The Cedars Care Home

Type of visit: Required - 1 Year

At approximately 10:00 AM, Licensing Program Analysts (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and was greeted by Justin Herold, Administrator. Facility is a Residential Care Facility for the Elderly (RCFE) with seven (7) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for four (4), with three (3) Hospice residents currently in care, and is approved for all non-ambulatory residents. At approximately 11:00 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Water temperatures in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, and hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable food and LPA informed Administrator of the requirement to maintain one week of non-perishable foods. Administrator agrees to bring the facility into compliance immediately, as well as obtain an emergency supply of water. Medications were centrally stored and locked. There is a shaded seating area in the backyard with outdoor space for activities. LPA observed two locked sheds in the backyard. LPA inspected and observed the contents of one consisting of furniture, resident care equipment, tools, and holiday decorations. LPA inspected and observed the contents of the second one containing a water tank which is not currently being used. LPA observed backyard gates all secured with bolt lock. Continued on LIC809-C... Continued from LIC809... Administrator states the fire department will be at facility next week and Administrator will consult with them about which ones need to be changed to latch locks in order to operate in compliance with fire code. LPA observed a piano, book shelves full of books, puzzles, and crafting supplies in the living room off of the main entrance. LPA observed residents enjoying live music during today's inspection. LPA was informed that the facility plans to develop more routine activities. Facility has internet access and Administrator agrees to ensure an internet access device is designated for resident use. Facility telephone was tested an operational during inspection. Facility has five (5) fire extinguishers which were observed charged and were last serviced 01/2025. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Facility recently changed administrators and disaster drill logs were not available. Administrator states that facility will conduct an Lastly, emergency disaster drill next week and understands that drills shall be conducted no less than quarterly to remain in compliance with regulation. LPA observed the facility's infection control plan, first aid kit, PPE, flashlights, and emergency supplies. Administrator states facility has a generator for emergency preparedness. LPA reviewed facility's emergency disaster plan last updated 1/2024. At approximately 1:00 PM, LPA conducted file review. Four (4) staff and four (4) residents' files were reviewed and LPA observed the following: Three (3) of four (4) staff files reviewed were missing proof of both initial and annual training to include medication training. Administrator states that with change of leadership documents are incomplete or lacking from files. LPA provided Administrator with Health and Safety Code sections which detail the training requirements and Administrator agrees to being the facility into compliance immediately. Additionally, two (2) of four (4) staff files were missing proof of current CPR and First Aid training certification. Administrator agrees to ensure all staff receive proof of certification immediately. Lastly, two (2) of four (4) staff files reviewed were missing the required health screenings with proof of negative TB results. Administrator agrees to being the facility into compliance immediately. Four (4) of four (4) resident files reviewed were observed missing current needs and services plans which Administrator agrees to complete and review with the residents' responsible parties immediately. Continued on LIC809C... continued from LIC809C... Lastly, two (2) of two (2) resident files reviewed were observed missing the required consent forms, which Administrator agrees to obtain and ensure all are present in resident files moving forward. LPA discussed the requirement that all staff and resident records are current and present in the files. Administrator agreed to ensure the facility is operating within compliance at all times moving forward. . At approximately 3:00 PM, LPA reviewed medications and medication records which are maintained and stored in compliance with regulation. Administrator states that the residents families coordinate residents' medical and dental appointments and transportation to and from visits. However, Administrator also states that facility will assist with coordinating these appointments and transportation for residents upon request. Facility does not manage P&I. LPA discussed the Department's Technical Support Program (TSP) with Administrator who has agreed to utilize this service. LPA will submit a referral for Administrator. Administrator had to leave at 3:15 and gave permission for a designated responsible party (DRP), staff Norma Rodriguez to sign today's visit report. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit: -LIC610E - Emergency Disaster Plan (updated) -LIC500 Personnel Report (updated) No deficiencies were cited during today's inspection. Exit interview conducted with DRP whose signature on form confirms receipt.the state’s words, verbatim · CDSS document, Nov 7, 2025

Type of visit: Case Management - Annual Continuation

At approximately 10:15 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a Case Management - Annual Continuation inspection and met with Viridiana Agapoff, Administrator. Facility is a Residential Care Facility for the Elderly with eight (8) residents in care. Three (3) residents are currently on Hospice and facility has a Hospice waiver for four (4). At approximately 11:00 AM, LPA conducted file review. Four (4) staff and five (5) residents' files were reviewed and LPA observed the following: All files reviewed contained the required documents per Title 22 regulations, including Hospice care plans for those residents receiving Hospice services. LPA discussed with Administrator the requirement ensuring all resident and staff records are current and present in the files and Administrator agreed to ensure the facility is operating within compliance at all times. At approximately 2:45 PM, LPA reviewed medications and medication records which are maintained and stored in compliance with regulation. No deficiencies were cited during today's inspection. Exit interview conducted with Administrator whose signature on form confirms receipt.the state’s words, verbatim · CDSS document, Apr 3, 2025

The state marks this report as 12 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

At approximately 9:45 AM, Licensing Program Analysts (LPAs) Julie Florio and Elias Magdaleno arrived unannounced to conduct a required 1-year annual inspection and were greeted by Viridiana Agapoff, Administrator. Facility is a Residential Care Facility for the Elderly (RCFE) with eight (8) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for four (4), with four (4) Hospice residents currently in care, and is approved for all non-ambulatory residents. At approximately 10:30 AM, LPAs initiated a tour of the facility with Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Water temperatures in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPAs observed a supply of clean linens, and hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. Medications were centrally stored and locked. There is a shaded seating area in the backyard with outdoor space for activities. LPAs observed two locked sheds in the backyard which LPAs inspected and observed the contents of one to consist of furniture, resident care equipment, and holiday decorations, and the other contains a water tank which is not currently being used. LPAs observed a piano, book shelves full of books, puzzles, crafting supplies and LPAs were informed that the facility plays bingo, watches movies, conduct afternoon exercises regularly, and has someone come play live music every Wednesday and Friday. Facility has an internet access device designated for resident use and internet service available. Facility telephone was tested an operational during inspection. Continued on LIC809-C... Continued from LIC809C... Facility has five (5) fire extinguishers which were observed charged and last serviced 01/2025. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Facility conducts quarterly disaster drills, and the most recent drill was conducted 12/2024. LPAs observed the facility's infection control plan, first aid kit, PPE, flashlights, and emergency supplies. Administrator states facility has a generator for emergency preparedness. LPAs reviewed facility's emergency disaster plan last updated 12/2024. Administrator states that the residents families coordinate residents' medical and dental appointments and transportation to and from visits. However, Administrator also states that facility will assist with coordinating these appointments and transportation for residents upon request. However, residents need to pay for this subcontracted transportation service. Facility does not manage P&I. Administrator had a family emergency. LPAs will return at a later date to complete the annual inspection. LPAs will review resident files, staff files, and medications and medication logs during that visit. No deficiencies were cited during inspection. Exit interview conducted with Administrator whose signature on form confirms receipt.the state’s words, verbatim · CDSS document, Jan 29, 2025

The state marks this report as 12 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

License Program Analyst (LPA) Hansen arrived unannounced to conduct an annual required - 1 yr. visit of the facility. LPA was welcomed by staff, Maria Sanchez. Viridiana Agapoff, Administrator was contacted by staff and arrived during the visit. There is a total of 7 residents, all with a diagnostic of dementia. There is 4 residents currently on Hospice. LPA toured the facility on 12/18/2023 at 9:00 AM; facility was found to be clean and at a comfortable temperature with all exits free from obstruction. The facility serves residents with dementia and has a plan of operation for special care and programming. All bedrooms have lighting & appropriate furnishings. There was a sufficient supply of both perishable and nonperishable food as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations on this day at the time of the visit. Toxins are stored in a locked cabinet in the laundry area. Hot water temperature measured between 130.8 degrees F and 135.5 degrees F, falling out of Title 22 acceptable regulation of 105 to 120 degrees F in 3 of 3 resident’s bathrooms while touring facility on 12/18/2023 at 9:30am. Administrator turned hot water heater down on the 1 (out of 2 hot water heaters at facility) regulating residents bathrooms (see LIC809-D). The bathrooms designated for residents at the facility were supplied with individual paper towels and hand soap dispensers. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present in the bathroom shower. Fire Extinguisher was found to be last charged on 12/23/2022 at the time of the visit. Facility has fire sprinklers throughout. Smoke detectors and carbon monoxide detectors were found to be operational during the visit. A review of 7 residents & 5 staff records as well as two resident’s medications was conducted during this visit. LPA reviewed resident’s files at 10:30 AM on 12/18/2023 and learned that 3 of 7 residents do not have an updated re-appraisals/needs & care plans and or updated physician’s assessments (LIC 602A) on file (see LIC809-D). Continue LIC 809-C At approximately 12:00 PM LPA reviewed a sample of staff records and learned that all facility staff present and a sample of other individuals who require caregiver background checks have received criminal record clearances or exemptions. Record review of 5 direct care staff files who were at work during inspection do not have proof of annual training requirements for 2023 on file (see LIC809-D). Administrator was unable to provide proof of First Aid & or CPR certification for staff that files were reviewed (see LIC809-D). Medications were centrally stored in locked cabinet in the facility kitchen area & office. The Medications of 2 out of 2 residents were found to be given according to physicians’ directions on 12/18/2023 at 1:30PM. Centrally Stored Medication Record (CSMR) of 2 out of 2 residents were found to be completed and accurate. LPA reviewed Licensing Information System (LIS) with administrator who stated that is corrected and updated at this time; no need to change any of the information. In addition, LPA advised facility to check with the County regarding what is the County Emergency Plan; ensure that disaster drills are conducted in different shifts, and review facility emergency plan to ensure accuracy according to the needs of facility residents. Per Administrator disaster Drills are conducted annually with the last being 8/1/2023 & prior to that 9/15/22 (see LIC809-D). LPA advised they need to be conducted quarterly. Viridiana Agapoff, Administrator Certificate # 6061275740 expires on 8/8/2024. Appeal of Rights Given. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided. LPA Hansen is requesting facility to submit the following documents to CCL by 1/15/2024: LIC 308 Designated LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan LIC 9020 Register of Facility Client’s/Resident’s Copy of Current Administrators Certificate Copy of Control of Property/New updated Lease Copy of Certificate of Liability Insurancethe state’s words, verbatim · CDSS document, Dec 18, 2023

The state marks this report as 12 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.