StarlynnCare

California · Alamo

New Alamo Residence Home

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.

836 Stone Valley Rd · Alamo, 94507

Quick facts

Licensed beds6
Memory careNot listed
Last inspectionFeb 2026
Last citationFeb 2026
Operated bySamamesh Llc
Map showing location of New Alamo Residence Home

Quality snapshot

Updated April 25, 2026

Compared 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

Severity
12th

Weighted citations per bed

Repeats
100th

Repeat deficiencies as share of total

Frequency
3th

Deficiencies per inspection

Tick mark at 50% = peer median · higher percentile = better facility

New Alamo Residence Home scores D. Better than 38% of comparable California RESIDENTIAL CARE ELDERLY facilities. Severity: bottom 12%. Repeats: top 0%. Frequency: bottom 3%.

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

↑ worsening

Weighted severity score per month · 24 months

May 24peer medianApr 26

Weighted score (24mo)

66

Last citation

Feb 26

Finding distribution

15 total · 36 months

Scope × Severity (CMS A–L)

IsolatedPatternWidespreadJKLG3HID12EFABCSev 4 · IJSev 3Sev 2Sev 1

View inspections & citations

The rules that apply to this facility

California Title 22 requirements for this facility, with the specific regulation and a suggested question for each.

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.

What must this facility report to the state — and how fast?22 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).

How does CDSS enforce these rules?22 CCR §87755–87777 / HSC §1569.58
  1. 1Notice of DeficiencyWritten citation with a correction deadline. Facility must submit a Plan of Correction.
  2. 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.
  3. 3Suspension of AdmissionsFacility cannot accept new residents until violations are corrected.
  4. 4Temporary Suspension or RevocationEmergency suspension for imminent danger; full revocation after administrative hearing.
  5. 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 citations

State records

California Dept. of Social Services · Community Care Licensing
License number
079200940
License type
RESIDENTIAL CARE ELDERLY
License status
LICENSED
License expires
Not yet indexed
Licensed beds
6
Operator
Samamesh Llc

Inspections & citations

8

reports on file

22

total deficiencies

5

Type A (actual harm)

Other visitFebruary 4, 2026Type A
13 deficiencies

Plain-language summary

During a routine annual inspection on February 4, 2026, inspectors found multiple safety and care concerns: medications and cleaning supplies were unlocked and accessible to residents, a lit candle was left unattended in a bedroom, a fire exit was blocked, bathrooms lacked non-skid mats, hot water in one bathroom exceeded safe temperature, and rat droppings were found in a storage shed. The facility also did not provide balanced or varied meals to meet residents' nutritional needs, lacked activity programming, and had staff training records that were not current. The state issued civil penalties totaling $750 for these violations.

View full inspector notes

On 2/4/2026 at 8:30 AM, Licensing Program Analysts (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Meeran Saxena and explained the purpose of the visit. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden residents. LPA toured facility with staff including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 8 total bedrooms which 6 bedrooms are occupied by the residents and 2 bedrooms are occupied by staff. All outdoor and indoor passageways are not kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars. There is a minimum of 2-day supply of perishable foods. Centrally stored medication and sharps were not locked and inaccessible to residents. Hot water temperature measured at 121.0 and 119.9 Degrees Fahrenheit. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last purchased on December 2025. Emergency Disaster Plan was last posted on 11/24/2024 (TV issued). First aid kit was observed to be complete. Emergency disaster drill was last conducted on 12/16/2025. At 10:00am, LPA reviewed 6 residents records. At 10:30 am, LPA reviewed 3 staff records and 3 of 3 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: At 9:14am LPA observed under kitchen sink cabinet unlocked with cleaning solutions/poisons, also observed on kitchen counter unsecured blue/cheeta print scissors/ yellow lighter and pink scissors in shared bathroom At 9:15am LPA observed unsecured prescription and PRN medications in kitchen cabinets (Aleve, Amlodipine), also unsecured medication in refrigerator on door (stomach relief, Lactulose, and NyQuil) At 9:20am LPA observed that the facility does not have enough food and of variety to meet the nutritional needs of residents At 9:21am LPA observed an unsupervised burning candle in room 2 At 9:21am LPA observed full bed rails on R6's bed without the required documentation/exception At 9:27am LPA observed that both bathrooms do not have non-skid mats At 9:30am LPA observed that hot water measured at 121 degrees Fahrenheit in 1 of 2 bathrooms At 9:36am LPA observed that extra supplies/PPE are being stored in a shed in the backyard and observed rat droppings throughout At 9:37am LPA observed fire exit from living room slider blocked with a stick placed to prevent the door from being opened inside At 10:15am during file review LPA observed R1, and R3 do not have up to date physicians reports or appraisals At 10:30am during file review LPA observed S2 and S3 do not have their required yearly training's up to date. At 12:10pm LPA observed the facility is not serving balanced meals and had to advise them during lunch (served boiled carrots, meatballs, cake, water) LPA observed throughout visit that facility does not have planned activities and also no activity calendar ***An immediate civil penalty for $500 is being assessed on todays date*** ***A civil penalty in the amount of $250 is being assessed for repeat violation on todays date*** Administrator Had to leave for an appointment and approved Caregiver, Steven Bagunas to sign off on report(s). Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 3/1/2026: LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance

Type ACCR §87309(a)

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 dangerous items accesable which poses an immediate safety risk to persons in care. POC Due Date: 02/04/2026 Plan of Correction 1 2 3 4 Items removed POC clear

Type ACCR §87465(h)(1)

Regulation

(h) The following requirements shall apply to medications which are centrally stored: (1) Medications shall be centrally stored under the following circumstances:

Inspector finding

Based on observation, the licensee did not comply with the section cited above in not securiing medications which poses an immediate safety risk to persons in care. POC Due Date: 02/04/2026 Plan of Correction 1 2 3 4 Staff secured medications POC clear

Type BCCR §87303(e)(2)

Regulation

(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C).

Inspector finding

Based on observation, the licensee did not comply with the section cited above in hot water being over 120 degrees F in 1 out of 2 bathrooms which poses a potential safety risk to persons in care. POC Due Date: 03/01/2026 Plan of Correction 1 2 3 4 By POC facility will adjust water and notify CCLD

Type BCCR §87303(e)(5)

Regulation

(5) Slip-resistant mats, strips, or flooring shall be used in all bathtub and shower floors.

Inspector finding

Based on observation, the licensee did not comply with the section cited above in not having any slip resistant mats in the showers which poses a potential safetyrisk to persons in care. POC Due Date: 03/01/2026 Plan of Correction 1 2 3 4 By POC facility will obtain and install mats and notify CCLD

Type BCCR §87307(e)(1)

Regulation

(e) The licensee shall supervise residents as needed and as determined by the resident's appraisal pursuant to Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, when residents are in proximity to or when there is use of the following items: (1) Ranges, ovens, heaters, fireplaces, wood stoves, inserts, and other heating devices…

Inspector finding

Based on observation, the licensee did not comply with the section cited above in having a lit candle in R6's room unsupervised which poses a potential safety risk to persons in care. POC Due Date: 02/04/2026 Plan of Correction 1 2 3 4 Candles removed POC clear

Type BCCR §87308(c)

Regulation

(c) General storage space shall be maintained for equipment and supplies as necessary to ensure that space used to meet other requirements of these regulations is not also used for storage.

Inspector finding

Based on observation, the licensee did not comply with the section cited above in not having the storage area maintained and PPE/Supplies covered in rat droppings which poses a potential health and personal rights risk to persons in care. POC Due Date: 03/01/2026 Plan of Correction 1 2 3 4 By POC facility will reorganize and have pest control come and notify CCLD

Type B

Regulation

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivisi…

Inspector finding

Based on record review, the licensee did not comply with the section cited above in 2 out of 3 staff not having met training requirements which poses a potential personal rights risk to persons in care. POC Due Date: 03/01/2026 Plan of Correction 1 2 3 4 By POC facility agrees to have staff trained by a CCLD approved vendor and notify CCLD

Type BCCR §87219(a)

Regulation

(a) Residents shall be encouraged to maintain and develop their quality of life through participation in a variety of planned activities. The activities made available shall include:

Inspector finding

Based on observation, the licensee did not comply with the section cited above in not conducting activities or having an activities schedule being followed which poses a potential personal rights risk to persons in care. POC Due Date: 03/01/2026 Plan of Correction 1 2 3 4 By POC facility will develop and implement an daily activities schedule and document activies and notify CCLD

Type BCCR §87555(a)

Regulation

(a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents an shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner.

Inspector finding

Based on observation, the licensee did not comply with the section cited above in not having food stocked/ served to meet the nutrition requriements which poses a potential health and personal rights risk to persons in care. POC Due Date: 03/01/2026 Plan of Correction 1 2 3 4 By POC facility agrees to review the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council and purchace food accordingly and notify CCLD. Facility also agrees to develop a poster …

Type BCCR §87555(b)(26)

Regulation

(26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises.

Inspector finding

Based on observation, the licensee did not comply with the section cited above in not having a one week supply of non-erishable foods which poses a potential health and personal rights risk to persons in care. POC Due Date: 03/01/2026 Plan of Correction 1 2 3 4 By POC facility agrees to purchase an additional emergency supply food bucket and notify CCLD

Type BCCR §87463(a)

Regulation

(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, th…

Inspector finding

Based on record review, the licensee did not comply with the section cited above in 3 out of 6 residents not having up to date appraisals which poses a potential personal rights risk to persons in care. POC Due Date: 03/01/2026 Plan of Correction 1 2 3 4 By POC facility agrees to have appraisals updated and notify CCLD

Type BCCR §87608(a)(5)(B)

Regulation

(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails.

Inspector finding

Based on observation and record review, the licensee did not comply with the section cited above in R6 having full bed rails without the required conditions being met which poses a potential personal rights risk to persons in care. POC Due Date: 03/01/2026 Plan of Correction 1 2 3 4 By POC facility agrees to take the neccasary steps to see if they can get an exception for R6's bed rails and notify CCLD.

Type ACCR §87203

Regulation

All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic.

Inspector finding

Based on observation, the licensee did not comply with the section cited above in living room fire exit blocked with a stick preventing it from opening on the inside which poses an immediate safety risk to persons in care. POC Due Date: 02/04/2026 Plan of Correction 1 2 3 4 Stik removed POC clear

ComplaintAugust 8, 2025· MixedType B
2 deficiencies

Inspector: Alona Gomez

Plain-language summary

This complaint investigation examined allegations that staff threw an item at a resident, spoke to residents inappropriately, and asked residents for monetary gifts. The investigator found these allegations unsubstantiated—while one staff member reported witnessing inappropriate speech and gift requests, they could not identify specific staff involved, the resident interviewed expressed happiness with the facility, and the investigator did not observe such behavior during visits.

View full inspector notes

Pertaining to allegations: Staff threw an item at resident, Staff spoke to resident in an inappropriate manner, and Staff solicited a monetary gift from resident. On 2/21/2025 LPA interviewed S1 who stated that they have not heard any staff speak to residents inappropriately. LPA gave examples of what might be inappropriate comments/conversations and S1 maintained that they have not witnessed that behavior. S1 also stated that no staff have ever thrown any items at residents or requested monetary gifts. S1 stated that sometimes around the holidays families will give small gifts to staff but never the residents. On the same day LPA interviewed S2 who stated that they have never observed staff throw any items at residents. S2 did confirm that they have witnessed staff speak to residents inappropriately and ask for gifts but that they believe that when staff asked for gifts it was in a joking manner. Although S2 confirmed that they have witnessed other staff speak to residents inappropriate S2 did not provide specific staff which brought into question their credibility. LPA did not witness any staff speaking to residents inappropriately during any visits. LPA briefly spoke with R1 an annual visit who expressed happiness at the facility and had no complaints. LPA was unable to interview other residents due to their cognitive abilities. Therefore the 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 . 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 LPA did conduct subsequent visits and observed that the temperature was within the 68-85 degree Fahrenheit range and that the facility had purchased additional food. Therefore the above allegations are SUBSTANTIATED. Based on LPAs observations and interviews which were conducted 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.

Type BCCR §87303(b)(1)

Regulation

(b) A comfortable temperature maintained at all times.(1)The facility shall...minimum of 68 degree F, (20 degrees C). This requirement is not met as evidence by:

Inspector finding

Based on observation, the licensee did not comply with the section cited above. On 2/21/25 LPA observed the facility temprature at 64 degrees F which posed a potential personal rights risk to persons in care.

Type BCCR §87555(b)(26)

Regulation

(b) The following...shall apply:(26)Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained... This requirement is not met as evidence by:

Inspector finding

Based on observation, the licensee did not comply with the section cited above. LPA observed that the facility did not have the required 2 days of perishables and 7 days of non- perishable foods. which posed a potential personal rights risk to persons in care.

InspectionMarch 14, 2025
No deficiencies

Inspector: Alona Gomez

Plain-language summary

An unannounced annual inspection on February 15, 2024 found the facility in compliance with all requirements, including proper fire safety equipment, adequate lighting and temperature, secure medication storage, and staff with current first aid training. The facility is licensed to care for up to five non-ambulatory and one bedridden resident, and all common areas and bedrooms met safety standards with grab bars and non-slip mats in bathrooms. No deficiencies were cited.

View full inspector notes

On 2/15/2024 at 3:00 PM, Licensing Program Analysts (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Meeran Saxena and explained the purpose of the visit. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden residents. LPA toured facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 8 total bedrooms which 4 bedrooms are occupied by the residents and 2 bedrooms are occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. 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. Hot water temperature measured at 117.2 Degrees Fahrenheit. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last purchased on 1/25/2025. Emergency Disaster Plan was last posted on 11/24/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 3/02/2025. At 10:45am, LPA reviewed 4 residents records. At 11:30 am, LPA reviewed 3 staff records and 3 of 3 have current first aid training and associated to the facility. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

InspectionFebruary 15, 2024
No deficiencies

Inspector: Alona Gomez

Plain-language summary

On February 15, 2024, the state conducted a routine annual inspection of the facility and found no violations. The facility was approved to care for up to six residents, had proper safety equipment including working smoke and carbon monoxide detectors, adequate lighting and temperature control, grab bars in bathrooms, locked medication storage, and sufficient food supplies; staff met training requirements for first aid and CPR. The facility was asked to submit updated administrative and insurance documents by the end of February.

View full inspector notes

On 2/15/2024 at 3:00 PM, Licensing Program Analysts (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Meeran Saxena and explained the purpose of the visit. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden residents. There are 6 residents and 2 staff present during inspection. LPA toured facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 8 total bedrooms which 6 bedrooms are occupied by the residents and 2 bedrooms are occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. 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. Hot water temperature measured at Degrees Fahrenheit. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was serviced on 3/17/2023. Emergency Disaster Plan was last updated on 3/23/2023. First aid kit was observed to be complete. Fire drill was last done 12/18/2023 At 3:30 PM, LPA reviewed 3 staff records and 2 of 3 have current first aid training and at least 1 staff have CPR training per shift. REPORT CONTINUES 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 2/29/2024 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 No Deficiencies cited during visit Exit interview conducted and a copy of this report provided.

InspectionMarch 15, 2023Type A
6 deficiencies

Inspector: Lizette Francisco

Plain-language summary

During a routine annual inspection on March 15, 2023, inspectors found several safety issues: medication stored in a resident's bedroom instead of locked storage, cleaning supplies stored in an unlocked bathroom cabinet, a broken sliding screen door in a resident's bedroom, one staff member's first aid training expired in 2020, emergency drills had not been conducted since 2019, and resident records were not readily available. The facility was required to correct these deficiencies and submit updated documentation by March 31, 2023, with inspectors scheduled to return for a follow-up visit.

View full inspector notes

On 3/15/2023 at 9:30 AM, Licensing Program Analysts (LPAs) L. Francisco and C. Fowler arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Administrator, Meeran Saxena and explained the purpose of the visit. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden residents. There are 6 residents and 4 staff present during inspection. LPAs toured facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 8 total bedrooms which 6 bedrooms are occupied by the residents and 2 bedrooms are occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 74 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. 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 serviced on 1/9/2022 Emergency Disaster Plan was last posted on 3/15/2023. First aid kit was observed to be complete. At 11:15 AM, LPAs reviewed 3 staff records and 2 of 3 have current first aid training and at least 1 staff have CPR training per shift. At 1:40 PM, LPA reviewed a sample of resident's medications. REPORT CONTINUES 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 THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: -at 9:58am, LPAs observed Tylenol stored inside medication cabinet in R2's bedroom -at 10:07am, LPAs observed unlocked clorox, drain cleaner, and oxyclean underneath bathroom sink -at 10:28am, LPA observed R3's sliding screen door is off track and in disrepair. -at 11:50am, LPA observed S1's first aid training expired December of 2020 -at 12:15pm, LPA observed quarterly drill was last completed in 2019. -at 12:25pm, LPA observed residents records are not maintained and available to LPAs. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 3/31/2023 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 deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and 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. LPA will return for annual continuation at a later time.

Type ACCR §87309(a)

Regulation

(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.

Inspector finding

Based on observation, the licensee did not comply with the section cited above. LPAs observed unlocked clorox, drain cleaner and oxy cleaner stored underneath bathroom sink cabinet which poses an immediate health and safety risk to persons in care. POC Due Date: 03/16/2023 Plan of Correction 1 2 3 4 DEFICIENCY CLEARED DURING VISIT. LPAs observed Administrator removed items and locked it away.

Type ACCR §87465(h)(2)

Regulation

87465(h)(2) INCIDENTAL MEDICAL AND DENTAL CARE (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 by having unlocked tylenol stored inside medication cabinet in R2's bathroom which poses an immediate health and safety risk to persons in care. POC Due Date: 03/16/2023 Plan of Correction 1 2 3 4 DEFICIENCY CLEARED DURING VISIT. LPAs observed Administrator removed tylenol and locked it away.

Type B

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 by not completing quarterly drills for each shift which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 03/20/2023 Plan of Correction 1 2 3 4 By POC date, Administrator agrees to conduct a drill with staff for each shift and submit a copy of drill with staff signatures to CCLD.

Type BCCR §87203

Regulation

87203 FIRE SAFETY All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic.

Inspector finding

Based on observation, the licensee did not comply with the section cited above. LPA observed fire extinguisher was last serviced on 1/9/22 which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 03/31/2023 Plan of Correction 1 2 3 4 By POC date, Administrator agrees to submit photo to CCLD

Type BCCR §87411(c)(1)

Regulation

87411(c)(1) 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…

Inspector finding

Based on record review and interview, the licensee did not comply with the section cited above. LPAs observed S1's first aid expired in December of 2020 and S1 stated S1 provides care which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 03/31/2023 Plan of Correction 1 2 3 4 By POC date, Administrator agrees to send a copy of S1's first aid certificate.

Type BCCR §87506(a)

Regulation

RESIDENT RECORDS (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff.

Inspector finding

Based on record review, the licensee did not comply with the section cited above by not having all residents records maintained and available to LPAs which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 03/24/2023 Plan of Correction 1 2 3 4 By POC date, Administrator agrees to maintain residents record at facility and submit self certification letter to CCLD

ComplaintJune 24, 2022Type B
1 deficiency

Inspector: Lizette Francisco

Plain-language summary

This was an unannounced infection control inspection in June 2022. The facility had adequate food supplies, proper screening procedures, hand sanitizer stations, and adequate personal protective equipment, but inspectors found that one staff member hired in March 2022 did not have a vaccination exemption on file and was not receiving required weekly COVID-19 testing as mandated at that time. The facility was asked to submit updated documentation by July 1, 2022, and was cited for this deficiency.

View full inspector notes

On 6/24/2022 at 12:25 PM, Licensing Program Analyst (LPA) L. Francisco arrived unannounced to conduct Infection Control Inspection. Upon arrival, LPA was greeted by Care Staff, Irene Joseph. Administrator, Meeran Saxena later arrived at 12:40 PM. During the Infection Control Inspection, LPA toured facility with Administrator 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. Visitors policy is posted on the front entrance. 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 Social distancing and hand washing posters were observed. Common touched surfaces are disinfected at least once daily. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. During record review, LPA reviewed 3 staff records and 3 of 3 have health screening and TB test results on file. Facility has a mitigation plan on file. THE FOLLOWING DEFICIENCY HAS BEEN OBSERVED At 1:15 PM, during record review and interview, S1 has been employed since March 2022, and no vaccination exemption on file is maintained in accordance to Public Health Order and PIN 22-05.1-ASC At 1:20 PM, during record review, weekly COVID-19 testing is not being conducted for S1 according to Public Health Order on September 28, 2021 and PIN 21-32.1-ASC 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 7/1/2022: 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. Administrator authorized Care Staff, Irene Joseph to sign report. Exit interview conducted with Care Staff. Appeal Rights and a copy of this report provided.

Type BCCR §87405(d)(2)

Regulation

87405(d)(2) Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (2) Knowledge of and ability to conform to the applicable laws, rules and regulations.

Inspector finding

Based on record review, the licensee did not comply with the section cited above. S1 does not have an exemption for COVID-19 on file and weekly COVID-19 testing is not being conducted in accordance to Public Health Order and PIN 22-05.1-ASC which poses a potential health and safety risk to persons in care.. POC Due Date: 07/08/2022 Plan of Correction 1 2 3 4 By POC, Administrator will submit a plan to CCLD indicating whether S1 will have an exemption on file or obtain COVID-19 vaccination and…

Other visitJune 24, 2022
No deficiencies

Inspector: Lizette Francisco

Plain-language summary

An inspector visited the facility on June 24, 2022 to investigate a complaint and found that a staff member was working at the facility without having completed the required fingerprint clearance process; the staff member had been working there since at least November 2021. The facility was cited for this violation and assessed a $500 civil penalty.

View full inspector notes

On 6/24/2022 at 12:25 PM, Licensing Program Analyst (LPA) L. Francisco arrived unannounced to conduct a Case Management visit. Upon arrival, LPA was greeted by Care Staff, Irene Joseph. Administrator, Meeran Saxena later arrived at 12:40 PM The Department conducted interviews and record during the course of investigation for complaint (#15-AS-20211222084738), the following deficiency was observed. Based on record review, S1 is not fingerprint cleared. S1 stated S1 has been living and employed with the facility since 11/05/2022. According to S2, S1 was employed on 11/15/2021. Although dates of employment are conflicting, record review shows that S1 is not cleared and The Department observed S1 working at the facility on 12/21/2021. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiency may result in civil penalties. A $500 Civil Penalty is being observed Administrator authorized Care Staff, Irene Joseph to sign report. Exit interview conducted with Care Staff. A copy of this report and appeal rights provided.

InspectionDecember 27, 2021
No deficiencies

Inspector: Lizette Francisco

Plain-language summary

This was a health and safety inspection conducted in December 2021 following a priority complaint. The facility had adequate food supplies, working smoke detectors and carbon monoxide detectors, charged fire extinguishers, and sufficient staffing; however, inspectors found that one staff member's fingerprint clearance was not properly associated with the facility in records.

View full inspector notes

On 12/27/2021 starting at 3:30 PM, Licensing Program Analyst (LPA) L. Francisco conducted a Health and Safety Inspection as a result of the Deparment receiving a Priority 1 complaint (#15-AS-20211222084738). LPA met with Administrator, Meeran Saxena. LPA toured facility including but not limited to the bedrooms, bathrooms, common area, kitchen, and outdoor area. There is a minimum of 2-day perishable and one week non-perishable food supply. LPA observed smoke detectors and carbon monoxide throughout facility. Fire extinguishers were observed to be fully charged. LPA reviewed LIC 500 and observed facility has sufficient staffing to meet resident's needs. -At 3:25 PM during record review, LPA observed S1 is fingerprint cleared. However, is not associated to the facility. The following deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. 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.

Federal summary

CMS Care Compare

Not 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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