Janie's 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.
197 Flying Cloud Isle · Foster City, 94404
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
Severity0thWeighted citations per bed
Repeats100thRepeat deficiencies as share of total
Frequency13thDeficiencies 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
Janie's Home scores D. Better than 38% of comparable California RESIDENTIAL CARE ELDERLY facilities. Severity: bottom 0%. Repeats: top 0%. Frequency: bottom 13%.
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)
109
Last citation
Jan 26
Finding distribution
25 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
- 415600809
- License type
- RESIDENTIAL CARE ELDERLY
- License status
- LICENSED
- License expires
- Not yet indexed
- Licensed beds
- 6
- Operator
- M3flyingc Inc.
Inspections & citations
9
reports on file
25
total deficiencies
20
Type A (actual harm)
Other visitFebruary 25, 2026No deficiencies
Plain-language summary
On February 25, 2026, inspectors conducted a follow-up visit to check whether the facility had corrected violations from an earlier inspection, including inadequate hot water temperature in resident bathrooms and an unlocked medication room. Both issues have been fixed—water temperature is now in the safe range and the medication room is now locked—and a $1,300 civil penalty that was imposed has been stopped. A question about whether the facility's liability insurance meets requirements is being clarified by the insurance broker.
View full inspector notes
On February 25, 2026, Licensing Program Analyst (LPA) Murial Han conducted an unannounced plan of correction visit to follow up on a civil penalty that was assessed. LPA met with administrator, Mitzi Murphy and LPA explained the purpose of today's visit. On February 5, 2026. LPA conducted an unannounced Plan of Correction visit to follow up on the citations that were issued during the annual visit on January 20, 2026. During the visit, LPA reviewed and validated the plan of correction that was submitted by the administrator and cleared 3 out of 5 citations and the following citations were not cleared: 87303(e)(2) Maintenance and Operation (hot water temperature), and 87465(h)(2) Incidental Medical and Dental Care Services (medication room unlocked). Due to the above citations that were not cleared, a civil penalty in the amount of $1300 was assessed from 1/30/2026 through 2/5/2026. During today’s visit, LPA observed the above citations are now cleared as the water temperature in the resident bathrooms was measured at 106-110 degree F and the medication room was locked and inaccessible to residents in care. Civil penalties will be stopped on 2/6/2026. During today's visit, LPA also followed-up on the current liability insurance as the facility was cited on 2/5/2026 for not having a current liability insurance. As a plan of correction, the facility provided a copy of current liability insurance on 2/18/2026, but the amount insured did not meet the requirement. The administrator called the insurance broker who provided explanation stating that the amount exceeded the requirement. The insurance broker will provide explanation to LPA in writing by the end of the day. No deficient is cited today. This report is reviewed and discussed with the administrator. A copy of the report is provided.
InspectionFebruary 5, 2026No deficiencies
Plain-language summary
On February 5, 2026, inspectors conducted a follow-up visit and found that three previously cited problems had been corrected, but two problems remained uncorrected: water temperature in bathrooms was too hot (125-134 degrees Fahrenheit), and the medication room was left unlocked where residents could access it. The facility was also unable to provide a current liability insurance document that had been requested during the earlier January inspection. The state assessed a civil penalty of $1,300 and stated the penalty will continue to accrue daily until these issues are fixed.
View full inspector notes
On February 5, 2026, Licensing Program Analyst (LPA) Murial Han and LPA Jaime Vado conducted an unannounced Plan of Correction visit to follow up on an annual inspection that was conducted on January 29, 2026. LPAs met with the administrator and explained the purpose of today's visit. During today's visit, LPAs observed the following deficiency is cleared: - 87309(a) Storage Space and Access - 87465(h)(5) Incidental Medical and Dental Care Services - 87563(a) Reappraisals During today's visit, LPAs observed the following deficiencies are not corrected - 87303(e)(2) Maintenance and Operation, LPAs observed the water temperature in the bathrooms were measured at 125-134 degrees F. - 87465(h)(2) Incidental Medical and Dental Care Services, LPAs observed the medication room was unlocked and accessible to residents in care. During the annual visit on January 29, 2026, LPA requested for a copy of the Liability Insurance and the administrator stated that it would be provided to LPA via email. However, as of 2/5/2026, the facility was not able to provide a copy of the current liability insurance. 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 Due to the above observation and deficiency not being corrected, a civil penalty is being assessed in the amount of $100 a day from 1/30/2026 through 2/5/2026 and will continue to accrue until corrected. A total civil penalty of $1300 is being accessed today. 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 this report and appeal rights were provided.
Other visitJanuary 29, 2026Type A5 deficiencies
Plain-language summary
During a routine unannounced inspection on January 29, 2026, inspectors found the facility clean and well-maintained, with proper food storage and emergency equipment, but identified three safety issues: a lighter and sharps containers that were unlocked and accessible to residents, a medication room that was sometimes left open and unlocked, and hot water throughout the facility exceeding safe temperatures (above 157 degrees F). The facility was assessed a $100 civil penalty for the hot water temperature violation and must submit current liability insurance documentation by February 6, 2026.
View full inspector notes
On January 29, 2026, Licensing Program Analyst (LPA) Murial Han conduct an unannounced annual inspection. LPA met with administrator and explained the purpose of today's visit. The administrator provided a tour of the facility and grounds. No accessible bodies of water or fire safety hazards observed. This is single story facility with 4 resident bedrooms, and administrator/staff room . The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use and extra linen was observed. Chemicals, and toxins were locked and inaccessible to residents in care. Sharps and one lighter were observed to be unlocked. Medications are stored in the medication room and it was observed to be opened at times and unlocked. Centrally stored medication records were reviewed and adequate. 2 days of perishables and 7 days of nonperishable foods were observed for the residents. Facility is equipped with smoke detectors and carbon monoxide detectors. Emergency/ Fire drill records reviewed. Fire extinguishes were last inspected on 1/30/2025. Hot water temperature through-out the facility was measured above 157 degrees F. 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 A review of (4) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. The following document was requested to be submitted to CCL by 2/6/2026 - current Liability insurance $100 civil penalty is being assessed today for failure to correct related to hot water temperature. 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 this report and the appeal rights were provided.
Regulation
(e) Water supplies and plumbing fixtures shall be maintained as follows: (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 degre…
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed the water temperature in the bathrooms were over 157 degrees F which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/30/2026 Plan of Correction 1 2 3 4 This observation was made during last year's annual. The administrator will develop a plan to ensure the water temperature is within range 105-120 degrees F. The administra…
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 sharps were 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: 01/30/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan of correction to ensure compliance and the plan shall include staff training. The administrator will provide a copy of the plan of correct…
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 during the course of the inspection, LPA observed the medication room door was unlocked and opened which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/30/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan of correction to ensure compliance and the plan shall include staff training. The administrator will provide a …
Regulation
(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers.
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed resident's medications were removed from its original container and poured into a cup and the administrator stated that those were prepared for lunch and dinner which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/30/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan of correction to ensure medication i…
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 LPA observed R2's reappraisal was last completed on 1/17/2024 which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 02/06/2026 Plan of Correction 1 2 3 4 The administrator will develop a plan of correction to ensure compliance and a copy of the updated reappraisal of R2 to CCL by 2/6/2026.
InspectionJanuary 7, 2025Type A8 deficiencies
Inspector: Murial Han
Plain-language summary
On January 7, 2025, state licensing conducted a routine annual inspection of this four-bedroom facility and found it clean, well-maintained, and in good repair, with proper storage of medications and chemicals. The inspector noted that one of two bathrooms lacked required grab bars and nonskid mats, and hot water temperatures throughout the facility ranged from 139 to 156 degrees Fahrenheit—both issues that required correction. The facility was assessed a $500 penalty for repeat violations.
View full inspector notes
On January 7, 2025, Licensing Program Analyst (LPA) Murial Han conduct an annual inspection. LPA met with assistant administrator and explained the purpose of today's visit. Assistant administrator provided a tour of the facility and grounds. No accessible bodies of water or fire safety hazards observed. This is single story facility with 4 resident bedrooms, administrator's room and two of them being shared. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. LPA observed 1 out of 2 bathrooms was equipped with grab bars, and nonskid mats. Facility temperature is comfortable. During the tour, LPA observed the Accessory Dwelling Unit (ADU) in the garage that was observed during the last annual inspection has been demolished and according to the assistant administrator, the facility has decided not to move forward with building the ADU even though a permit was obtained from the city. In addition, the asst. administrator stated that the city code/building department was notified yesterday, 1/6/2025 of such decision. Chemicals, toxins, sharps and medications are observed to be locked and inaccessible to residents in care. Centrally stored medication records were reviewed and adequate. 2 days of perishables and 7 days of nonperishable foods were observed for the residents. Facility is equipped with smoke detectors and carbon monoxide detectors. Emergency/ Fire drill records reviewed. Fire extinguishes were last inspected on 1/15/2024. 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 Hot water temperature through-out the facility is measured at 139-156 degrees F. A review of (4) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. The following documents were requested to be submitted to CCL by 1/14/2025: - liability insurance; updated facility sketch $500 is being assessed today for repeat violations. 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 asst. administrator. A copy of this report and the appeal rights were provided.
Regulation
(e) Water supplies and plumbing fixtures shall be maintained as follows: (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 degre…
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as based on observation, hot water temperature in the kitchen ad bathroom were measured at 139- 156 degrees F which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/08/2025 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure hot water temperature is within range, the plan shall include what action the facility will t…
Regulation
(d) All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance:
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above based on record review, Staff #1 (S1) did not have proof that on-the- job training was completed which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/08/2025 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure S1 and all newly hired staff training is completed accordingly. In the plan, it shall indicate when S1 wil…
Regulation
(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (2) In facilities licensed to provide care for 15 or fewer persons, the employee shall complete 10 hours o…
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as Staff #1 did not have proof that this training was completed which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/08/2025 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure this training is completed for S1 and all newly hired staff. In the plan, it shall indicate when S1 will be completing the required traini…
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 based on observation, record review and interview, the facility provided documentation indicating that the emergency and disaster drills were not completed accordingly which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/08/2025 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure compliance and will submit a plan t…
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 out of 4 residents have bedrails by the head of the bed without a physician's order which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/08/2025 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure a physician's order is obtained for the residents who have bedrails and in the plan, it shall indicate when an ord…
Regulation
On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,00…
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as facility did not have a current Liability Insurance which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 01/14/2025 Plan of Correction 1 2 3 4 The administrator will provide a copy of the current Liability Insurance to CCL by 1/14/2025.
Regulation
87411 Personnel Requirements - General
Inspector finding
Based on record review, Staff #1 (S1)'s health screen was incomplete Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as based on record review, Staff #1 (S1)'s health screen was incomplete which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/08/2025 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure all staff's health scre…
Regulation
87458 Medical Assessment (a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record.
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above based on observation, interview and record review, 2 out of 4 residents did not have a current medical assessment which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 01/14/2025 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure all residents have a current medical assessment and the plan shall indicate the date…
Other visitJanuary 10, 2024Type A8 deficiencies
Inspector: Murial Han
Plain-language summary
During a routine annual inspection on January 10, 2024, inspectors found that chemicals, medications, and sharp objects were left unlocked and accessible to residents, and that required resident care documents were incomplete or unsigned — specifically, one resident's service plan was incomplete and three residents' appraisals lacked proper signatures and dates. The facility also had an unpermitted structure in the garage that was not on the official facility plan, and one staff member's training records were missing. The facility was otherwise clean and well-maintained, with appropriate safety equipment in place.
View full inspector notes
On January 10, 2024 Licensing Program Analyst (LPA) Murial Han conduct an annual inspection. LPA met with assistant administrator and explained the purpose of today's visit. Assistant administrator provided a tour of the facility and grounds. No accessible bodies of water or fire safety hazards observed. This is single story facility with 5 resident bedrooms and one of them being shared room that is currently occupied by one resident. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and nonskid mats. Facility temperature is comfortable. During the tour, LPA observed an Accessory Dwelling Unit (ADU) in the garage with a bed, table, TV and other furniture. This ADU is not part of the facility sketch on record. According to the assistant administrator it was build in 2019 without a proper permit. Chemicals, toxins, sharps and medications are observed to be unlocked and accessible to residents in care. Centrally stored medication was reviewed and observed 4 out of 4 residents did not have a centrally stored medication record. 2 days of perishables and 7 days of nonperishable foods were observed for the residents. Facility is equipped with smoke detectors and carbon monoxide detectors. Fire drill records reviewed. Hot water temperature through-out the facility is measured at 108- 115 degrees F. 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 reviewed 4 resident records and all of them contained admission agreement, medical assessment- LIC 602 (Physician Order), Resident Rights, Resident Identification information. However, 1 out of 4 resident's Appraisal Needs and Service Plan was incomplete, and 3 out of 4 resident's Appraisals were not signed and dated by the facility representative and the applicant or the responsible party. LPA reviewed 3 staff files and all of them contained personnel records, TB screening, First Aide/CPR, Criminal Record Statement, fingerprint cleared and associated to the facility and training records except for staff #1(S1) who did not have the initial training records. 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 asst. administrator. A copy of this report and the appeal rights were provided.
Regulation
Prior to construction or alterations, all facilities shall obtain a building permit.
Inspector finding
Based on observation, record review and interview the licensee did not comply with the section cited above as LPA observed an Accessory Dwelling Unit (ADU) as living space in the garage without a proper permit which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/11/2024 Plan of Correction 1 2 3 4 The Licensee/administrator will remove all the furniture in the ADU and send photo(s) to proof that it was completed by 1/11/24. In addition, administ…
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 and interview the licensee did not comply with the section cited above as sharps and chemicals were not locked and accessible to resident in care which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/11/2024 Plan of Correction 1 2 3 4 The administrator/licensee will develop a plan to ensure compliance and will send photos to ensure locks are installed on the storage areas for the chemicals and sharps.
Regulation
(6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility.
Inspector finding
Based on observation, interview and record review the licensee did not comply with the section cited above as 4 out of 4 residents did not have Centrally Stored Medication Record which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/11/2024 Plan of Correction 1 2 3 4 The administrator/licensee will provide a copy of the completed centrally stored medication record for all 4 residents by 1/11/2024.
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, record review and interview the licensee did not comply with the section cited above as drills were not completed accordingly which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/11/2024 Plan of Correction 1 2 3 4 The administrator/licensee will submit a plan of compliance and provide a copy of the plan to CCL by 1/11/2024.
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, record review and interview the licensee did not comply with the section cited above as 3 out of 4 resident's appraisals were not signed by the facility representative and applicant and responsible party which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/11/2024 Plan of Correction 1 2 3 4 The administrator/licensee will provide a copy of the signed and dated appraisal service needs and plans for all 3 residents to CCL by 1…
Regulation
(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (2) In facilities licensed to provide care for 15 or fewer persons, the employee shall complete 10 hours o…
Inspector finding
Based on observation, interview and record review, the licensee did not comply with the section cited above as staff #1 (S1) did not have documents to proof that the initial training was completed prior to working which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 01/17/2024 Plan of Correction 1 2 3 4 The administrator/licensee will provide a copy of staff #1's required training record to CCL by 1/17/2024.
Regulation
(a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident's physical, medical, mental, and social condition. Significant changes shall include but not be limited to:
Inspector finding
Based on observation, record review and interview the licensee did not comply with the section cited above as 1 out of 4 resident's appraisal service needs and plan was incomplete which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 01/17/2024 Plan of Correction 1 2 3 4 The administrator/licensee will provide a copy of the completed appraisal service needs and plan to CCL by 1/17/2024.
Inspector finding
Based on observation, and interview the licensee did not comply with the section cited above as medications were observed in the living room to be unlocked and accessible to residents in care which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 01/11/2024 Plan of Correction 1 2 3 4 The administrator/licensee will provide a plan to ensure compliance to CCL by 1/11/2024.
Other visitNovember 16, 2023No deficiencies
Inspector: Murial Han
Plain-language summary
This was a follow-up visit on November 16, 2023 to check that the facility had fixed problems found in earlier inspections and complaint investigations. The inspector found that personnel records were in order, the facility was clean and well-maintained, and required postings were displayed; the facility also agreed to stop using a room in the garage as staff housing and to obtain a city inspection. All previously cited deficiencies were cleared.
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On November 16, 2023, Licensing Program Analyst (LPA) conducted an unannounced Plan of Correction (POC) visit to follow up on deficiencies cited on November 1, 2023 during a case management visit and complaint visit on October 19, 2023. Upon arrival, LPA was greeted by caregiver, Aldelyn Batara and administrator, Mitzi Murphy and LPA explained the purpose of the visit. The assistant administrator arrived shortly thereafter to assist with the visit. During today's visit, LPA toured the facility and review files. During the tour, LPA observed 5 residents (4 eating lunch in the dining room and 1 in the room) and 3 facility staff (administrator, assistant administrator and caregiver) and LPA did not observed any additional adults. LPA observed facility to be cleaned and tidy, there was no apparent noise from the construction, and required poster posted on the wall by the medication/office. In regards to the room in the garage, the assistant administrator stated that facility will pay for the inspection fee today and the room will not be used as a live-in space for staff as of 11/16/2023 until the inspection by City of Foster City. Based on documents provided, LPA reviewed 4 out of 4 personnel files 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 The following deficiencies are cleared: 87412 Personnel Records..(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: 87405 Administrator - Qualifications and Duties..(d) The administrator shall have the qualifications..(2) Knowledge of and ability to conform to the applicable laws, rules and regulations... 87355 Criminal Record Clearance..(e) All individuals subject to a criminal record the Department 87305 Alterations to Existing Building or New Facilities... (a)Prior to construction or alterations, all facilities shall obtain a building permit. 87468.1 Personal Rights of Residents in All Facilities..(a) Residents in all residential care facilities shall have all of the following personal rights:..(2) To be accorded safe, healthful and comfortable accommodations.. 87303 Maintenance and Operation..a) The facility shall be clean, safe, sanitary and in good repair at all times 87468.1 Personal Rights of Residents in All Facilities..(a) Residents in all residential care facilities.. shall have all of the following personal rights:4) To be informed by the licensee of the provisions of law regarding complaints and of procedures for confidentially registering complaints,.. Report is reviewed with the assistant administrator; POC letter is generated and provided on this day. A copy of this report is provided.
ComplaintNovember 3, 2023No deficiencies
Inspector: Murial Han
Plain-language summary
During a follow-up inspection on November 3, 2023, inspectors found that the facility was still not maintaining complete personnel files for staff members and had allowed a staff member without proper background clearance to provide care to a resident. The facility had been given time to correct these issues after an October inspection but failed to do so, resulting in a civil penalty of $2,800.
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On November 3, 2023, Licensing Program Analyst (LPA) conducted an unannounced visit to follow up with the plan of correction (POC) that was submitted by the administrator/Licensee, May Mitzi Murphy. LPA met with the administrator and explained the purpose of today's visit. On October 19, 2023 LPA conducted an unannounced visit to deliver the findings in reference to complaint # 14-AS-20230901133006 and observed the assistant administrator, staff #1 (S1) and staff #2 (S2) did not have their personnel files, and S1 was not associated with the facility and not fingerprinted cleared. During today's POC visit, LPA observed staff #3 (S3) was providing care to resident #1(R1) and administrator was not able to provide S3's personnel file to review as the administrator stated that this person/staff only today. Due to the above observation and deficiency not being corrected, a civil penalty is being assessed in the amount of $100 a day from 10/21/2023 through 11/2/2023 and will continue to accrue until corrected. A total civil penalty of $2,800 is being assessed . This report is reviewed and discussed with the assistant administrator. A copy of this report and appeal rights were provided.
Other visitNovember 3, 2023Type A1 deficiency
Inspector: Murial Han
Plain-language summary
This was a follow-up visit in November 2023 to check whether the facility had fixed problems from a previous inspection. The inspector found that the facility had a staff member working without having his personnel file and criminal background clearance available for review, and the administrator could not produce these documents during the visit. The facility was assessed civil penalties totaling $350 for this violation and a repeat violation.
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On November 3, 2023, Licensing Program Analyst (LPA) conducted an unannounced visit to follow up on the plan of correction (POC) that was submitted by the administrator/Licensee, Mitzi Murphy. LPA met with the administrator and explained the purpose of today's visit. During today's visit, LPA observed staff #1 (S1) was assisting the administrator with providing care to resident #1(R1), however, the administrator was not able to provide S1's personnel file and criminal background clearance record to LPA for review as the administrator stated that this staff only worked today and the facility is experiencing staffing shortage. Administrator asked S1 to leave the facility during visit. A civil penalty of $100 per day x 1 day = $100 is being assessed. A civil penalty of $250 is being assessed for repeat violation. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809-D. Failure to correct the deficiencies may result in additional civil penalties. Report is reviewed with assistant administrator and a copy is provided with civil penalties and appeal rights.
Regulation
87355 Criminal Record Clearance..(e) All individuals subject to a criminal record review..(1) Obtain a California clearance or a criminal record exemption as required by the Department
Inspector finding
This requirement is not met as evidenced by LPA observed S1 to be not fingerprint cleared which poses an immediately health risk to residents in care.
InspectionOctober 19, 2023Type A3 deficiencies
Inspector: Murial Han
Plain-language summary
During an unannounced inspection on October 19, 2023, inspectors found that the facility employed a staff member who had not been fingerprint cleared and was not associated with the facility as required. The facility was assessed a civil penalty of $500 for this violation. The facility was informed of the finding and their right to appeal.
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On October 19, 2023 Licensing Program Analysts (LPA) Murial Han conducted an unannounced visit to deliver the findings in reference to complaint # 14-AS-20230901133006 and during the visit, LPA made the following observation. LPA met with assistant administrator and explained the purpose of the visit. During today's visit, LPA requested to reviewed staff #1 (S1) and staff #2 (S2) and assistant administrator's personnel files. According to the assistant administrator and the administrator, both S1 and S2 have been working at the facility since September 1, 2023 and the facility does have their files as the facility is in the process of getting their files together. In addition, S1 is not associated with the facility and not fingerprint cleared. This violation results in a civil penalty of $100 per day x 5 day = $500 Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809-D. Failure to correct the deficiencies may result in additional civil penalties. Report is reviewed with assistant administrator and a copy is provided with civil penalties and appeal rights.
Regulation
87405 Administrator - Qualifications and Duties..(d) The administrator shall have the qualifications..(2) Knowledge of and ability to conform to the applicable laws, rules and regulations...This requirement is not met as evidenced by
Inspector finding
The administrator failed to ensure facility staff personnel files are adequate and staff is fingerprint cleared and associated prior to employment which poses an immediate health risks to resident in care.
Regulation
87412Personnel Records..(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
This requirement is not met as evidenced by facility did not have S1 and S3's personnel files which poses an immediate health risks to resident in care.
Regulation
87355 Criminal Record Clearance..(e) All individuals subject to a criminal record review..(1) Obtain a California clearance or a criminal record exemption as required by the Department
Inspector finding
This requirement is not met as evidenced by LPA observed S1 to be not fingerprint cleared which poses an immediately health risk to residents in care.
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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