Mission Carehome North

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Janet Ngallo conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted by, identified themselves to and discussed the purpose of the visit with Caregiver Gisela Radoc. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, of which one (1) may be bedridden. Hospice waiver for three (3). During today’s inspection there were five (5) residents in care with one (1) bedridden and two (2) residents on hospice. Licensee Alexander Limpin arrived later during the visit. LPA with Caregiver Radoc toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Hot water temperatures for both bathrooms were in compliance at 105 F and 120 F. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Licensee Limpin, no firearms or ammunition are kept at the facility. (Cont. on LIC 809-C) (Cont. from LIC 809) Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. During the facility tour, LPA observed medications being stored in plastic containers with different sections for morning, noon, evening, and bed time. An interview with Staff #1 (S1) revealed that S1 transfers medications into the corresponding time residents are suppose to receive their medication. These medications were not stored in the original medication packages. LPA explained to the licensee that medications must not be transferred into different containers in this way and in accordance with licensing guidelines must stay in their original packaging. A deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D page). A Plan of Correction was jointly developed with the Licensee. An exit interview was conducted with Licensee Limpin to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Nov 4, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted by, identified themselves to and discussed the purpose of the visit with Caregiver Linda Alforque. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, of which one (1) may be bedridden. Hospice waiver for three (3). During today’s inspection there were five (5) residents in care with one (1) bedridden and two (2) residents on hospice. Licensee Alexander Limpin arrived later during the visit. LPA with Caregiver Alforque toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Licensee Limpin, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Licensee Limpin to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Nov 14, 2024

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Daniel Pena and Mark Mandel conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPAs were welcomed by, identified themselves to, and discussed the purpose of the visit with Caregiver Juliet Remulla. LPAs then met with Alex Limpkin, Manager, who arrived later during the visit. According to the facility’s license, the facility has a maximum capacity of six (6) residents, age range 60 and over six (6) non-ambulatory of which, one (1) may be bedridden. Hospice waiver for three (3). On day of visit, there were two residents on Hospice. During today’s inspection, there were a total of four (4) clients in care, of which two (2) were non-ambulatory, and none were bedridden. These non-ambulatory clients were each assigned to bedrooms which had french glass doors leading directly outside, consistent with the facility sketch. The facility sketch was accurate to the current layout of the facility. This facility does not feature a secured perimeter or delayed egress doors. Required licensing postings were observed in visible areas of the facility. LPAs, accompanied by licensee’s staff, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens, and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was comfortable. LPAs observed via measurement with a thermometer device that hot water temperature at taps accessible to clients were compliant: Kitchen was 112.7 and resident bathroom was 113.6. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. Medications were labeled, as required, and secured. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. No pools or bodies of water were observed on the premises. Per the licensee, no firearms or ammunition are kept at the facility. LPAs interviewed staff and clients, and reviewed staff and client records/files. The interviews did not raise any licensing concerns. No deficiencies were cited during today’s visit. An exit interview was conducted with Mr. Limpkin and a copy of this report, along with the Licensee Rights (LIC 9058 FAS 01/16) were provided to Mr. Limpkin.the state’s words, verbatim · CDSS document, Nov 29, 2023

Allegation investigated: Licensee did not administer medication as prescribed. Licensee took residents personal property

Licensing Program Analyst (LPA) Iby Strong made an unannounced visit to open an investigation on the above mentioned allegations. LPA identified herself and disclosed the purpose of her visit. LPA met withCaregiver Corona Dumaguing and discussed the basic elements of the complaint. Caregiver Linda Alforque arrived shortly after. According to allegations, Resident 1 (R1) did not get medication issued as prescribed and R1's personal items were taken from them. During the visit, LPA Strong was able to establish that Resident 1 (R1) is not and was not a resident of this facility. Therefore the complaint is unfounded. An exit interview was conducted and a copy of Licensee's Rights (LIC 9058 03/22) along with a copy of this report was provided to Caregiver Linda Alforque. Unfoundedthe state’s words, verbatim · CDSS document, Nov 1, 2023 · control 08-AS-20231023143501