Burlingame Senior Home 2
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.
1738 Quesada Way · Burlingame, 94010
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
Severity2thWeighted citations per bed
Repeats100thRepeat deficiencies as share of total
Frequency9thDeficiencies 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
Burlingame Senior Home 2 scores D. Better than 37% of comparable California RESIDENTIAL CARE ELDERLY facilities. Severity: bottom 2%. Repeats: top 0%. Frequency: bottom 9%.
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
↑ worseningWeighted severity score per month · 24 months
Weighted score (24mo)
92
Last citation
Feb 26
Finding distribution
24 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.
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
- 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
- 415600648
- License type
- RESIDENTIAL CARE ELDERLY
- License status
- LICENSED
- License expires
- Not yet indexed
- Licensed beds
- 6
- Operator
- Bay Area Residential Care Inc.
Inspections & citations
7
reports on file
24
total deficiencies
14
Type A (actual harm)
InspectionFebruary 25, 2026Type A6 deficiencies
Plain-language summary
On February 25, 2026, an unannounced annual inspection found the facility's bedrooms, bathrooms, and common areas to be in good condition with appropriate safety features like grab bars and locked medication storage. However, inspectors found two knives and two pairs of scissors unlocked and accessible to residents in the kitchen, and the facility could not immediately produce staff training records, one resident's physician report, and emergency drill documentation—a repeat problem from the previous two years that resulted in a $250 penalty.
View full inspector notes
On February 25, 2026 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with Caregiver, Ligaya Munoz, and caregiver, Jonaan Jaochico. LPA explained the purpose of today's visit. Administrator, Fereshteh Ehsanipour arrived an hour later and assisted with the inspection. LPA toured the facility and grounds with caregiver. No accessible bodies of water or fire safety hazards observed. This is a single story facility with 6 resident bedrooms, 1 staff bedroom, 1 full bathroom and 5 half bathrooms.. LPA observed all 6 resident rooms; 1 with a full bathroom and 5 with half baths. Resident's rooms were observed to be private rooms. Bedrooms were equipped with the required furniture for resident to use, Bathrooms were equipped with grab bars, and non-skid mats. Hot water temperature was measured at 108- 117 degrees F. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable present. A comfortable temperature is maintained, lighting is sufficient for comfort. Centrally stored medications, toxins and chemicals were observed to be locked and inaccessible to residents in care. 2 knives and 2 pairs of scissors were observed to be unlocked in the kitchen drawers and accessible to residents in care. A review of (5) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. Emergency Drills were observed to be adequate. 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 Upon entry, caregiver, S1 was not able to provide, annual training records for herself and for S2, resident # 5 (R5)'s physician's report, and emergency disaster drills. According to S1, the administrator has all the files and will bring them to the facility after she was done with escorting a resident to a medical appointment. This observation was observed during the annual inspections in 2024 and 2025. Due to the above observation, an immediate civil penalty of $250 is being assess today for repeat violation- 87755(c) Inspection Authority. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in additional civil penalties. This report is reviewed and discussed with the administrator; a copy of the report and appeal rights were 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) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed scssiors and knifves were in the kitchen drawers unlocked which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 02/26/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure all sharps are locked at all times and provide a copy of the plan of correction to CCL by 2/26/2026.
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) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed R5 has bed rails at the head and foot of the bed which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 02/26/2026 Plan of Correction 1 2 3 4 The administrator stated that she will remove the bed rails by the head of the bed and provide proof/ photo(s) to CCL by 2/26/2026.
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) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed the hot water faucet did not work in R3's room which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 03/11/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure the hot water faucet is fixed and will provide a copy of the plan to CCL by 3/11/2026.
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: (11) A health screening as specified in Section 87411, Personnel Requirements - General.
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed S2's health screen was incomplete which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 03/11/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan of correction to ensure compliance and will provide a copy of S2's health screen to CCL by 3/11/2026.
Regulation
(a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (3) Obtain and evaluate a recent medical assessment.
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed R5's physician report was not signed which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 03/11/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan of correction to ensure compliance and will provide a copy of R5's physician's report to CCL by 3/11/2026.
Inspector finding
based on observation, upon entry, S1 was not able to provided required documents for LPA to inspect. Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above based on observation, upon entry, S1 was not able to provided required documents for LPA to inspect which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 02/26/2026 Plan of Correction 1 2 3 4 The adminis…
Other visitMarch 11, 2025Type A6 deficiencies
Inspector: Murial Han
Plain-language summary
During an unannounced inspection in March 2025, regulators found that medications and sharp objects were stored unlocked and accessible to residents, and that emergency drill documentation was not available—both issues that had also been cited the previous year. The facility was also cited for not having liability insurance on file and assessed a $500 penalty for these repeat violations. The facility's physical conditions, including bedrooms, bathrooms, and safety features like grab bars, were found to be adequate.
View full inspector notes
On March 11, 2025 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with Caregiver, Ligaya Munoz, and caregiver, Isabelita Nojadera. LPA explained the purpose of today's visit. Administrator, Fereshteh Ehsanipour arrived shortly thereafter and assisted with the inspection. LPA toured the facility and grounds with caregiver. No accessible bodies of water or fire safety hazards observed. This is a single story facility with 6 resident bedrooms, 1 staff bedroom, 1 full bathroom and 5 half bathrooms.. LPA observed all 6 resident rooms; 1 with a full bathroom and 5 with half baths. Resident's rooms were observed to be private rooms. Bedrooms were equipped with the required furniture for resident to use, Bathrooms were equipped with grab bars, and non-skid mats. Hot water temperature was measured at 108- 117 degrees F. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable present. A comfortable temperature is maintained, lighting is sufficient for comfort. Centrally stored medications and sharps were observed to be unlocked and accessible to residents in care. Toxins, chemicals and disinfectants were observed to be locked and inaccessible to residents. Upon entrance, staff #2 was not able to provide staff and resident files for LPA to review as part of the inspection process and stated that the administrator has the key to the cabinets. This observation was identified during the annual inspection in 2024. A review of (5) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. Emergency Drills were observed to be inadequate because the administrator was not able to provide documents that it was conducted accordingly. 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 During today's visit, an immediate civil penalty of $500 is being assess as LPA observed 3 repeat violations that were cited during the annual inspection in 2024 :87465(h)(2), 87755(c), and 1569.695(c). The administrator will provide a copy of the liability insurance to CCL by 3/12/2025. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in additional civil penalties. This report is reviewed and discussed with the administrator; a copy of the report and appeal rights were provided.
Regulation
(c) Licensees shall maintain in the personnel records verification of required staff training and orientation.
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as 2 out of 2 staff did not have proof that required annual training was completed which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 03/12/2025 Plan of Correction 1 2 3 4 The administrator will provide a plan of correction to ensure staff training is completed and will provide a copy of the plan to CCL by 3/12/2025.
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) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed medication cabinet and sharps were unlocked and accessible to residents in care which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 03/12/2025 Plan of Correction 1 2 3 4 The administrator will provide a plan of correction to ensure medication cabinet and sharps are locked and inaccessible to resident at all times and will …
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 [(observation) (interview) (record review)], the licensee did not comply with the section cited above as the administrator was not able to provide proof that emergency drills were completed which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 03/12/2025 Plan of Correction 1 2 3 4 The administrator will provide a plan of correction to ensure emergency drills are completed and will provide a copy of the plan to CCL by 3/12/2025.
Regulation
(a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions: (3) A written order from a physicia…
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as 3 residents have bedrails without a physician's order which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 03/12/2025 Plan of Correction 1 2 3 4 The administrator will provide a plan of correction to ensure physician orders are obtained for the residents with bedrails and will provide a copy of the plan to CCL by 3/12/2025.
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 [(observation) (interview) (record review)], the licensee did not comply with the section cited above as 6 out of 6 residents did not have a reappraisal and/or an updated reappraisal which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 03/18/2025 Plan of Correction 1 2 3 4 The administrator will provide a plan of correction to ensure all residents have a reappraisal and/or an updated reappraisal and will provide a copy of the plan to C…
Regulation
87755 Inspection Authority of the Licensing Agency
Inspector finding
S2 was not able to provide staff and residents files for reveiw as the administrator has the key(s) to the file cabinets and the administrator was not on-site upon LPA's entrance. Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above S2 was not able to provide staff and residents files for review as the administrator has the key(s) to the file cabinets and the administrator was not on-site upon LPA's e…
Other visitFebruary 28, 2024No deficiencies
Inspector: Murial Han
Plain-language summary
On February 28, 2024, a state inspector returned to follow up on violations found during an earlier inspection and a civil penalty that had been assessed. The facility had corrected eight of nine violations from the earlier visit, but one violation related to inspection authority had not been fixed by the deadline, resulting in an $800 penalty. During this follow-up visit, the inspector confirmed the remaining violation had been corrected, and the penalties were stopped.
View full inspector notes
On February 28, 2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced plan of correction visit to follow up on a civil penalty that was assessed on 2/22/2024. LPA met with caregiver, Ligaya and explained the purpose of the visit. On February 22, 2024. LPA conducted an unannounced Plan of Correction visit to follow up on the citations that were issued during the annual visit on February 13, 2024. During the visit, LPA reviewed and validated the plan of correction that was submitted by the facility and cleared 8 out of 9 citations. However, LPA observed the remaining citation of 87755(c) Inspection Authority Of The Licensing Agency was not corrected and due to the citation not being corrected by 2/14/2024, a civil penalty in the amount of $800 was assessed from 2/15/2024 through 2/22/2024. During today’s visit, LPA interviewed staff and observed the above citation has been corrected and citation is now cleared. Civil penalties will be stopped on 2/23/2024. This report is reviewed and discussed with caregiver; A copy is provided.
Other visitFebruary 22, 2024No deficiencies
Inspector: Murial Han
Plain-language summary
During a follow-up inspection on February 22, 2024, inspectors found that the facility had not corrected a deficiency from the previous month: staff and caregivers could not access locked record drawers because they did not have keys, which prevented inspectors from reviewing records as required. The facility had submitted a plan to fix this but failed to do so, and the state issued a civil penalty of $800. Most other previously cited deficiencies had been corrected by the time of this visit.
View full inspector notes
On February 22, 2024, Licensing Program Analyst (LPA) conducted an unannounced Plan of Correction (POC) visit to follow up on deficiencies cited on February 13, 2024 during an annual inspection. Upon arrival, LPA was greeted by caregiver, Ligaya Munoz and LPA explained the purpose of the visit. The administrator, Fereshteh Ehsanipour arrived later and assist with the visit. During today's visit LPA observed the following deficiency was not corrected. The administrator submitted a plan of correction on February 14, 2024 stating that facility staff will have access to all locked record drawers. However, upon arrival, facility staff was not able to provided staff and residents records for inspection and they stated that they did not have the key to open the locked record drawers. LPA was not able to conduct record reviews until the arrival of the administrator who has the key(s) the lock drawers. 87755 Inspection Authority of the Licensing Agency ..(c)The licensing agency shall have the authority to inspect, audit, and copy resident or facility records upon demand during normal business hours. Records may be removed i f necessary for copying. Removal of records shall be subject to the requirements in Sections 87 412 (f), 875 06 (d), and 875 08 (b). Due to the above observation and deficiency not being corrected, a civil penalty is being assessed in the amount of $100 a day from 2/15/2024 through 2/22/2024 and will continue to accrue until corrected. A total civil penalty of $800 is being assessed . LPA observed the following deficiencies were corrected: 87309(a) , 87113 , 80065(i)(2), 87468(c)(2) , 87468(c)(2)(A) , 87468(d) , 87465(h)(2) , 87468.1(a)(2). This report is reviewed and discussed with the administrator; A copy is provided with the appeal rights..
InspectionFebruary 22, 2024Type A3 deficiencies
Inspector: Murial Han
Plain-language summary
An unannounced follow-up inspection was conducted on February 22, 2024, following an annual inspection from the previous week. The inspector toured the facility, interviewed staff and residents, and reviewed records, finding at least one deficiency that must be corrected. The facility was notified of the violations and their right to appeal.
View full inspector notes
On February 22, 2024, Licensing Program Analysts (LPA) Murial Han arrived unannounced to conduct an annual continuation for an annual required inspection that was conducted on February 13, 2024. LPA met with caregiver, Ligaya Munoz and explained the purpose of the visit. The administrator arrived momentarily and assisted with the inspection. During today's visit, LPA toured the facility, interviewed staff and residents, review records and resident and staff files. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with the administrator. A copy of this report and appeal rights were provided.
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 [(observation) (interview) (record review)], the licensee did not comply with the section cited above as the administrator was not able to provide documentation of the drills for 2023 to present which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 02/23/2024 Plan of Correction 1 2 3 4 The administrator will conduct a drill immediately and provide a copy of the staff in-service sign-in record of the drill to CCL by 2/23/2024. In addition, t…
Regulation
(a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (2) Perform a pre-admission appraisal.
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as 2 out of 3 residents did not have documents to proof that preadmission appraisal were completed which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/29/2024 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure all pre-admission appraisal is completed and will provide a copy of the plan to CCL by 2/29/2024.
Regulation
(d) A facility shall review the plan annually and make updates as necessary, including changes in floor plans and the population served. The licensee or administrator shall sign and date documentation to indicate that the plan has been reviewed and updated as necessary.
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as the administrator was not able to provide proof that this plan was reviewed and updated accordingly which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/29/2024 Plan of Correction 1 2 3 4 The administrator will provide a copy of the updated emergency disaster plan to CCL by 2/29/2024 and will submit a plan to CCL by 2/29/2024 to …
InspectionFebruary 13, 2024Type A9 deficiencies
Inspector: Murial Han
Plain-language summary
During an unannounced annual inspection on February 13, 2024, inspectors found that medications and cleaning supplies were stored unlocked and accessible to residents, and two medications for one resident were expired. The inspector was unable to complete a full review of resident and staff records because the administrator had locked the files and was not present, so a follow-up inspection will be needed. The facility was otherwise found to be properly maintained with adequate bathrooms, grab bars, and appropriate temperature controls.
View full inspector notes
On February 13, 2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with Caregiver, Ligaya Munoz, and caregiver, Isabelita Nojadera. Administrator, Fereshteh Ehsanipour was not available to join the inspection. LPA explained the purpose of the visit. LPA toured the facility and grounds with caregiver. No accessible bodies of water or fire safety hazards observed. This is a single story facility with 6 resident bedrooms, 1 staff bedroom, 1 full bathroom and 5 half bathrooms.. LPA observed all 6 resident rooms; 1 with a full bathroom and 5 with half baths. Resident's rooms were observed to be private rooms. Bedrooms were equipped with the required furniture for resident to use, Bathrooms were equipped with grab bars, and non-skid mats. Hot water temperature was measured at 106- 110 degrees F. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable present. A comfortable temperature is maintained, lighting is sufficient for comfort. Centrally stored medications, toxins, and sharps were observed to be unlocked and accessible to residents. LPA reviewed centrally stored medication and observed 2 medications for resident #1 (R1) to be expired. LPA requests the following forms to be submitted to CCLD by 2/15/2024 LIC308 Designation of Administrative Responsibility LIC309 Administrative Organization Liability Insurance Administrator Certificate 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 was not able to complete the inspection today and will return on another day as the resident and staff records were locked and not accessible for review. According to the staff, they do not have access to the files and the administrator is the only one who has the keys to the files. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with caregiver. A copy of this report and the appeal rights were provided.
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) (interview) (record review)], the licensee did not comply with the section cited above as chemicals stored underneath the kitchen sink were unlocked which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 02/14/2024 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure all the toxins and chemicals are locked at all times. The administrator will provide a copy of the plan of correction and photos to proof tha…
Inspector finding
Staff Association Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as S1 who was hired in March 2023 is not associated with the facility which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 02/14/2024 Plan of Correction 1 2 3 4 The administrator will associate S1 immediately and provide proof of S1's association to CCL by 2/14/2024.
Regulation
The license shall be posted in a prominent location in the licensed facility accessible to public view.
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA did not observed it was posted during tour which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/20/2024 Plan of Correction 1 2 3 4 The administrator will ensure the license is posted and provide a photo to CCL by 2/20/2024.
Regulation
(c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. (2) Information on the appropriate reporting agency in case of a complaint or emergency, including procedures for filing confidential complaints, shall be posted as follows:
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA did not observed it was posted during the tour and according to the administrator, it fell and was not reposted which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/20/2024 Plan of Correction 1 2 3 4 The administrator will ensure the license is posted and provide a photo to CCL by 2/20/2024.
Regulation
(c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. (2) Information on the appropriate reporting agency in case of a complaint or emergency, including procedures for filing confidential complaints, shall be posted as follows: (…
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA did not observed it was posted during the tour and according to the administrator, it fell and was not re-posted which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/20/2024 Plan of Correction 1 2 3 4 The administrator will post the required posters and will provide a photo to CCL of the above poster by 2/20/2024.
Regulation
(d) Licensees shall post the personal rights, nondiscrimination notice, and complaint information specified above in English, and, in any other language in which at least five (5) percent of the residents can only read that other language.
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA did not observed it was posted during the tour and according to the administrator, it fell and was not reposted which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/20/2024 Plan of Correction 1 2 3 4 The administrator will post the required posters and will provide a photo to CCL of the above poster by 2/20/2024.
Inspector finding
centrally stored medication observed to be not locked and accessible to residents in care. Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as centrally stored medication observed to be not locked and accessible to residents in care which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 02/14/2024 Plan of Correction 1 2 3 4 The administrator shall devel…
Inspector finding
Personal Rights of Residents in All Facilities Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed 2 of resident #1's medications were expired which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 02/14/2024 Plan of Correction 1 2 3 4 The administrator will review all resident's medication to ensure all medications are not expired and will…
Inspector finding
Inspection Authority of the Licensing Agency Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as resident and staff records/files were locked and inaccessible for LPA to review which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 02/14/2024 Plan of Correction 1 2 3 4 The administrator shall develop a plan to ensure records are available to inspect acc…
ComplaintMarch 28, 2022No deficiencies
Inspector: Komal Charitra
Plain-language summary
On March 28, 2022, an inspector made an unannounced annual visit and found no violations at this six-bed facility. The inspector observed good infection control practices and proper storage of medications and hazardous materials, and offered minor suggestions such as adding hand-washing signage and switching to paper towels in bathrooms and the kitchen. The facility was asked to submit routine administrative paperwork by April 4, 2022.
View full inspector notes
On March 28, 2022, at 11;45am, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual inspection. Upon arrival, LPA did not observe COVID signage posted at the front door. LPA met with Caregiver, Ligaya Munoz, and Administrator, Fereshteh Ehsanipour joined shortly thereafter. LPA Charitra explained the purpose of the visit. This is a single story facility with 6 resident bedrooms, 1 staff bedroom, 1 full bathroom and 5 half bathrooms. LPA toured the facility and grounds with the Administrator. No accessible bodies of water or fire safety hazards observed. Infection control practices are observed: entry procedures, screening log documentation for staff, visitors, and residents, and 30-day PPE supply. LPA observed the main bathroom and advised Administrator to put a hand-washing sign and to ensure the trash is covered with a lid. In addition, LPA advised Administrator to remove all hand-towels and to replace them with paper-towels. LPA observed all 6 resident rooms; 1 with a full bathroom and 5 with half baths. Resident's rooms were observed to be private rooms; 1 room is vacant at this time. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable present. Medications, toxins and sharps are stored appropriately and inaccessible to residents, and a comfortable temperature is maintained, lighting is sufficient for comfort. First aid kit was observed to be completed. LPA advised Administrator, to ensure hand-towels are not in the kitchen. LPA requests the following forms to be submitted to CCLD by 4/4/22: LIC308 Designation of Administrative Responsibility LIC500 Personnel Report Administrator Certificate LIC610E Emergency Disaster Plan No deficiencies were cited during the visit. LPA reviewed the report with caregiver, and a copy is provided.
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.
Family reviews
No reviews yet — be the first to share your experience
No published reviews yet. Use the button above to share your experience.