Sakura Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct an annual inspection. LPA met with Administrator Julie Malitskiy during today's inspection. LPA toured facility with administrator to ensure health and safety of residents in care. LPA toured 6 resident rooms, 1 staff room, 2 bathrooms, kitchen, common living spaces, backyard and the garage area. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA toured the backyard and all exits are accessible and unlocked. There is a locked storage for medications and toxins. Food supply is adequate for 2-day perishable and 7-day nonperishable. LPA observed an adequate amount of linens and found the first aid kit to be complete. Hot water temperature was measured at 107 degrees. LPA reviewed 3 of 6 resident files and 2 staff files. LPA reviewed medications of two residents comparing with Centrally Stored Medication Record and physician orders. A review of staff records indicates that all facility staff has received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated training was completed. LPA observed a copy of current liability insurance. No deficiencies are being cited as a result of todays inspection. Exit interview conducted.the state’s words, verbatim · CDSS document, Jan 9, 2026

Allegation investigated: Facility staff did not assist residents with care needs.

Licensed Program Analysts (LPAs) Cassandra Mikkelson and Michael Hood arrived at the facility unannounced and met with Julie Malitskiy to deliver findings for the above complaint allegation. During the investigation, LPAs conducted interviews, conducted a tour of the facility, and reviewed documentation pertinent to the investigation. The results of the investigation are as follows: ** Report continued on 9099-C ** Unsubstantiated Interviews conducted with staff members S1, S2, and Administrator indicated that staff are providing residents with assistance showering once to twice a week. During subsequent visit, interview with R2 confirmed that staff were providing assistance with two (2) showers a week. S1, S2, and Administrator stated that care staff provide bed baths daily for the residents needing incontinence care. S1, S2, and Administrator stated that care staff are providing assistance with incontinence care for the residents, including assistance with residents' catheters and transfer assistance to the toilet for R1. During multiple visits conducted at the facility, LPAs observed daily bed baths are documented as given daily for residents R1 and R2. LPAs did not observe showers documented in facility progress notes. Interview with Administrator indicated that R1 and R2 have no cognitive impairment and can request additional showers if wanted. LPAs observed R1 and R2's documentation, which indicates that neither have cognitive impairment and both are able to communicate their own needs. Interview with S1 indicated that R2's physical therapist and Administrator provide assistance with walking. Interview with Administrator indicated that they assist with R2 walking three (3) or four (4) times a week. Interview with R2 indicated that Administrator is helping them ambulate throughout the facility. During subsequent visit, R2 stated that care staff were now providing assistance with walking around the facility. Interviews with R1 and R2 stated that they are satisfied with the care being received at the facility by the care staff. R1 stated that they receive assistance with showering and hygiene, toileting and walking in the facility. R2 stated that they received assistance with showering, hygiene and walking in the facility. R1 and R2 stated that they receive bed baths daily and showering one (1) shower weekly. Based on interviews conducted, observations, and records reviewed, the preponderance of evidence standards have not been met. Therefore, the above allegation is found to be UNSUBSTANTIATED. Findings that the complaint is Unsubstantiated means that, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted with Julie Malitskiy. A copy of this report was provided. Signature on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Jan 21, 2025 · control 59-AS-20241122162534

Type of visit: Case Management - Deficiencies

Licensing Program Analysts (LPAs) Cassandra Mikkelson and Michael Hood arrived at the facility and met with Administrator, Julie Malitskiy, to conduct a case management visit in relation to a separate inspection conducted on 12/12/2024. LPAs observed that resident R2's LIC 602A dated 10/3/2024 indicates R2 does not have bowel or bladder impairment with written comments stating "needs assistance getting there." R2's LIC 602A states R2 is able to bathe, dress, groom, feed, and toilet themselves with written comments stating "may need some assistance." R2 is listed as nonambulatory. R2 is able to communicate their own needs and has no cognitive impairment. Interviews with Staff members S1 and S2, Administrator, and R2 indicated that R2 needed assistance with bathing, dressing, grooming, feed, and toileting. LPAs inquired about the discrepancies in R2's documents with Administrator. Administrator stated that R2 was admitted without Administrator obtaining a copy of R2's LIC 602A. As a result of today's inspection, a deficiency is being cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Deficiency is listed on 809-D pages. Exit interview was conducted with Administrator. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Jan 21, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87458 · Plan of correction due date: Jan 28, 2025

87458 Medical Assessment (a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional (...). This requirement is not met as evidenced by: Based on interviews conducted, LPAs' observations, and records reviewed, the facility did not ensure to obtain a medical assessment for R2 prior to admission, which poses a potential health, safety, and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jan 21, 2025

Plan of correction: Facility obtained a updated LIC 602A for R2 on 01/03/2025 that is consistent with R2's care. LPA cleared deficiency at the conclusion of this visit.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Cassandra Mikkelson and Michael Hood arrived unannounced to conduct an annual inspection. LPAs met with Administrator Julie Malitskiy during today's inspection. LPAs conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPAs observed six (6) resident rooms, one (1) staff room, and two (2) common area bathrooms. LPAs observed rooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition and properly maintained. LPAs checked the kitchen area for the ability to prepare and store food. Care home has required (2) two day perishable and (7) seven day non-perishable food supply on hand. Smoke detectors and carbon monoxide detectors are operational in the care home. Fire extinguishers and first aid kit are maintained and ready for emergency use. LPAs checked medication storage and found medications to be locked away and inaccessible to the residents. LPAs reviewed three (3) resident files, three (3) staff files and two (2) resident medications. Facility has a current copy of certificate of liability insurance and LPAs obtained a copy. As a result of this visit, no deficiencies were cited. Exit interview was conducted with Administrator.the state’s words, verbatim · CDSS document, Dec 2, 2024

The state marks this report as 6 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: Post Licensing

Licensing Program Analysts (LPAs) Cassandra Mikkelson and Michael Hood arrived at the care home today and met with the Administrator, Julie Malitskiy, to conduct an annual required and post licensing visit. For more information on the post licensing visit please see LIC 809 dated 12/02/2024. No deficiencies cited for the post licensing visit.the state’s words, verbatim · CDSS document, Dec 2, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct a pre-licensing inspection. LPA met with Licensee/Administrator Julie Malitskiy during today's visit. Currently there are 6 clients residing within the facility. Facility was inspected both indoors and outdoors. LPA inspected 6 client bedrooms, 3 bathrooms, 1 staff room, common living areas, garage and kitchen. Outdoor area is free from hazardous debris. Outdoor exits are clear and accessible. First aid kit was present in the facility. Centrally stored medications will be locked in the hallway closet. The facility has adequate lighting throughout. Water temperature was observed at 120 degrees F. LPA inspected client bedrooms and the bedroom had appropriate furnishings, chair, adequate lighting and storage. Bathrooms are clean, sanitary, and in good repair. Smoke detectors and carbon monoxide detectors were operational. Fire clearance was granted on 10/30/2023 for 6 non-ambulatory clients. Kitchen is clean, sanitary, and in good repair. A working telephone has been set up for client use. This report will be forwarded to the centralized application unit for continued processing. COMP III was completed during today's inspection. Exit interview and copy of report provided.the state’s words, verbatim · CDSS document, Jan 10, 2024

Type of visit: Office

Facility Type: Residential Care Facility for the Elderly Application Type: Change of Ownership Capacity: 6 Census (if any clients in care): 6 COMP II Participants: Julie Malitskiy Interview Method: Telephone interview On December 27, 2023, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restricted/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Dec 27, 2023