Gines Residential Care Home Iii
RCFE
A Residential Care Facility for the Elderly (RCFE) is a non-medical residential care home licensed by California CDSS under Health & Safety Code §1560. Residents receive assistance with daily living activities such as bathing, dressing, meals, and medication management in a home-like setting. RCFEs are not hospitals or skilled nursing facilities — they do not provide round-the-clock medical care.
2565 Stone Valley Road · Alamo, 94507
Quick facts
Quality snapshot
Updated April 25, 2026Compared to 214 California RCFE facilities of similar size, over the last 36 months.
Source: California Department of Social Services, Community Care Licensing Division. View raw inspection records →
Quality grade· click to show how this was calculated
Severity8thWeighted citations per bed
Repeats100thRepeat deficiencies as share of total
Frequency25thDeficiencies per inspection
Tick mark at 50% = peer median · higher percentile = better facility
Quality grade· click to show how this was calculated
Weighted citations per bed
Repeat deficiencies as share of total
Deficiencies per inspection
Tick mark at 50% = peer median · higher percentile = better facility
Gines Residential Care Home Iii scores C−. Better than 44% of comparable California RESIDENTIAL CARE ELDERLY facilities. Severity: bottom 8%. Repeats: top 0%. Frequency: 25th percentile.
Each metric is converted to a 0–100 percentile within the peer set (higher = better). The composite grade averages all four. Peer set: CA / rcfe_general / small beds (214 facilities).
Citation severity over time
↓ improvingWeighted severity score per month · 24 months
Weighted score (24mo)
68
Last citation
Nov 25
Finding distribution
15 total · 36 monthsScope × Severity (CMS A–L)
The rules that apply to this facility
California Title 22 requirements for this facility, with the specific regulation and a suggested question for each.Rules this facility has been cited for are shown first.
What must this facility report to the state — and how fast?Cited Oct 202422 CCR §87211 / WIC §15630
- ImmediateElopement, fire, epidemic outbreak, or poisoningImmediately
- 2 hoursAbuse with serious bodily injury2-hour phone report + 2-hour written report — to the California Department of Social Services (CDSS), Adult Protective Services, and law enforcement
- 24 hrsAbuse without serious bodily injuryWithin 24 hours
- Next dayDeath of a residentPhone by next working day; written within 7 days
- Next dayInjury requiring medical treatment beyond first aidPhone by next working day; written within 7 days
- WrittenBankruptcy, foreclosure, eviction, or utility shutoff noticeWritten notice to CDSS and residents — $100/day penalty (max $2,000) for failure
Your enforcement lever:Incidents that aren't reported on time are themselves a separate violation. If you believe a reportable event wasn't filed, you can submit a complaint directly to the California Department of Social Services (CDSS).
What training are all staff required to complete?22 CCR §87411
All direct-care staff must complete:
- 10 hours initial training within the first four weeks of employment.
- 4 hours annual in-service every year thereafter.
- Administrator certificate from a CDSS-approved program — 80 hours for first-time, 40 hours renewal every 2 years.
Ask on tour: Ask when the last staff training was completed and how it's tracked.
How many staff must be on duty overnight?22 CCR §87415
Based on 6 licensed beds:
One qualified staff member must be on call and physically on premises at all times overnight.
Violation pattern to watch for:A facility that documents a staff member as "on call" but with that person physically off-site — when the law requires on-premises presence — is in violation of this section.
Ask on tour: Ask the facility to walk you through their overnight staffing plan and confirm whether on-call staff are on premises or off-site.
What health conditions can this facility legally accept or refuse?22 CCR §87612–87615
Restricted — allowed with physician order + care plan
- Supplemental oxygen
- Insulin and injectable medications
- Indwelling or intermittent catheters
- Colostomy / ileostomy
- Stage 1 and Stage 2 pressure injuries
- Wound care (non-complex)
- Incontinence
- Contractures
Prohibited — facility must refuse or discharge
- Stage 3 or Stage 4 pressure injuries
- Feeding tubes (PEG, NG, or J-tube)
- Tracheostomies
- Active MRSA or communicable infections requiring isolation
- 24-hour skilled nursing needs
- Total ADL dependence with inability to communicate needs
A hospice waiver (HSC §1569.73) can allow continued care for residents on hospice who would otherwise fall into a prohibited category.
Ask on tour: Ask whether your loved one's specific care needs are restricted or prohibited, and what the facility's process is if needs change after admission.
How does CDSS enforce these rules?22 CCR §87755–87777 / HSC §1569.58
- 1Notice of DeficiencyWritten citation with a correction deadline. Facility must submit a Plan of Correction.
- 2Civil PenaltyStarts at $50/day for non-serious; $150/day for serious deficiencies — immediately, with no grace period. Repeats escalate to $150 first day + $50/day, then $1,000 first day + $100/day.
- 3Suspension of AdmissionsFacility cannot accept new residents until violations are corrected.
- 4Temporary Suspension or RevocationEmergency suspension for imminent danger; full revocation after administrative hearing.
- 5Exclusion OrderAdministrator and operator can be barred from all CDSS-licensed facilities — not just this one.
See how these rules have been applied to this specific facility:
View state inspection record and citationsState records
California Dept. of Social Services · Community Care Licensing- License number
- 075601041
- License type
- RESIDENTIAL CARE ELDERLY
- License status
- LICENSED
- License expires
- Not yet indexed
- Licensed beds
- 6
- Operator
- Gines, Isidro G. & Erlinda R.
Inspections & citations
13
reports on file
16
total deficiencies
5
Type A (actual harm)
Other visitApril 14, 2026No deficiencies
Plain-language summary
On April 14, 2026, state licensing staff conducted the facility's required annual inspection and found no violations. The inspector checked the building's safety features, food storage, medication security, resident records, and staff qualifications, and confirmed that grab bars, lighting, fire detectors, and emergency supplies were all in place and working properly. The facility was asked to send updated administrative documents to the state by April 20, 2026.
View full inspector notes
On 4/14/2026 at 9:30 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Licensee, Erlinda Gines and explained the purpose of the visit. The facility’s fire clearance was approved for all may be non-ambulatory. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. Temperature is maintained at 73 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 110.8 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last purchased on March 2026. Emergency Disaster Plan last reviewed March 2026. Emergency Disaster Drill conducted March 24 2026. First aid kit was observed to be complete. LPA reviewed 4 residents records. LPA reviewed 3 staff records and 3 of 3 have current first aid training and associated to the facility. Updated copies of the following documents were requested for facility file and are to be mailed to CCL by 4/20/2026: LIC 308 Designation of Administrative Responsibility Activities Calendar LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
Other visitNovember 4, 2025Type A1 deficiency
Plain-language summary
On November 4, 2025, state inspectors visited the facility after learning that a resident had been given the wrong medication for four days and required emergency room care; the pharmacy had sent medications labeled for a different person, and staff did not catch the error until after the resident was hospitalized. The resident is currently in the hospital but expected to make a full recovery. The facility was cited for medication handling violations and instructed on proper procedures for logging and administering medications.
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On 11/4/25 at 9:00 AM, Licensing Program Analyst (LPA) A. Gomez conducted a case management visit as a result of an self-reported incident report received 11/3/2025. LPA notified Licensee Erlinda Gines over the phone that they were at the facility and Licensee arrived at approximately 11:20 AM . It was reported that R1 was administered the incorrect medication for approximately four (4) days and had to be sent out to the emergency room. Licensee states that the oversight was made because the pharmacy sent out medications for an individual who does not reside at the facility and they did not notice. Licensee noticed the name on the medications belonged to someone else after R1 was sent out. Licensee states that R1 is still at the hospital but is expected to make a full recovery. LPA went over proper medication procedure and logging new medications with the Licensee. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.
Regulation
(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs...for the provision of adequate services. This requirement was not met as evidence by:
Inspector finding
Based on interview with the Licensee R1 was administered the incorrect medication because the Licensee failed to verify the medications received by the pharmacy thereby requiring R1 to be hospitilized which poses an immediate health and safety risk to residents in care.
ComplaintOctober 30, 2025· MixedType B1 deficiency
Inspector: Alona Gomez
Plain-language summary
A complaint investigation found that allegations of inadequate food service were unsubstantiated—inspectors observed residents being served quality meals including homemade stew and appropriately prepared food for those on special diets. However, inspectors substantiated allegations that staff were not meeting residents' needs, finding that on October 30, 2025, at 3:30 a.m., two residents with known wandering behavior were found unattended in the facility (one without pants), and that residents requiring incontinence care sometimes went as long as 12 hours between changes, with no set schedule for staff checks of residents, particularly in the evening.
View full inspector notes
LPAs observed that there is adequate food and snacks of good quality available to residents. LPAs also observed that at the time of the visit residents where served lunch at approximately 11:30am that consisted of homemade ground beef stew that included ground beef, tomato paste, peas, potatoes, and onions. LPAs also observed that residents with a puree diet were served a puree of bread, rice, ground beef, tomato paste, peas, potatoes, and onions. Therefore the allegation Staff are not providing adequate food service to resident's is Unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED . exit interview conducted and a copy of this report provided. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LPAs observed that on 10/30/2025 at around 3:30AM R2 was wandering the facility nude from the waist down and R3 was also wandering the facility at the same time. No staff responded to R2 or R3. LPA's also interviewed Administrator and S1 and found that there is not a set schedule for Staff and Staff checks of residents primarily in the evening. LPAs observed in R2 and R3's files that they both have documented wandering behavior. LPA's also found through interview and review of camera footage that residents requiring incontinence care are having as much as a 12 hour gap between having their incontinence changed (6pm-6am). Therefore the allegation of Staff are not meeting residents needs is Substantiated. Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D. Exit interview conducted. Appeal Rights and a copy of this report provided.
Regulation
(a) Facility personnel shall at all times be sufficient in numbers...to meet resident needs...of adequate services. This requirement is not met as evidence by
Inspector finding
Based on observations of facility cameras LPAs observed R2 wandering the facility nude from the waist down at approximately 3:30am on 10/30/2025 as well as R3 wandering around at the same time frame. Both residents have wandering behaviors noted in their files. No staff responded to the residents movments which poses a potential personal rights and safety risk to residents in care.
ComplaintSeptember 18, 2025· UnsubstantiatedNo deficiencies
Inspector: Alona Gomez
Unsubstantiated — the California Department of Social Services (CDSS) investigated and did not find a violation.
Plain-language summary
A complaint alleged the facility lacked night staff and failed to provide drinking water to a resident. Investigators reviewed camera footage, staff schedules, and the facility's water supply, and confirmed that staff are present at night and water is available to residents, though the resident in question chooses to drink their own purchased water. Both allegations were found to be unsubstantiated, and no violations were cited.
View full inspector notes
On the allegations F acility does not have staff on duty at night and Staff does not ensure resident is provided drinking water the following was found: LPAs reviewed camera footage available at the facility for the month of September focusing on the night hours. LPAs observed staff on camera providing care/supervision at night. LPAs reviewed the staff roster along with their schedule and observed that there is at least one staff available on call at night for each night of the week. Therefore the allegation of Facility does not have staff on duty at night is UNSUBSTANTIATED . LPAs also toured the kitchen and observed water bottles available in the pantry as well as cold water from a Britta pitcher available in the refrigerator. Facility states that they primarily utilize the pitcher water offered to residents in a glass. LPAs interviewed S2, Administrator, and Backup Administrator who all confirmed that water is available for all residents. S2 and Administrator states that R1 declines the facilities water and insists on drinking the water that they purchased for themselves. Therefore the allegation of Staff does not ensure resident is provided drinking water is UNSUBSTANTIATED . Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED . No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
ComplaintSeptember 10, 2025· UnsubstantiatedNo deficiencies
Inspector: Alona Gomez
Unsubstantiated — the California Department of Social Services (CDSS) investigated and did not find a violation.
Plain-language summary
A complaint was investigated on August 26, 2025 regarding a resident's alleged assault of staff and behavioral issues at the facility. The investigation found no violation: while staff documented the resident's escalating behaviors and refusals of medical evaluation, there was insufficient evidence to substantiate the assault allegation, and the facility was providing medications as prescribed and had valid certifications and current staff training. The administrator offered the resident new medical assessments and medication management support, which the resident declined.
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On 6/22/2025 an eviction notice was issued to R1 for repeated violation of the facilities house rules. An additional eviction notice was issued on 9/2/2025 for non-payment of August 2025 rent and partial payment of July 2025. LPA reviewed incident reports for R1 and found multiple incidents documented from 6/4/2025 – Present alleging that R1 had in some way violated the house rules and/or other residents personal rights. LPA observed that R1’s care plan dated 4/22/2025 and physicians report dated 5/23/2025 noted R1 as being angry with outbursts however the facility alleged that R1's behaviors were escalating. On 8/16/2025 the facility notified residents that they would be installing cameras in common areas. On 8/26/2025 LPA visited the facility for a case management because it was alleged that R1 assaulted a staff member. During the visit LPA observed R1 yelling and cursing in common areas without provocation. LPA also reviewed camera footage and observed R1 going into another residents room while they were having their incontinence changed and also blocking the caregivers from allowing police into the facility by pressing their feet against the door. LPA requested that a new appraisal and physicians report be done for R1 to assess their change in condition. On 8/26/2025 LPA observed that the facility helped to facilitate the required incidental medical assistance for R1 to receive possible medication assistance and a new physicians assessment. R1 later refused to go to the appointments and update their care plan according to Administrator and W1. LPA observed that the administrator holds a valid administrator certificate and that their backup administrator was knowledgeable of procedures. All staff are also current on their required training's. Facility does not have a MAR but LPA reviewed the medication and was unable to locate where the facility did not provide medications to R1 as prescribed. Throughout the investigations LPA received correspondences from W1 who corroborated that R1's behaviors are escalating and R1 is refusing assistance for their change in condition. Therefore, the above allegations are unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
ComplaintSeptember 8, 2025· UnsubstantiatedNo deficiencies
Inspector: James Sampair
Unsubstantiated — the California Department of Social Services (CDSS) investigated and did not find a violation.
Plain-language summary
A complaint alleged that staff were not providing a resident with a diet appropriate for his health needs. The facility serves the resident a diabetic diet, but he frequently refuses it in favor of foods he personally purchases or requests, such as peanut butter and jelly sandwiches. The investigation found insufficient evidence to support the complaint.
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. . . Continued from LIC 9099 The complaint alleges that staff do not provide R1 with a diet according to resident’s health needs. R1 stated that they do not feed him the food he wants. ADM 1 and ADM 2 stated and the LPA observed that they are serving R1 a diabetic diet but he often refuses to eat it in favor of personally bought food or demands that he be fed non-diabetic foods such as peanut butter and jelly sandwiches. The data collected does not support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it; therefore, the allegation is UNSUBSTANTIATED . Exit interview conducted with ADM 1 and ADM 2 and a copy of this report was provided.
InspectionAugust 26, 2025Type B1 deficiency
Plain-language summary
A licensing analyst visited the facility on August 26, 2025 to investigate a self-reported incident in which a resident assaulted a staff member. The facility was required to update the resident's care plan and obtain a new physician's report by August 29, 2025, and was told to remove a table that was blocking the kitchen passageway.
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On 8/26/25 at 8:30 AM, Licensing Program Analyst (LPA) A. Gomez conducted a case management visit as a result of an self-reported incident report received 8/19/2025. LPA met with Assistant Administrator Elizabeth Boehmer. It was reported that R1 assaulted S1. LPA reviewed R1's care plan and spoke with staff. LPA requested that R1 get an updated care plan and appointment for a new physicians report by 8/29/2025. While at the facility LPA observed the facility blocking the passageway into the kitchen with a round table. LPA had the facility remove the table. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.
Regulation
(d) The following...shall apply to all facilities(6)All... passageways...shall be kept free of obstruction. This requirement was not met as evidence by:
Inspector finding
Based on observation the facility was not in compliance with the above regulation by having a table blocking the passage way into the kitchen which poses a potential safety risk to residents in care.
Other visitMarch 7, 2025Type A5 deficiencies
Inspector: Alona Gomez
Plain-language summary
During a routine annual inspection on March 7, 2025, inspectors found that the facility had unlocked drawers and cabinets containing kitchen knives, scissors, and medications that residents could access, and discovered that an excluded staff member was working at the facility. The facility was also cited for not having a current emergency disaster plan or records of emergency drills, and was assessed a $500 civil penalty.
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On 3/07/2025 at 8:30 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Licensee, Erlinda Gines and explained the purpose of the visit. The facility’s fire clearance was approved for all may be non-ambulatory. LPA toured facility with Licensee including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. Heater is currently out of service since 3/6/2025 and is scheduled for repair 3/7/2025 temperature is maintained at 58 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 109.7 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last purchased on 04/13/2024. Emergency Disaster Plan not available. First aid kit was observed to be complete. At 10am, LPA reviewed 6 residents records. At 10:40 am, LPA reviewed 2 staff records and 2 of 2 have current first aid training and associated to the facility. Report Continues on LIC809-C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: LPA observed kitchen drawer unlocked with butcher Knife and kitchen scissors LPA observed the medication cabinet unlocked and over the counter medication unlocked in kitchen cabinet used by staff. LPA observed staff working at facility that is listed as excluded in Guardian. $500 civil penalty Facility does not have an updated/current emergency disaster plan Facility does not have records of emergency disaster drills ***Civil Penalties in the amount of $500 are being assessed on todays date*** Administrator had to leave the visit early and Licensee approved caregiver to sign report. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.
Regulation
(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage.
Inspector finding
Based on observation, the licensee did not comply with the section cited above in having unlocked sharps which poses an immediate safety risk to persons in care. POC Due Date: 03/07/2025 Plan of Correction 1 2 3 4 Facility staff locked away all sharps POC clear.
Regulation
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (13) For employees that are required to be fingerprinted pursuant to Section 87355, Criminal Record Clearance: (B) Documentation of either a criminal record clearance …
Inspector finding
Based on record review, the licensee did not comply with the section cited above inhaving a staff working at the facility that has been excluded in guardian which poses an immediate safety and personal rights risk to persons in care. POC Due Date: 03/07/2025 Plan of Correction 1 2 3 4 Staff removed all belongings and left the facility POC clear. LPA also assesed an immediate $500 civil penalty.
Regulation
(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.
Inspector finding
Based on observation, the licensee did not comply with the section cited above in having the medication cabinent unlocked and accesable which poses an immediate safety risk to persons in care. POC Due Date: 03/07/2025 Plan of Correction 1 2 3 4 Staff locked and secured the cabinent POC clear.
Regulation
(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following:
Inspector finding
Based on record review, the licensee did not comply with the section cited above innot having an updated emergency disaster plan which poses a potential safety risk to persons in care. POC Due Date: 03/14/2025 Plan of Correction 1 2 3 4 By POC Licensee agrees to update and review emergency disaster plan and mail a copy to CCLD.
Regulation
(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill,…
Inspector finding
Based on record review, the licensee did not comply with the section cited above innot having any record or dates for drills conducted which poses a potential safety risk to persons in care. POC Due Date: 03/14/2025 Plan of Correction 1 2 3 4 By POC Licensee agrees to conduct emergency disaster drills and mail a copy of the logs to CCLD.
ComplaintOctober 25, 2024· MixedType A3 deficiencies
Inspector: Alona Gomez
Plain-language summary
This complaint investigation found that staff failed to notify the resident's doctor about health changes, instead deferring to the resident's niece who was not authorized to make medical decisions, which delayed necessary medical care. The facility also knew since November 2023 that the resident was experiencing financial abuse but waited until March 2024 to report it, leaving the resident vulnerable during that four-month period. All three allegations in the complaint were substantiated.
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Additionally, despite noticing changes in R1’s health condition, the staff failed to notify R1’s physician, as required. The administrator admitted, “I did not contact the physician because I was told that the niece was the main point of contact,” which directly contributed to gaps in R1’s medical care and oversight. Therefore the allegation is SUBSTANTIATED On the allegation "Staff did not prevent resident from being financially abused while in care" it was found that staff were aware of financial issues involving R1 as early as November 2023 but did not act promptly to prevent further financial abuse. The administrator admitted, “ We knew the POA was not paying, and the niece would sometimes pay R1’s rent, ” but a financial abuse report was not filed until March 22, 2024. Additionally, despite being advised to contact Adult Protective Services (APS), staff did not make an immediate report. The administrator further acknowledged that “ we waited too long to do anything because we were trying to be nice and help R1, ” which resulted in prolonged financial vulnerability for R1. Therefore the allegation is SUBSTANTIATED. On the allegation " Staff did not adequately address resident's change in condition" it was found that Staff failed to respond adequately to changes in R1’s health condition. The administrator disclosed that R1’s niece, who was not the designated Power of Attorney (POA), was making significant healthcare decisions on R1’s behalf. When asked about this, the administrator stated, “ We listened to the niece and let her make decisions for R1, even when R1 had a change in condition. ” This deference to an unauthorized individual led to a delay in medical intervention. Staff was unable to adequately provide care to the resident because of the condition change. The administrator admitted that she did not notify R1’s physician, explaining, “ I was told that the niece was the main point of contact. ” However, there was no POA documentation stating that the niece could make decisions for R1. Therefore the allegation is SUBSTANTIATED. LPA also obtained POA documentation along with other documents for R1. LPA was unable to make contact with R1 or any responsible parties for R1. Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED . California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D.
Regulation
a)Each licensee shall furnish...the following:(1)A written report shall be submitted...within seven days of the occurrence of any of the events ... This requirement was not met as evidence by:
Inspector finding
Based on file review and interview the Licensee did not report incidents regarding R1 in a timely manner which posed a potential health and personal rights risk to resident in care.
Regulation
The licensee shall ensure that residents are regularly observed... When changes ... are observed, the licensee shall ensure that such changes are ... brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement was not met as evidence by:
Inspector finding
Based on file review and interview the Licensee did not report changes in R1's condition to the appropiate persons which posed a potential safety and personal rights risk to resident in care.
Regulation
(a) In addition to the rights listed in Section 87468.1,...Residents... privately operated ... shall have...(8)To be free from...financial exploitation...abuse. This requirement was not met as evidence by:
Inspector finding
Based on interview with Administrator they did not stop R1 from being financialy abused which posed an imediate personal rights risk to resident in care.
InspectionApril 8, 2024No deficiencies
Inspector: Alona Gomez
Plain-language summary
On April 8, 2024, inspectors conducted a health and safety inspection after a resident was relocated to this facility due to a fire elsewhere, and found the facility met all requirements: hot water temperature, food supplies, medication storage, fire safety equipment, first aid kit, and emergency detectors were all in place and functioning. The resident who transferred is on hospice care and was not injured in the fire. No violations were found.
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On 04/08/2024 at 11:39 AM, Licensing Program Analyst (LPA) A. Gomez conducted a Health & Safety inspection as a result of CCLD receiving notification of a Resident being relocated to facility due to a fire at another facility. LPA met with Administrator, Erlinda Gines and explained the purpose of the visit. LPAs toured facility including but not limited to the bedrooms, bathrooms, common area, kitchen, and outdoor area. Hot water temperature was measured at 114.2 degrees F in the hallway bathroom. 7-day of non-perishable and 2-day of perishable food supplies were sufficient. Resident's medications were kept locked. Smoke detectors are interconnected with the sprinkler system. A comfortable temperature was maintained at 71 degrees F. Carbon monoxide detector observe. First-aid kit was complete. Fire extinguisher was observed to be full and last serviced on 04/18/2023. There are no accessible bodies of water observed. Indoor and outdoor passageways are free of obstruction. LPA spoke with R1 to see how they are adjusting to the facility. R1 has dementia and was unable to give coherent answers . R1 is currently on Hospice. R1 was seen by the doctors this morning and sustained no injuries due to fire. Administrator is still awaiting residents file. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
InspectionMarch 12, 2024Type B1 deficiency
Inspector: Alona Gomez
Plain-language summary
On March 12, 2024, inspectors conducted a routine annual inspection and found the facility generally clean and safe with adequate lighting, temperature control, working safety equipment, and sufficient food and hygiene supplies. However, inspectors identified that the facility did not have enough staff to meet the needs of all residents, specifically noting that one resident required two-person assistance but adequate staffing was not in place. The facility was also asked to submit updated documentation by March 31, 2024.
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On 3/12/2024 at 10:00AM Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct a 1-Year Annual Required visit and met with Administrator, Erlinda Gines . The facility is cleared for all may be non-ambulatory. LPA toured and inspected the facility inside and outside with administrator including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of seven (7) total bedrooms which four (4) bedrooms are currently occupied by the residents and one (1) bedroom is occupied by staff. The facility has auditory signals on each sliding door in the resident's room. All outdoor and indoor passageways are kept free of obstruction. There were no bodies of water present at this facility. LPA observed medication located in Kitchen and were observed to be locked. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. A comfortable temperature is maintained at 70 degrees Fahrenheit. Hot water temperature in the residents’ shared bathroom was measured at 113.3 degrees F. Resident's bathrooms have grab bars inside the shower. The showers have non-skid mat. Hygiene items, extra linens and toiletry supplies were checked and sufficient. Fire extinguisher in kitchen was last serviced on 4/18/2023, smoke detectors and carbon monoxide were operational. First aid kit was inspected and was complete. Food supplies were sufficient to meet 2-day perishable and 7-day non-perishable requirements. 4 of 4 Resident records were reviewed at approximately 10:15AM. 3 of 3 Staff records were reviewed at approximately 10:36 AM. All staff were fingerprinted and associated to the facility. All staff have current CPR First aid certifications. First Aid kit was observed complete. Emergency disaster plan last reviewed 3/11/2024. report continues on LIC809-C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 The Following Deficiencies were Observed At 10:50 during file review LPA observed and found out through conversation with administrator that there is not adequate staffing for the needs of residents as R4 can require a 2 person assist Updated copies of the following documents were requested for facility file and are to be submitted to CCLD by 03/31/2024: LIC 500 Personnel Report LIC 308 Designation of Administrative Responsibility LIC 610E Emergency Disaster Plan The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.
Regulation
(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall…
Inspector finding
Based on observation and interview, the licensee did not comply with the section cited above in not having enough staff scheduled for a 2 person assist which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 03/12/2024 Plan of Correction 1 2 3 4 Durring visit Administrator called in more staff.
InspectionNovember 30, 2023Type B3 deficiencies
Inspector: Alona Gomez
Plain-language summary
During a routine annual inspection on April 25, 2026, inspectors found the facility well-maintained with proper safety features, adequate supplies, and secure medication storage, but identified that four staff members lacked current First Aid certification, one staff member's file was not properly associated with the facility, and the administrator's file was incomplete (missing physician report, TB screening documentation, and criminal record statement). The facility was given until December 11, 2023 to submit corrected documentation and updated forms to the licensing agency.
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At 10:35 AM Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct a 1-Year Annual Required visit and met with caregiver, Emelia Domingo. Administrator, Erlinda Gines arrived at approximately 11:00AM. The facility staffs all had criminal record clearances to work at the facility. LPA toured and inspected the facility inside and outside with administrator including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of seven (7) total bedrooms which five (5) bedrooms are occupied by the residents and one (1) bedroom is occupied by staff. The facility has auditory signals on each sliding door in the resident's room. All outdoor and indoor passageways are kept free of obstruction. There were no bodies of water present at this facility. LPA observed medication located in Kitchen and were observed to be locked. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the residents’ shared bathroom was measured at 118.1 degrees F. Resident's bathrooms have grab bars inside the shower. The showers have non-skid mat. Hygiene items, extra linens and toiletry supplies were checked and sufficient. Fire extinguisher in kitchen was last serviced on 4/18/2023 , smoke detectors and carbon monoxide were operational. First aid kit was inspected and was complete. Food supplies were sufficient to meet 2-day perishable and 7-day non-perishable requirements. Resident records were reviewed at approximately 11:15AM . Staff records were reviewed at approximately 12:00 PM. The following deficiencies were observed; · At approximately 12:10pm during staff file review LPA observed S1, S2, S3, S4 did not have current First Aid certification. · At approximately 12:20pm during staff file review LPA observed S5 is not associated to facility. · At approximately 12:30pm during staff file review LPA observed Administrator file incomplete missing Physicians report, TB screen, and Criminal record statement. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Continued from LIC809 The following forms are to be updated and submitted to CCLD by 12/11/2023. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (9 pages) Liability Insurance Updated Facility floor plan/ Sketch The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct these deficiencies and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted, a copy of this report provided and appeal rights provided
Regulation
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:
Inspector finding
Based on record review, the licensee did not comply with the section cited above in not having a complete file for administrator which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 12/11/2023 Plan of Correction 1 2 3 4 By POC date administrator agrees to submit a checklist for the required documents in admistrator file to CCLD
Regulation
87411 Personnel Requirements – General (c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 (1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as th…
Inspector finding
Based on record review of five staff, the licensee did not comply with the section cited above in not having the required staff first aid certified which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 12/11/2023 Plan of Correction 1 2 3 4 By POC date Administrator agrees to have all required staff first aid trained and certified and submit certificates to CCLD.
Regulation
87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility(2) Request a transfer of a criminal record clearance as specified in Section 87355(c)
Inspector finding
Based on interview and record review, the licensee did not comply with the section cited above in having S5 not associated to facility which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 12/11/2023 Plan of Correction 1 2 3 4 By POC date administrator agrees to submit the nessesarry documents to associate S5 and self certify submission to CCLD
ComplaintJuly 26, 2022Type B1 deficiency
Inspector: Lizette Francisco
Plain-language summary
An infection control inspection on July 26, 2022 found the facility generally compliant with screening, hygiene, and food safety practices; however, inspectors observed a wooden block blocking a side gate exit, which staff removed during the visit. The facility was asked to submit updated documentation including emergency disaster plans and insurance information by August 1, 2022.
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On 7/26/2022 starting at 10:40 AM, Licensing Program Analyst (LPA) L. Francisco arrived unannounced to conduct Infection Control Inspection. Upon arrival, LPA met with Care Staff, Fely Pisco. Administrator, Erlinda Gines later arrived at 11:24 AM. LPA toured facility with Care Staff including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and backyard. Facility has a sufficient 2-day perishable and one week non-perishable food supply. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, and hand washing posters were observed. Common touched surfaces are disinfected at least once daily. Bathrooms are equipped with liquid soap, paper towel and trash bins. Facility staff were observed to be wearing proper PPE. At 11:50 AM, LPA reviewed 3 staff records and 3 of 3 have health screening and TB test on file. Facility has a mitigation plan and maintains record of routine screening for residents and staff. THE FOLLOWING DEFICIENCY WAS OBSERVED DURING VISIT: At 11:05 AM, LPA observed a 2x4 block placed against the other side of the side gate which was preventing the gate to open. LPA observed staff remove the block. REPORT CONTINUES ON 809C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 8/1/2022. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate The following deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiency by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.
Regulation
(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction.
Inspector finding
Based on observation, the licensee did not comply with the section cited above. LPA observed a 2x4 block placed against the side gate thus preventing the gate to open which poses a potential heatth, safetyy or personal rights risk to persons in care. POC Due Date: 08/01/2022 Plan of Correction 1 2 3 4 LPA observed staff removed block. By POC date, Administrator will review regulation and submit self-certification letter stating Administrator have read and understood regulation.
Federal summary
CMS Care CompareNot a CMS-certified facility
California RCFEs (residential care facilities for the elderly) are licensed by the state, not by CMS. CMS data only applies to skilled nursing facilities or to CCRCs that operate a licensed SNF wing.
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