Uc Senior Care IV

Type of visit: POC

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced Plan of Correction visit. LPA was greeted and allowed entry into the facility by Staff, Laura Anguiano Leon. LPA soke with Administrator, Flora Kelly via telephone while at the facility. Staff, Beatriz Jimenez arrived during the visit. On 02/19/26, the licensee was issued deficiencies during an annual inspection with a correction date of 02/26/26. The deficiencies were regarding the facility not having a staff file for an active employee working and TB test results for an existing resident. As of today, the administrator confirmed the deficiencies have not been corrected. The administrator agreed to contact LPA once the deficiencies have been corrected. The administrator was made aware that civil penalties were being assessed today for failure to correct and will be ongoing until corrected. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Beatriz Jimenez whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Mar 3, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted and allowed entry into the facility by Staff, Raquel Jimenez. Administrator, Flora Kelly arrived during the visit. LPA, accompanied by administrator, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. However the facility did not have Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Hot water temperature at taps accessible to residents were all compliant and measured at 107 F.. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, and/or fireplaces accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water were observed on the premises. Per the administrator, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed multiple staff and resident records/files. Some residents did not have current Resident Appraisals, which were dated back to 01/2025. Resident #4 does not have TB test results. Continued on LIC 809C. The Emergency Disaster Plan was not updated and training was last conducted in 2022. The administrator was advised Staff #1, currently working today at the facility has a fingerprint clearance but is not associated to the facility. Also, there was no staff file for Staff #1. Portable heaters with red coils were observed in the facility, which poses a danger to their residents with dementia. The administrator removed them and stated they will purchase new ones without hot red coils. There was a gap in the window located in the kitchen area due to an air conditioning unit inserted into the window. Other windows with air conditioners have cardboard on the outside of the window to fulfill the gaps. However, due to current rain the cardboard's have water damage. A better seal is needed for the windows with the air conditioners. The administrator was advised of the new Dementia laws and the requirement of the updated dementia plan of operation. Deficiencies were observed or cited during today's annual inspection. Also, Advisory Notes were issued, along with a civil penalty. An exit interview was conducted with Staff, Raquel Jimenez to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Feb 19, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced Required Annual Inspection. The LPA introduced herself and disclosed the purpose of the visit to Caregiver Raquel Jimenez. Administrator Flora Kelly arrived during the visit and assisted the LPA. The facility is licensed for a capacity of six (6) non-ambulatory residents with an approved hospice waiver for five (5) hospice residents. LPA, accompanied by caregiver, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, and stored in locked areas. No pools, nor bodies of water were observed on the premises. Per staff, no firearms, nor ammunition were kept at the facility. Carbon monoxide detectors, and facility telephone were all working. Fire extinguisher(s) were present. Required licensing postings were observed in visible areas of the facility. The LPA interviewed staff and reviewed multiple staff and client records/files. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Administrator Flora Kelly, to whom a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 10, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Case Management- Annual Continuation visit. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Maria Moreno. Caregiver Beatriz Jimenez arrived during the visit and assisted the LPA. The facility was licensed for a capacity of six (6) non-ambulatory residents with an approved hospice waiver for five (5) hospice residents. During the annuals visits, the LPA toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled and stored in locked areas. No pools, nor bodies of water were observed on the premises. Per staff, no firearms, nor ammunition were kept at the facility. Carbon monoxide detectors, and facility telephone were all working. A fire extinguisher and first aid kit were readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and reviewed multiple staff and client records/files. The files which LPA reviewed contained required documents. Confidential records were stored in locked areas. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Caregiver Beatriz Jimenez. A copy of this report, and the Licensee/Appeal Rights (LIC9058), were sent to the administrator via email. An email read receipt confirms the documents were received by the administrator.the state’s words, verbatim · CDSS document, Feb 5, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. The LPA introduced himself and disclosed the purpose of the visit to Caregivers Raquel Jimenez and Oscar Bojoquez. During today’s visit, The LPA toured the facility, reviewed the facility food supply and stored medication. No deficiencies were cited during today’s visit. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection. An exit interview was conducted with Caregiver Jimenez, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058), were providedthe state’s words, verbatim · CDSS document, Jan 31, 2024