Perry's Home Care

Type of visit: POC

On 08/03/26 at 2PM, Licensing Program Analyst (LPA) D Panlilio conducted a case management visit regarding use of audio and camera devices inside residents (R1, R2) bedrooms. At 2:30PM, LPA toured the facility with staff (S1) and observed active cameras and audio devices operating inside R1 and R2's bedrooms. Immediate civil penalty of $250 assessed during visit for repeat violation of Personal Rights Section 87468.1 (a)(1). Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in additional civil penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 3, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Aug 28, 2026

To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by licensee operating inside cameras with audio capability in R1 and R2 bedrooms which posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 3, 2026

Plan of correction: Immediate civil penalty of $250 assessed during visit for repeat violation of Personal Rights Section 87468.1 (a)(1). By POC due date, ADM agrees to complete and submit to CCLD proof of correction that all camera and audio devices in all private areas removed.

Allegation investigated: Licensee has installed cameras that monitors audio

On 08/03/26 at 1:30PM, Licensing Program Analyst (LPA) D Panlilio conducted a subsequent visit and met with administrator (ADM). LPA explained the purpose of the visit with ADM. This is an AMENDMENT of original complaint report dated 07/20/26. Allegation: Licensee has installed cameras that monitors audio Investigation Finding: Substantiated On 07/20/26 at 3:30PM, LPA toured the facility including but not limited to residents’ bedrooms, bathrooms, living room, kitchen and dining areas. LPA observed facility had inside cameras with audio capability in the kitchen, dining, and living room areas. ADM confirmed with LPA that inside cameras had audio capability and agreed to remove them permanently during visit. Based on LPA’s observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) was found to be substantiated. Continued on next page, LIC 9099-C Substantiated Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (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. Appeal Rights and a copy of this report provided. Allegation: Staff did not meet resident's incontinence needs Investigation Finding: Unsubstantiated During investigation, LPA conducted interviews with resident (R1), facility staff (ADM, S1) and reviewed resident (R1) documents. R1's admission agreement showed he was first admitted at the facility on 03/07/26. LPA observed R1 to be coherent, does not wear a diaper and can independently use the toilet when needed using his walker. He ambulates with a walker and has a wheelchair that uses daily. R1 stated that he uses the toilet every 1 1/2 hours and is happy living at the home. R1 stated that he does not wear any diaper during the day and uses the toilet independently every 1 1/2 hours. R1 stated that he is independent with his toileting and personal hygiene. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED. Allegation: Staff prevent resident from accessing bedroom Investigation Finding: Unsubstantiated During investigation, LPA conducted interviews with resident (R1), facility staff (ADM, S1) and reviewed resident (R1) documents. During visit, LPA interviewed R1 who stated that he prefers to relax in his wheelchair or exercise in the back patio during the day. He stated that staff make up his bed if he requests to go back to bed during the day. He stated that staff does not prevent him from accessing his bedroom. Staff denied preventing R1 in using his bedroom and bed during the day. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED. Continued on next page, LIC 9099-C pg2 Allegation: Staff do not ensure sheets are readily available to resident Investigation Finding: Unsubstantiated During investigation, LPA conducted interviews with resident (R1), facility staff (ADM, S1) and reviewed resident (R1) documents. ADM stated that R1's beddings (mattress pad and linens) are cleaned, aired out and sanitized daily because he poops and urinates in his diapers during the night which leaks onto the beddings. During visit, LPA interviewed R1 who stated that staff make up his bed if he requests to go back to bed during the day and that his bed is always clean and odor free. Staff stated that they prepare his mattress with covers, pads and ensures sheets readily available to R1 at all times. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 20, 2026 · control 15-AS-20260716113337

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Jul 20, 2026

To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by video cameras with audio being used in the living, dining, kitchen and hallway areas. which posed a potential health & safely risk to residents in care.the state’s words, verbatim · CDSS document, Jul 20, 2026

Plan of correction: Deficiency corrected during visit. ADM permanently removed all video cameras in the living, dining, kitchen and hallway areas.

Type of visit: Required - 1 Year

On at 11:45AM, Licensing Program Analyst (LPA) Andrew Christy arrived unannounced to conduct the 1-Year Annual Required inspection. LPA met with Administrator, Jason Perry, and explained the purpose of the visit. The facility currently houses five (5) residents with a max capacity of six (6) residents. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. No bodies of water were observed. A comfortable indoor temperature is maintained at 71.0 degrees Fahrenheit. The hot water temperature in the residents’ shared bathroom was measured at 111.6 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. 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 10/04/2025. At 12:30PM, LPA reviewed four (4) resident files and four (4) staff files, all found to be complete. The emergency disaster plan was last reviewed 12/10/2025. Quarterly emergency drills were last conducted 08/12/2025. A review of resident medications and the Medication Administration Record (MAR) found no outstanding errors. No deficiencies cited during visit. Exit interview conducted and a copy of this report was provided to the administrator.the state’s words, verbatim · CDSS document, Dec 31, 2025

Type of visit: Required - 1 Year

On 12/12/24 at 2PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 73 deg F. Hot water temperature was measured at 119 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. Fire extinguisher was observed fully charged and purchased on 09/01/24. LPA reviewed 2 staff and 4 resident files. Updated copies of the following documents were collected for facility file:  LIC500- Personnel Report  Resident Roster  LIC308- Designation of Facility Responsibility  LIC610E- Emergency/Disaster Plan including infection control plans  Evidence of Liability Insurance No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Dec 12, 2024

Type of visit: Required - 1 Year

On 10/26/23 at 3:10PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 71 deg F. Hot water temperature was measured at 117 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. LPA reviewed 3 staff and 4 resident files. LPA also conducted 2 staff and 2 resident interviews during visit. At 4:38PM, LPA observed the following deficiency during visit: Expired fire extinguisher Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Continued on next page, LIC 809-C Updated copies of the following documents were collected for facility file:  LIC500- Personnel Report  Resident Roster  LIC308- Designation of Facility Responsibility  LIC610E- Emergency/Disaster Plan including infection control plans  Evidence of Liability Insurance Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Oct 26, 2023