K & J Residential Care Home
What is an RCFE with Memory Care?
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 help with daily living activities such as bathing, dressing, and medication management. An RCFE with a Memory Care designation is additionally required by California Title 22 (§87705 and §87706) to provide specialized staff training in dementia care, individualized care plans for residents with cognitive impairment, and appropriate supervision protocols — requirements that go beyond a standard RCFE license.
1954 Rosemary Ct. · Fremont, 94539
Record last updated April 20, 2026.
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Quick facts
Memory care context
K & J Residential Care Home is a California-licensed RCFE with 6 beds and a memory care designation, operated by Ksai Liang. California Title 22 requires facilities serving dementia residents to meet specific standards under §87705 and §87706, covering individualized care plans, staff training in dementia care, and appropriate supervision. CDSS has cited this facility three times under these dementia-care sections. State records show 6 inspections with 22 total deficiencies: 5 Type A citations (actual harm to residents) and 17 Type B citations (potential for harm). The most recent inspection was January 26, 2026. The presence of Type A deficiencies indicates documented instances where residents experienced actual harm, which warrants careful inquiry during any visit.
Questions to ask on your tour
Based on K & J Residential Care Home's state inspection record.
State records show 5 Type A deficiencies indicating actual harm to residents — can you explain what each incident involved, what corrective actions were taken, and what has changed to prevent recurrence?
The facility has been cited three times under §87705 or §87706 for dementia-care requirements — which specific provisions were violated, and how has staff training or supervision changed as a result?
With 22 total deficiencies across 6 inspections, what systemic changes has the facility implemented to address the pattern of non-compliance with Title 22 regulations?
As a 6-bed home, how many direct-care staff are on duty during daytime, evening, and overnight shifts, and what happens when a caregiver is absent?
California §87705 requires dementia-specific training for all staff — how do you verify that operator Ksai Liang and any other caregivers have completed and maintained current certification in dementia care?
State records
California CDSS · Community Care Licensing Division- License number
- 019200987
- License type
- RESIDENTIAL CARE ELDERLY
- License status
- LICENSED
- License expires
- Not yet indexed
- Licensed beds
- 6
- Operator
- Liang, Ksai
Inspections & citations
6
reports on file
22
total deficiencies
5
Type A (actual harm)
3
dementia-care citations
Other visitJanuary 26, 2026No deficiencies
Inspector notes
On 01/26/2026 at 10:35 AM, Licensing Program Analyst (LPA) P. Manalo conducted an unannounced Case Management. LPA met with Warlita Rivac, and explained the purpose of the visit. While LPA was at the facility for another visit, LPA observed the following deficiencies: At 10:35 AM, LPA observed unlocked sanitizing wipes and hydrocortisone ointment in the bathroom. A civil penalty of $250 is assessed for repeat citation. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. A copy of this report, LIC421FC, and appeal rights provided.
InspectionJune 18, 2025No deficiencies
Inspector notes
On 01/26/2026 at 9:25 AM, Licensing Program Analyst (LPA) P. Manalo conducted an unannounced Case Management visit regarding a self-reported death report. The facility sent in a death report on 01/08/2026. LPA met with Co-Administrator, Warlita Rivac, and explained the purpose of the visit. Death Report (LIC624A) indicated that on 01/07/2026 Resident 1 (R1) passed away on 01/07/2026. Report indicated that R1 was alert and responsive, and the immediate cause of death was respiratory problem. During the visit, LPA reviewed and obtained documents including but not limited to Admission Agreement, After Visit Summary, Incident Report, Facility’s Communication Log, Physician Report, Physician Orders for Life-Sustaining Treatment (POLST), and Identification and Emergency Information. LPA interviewed Co-Administrator and Staff 1 (S1). LPA will be requesting for a death certificate. LPA may return at a later time. No deficiency cited during today’s visit. Exit interview conducted and a copy of this report provided.
InspectionJune 21, 2024Type A6 deficiencies
Inspector notes
On 06/18/2025 at 9:15 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Back Up Administrator, Warlita Rivac and explained the purpose of the visit. The Administrator was unable to come during the visit and gave authorization for Back Up Administrator to sign the report. Administrator certificate is current. LPA toured facility with inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 7 total bedrooms which 6 bedrooms are occupied by the residents, 1 bedroom is occupied by staff, and one office space. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 71 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 109.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 06/18/2025. Emergency disaster drill was last conducted on 03/10/2025. At 10:44 AM, LPA reviewed 5 residents records. At 11:08 AM, LPA reviewed 3 staff records and all have current first aid training and associated to the facility. At 12:00 PM, LPA reviewed two sample of resident’s medications. Continue to 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 Continue from LIC809... Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 06/26/2025: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate Infection Control THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 9:30, LPA observed unlocked cleaning supplies such as Ajax, Lysol Spray, Borax and unlocked medications such as Nyquil, Allergy Medicine, and Suppositories. At 9:37 AM, LPA observed a rotten tomato in the fridge and expired canned goods in the storage room. At 11:35 AM, LPA observed the facility does not have the Administrator records on file. At 11:38 PM, record review showed that there was no staff training conducted. At 11:55 AM, LPA observed all residents' record is incomplete. At 12:16 PM, LPA observed R1, R2, and R4 have half bed rails with no doctor's order for it. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview. Appeal Rights and a copy of this report provided.
(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.
Based on observation, the licensee did not comply with the section cited above in by having unlocked cleaning supplies such as Ajax, Lysol Spray, Borax and unlocked medications such as Nyquil, Allergy Medicine, and Suppositories which poses an immediate health and safety risk to persons in care. POC Due Date: 06/19/2025 Plan of Correction 1 2 3 4 The Administrator will sent proof of the items removed and locked away by POC date.
(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…
Based on record review, the licensee did not comply with the section cited above by not conducting annual staff training which poses a potential health and safety risk to persons in care. POC Due Date: 07/02/2025 Plan of Correction 1 2 3 4 The Administrator agrees for staff to complete their training and send proof by POC date.
(b) The following food service requirements shall apply: (8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained.
Based on observation, the licensee did not comply with the section cited above by having a rotten tomato in the fridge and expired canned goods in the storage room which poses a potential health and safety risk to persons in care. POC Due Date: 06/19/2025 Plan of Correction 1 2 3 4 The Administrator will sent proof of the items removed by the POC date.
(b) Each resident's record shall contain at least the following information:
Based on record review, the licensee did not comply with the section cited above by not having a complete file for all the residents which poses a potential health and personal rights risk to persons in care. POC Due Date: 07/02/2025 Plan of Correction 1 2 3 4 The Administrator agrees to send proof of the residents' file complete by POC date.
(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed.
Based on record review, the licensee did not comply with the section cited above by not having a half bed rail order for R1, R2, and R4 which poses a potential health and safety risk to persons in care. POC Due Date: 07/02/2025 Plan of Correction 1 2 3 4 The Administrator agrees to obtain an order for the residents' half bed rail and send proof to CCLD by POC date.
(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:
Based on record review, the licensee did not comply with the section cited above by not having the Administrator's file in the facility which poses a potential health risk to persons in care. POC Due Date: 06/25/2025 Plan of Correction 1 2 3 4 The Administrator agrees to have their file accessible in the facility and send proof to CCLD by POC date.
InspectionJune 30, 2023Type A6 deficiencies
Inspector: Alona Gomez
Inspector notes
On 6/21/2024 at 7:55 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Warlita Agmata-Rivac and explained the purpose of the visit. The facility’s fire clearance was approved for 6 non-ambulatory. LPA toured facility with Warlita Agmata-Rivac including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 7 total bedrooms which 6 bedrooms are for the residents and 1 bedroom is 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 71 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 113.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 8/11/2023. Emergency Disaster Plan was last posted on 1/1/2024. First aid kit was observed to be complete. At 8:15am, LPA reviewed 5 residents records. At 11:00am, 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 8:00am LPA observed a bed set up in the living room that is used by staff to sleep on during the night. Administrator confirmed that the staff sleep on the bed. Also At 9:40am during facility tour LPA observed that in the backyard a shed has been converted and is being occupied by a caregiver. The structure is not cleared on the facility sketch and Administrator confirmed that the shed was converted after the last annual inspection was conducted. (Repeat Violation: 87307(a)(2)(B) ) $250 At 8:30am during file review LPA observed that R2 does not have an Needs and Services Plan. Administrator confirmed they have not done the appraisal. (Repeat Violation: 87506(b) ) $250 At 8:50am during file review LPA observed that R3's physicians report lists them as BEDRIDDEN. LPA contacted the primary care physician to confirm this diagnosis. Physician confirmed resident is bedridden. Facility is not cleared for bedridden. (Immediate Civil Penalty: 87202(a)(2) ) $500 At 9:28am during facility tour LPA observed the dishwasher being used as a storage place for dishes. LPA observed a large cooking knife with a yellow handle stored inside. Administrator removed and locked away knife. Also at 9:29am during facility tour LPA observed ZZZQuil unlocked in the bottom kitchen counter. Administrator removed and locked away PRN. At 10:17am LPA contacted desk duty to inquire about the status of the Administrators certificate. There is no certificate application pending. The last certificate expired 12/17/2021.(Repeat Violation: 87412(d) ) $250 At 11:22am during file review LPA did not observe a disaster drill on file. Administrator states they have not done any drills this year. ***An immediate civil penalty is being assessed today for $500 for fire clearance violation 87202(a)(2)*** **A civil penalty is being assessed today for $750 for all other repeat violations {$250 per violation x 3}** Civil penalty total= $1,250 The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.
87412(d) Personnel Records: (d) The licensee shall maintain documentation that an administrator has met the certification requirements specified in Section 87406, Administrator Certification Requirements or the recertification requirements in Section 87407, Administrator Recertification Requirements.
Based on observation, and record review, the licensee did not comply with the section cited above in not having a current administrator certificate on file which poses a potential health, safety, and personal rights risk to persons in care. POC Due Date: 07/01/2024 Plan of Correction 1 2 3 4 By POC date administrator agrees to submit the required documentation to start the certificate renewal process.
(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fi…
Based on interview and record review, the licensee did not comply with the section cited above in R2 being bedridden which poses an immediate health and safety risk to persons in care. POC Due Date: 07/01/2024 Plan of Correction 1 2 3 4 By POC date Administrator agrees to have resident reassesed or come up with a placement plan and notify CCLD.
(f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s).
Based on observation, the licensee did not comply with the section cited above in having dangerous items unlocked which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 06/21/2024 Plan of Correction 1 2 3 4 Administrator removed and secured items.
(2) Resident bedrooms shall be provided which meet, at a minimum, the following requirements: (B) No room commonly used for other purposes shall be used as a sleeping room for any resident. This includes any hall, stairway, unfinished attic, garage, storage area, shed or similar detached building.
Based on observation and interview, the licensee did not comply with the section cited above in having a bed set up in the living room for staff to sleep on which poses a potential personal rights risk to persons in care. POC Due Date: 07/01/2024 Plan of Correction 1 2 3 4 By POC date Administrator agrees to remove bed and notify CCLD.
(b) Each resident's record shall contain at least the following information:
Based on record review, the licensee did not comply with the section cited above in R2 not having a needs and services plan which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 07/01/2024 Plan of Correction 1 2 3 4 By POC date Administrator agrees to review all residents files to ensure the are complete and up to date and notify CCLD.
(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,…
Based on interview and record review, the licensee did not comply with the section cited abovenot having done a disaster drill this year which poses a potential safety risk to persons in care. POC Due Date: 07/01/2024 Plan of Correction 1 2 3 4 By POC date administrator agrees to complete and log emergency disaster drill and notify CCLD.
InspectionJune 10, 2022Type B5 deficiencies
Inspector: Liridon Fici
Inspector notes
On 6/30/2023 starting at 10:00 AM, Licensing Program Analyst (LPA) L. Fici arrived unannounced to conduct 1-Year Annual Required Inspection. LPA met with Warlita Agmata-Rivac, Administrator (ADM) and explained the purpose of the visit. Administrators certificate (6007524740) expired on 12/17/2021. The facility’s fire clearance was approved for six (6) non- ambulatory residents, which all 6 may be on hospice. Upon entry, LPA observed one (1) staff and two (2) residents present during inspection. Starting at 10:20 AM, LPA toured facility with ADM including but not limited to six (6) bedrooms, three (3) bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which all 6 bedrooms are private. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 71 Degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents'. The hot water temperature in residents’ common area bathroom was measured at 114.3 Degrees Fahrenheit. Residents’ bathrooms are equipped non-skid mats. There is a minimum of one-week supply of nonperishable and 2-day supple of perishable foods. Sharps and toxins were locked and inaccessible to residents'. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was observed last serviced on 7/7/2021. First aid kit was observed to be complete. Continue 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 Continued from Lic809 Starting At 11:50AM, LPA reviewed 2 of 2 staff records. At 12:27 PM, LPA reviewed 3 of 3 residents' record. At 1:02 PM, LPA reviewed a sample of 3 of 3 residents' medications. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiencies and/or repeat deficiencies within a 12-month period may result in civil penalties. 1. At 10:27AM, LPA observed a bed in the living room that staff are sleeping on. 2. At 11:12AM, LPA observed S2 does not have current administration certificate on file; Certificate expired on 12/17/2021. 3. At 12:00PM, LPA observed S1 with no first aid and CPR training on file 4. At 12:08PM, LPA observed S1 with no Lic500 (personnel record), Lic503 (Health screening), and Lic508 (Criminal record statement) on file. S2 does not have an Lic508 on file. 5. At 12:40PM, LPA observed during record review that R1, R2, and R3 with no Lic625 (Needs/service plan) on file. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 7/7/2023: · LIC 308 Designation of Administrative Responsibility · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan (9 Pages) · Liability Insurance Exit interview conducted with ADM, appeal rights given and a copy of this report provided.
(c) The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require sta…
Based on observation and record review, the licensee did not comply with the section cited above by allowing S1 to work in the facility with no First aid and CPR training on file which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 07/07/2023 Plan of Correction 1 2 3 4 Administrator agreed for S1 to attend First aid and CPR training and to submit proof of training to CCL by POC due date.
(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:
Based on observation and record review, the licensee did not comply with the section cited above by not maintaing staff records for S1, and S2; S1 does not have an Lic501 (Personnel record), 503 (Health screening), and 508 (Criminal record statement) on file, and S2 does not have an Lic508 on file which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 07/07/2023 Plan of Correction 1 2 3 4 Administrator agreed to fill out an Lic 501, 503, and 508 …
(b) Each resident's record shall contain at least the following information:
Based on observation and record review, the licensee did not comply with the section cited above by not maintaining an Lic625 (Needs and service plan) for R1, R2, and R3 which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 07/07/2023 Plan of Correction 1 2 3 4 Administrator agreed to fill out an Lic625 form for R1, R2, and R3, and to submit to CCL by POC due date.
87307 Personal Accommodations and Services: (a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply: (2) Resident bedrooms …
Based on observation, the licensee did not comply with the section cited above in having a bed placed in the living room that staff are using for sleeping, which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 07/07/2023 Plan of Correction 1 2 3 4 Submit to CCL by POC date. Administrator agreed to remove the bed from the living room and to submit a picture as proof.
87412(d) Personnel Records: (d) The licensee shall maintain documentation that an administrator has met the certification requirements specified in Section 87406, Administrator Certification Requirements or the recertification requirements in Section 87407, Administrator Recertification Requirements.
Based on observation, and record review, the licensee did not comply with the section cited above in not having a current administrator certificate on file for S2 which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 07/21/2023 Plan of Correction 1 2 3 4 Administrator agreed to follow up with Sacramento's Administrator Certificate office to get S2's certificate and to submit proof of certificate to CCL by POC due date.
InspectionJune 22, 2021Type A5 deficiencies
Inspector: Liridon Fici
Inspector notes
On 06/10/2022 at 12:00pm, Licensing Program Analyst (LPA) L. Fici & C. Lin arrived unannounced to conduct an annual Infection Control Inspection. LPAs met with back up Administrator (ADM), Agmata Warlita and explained the purpose of the visit. LPAs toured facility with including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen, and backyard. Facility has a sufficient 2-day perishable and one week non-perishable food supply. There is one central entry point for universal screening for staff, residents, and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Common touched surfaces are disinfected at least once daily. Bathrooms are equipped with liquid soap, paper towel and trash bins with touchless lids. Facility staff were observed to be wearing proper PPE. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. Fire extinguisher was observed serviced 10/22/2021. LPAs observed facility passages inside and out free of obstruction. Continue on LIC809C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Continued on Lic809C The following deficiency was observed: 1:00pm- LPAs observed flies coming out from under the sink; approximately 15 flies or more. 1:03pm- LPAs observed 2 knifes and scissors in the kitchen cabinet unlocked and accessible to residents. 1:05pm- LPAs observed cleaning Tide detergent on top of the washer machine in the garage. 1:10pm- LPAs observed R1 with half bed rail, and with no physicians order. 1:25pm- LPAs observed a shed in the back yard where administrator told LPAs S1 sleeps in there. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties . Exit interview conducted with ADM Report provided along with appeal rights.
Care of Persons with Dementia: (f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s).
Based on observation, the licensee did not comply with the section cited above in having inaccessible Sharps, which poses an immediate health and safety risk to persons in care. POC Due Date: 06/11/2022 Plan of Correction 1 2 3 4 Administrator agreed to re-train staff on regulations and submit an in service training with staff signatures to CCL by POC date. Administrator locked up knifes and sccissors during visit.
Care of Persons with Dementia: (f) The following shall be stored inaccessible to residents with dementia: (2) Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants.
Based on observation, the licensee did not comply with the section cited above in having inaccessible toxins, which poses an immediate health and safety risk to persons in care. POC Due Date: 06/11/2022 Plan of Correction 1 2 3 4 Administrator agreed to re-train staff on regulations and submit an in service training with staff signatures to CCL by POC date. Administrator locked up knifes and sccissors during visit.
87555 General Food Service Requirements: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects.
Based on observation, the licensee did not comply with the section cited above in not having the kitchen free of insects, which poses a potential health and safety risk to persons in care. POC Due Date: 06/17/2022 Plan of Correction 1 2 3 4 Administrator agreed to submit a photo copy to CCL by POC date by patching up the crack under the sink so flies will not enter the facility.
87305 Alterations to Existing Building or New Facilities: (a) Prior to construction or alterations, all facilities shall obtain a building permit.
Based on observation and record review, the licensee did not comply with the section cited above by not obtaining a permit for shed located in backyard using to reside staff member which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/17/2022 Plan of Correction 1 2 3 4 Licensee agrees to submit a copy of a permit for the shed located in the backyard by POC date.
87608 Postural Support: (5) Under no circumstances shall postural supports include tying, depriving, or limiting the use of a resident's hands or feet. (A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed.
Based on observation and record review, the licensee did not comply with the section cited above by not having a doctor’s order for half bed rail for R1, Which poses a potential health and safety risk to persons in care. POC Due Date: 06/17/2022 Plan of Correction 1 2 3 4 Adminisinstraor agrees to submit a physcians order for half bed rail for R1 to CCL by POC due date.
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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