Woodcliff Care Home

Type of visit: Required - 1 Year

On 02/20/2026, Licensing Program Analyst (LPA) Marisa Chiarelli, arrived at the facility unannounced to conduct a 1-Year Required Annual Inspection. LPA met with Caregiver Azel Miranda and administrator Jaime Calloway and explained the purpose of the visit. LPA Chiarelli and Administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, backyard, shed, and common restrooms. LPA observed the facility to be clean, in good repair and odor-free and each bathroom to have the necessary grab bars, non-skid flooring or shower chair, paper towels, and trash can with lids. Facility has a 2-day perishable and a 7-day non-perishable amount of food and sharps to be locked. Hot water temperature was measured at 117.9 F. LPA observed fire extinguisher, fire detectors, and carbon monoxide detectors all of which were serviced in October of 2025. LPA reviewed a total of five (5) residents' files which had all required documentation. LPA reviewed four (4) staff files but was missing documentation refer to technical violations. LPA reviewed two (2) residents medications. Several topics were discussed. No deficiencies are being cited as a result of today’s inspection. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Feb 20, 2026

The state marks this report as 5 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

On December 17, 2024 at approximately 11:00 AM, Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Woodcliff Care Home for the purpose of conducting a Required 1 year inspection. LPA was greeted at the door by Caregiver, Azel Miranda and was granted access into the facility. Administrator arrived 30 minutes later. LPA and Caregiver toured the facility. LPA observed the facility to be clean and at a comfortable temperature with all exits free from obstruction. Fire Extinguisher was found to be last charged on December 2024 at the time of the inspection. All smoke detectors sound directly to the fire station. Water temperature in facility bathrooms measured at 108 degrees, within acceptable range of 105 to 120 degrees F. LPA observed sufficient perishable and non-perishable foods located in the kitchen. There are special provisions made for individuals with special dietary needs. Food menu was presently available for viewing during the inspection. Medications were centrally stored and locked. Cleaning products and other toxins are located in the laundry room that was locked and inaccessible to residents in care. There was a supply of linens, cleaners, hygiene products and paper products available for residents. All bathrooms designated for residents in the common areas at the facility were supplied with individual paper towels and hand soap. Bathrooms in resident’s rooms have a towel and soap. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. A tour of bedrooms were conducted, and bedrooms inspected have lighting and appropriate furnishing. LPA advised facility to contact County Public Health and Community Care Licensing immediately if symptoms of COVID-19 or other infectious diseases are present in the facility. LPA reviewed the infection control plan. LPA was made aware that the facility is currently in the process of updating the Infection Control Plan (See LIC 9102-Technical Violation) First Aid kit was inspected and found to be appropriate during the inspection. Emergency Disaster Drill was last conducted on November 2024. (Report continued on LIC 809C) LPA reviewed 5 of 5 resident files.1 out of 5 residents did not have a Pre-Placement appraisal. LPA educated the Administrator on the importance of performing, completing and retaining a Pre-Placement Appraisals for residents in care (See LIC 9102-Technical Violation). During a facility file review, LPA observed that no notification in writing was made to the Local Fire Jurisdiction regarding a resident that requires oxygen (See LIC 9102-Technical Violation). LPA educated the Administrator on the importance of ensuring that the Local Fire Jurisdiction is made aware of oxygen being in the facility. LPA reviewed staff files and found those files to be appropriate during the review. LPA provided Technical Assistance regarding how staff and resident files are supposed to be organized, managed and retained in the facility (See LIC 9102-Technical Assistance). LPA requested the following documents to be sent: LIC 500- Personnel Report LIC 308- Designation of Facility Responsibility LIC 309- Administrative Organization Most up-to-date Liability insurance Emergency Disaster Plan Control of Property Register of residents Most updated Infection Control Plan No deficiencies were cited during today's Required 1 year inspection. Exit interview was conducted and a copy of this report was signed and given to the Administrator.the state’s words, verbatim · CDSS document, Dec 17, 2024

The state marks this report as 6 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Case Management - Deficiencies

06/14/2024 10:00 AM Licensing Program Analyst Rebecca Knight conducted an unannounced case management visit and met with administrator Jaime Calloway. Today’s visit is regarding a death report tht was submitted to licensing on 06/10/2024 by the facility concerning a death that occurred at the facility on 05/12/2024 and was reported to licensing on 5/13/2024. Resident 1 (R1) was not on hospice. Per the coroner’s report the immediate cause of death was ACUTE HYPOXIC RESPIRATORY FAILURE, the secondary cause of death was ASPIRATlON PNEUMONIA and DYSPHAGIA. It was reported that on 5/11/2024 R1 was having difficulty breathing, staff called 911 and R1 was transported to the local emergency room for treatment. R1 was evaluated by hospital staff, placed on comfort care, and passed away on 5/12/2024. During the course of the investigation, it was learned that R1 was generally declining in health status over time. R1 had a swallow test performed at the hospital and at a skilled nursing facility and both times it was determined that R1 did not require a modified diet. The facility had been feeding R1 a soft diet since he was discharged from the hospital 2 weeks prior to his death. R1’s family wanted R1 to come back to the facility after discharge from the hospital rather than go to skilled nursing. Even though the administrator had doubts as to whether R1 should come back to the facility based on R1’s declining health status, he allowed R1 to come back. It was determined that R1 was beyond acceptance and retention limitations of the facility based on his health status upon discharge from hospital, and recent admissions to skilled nursing. Based on interviews and evidence obtained during the investigation, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22), is being cited on the attached LIC809D. Appeal rights were provided. Exit interview conducted and a copy of the report was provided to administrator Jaime Calloway.the state’s words, verbatim · CDSS document, Jun 14, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87455(c)(2) · Plan of correction due date: Jun 28, 2024

87455(c)(2) Acceptance and Retention Limitations (c) No resident shall be accepted or retained if any of the following apply: (2) The resident requires 24-hour, skilled nursing or intermediate care as specified in Health and Safety Code Sections 1569.72(a) and (a)(1). This requirement was not met as evidenced by: Based on interviews and document review it was determined that the licensee should not have accepted the resident back in the facility due to health decline after a series of hospital and skilled nursing stays which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jun 14, 2024

Plan of correction: Administrator agrees to submit a plan to LPA outlining the steps he will take to determine whether a resident is suitable to be accepted back into the facility after discharge from hospital and/or skilled nursing. Administrator to submit plan to LPA by 06/28/2024.

Type of visit: Required - 1 Year

On 12/13/ 2023, Licensing Program Analyst (LPA) Jaynae Boyles, arrived at the facility unannounced to conduct a 1-Year Required Annual Inspection. LPA met with Direct Care Staff Marlet Gulbrantson and explained the purpose of the visit. LPA Boyles and Administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, garage, backyard, shed, and common restrooms. LPA observed the facility to be clean, in good repair and odor-free and each bathroom to have the necessary grab bars, non-skid flooring or shower chair, paper towels, trash can with lids and 20-second hand-washing poster. Facility has a 2-day perishable and a 7-day non-perishable amount of food and sharps to be locked. Hot water temperature was measured at 113 F. LPA observed one (1) fire extinguishers, fire detectors, and carbon monoxide detector. LPA observed the first aid kit which contained all the requirements. LPA observed toxic chemicals stored under the sink. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA reviewed a total of six (6) residents' files and five (3) staff files. Two of three staff files reviewed are missing TB testing and results. Two of six residents had half bed rails without an order from a medical provider. Several topics were discussed. Deficiencies cited from Title 22 Regulations and or the California Health and Safety Code. Several topics were discussed. An exit interview was conducted, and Plans of Corrections were reviewed and developed collaboratively. A copy of this report, LIC 809-D, and Appeal Rights were discussed and provided.the state’s words, verbatim · CDSS document, Dec 13, 2023

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.