state’s words, verbatim · CDSS document, Jun 16, 2026

Type of visit: Required - 1 Year

On September 17, 2025, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Administrator Teresita Lozano arrived shortly after and was available to assist with the facility inspection. The facility is licensed for six (6) non-ambulatory Residents with approved Hospice waiver for two. Currently, there is Five (5) Residents present during today’s visit. During today’s visit there was zero (0) residents on hospice. This is a single story with detached garage facility. The facility has six bedrooms (five resident rooms and one staff room), four restrooms, living room, dining room, kitchen and three bathrooms. At around 1:15PM, LPA conducted a tour of the physical plant accompanied by Caregiver, and the following was observed: Facility has pool in backyard with a secured gate. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for resident’s personal belongings was observed. Bed linens, blankets and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 107.9 to 114.6 degrees F. LPA observed the facility to be furnished at the time of the visit. Storage areas for cleaning supplies and sharps objects were stored and not accessible to residents. The kitchen was inspected, and facility has two day perishables and seven day non-perishable food. Facility has supply of emergency food and water. Facility has one fire extinguisher which was charged. CONTINUED ON 809C During the visit, LPA observed the facility has supply of Personal Protective Equipment (PPE). LPA observed First Aid Kit was maintained. The facility had operational smoke and carbon monoxide detectors in bedrooms and common areas. The facility has current liability insurance on file effective 6/27/2025 – 6/27/2026 A review of five Residents (R1-R5) service files and three staff (S1-S3) personnel files was conducted. LPA verified Administration certification on file for Teresita Lozano - Expiration 5/22/2027. A technical Violation was issued during visit. An exit interview was conducted with Administrator Teresita Lozano and a copy of the report was provided.the state’s words, verbatim · CDSS document, Sep 17, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by Staff Maryjane Tan. Administrator (AD) Teresita Lozano arrived shortly after. For today’s visit, LPA observed a total of five residents in care and three staff members on duty. LPA Ramirez toured the interior and exterior portions of the facility with AD Lozano. The facility is a single level structure and is licensed for six non-ambulatory residents, of which two may be on hospice and zero bedridden. There are a total of six bedrooms, of which five are resident bedrooms and one staff bedroom. LPA Ramirez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of four restrooms of which one is for staff and three are for residents. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 108.6-110.8 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located by the dining room. CONTINUED ON LIC809-C.. LPA Ramirez observed the emergency disaster and evacuation plan, which is located by the staff's office. Facility had back-up emergency food and water supply. LPA observed that First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA Ramirez observed a shaded area, patio furniture, and the grounds were free of any hazards. There are two gates in the backyard, which both are self-closing and self-latching. LPA observed a pool which fenced by a five feet height metal fence. LPA reviewed five resident files and two staff files. LPA interviewed residents and staff present. For today's visit deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Lozano. A copy of this report was provided at the time of exitthe state’s words, verbatim · CDSS document, Jun 14, 2024

Allegation investigated: Staff allow resident to continue self-neglect

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegation received on 11/15/23. LPA was greeted and granted entry into the facility and met with Staff Maryjane Tan. LPA explained the reason for the visit. Administrator (AD) Teresita Lozano was notified by staff via telephone. This agency has investigated the complaint alleging that staff allow resident to continue self-neglect. LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent documents. Regarding the allegation, the following was revealed: One of six individuals interviewed confirmed the allegation. During the investigation LPA reviewed documents including the Lorraine Guest Home Appraisal/Needs and Service Plan dated 09/07/21 for Resident 1 (R1). Per Appraisal/Needs and Service Plan the Socialization, Emotional, Mental, Physical/Health and Functioning Skills sections were left blank. Therefore, the facility failed to properly assess R1 prior to admission. CONTINUED ON LIC9099-C... Substantiated Records reviewed by LPA Ramirez included the Unusual Incident/Injury Report (UIIR) dated 09/15/23 for R1. Per UIIR R1 was observed disoriented to reality. Per UIIR dated 10/30/23 R1 was agitated, disoriented, confused, delusional and anxious. Per California Code of Regulation under Reappraisal 87463 (a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident's physical, medical, mental, and social condition. During the investigation LPA reviewed documents including the Physician Report (LIC602A) dated 07/25/22 for R1. Per Physician Report R1 has a diagnosis of Mild Cognitive Impairment and is Able to Manage Own Medications. During the course of the interviews, AD stated that recently the facility began managing R1’s medications. During interviews with R1’s family member it was reported that while moving R1’s belongings that she found opioids and disposed of them. Per R1’s family member she decided to move R1 because she needed a higher level of care. Based on the interviews which were conducted and the records that were reviewed, the preponderance of evidence standard has been met, therefore the following allegation: staff allow resident to continue self-neglect is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D. An exit interview was conducted with staff Tan and a copy of this report along with the Appeal Rights were provided at the time of this visit.the state’s words, verbatim · CDSS document, Feb 16, 2024 · control 22-AS-20231115094434

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87457(c)(1) · Plan of correction due date: Feb 19, 2024

Pre-Admission Appraisal - General (c)Prior to admission a determination of the prospective resident's suitability for admission shall be completed...(1)The appraisal shall include, at a minimum, an evaluation of the prospective resident's functional capabilities, mental condition and an evaluation of social factors...This requirement was not met as evidence by: The facility did not complete a Pre-Admission Agreement prior to R1 being admitted to the facility. Therefore, the facility failed to properly assess R1 prior to admission. This poses an immediate risk to the Health and Safety of residents in care.the state’s words, verbatim · CDSS document, Feb 16, 2024

Plan of correction: Licensee/Administrator agrees to read regulation and sign a statement of understanding and forward proof to LPA by POC due date.

Allegation investigated: Resident's medications were mismanaged while in care

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegation and to deliver the findings of the investigation. LPA was greeted and granted entry into the facility and met with Caregiver Adoracion Torres. LPA explained the reason for the visit. Administrator (AD) Teresita Lozano arrived shortly after. On today’s visit LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent documents. Regarding the allegation, the following was revealed: One of five individuals interviewed corroborated the allegation. During interviews conducted with Resident 1 (R1), R1 reported that the caregivers manage their medications. During interviews conducted with staff, Staff 1 (S1) reported that the AD prepares the medications a day in advance and places it in individual plastic containers. During the investigation LPA reviewed documents including the Physician Report (LIC602A) dated 08/26/2019 for R2 and 12/21/2020 for R3. CONTINUED ON LIC9099-C... Substantiated Per Physician Report R2 and R3 are not Able to Administer Own Prescription Medications. At 12:58 PM LPA toured the facility and observed ready to dispense medication in small labeled plastic pill organizers. Based on the observations, interviews which were conducted and the records that were reviewed, the preponderance of evidence standard has been met, therefore the following allegation: Resident's medications were mismanaged while in care is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D. An exit interview was conducted with AD Lozano and a copy of this report and the Appeal Rights were provided at the time of this visit.the state’s words, verbatim · CDSS document, Nov 21, 2023 · control 22-AS-20231115094434

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(5) · Plan of correction due date: Nov 22, 2023

Incidental Medical and Dental Care: The following requirements shall apply to medications which are centrally stored: Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement is not met as evidence by: Per interviews conducted and LPA's observations, the Administrator prepares the residents' medication a day in advance and places it in small labeled plastic pill organizers. This poses an immediate risk to resident’s health and safety.the state’s words, verbatim · CDSS document, Nov 21, 2023

Plan of correction: Per Licensee/Administrator an in-house training on how to properly manage centrally stored medications will be conducted. Licensee to email POC to LPA by POC due date.

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.