Stetson Court Living

Type of visit: Required - 1 Year

Unannounced Annual visit made out to this facility on 05/22/2026 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility caregiver, Concepcion Castro, who was briefly interviewed at this time. The facility designated Administrator, Christian Gaoiran, was present at this facility at this time. Current census was 5 residents. It was learned that there weren't any residents under the care of hospice at this time. This facility does have an approved waiver to be able to accept and retain up to (4) residents under the care of hospice at any given time. It was learned that this facility has a program to be able to accept and retain dementia residents at any given time. It was learned that there was (1) resident diagnosed with dementia at this time. It was learned that there weren't any residents receiving services through home health at this time. It was learned that this facility does have a bedridden fire clearance to be able to accept or retain up to (2) residents deemed to be bedridden at any given time. Tour of this facility was conducted. Dining area, living area, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Linen closet, located in facility hallway closet, was reviewed and observed to contain a sufficient supply of towels, sheets, and bedding able to meet the needs of the residents at this time. Kitchen area was toured. Kitchen drawers and cabinets were opened and reviewed. Food supply for 2-day perishable and 7-day nonperishable quantities was reviewed to make sure that they were in compliance at all times. Pantry area was toured. Garage area was toured. Laundry area, located next to the garage area, was toured and observed to be locked at this time. A review of the bleach, detergent, and all other cleaning supplies was conducted to make sure that they were locked and made inaccessible to the residents at this time. Administrator certificate # 7006289740 for Christian Gaoiran which was observed to expire on 11/04/2026 and in compliance at this time. Medication cabinet, located in the facility front closet, was observed to be locked and made inaccessible to the residents at this time. First aid kit, located in the front closet, was reviewed. This LPA observed that it did contain all of the required components at this time. Fire extinguisher located hanging on the wall adjacent to the kitchen was observed to have been annually inspected by the local fire extinguisher company, Edison Fire Extinguisher Inc., with the inspection date of 11/03/2025 and in compliance at this time. Facility resident bedrooms were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Facility resident restrooms were toured. Grab bars and non skid mats were observed to be present and in good repair at this time. Hot water temperatures were taken to make sure that they were within the allowed range of 105-120 degrees at all times. A tour of the facility exterior grounds was conducted. A review of the facility perimeter fence, side gates, and all other exits was conducted. A review of (5) facility personnel records was conducted and noted on the following LIC 859. A review of (5) facility resident records was conducted and noted on the following LIC 858. The following forms and documents were requested to be updated and submitted into CCL for review by this LPA: LIC 308 LIC 400 LIC 500 LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Codes. Appeal Rights were printed and a version was given to the facility designated Administrator at this time. Exit Interviewthe state’s words, verbatim · CDSS document, May 22, 2026

Type of visit: Required - 1 Year

On 5/7/25 at 10:20 AM, Licensing Program Analysts Noel Wolf Petersen and Michael Bilger arrived unannounced to conduct the annual inspection. They were met by staff and explained the purpose of the visit. This facility has 5 clients, two bedridden, one with oxygen administration, 3 non ambulatory, 2 on hospice care, and a capacity of 8. LPA's conducted a Physical Plant inspection including but not limited to the resident bedrooms, resident bathrooms, kitchen, hallways, evacuation routes, and the exterior. The required furnishings and furniture are present, the passages are unobstructed and well lit, the facility is clean and in good repair. The fire extinguisher was last checked 8/20/24, the fire/smoke alarms are in working order, the first aid kit has necessary items, the sharps and toxics and medications are in locked containers and away from the residents in care. The air temperature is 74. The water temperature in the residents bathrooms was measured within the required range of 105-120*f. the required postings of evacuation routes, administrator license, ombudsman poster, client rights poster, and federal workers rights poster. The last fire drill was conducted on 1/23/25, within the quarterly timing. A review of five (5) client files contained up-to-date needs and services plan, admission agreements, and physicians reports for each client. A Medication review, conducted with 2 random clients medications and MAR were found to be fully documented and in order Continued on C-page. A review of five (5) staff files and administrator documents contained up-to-date staff list, facility sketch, liability, and required administrator training, as well as the individual files for the staff's first aid, other on going trainings, and background checks. LPA asked for and updated LIC 308, LIC 500, Fire clearance and Facility sketch to be emailed to noel.wolfpetersen@dss.ca.gov by end of day. No citations issued at this time, an exit interview was conducted and a copy of the report was read and left with staff.the state’s words, verbatim · CDSS document, May 7, 2025

Type of visit: POC

On 01/07/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct a Plan of Correction visit. LPA met with caregiver Maria Elena Patag and explained the purpose of the visit. LPA asked the Caregiver Patag call the Facility Designated Administrator that CCL was present. Shortly after, LPA spoke with Licensee Albert Gaoiran who stated that the Administrator was not able to come to the facility at the time. LPA asked who would be the representative at this time to complete this visit. There were two other staff members present, Amalia Francisco and Felicitas Anova. Current census is 6. The purpose of this visit was to follow up on a deficiency cited on a case management visit on 11/27/2024. On 11/27/2024 and 04/03/2024, it was found that the facility staff was sleeping on common areas within the facility, a resident was sleeping in a designated staff room and the facility was housing 2 residents in which was out of their fire clearance allowance. In addition, there was obstruction by the side gate that prohibited access to the emergency exit. Based on interviews conducted, it was learned that the licensee has sent a new facility sketch as well as a new fire clearance to obtain 2 non-ambulatory residents, 2 ambulatory residents and 2 bedridden residents. It was learned that the Licensee has a future fire inspection on 1/09/2024 at 1:00pm. A tour of the facility was conducted. LPA observed 6 residents. 1 resident was sleeping in bedroom #1, #2, and #3. 1 resident was sitting on the living room couch. 1 resident was eating lunch. 2 residents were in bedroom #4 sleeping. It was observed that all 4 bedrooms had 2 beds in each room. LPA did not observe any rolling beds in any of the common areas. LPA observed no obstructions to the emergency exit gate, however the gate was not self-latching. LPA reviewed 6 resident files. Based on record review, it was learned that 3 residents are under hospice services. It was observed that all 3 residents were unable to get out of their respective bed without total assistance from the facility staff. A technical assistance was provided today for section 87303 regarding self-closing and self-latching gates and 87202 regarding obtaining proper fire clearance. An exit interview was conducted and a copy of this report was provided to the facility at the end of this visit.the state’s words, verbatim · CDSS document, Jan 7, 2025

Type of visit: Case Management - Deficiencies

LPA Jason Lund arrived unannounced to conduct an health and safety check. LPA met with care staff Concepion Castas. LPA Lund spoke with Licensee/Administrator Albert Gaoiran over the phone and explained the reason for the visit. Census:6 LPA Lund observed five residents at the facility and one resident at a doctor’s appointment. LPA Lund observed that there were three residents on hospice out of the six residents. All three residents are bedridden and get out of bed with out the help of staff. Resident (R1) was put on hospice on 9/3/2023 and is bedridden. Resident (R2) was put on hospice on 10/15/2024. Resident (R3) was put on hospice on 6/13/2023. All three residents are bedridden and get out of bed with the help of staff. The facility license dated 4/30/2013 states that facility is licensed for 6 nonambulatory residents and hospice for four. The license doesn’t state the facility can have bedridden residents. LPA Lund observed debris on the side of the facility and the emergency exit gate doesn’t have a latch and needs to be fixed. LPA requested the following updated documents for community care licensing to be submitted via email. LIC 500 - Personnel Report, Based on today’s visit, Per California Code of Regulations, Title 22 Division 6, Chapter 8, see 809-D's for deficiencies observed or cited today. If the deficiencies are not corrected by the noted due date civil penalties may be assessed. LPA Lund called LPA Lund spoke with Licensee/Administrator Albert Gaoiran over the phone. LPA Lund amended the visit on 12/6/2024the state’s words, verbatim · CDSS document, Nov 27, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a) · Plan of correction due date: Dec 2, 2024

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: . LPA Lund observed that there were three residents on hospice out of the six residents. All three residents are bedridden and get out of bed with out the help of staff.the state’s words, verbatim · CDSS document, Nov 27, 2024

Plan of correction: Administrator shall submit a new fire clearance by 12/2/2024 or issue 30 day notices to residents to LPA Lund.

From the deficiency page — Deficiency type: Type B · Section cited: CCR80087(a) · Plan of correction due date: Dec 10, 2024

Buildings and Grounds - The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. LPA Lund observed debris on the side of the facility and the emergency exit gate doesn’t have a latch and needs to be fixed.the state’s words, verbatim · CDSS document, Nov 27, 2024

Plan of correction: Administrator shall submit pictures of debris on the side of the facility and the emergency exit gate doesn’t have a latch and needs to be fixed. The pictures shall be sent by POC 12/10/24.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Wallace conducted a unannounced Required 1 year Inspection Visit. LPA met with direct care staff and explained the purpose of visit. Administrator's Certificate expires 12/18/2024. LPA and direct care staff inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, and outside backyard. LPA observed sufficient furniture and lighting throughout the facility. LPA observed sufficient seven day non-perishable and two day perishable food supplies. LPA measured the hot water temperature in resident's bathroom at 111.9 degrees Fahrenheit which is within the required range of 105 to 120 degrees. First aid kit was checked and is complete. LPA observed carbon monoxide detectors in the facility. Fire extinguishers were last inspected on 7/24/2023. Smoke detectors are operational. LPA observed centrally stored medications are kept locked and inaccessible to residents. LPA reviewed and compared resident medication vs. medication logs. LPA observed carbon monoxide detectors in the facility. The facility conducts fire/disaster drills with residents on 3/25/2024. Staff have been sleeping on a roll away bed in common areas which is not on fire clearance. Facility sketch shows bedroom #3 as staff room, but a resident in presently in #3 bedroom. LPA reviewed four resident files and four staff files, including criminal record clearances. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks are Fingerprint cleared and associated to the facility. LPA verified staff training for staff file reviews. LPA requested the following updated documents for community care licensing to be submitted via email by April 8, 2024: Facility Sketch, Fire Clearance, LIC 308 Designation of Administrator, LIC 500 - Personnel Report, Copy of Administrator's Certificate, and Copy of Liability Insurance. ruth.wallace@dss.ca.gov Based on today’s visit, Per California Code of Regulations, Title 22 Division 6, Chapter 8, see 809-D's for deficiencies observed or cited today. If the deficiencies are not corrected by the noted due date civil penalties may be assessed. Exit interview conducted with administrator. A copy of report and LIC 811 (Confidential Names) left at facility.the state’s words, verbatim · CDSS document, Apr 3, 2024