Temple Green

Type of visit: Required - 1 Year

On 01/17/25 Licensing Program Analysts (LPAs) Abdoulaye Zerbo and Venus Mixson conducted an unannounced one (1) year required visit. LPAs were granted entry by Licensee, Hoobs Esta, who was informed of the purpose of visit. At the time of the visit there were no residents residing at the facility. Licensee was observed to have obtained proper fingerprint clearance and was associated to the facility. LPAs conducted a tour of the facility with Licensee, Hoobs Esta. The physical plant is a single-story structure that consisted of six (6) resident bedrooms three (3) bathrooms, and a pool meeting the department's regulations. The facility has a formal dining room, kitchen, living room. Indoor and outdoor passageways were free of obstruction. The facility has more than a two (2) day supply of perishable foods and seven (7) day supply of non-perishable foods. Water temperature measured at 113.8-degree Fahrenheit meeting the required limits. Dishes and utensils were in sufficient supply and in good repair. Knives and other sharp objects are stored in a locked drawer in the kitchen. Disinfectant and other cleaning solutions were observed in a locked cabinet under the sink. According to Licensee, there are no firearms or ammunition on the premises. Resident bedrooms had the required bedding, furniture, and lighting. Smoke and carbon monoxide detectors were observed to be operable. Licensee, Hoobs Esta, does not have any residents and staff at the facility. Therefore, there are no staff/resident files for LPAs to review. During today's visit, LPA's did not observe any immediate violations or concerns. The licensee is in process of doing a change of ownership. An exit interview was conducted, and a copy of this report was reviewed and provided to Licensee, Hoobs Estathe state’s words, verbatim · CDSS document, Jan 17, 2025

Type of visit: POC

Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the for a plan of correction visit. LPA met with Licensee, Esta Hobbs who was informed of the purpose of the visit. LPA conducted walk through of the home and interview with the licensee. On 9/25/2024, LPA conducted an unannounced visit to the facility in order to conduct a case management. On this date, the licensee was unable to provide access to the home. Health and Safety Code section 1569.33(a) Unannounced Inspections was cited and plan of correction was due by 9/26/2024. LPA conducted an unannounced visit on today’s date 9/26/2024 and was granted entry by the licensee. LPA was able to tour the home and facility grounds. Therefore, the plan of correction has been satisfied. Licensee was advised on outstanding plan of correction for citation cited on 9/25/2024 for application for change of ownership. The licensee understands civil penalties may apply if the correction is not received by Close of Business, 5:00 p.m. An exit interview was conducted, where this report and clearance letter was reviewed and provided.the state’s words, verbatim · CDSS document, Sep 26, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to conduct a case management visit. LPA contacted Licensee, Esta Hobbs over the phone and met with Zohaib Alvi who were informed of the purpose of the visit. During the time of the visit, LPA conducted interviews. Upon parking outside of the facility, LPA met with Zohaib Alvi of RNZ Quality Care. LPA interviewed him and he left shortly after. Alvi stated Licensee was at the facility and could meet with LPA. LPA attempted to gain entry to the home and contacted the licensee Esta Hobbs over the phone who informed they were not in town and no other person could give LPA access to the home. LPA reviewed the report with licensee over the phone. Due to not being able to inspect the home on this date, an immediate civil penalty of $500 is being issued. The case management visit is in response to written notification from the licensee received on August 15, 2024 of change in facility ownership to RNZ Quality Care becoming effective September 15, 2024. LPA contacted the licensee on 9/4/2024 who revealed there are no clients in care, no current staff other than the licensee who resides in the home, and would ensure the RNZ Quality Care would submit an application for change of ownership with (5) days of the effective transition date. The licensee also acknowledged the need to associate any new staff to the facility and to notify the department if any resident is accepted during the transition process. LPA contacted RNZ Quality Care’s Ruze Rahman, Zohaib Alvi, and Mohammad Rahman and licensee Esta Hobbs on 9/4/2024 and 9/23/2024 and had not received confirmation of submitting an application to the department’s applications Bureau. On today’s date LPA spoke with Zohaib Alvi and requested documentation of proof. Zohaib stated they had not submitted the application for change of ownership. Therefore, the facility failed to ensure an application for change of ownership was submitted within the required time frame. The Health and Safety Code is being cited on the attached LIC809D. A collaborative plan of correction was created with licensee Esta Hobbs. LPA reviewed and provided this report, LIC809D and appeal rights.the state’s words, verbatim · CDSS document, Sep 25, 2024

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.161(b) · Plan of correction due date: Sep 26, 2024

(b) Except as provided in subdivision (e)… (2) The prospective buyer shall submit an application for a license…within five days of the acceptance of the offer by the seller. This requirement was not met as evidenced by: Based on interview and record review, an application for change of ownership was not submitted to the department within the required time frame. This poses a potential health, safety, or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Sep 25, 2024

Plan of correction: The licensee and new ownership agreed to send LPA mail receipt and documents mailed to Central Applications Bureau by the POC due date. The licensee and new ownership agreed to send written statement that no residents will be accepted into the facility until an application is submitted to the department. This is also due by the POC due date.

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.33(a) · Plan of correction due date: Sep 26, 2024

(a) Every licensed residential care facility for the elderly shall be subject to unannounced inspections by the department. The department shall inspect these facilities as often as necessary to ensure the quality of care provided. This requirment was not met as evidenced by:Based on LPA's inability to conduct a facility inspection on 9/25/2024, Licensee unable to give LPA access to the home. This posses an immediate health safety or personal rights risk.the state’s words, verbatim · CDSS document, Sep 25, 2024

Plan of correction: The licensee agreed to write a statement of understanding of the section cited and submit to LPA by the POC due date.

Type of visit: Required - 1 Year

On 1/25/2024, Licensing Program Analyst (LPA) Chinwe Nwogene arrived unannounced at the facility to conduct an annual inspection. LPA Nwogene was greeted and granted entry by Licensee, Esta Hobbs who was informed of the purpose of the visit. At the time of visit there was zero #0 staff and #0 residents present. Esta informed LPA that facility is not currently operating, however, still want to maintain its license. LPA toured the facility inside and out with Esta Hobbs. Tour included: Kitchen: LPA toured the kitchen and observed the kitchen to be clean. Food is stored in a safe and healthful manner. Utensils and dishware are sufficient for the capacity. The refrigerator and stove are in working order. Sharps are stored in a locked kitchen drawer, available only to authorized individuals. Trash cans has tight-fitting lid. Fridge, freezer, and all need appliances were present and shown to be in working condition and clean. Dining and Livingroom; LPA toured the dinning and Livingroom area. LPA observed area to be clean and furnitures in good condition. Temperature was 70 degrees Fahrenheit. Hallway: LPA toured the hallway and observed hallway to be clean with no pathway obstruction. LPA inspected the fire extinguisher and found it to be in compliance and record to be up to date. Carbon monoxide & smoke detector were tested and functioning properly. LPA observed additional linens and hygiene items. Medication: Medications will be stored in a medication cabinet. The first aid kit was complete. Bathroom: LPA toured three #3 resident bathrooms and observed bathrooms to be clean and equipped with grab bar. There is also a good number of personal toiletries available. The hot water measured at 120 degrees Fahrenheit. Night lights were maintained throughout the facility. Bedroom: LPA toured six #6 out of #6 resident bedrooms and observed bedrooms to be clean and furnished according to regulation, which includes proper furniture, dressers, chairs, and lighting. LPA observed resident bedroom #3 ceiling was broken. Esta stated the ceiling will be fixed by February 2024. Garage: LPA tour the garage and observed garage to be clean. Laundry: Washing machine and dryer are all in good repair and sufficient for the census. Cleaning supplies are stored away in the laundry room. Backyard: LPA toured the backyard and observed backyard to be clean and furnitures in good condition. The backyard was free from obstruction and the side gate remain unlocked. LPA observed facility pool was adequately secured. Food Services: There are seven days non-perishable and two days of perishable food supply present, and all food was properly stored and available to residents. Fridge and Freezer are large enough to accommodate required perishable foods. Records: All required postings were posted near the entryway and throughout the facility. The administrator certificate expires on 9/27/2024. No deficiencies noted at the time of visit. An exit interview was conducted, and a copy of this report was reviewed and provided to Esta Hobbs.the state’s words, verbatim · CDSS document, Jan 25, 2024

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.