Memory Lane Elderly Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Flavia Borduz, Administrator/ Licensere. During today’s visit, LPA met with Flavia and Gheorghe Borduz, Licensees. The facility is a six bedroom, three bathroom single story home with an approved fire clearance of five non-ambulatory, one bedridden with a hospice waiver of two. The facility currently has a census of no residents in care. During today’s visit, LPA toured the facility and inspected all smoke detectors, testing hot water temperature in two of two resident bathrooms. The hot water temperature measured between 107.0 to 107.7 degrees Fahrenheit and all smoke and carbon monoxide detectors were operational. The fire extinguisher is charged and was serviced on February 8, 2025. LPA reviewed the Emergency Disaster Plan which is current. LPA toured the kitchen and inspected the food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA did not review medications since there are no residents in care. A First Aid Kit had all of the required elements. LPA observed the PUB 475, See Something, Say Something sign in the hallway. Currently the liability insurance has lapsed since there have not been residents in care for almost two years. Licensee will notify the Department when they decide to accept new residents and will show proof of current liability insurance at that time. Currently the facility does not plan to accept residents in the near future but does not wish to close. (Continued on LIC 809-C) (Continued from LIC 809) LPA toured the exterior of the property and observed a shaded seating area. Temporary rain gutters were installed during the rainy weather but are removed after the rain. There is ample space for activities and various fruit trees in the yard. LPA reviewed two of two staff training and fingerprint records and staff training is current. Licensing fees are current and licensees updated the facility phone numbers. LPA confirmed that administrator has a current administrator certificate which expires on September 17, 2027. Based on the observations made during today’s visit, the facility appears to be in compliance with Title 22 Division 6 of the California Code of Regulations, no deficiencies cited on this date. An exit interview was conducted with Flavia Borduz, Licensee.and a copy of the report was given at the time of the visit.the state’s words, verbatim · CDSS document, Feb 17, 2026

The state marks this report as 5 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 Analysts (LPAs) Rose Ruppert and Hanna Gough are conducting this unannounced visit to complete the required annual inspection. LPAs arrived at the facility and were greeted and granted entry by staff. LPAs met with Gheorghe Borduz, Licensee, and explained the nature of the visit. The Facility is a single story home with six bedrooms with three resident bedrooms, four bathrooms, with two of the bathrooms for residents. The resident quarters also has a living room and a dining room. The licensee resides on the premises and has three bedrooms, a living room, 2 bathrooms, and the kitchen all divided by doors that can lock. The garage is attached with the entrance being inaccessible to residents. The facility currently has no residents. LPAs toured the facility with the licensee. LPAs observed the See Something, Say Something poster along with the ombudsman poster in the main resident hallway. LPAs toured the kitchen and food storage areas. There is a minimum of seven days of non-perishable foods and two days of perishable foods readily available with an emergency food and water supply stored in the garage. There is additional food stored in the garage refrigerator with all temperatures between regulatory degrees. LPAs inspected that medications are centrally stored in a locked cupboard in the resident hallway. LPAs measured the hot water temperature which measured between 107.9 and 108.8 degrees Fahrenheit. All bathrooms were observed to have a supply of soap, toilet paper and paper towels. LPAs observed that toxic chemicals, cleaning solutions and disinfectants are stored in the cabinet under the sink and that it is locked. LPAs observed that the facility has a clean supply of linens. (Continued on LIC 809-C) (Continued from LIC 809) LPAs inspected resident bedrooms which had all the required furnishings and components. Fire and carbon monoxide detectors were tested and found to be operational. LPAs toured the outside of the facility and saw a shaded seating area for resident use. LPAs observed games and activities for resident pleasure. LPAs observed a fire extinguisher in the kitchen with a purchase date of May 8, 2024. The last fire drill conducted was on May 25, 2024. LPAs gave a technical violation due to no residents at the facility. LPAs reviewed one of one staff file no discrepancies were observed. All staff present had a criminal record clearance and associated to the facility. This report was reviewed with Licensee Gheorghe Borduz, an exit interview was conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Feb 7, 2025

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

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) Gheorghe Borduz and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 2:00PM, 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 detached garage that is being used for storage. There is a back yard with a patio cover for the residents. LPA and AD observed 2 staff and 1 resident present at the facility. Resident Bedrooms: the 3 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the 3 staff bedroom. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 110 degrees F and 111 in the 2 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 medication cabinet. Toxins: observed locked in the garage. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 3:00PM, LPA reviewed 1 resident file and 3 staff files, interviewed 1 resident and 1 staff, and inspected medications for 1 resident. Facility does not handle resident money. CONTINUED During the inspection, LPA and AD observed the following: based on documents and admission, the licensee did not ensure the facility currently has liability insurance; based on documents, the licensee did not maintain training records for S1 and S2; based on documents, the licensee did not document medication training for S1 and S2; based on documents and admission, the facility has not been conducting emergency disaster drills; and based on observation, the fire extinguisher was purchased in 2021 and has not been certified in the last year. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. 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, May 6, 2024