Bella Vista.
Bella Vista is Ranked in the bottom 8% on citation frequency among California peers with 18 CDSS citations on record; last inspected Mar 2026.
Memory Care Facility in Hayward's D Street Corridor, reviewed on public record.
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Compared to 26 California facilities with a similar number of beds.
RCFE memory care · 36-month window. Higher percentile = better performance on inspection record. Source: California Dept. of Social Services · Community Care Licensing.
among peers to rank.
Rankings based on 36-month CDSS inspection data. Severity and frequency: fewer citations = higher percentile. Repeat rate: lower repeat citation share = higher percentile.
FACILITY WATCH · BETA
Bella Vista has 18 citations on record. Know the moment anything changes.
New findings, complaint investigations, or status changes — emailed to you free.
Citation history, plotted month by month.
18 deficiencies on record. Each bar is a month with a citation.
Finding distribution
18 total · 36 monthsScope × Severity (CMS A–L)
The rules that apply to this facility.
State requirements with the exact regulation citation, plain-language explanation, and a question to ask on tour. Rules this facility has been cited for appear first.
Plain language
Because a facility markets dementia or Alzheimer's care, state law mandates higher training standards: 12 hours of initial dementia training (6 hours before a staff member works independently with residents, 6 more within the first 4 weeks), 8 hours of annual dementia in-service every year thereafter, and an administrator must include 8 hours of dementia-specific continuing education in every 2-year recertification cycle. Training must cover individualized care plans, behavioral expressions, appropriate supervision, and the facility's dementia care philosophy.
Ask on tour
“Can you show me each direct-care staffer's most recent dementia training certificate, and tell me when their next refresher is due?”
Questions to ask before you visit.
A short pre-tour checklist tailored to Bella Vista's record and state requirements.
State records show 4 Type A deficiencies, which indicate actual harm to residents — what were the specific circumstances of each, and what corrective actions were implemented?
Ask the operator on tour. Take notes and compare answers across facilities you visit.
Five complaints were filed with CDSS during the inspection period on file — can you explain which complaints were substantiated and what changes resulted from each?
Ask the operator on tour. Take notes and compare answers across facilities you visit.
The facility was cited under §87705 or §87706 for dementia care requirements — what was the specific deficiency, and how has the facility addressed compliance with dementia-specific care plan and training standards?
Ask the operator on tour. Take notes and compare answers across facilities you visit.
Every inspection visit, verbatim.
13 inspections in the public record, most recent first. Click any row to expand — cited rows open automatically.
2026-03-11Other VisitType B · 1 finding
Plain-language summary
During a complaint investigation on March 11, 2026, inspectors found that a resident's medication prescribed to be taken three times daily since February 10 had one tablet unaccounted for, and staff could not explain the discrepancy or confirm it was a recording error. The facility was cited for failing to properly account for medication administration. The facility has been directed to submit a plan to correct this issue by a specified deadline.
“-Based on record review, the licensee did not comply with the section when R1 has 1 remaining tablet for 1 of the medications which does not match what should have left based on the recorded start date on LIC622 which poses a potential health and/or personal rights risks to person in care.”
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While at the facility conducting investigation of a complaint (Complaint Control # 15-AS-20260305094639) on this day, March 11, 2026, and upon review of resident's (R1) record, Licensing Program Analyst (LPA) Delmundo observed one of R1's medications which was filled on February 10, 2026 with 84 tablets and administered 3x/day, with start date of administration February 10, 2026, showed this particular medication still has one remaining tablet. Staff (S1) who administers residents medications was not able to explain what happened why there is still one remaining tablet. This was discussed with Haidie Bautista, administrator (ADM), who stated that it could be a recording error. Deficiency is cited from Title 22 California Code of Regulations and listed on 809D. Failure to submit proof of correction by plan of correction due date may result in civil penalty. Deficiency and plan and proof of correction were discussed with ADM. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.
2026-03-11Complaint InvestigationUnsubstantiatedNo findings
Plain-language summary
A complaint alleged that a staff member punched a resident in the head twice, grabbed his shirt, and yelled threats at him in October 2025. The investigator interviewed the staff member, other residents, facility employees, and reviewed medical records of the resident's falls and hospital visits, but found insufficient evidence to substantiate the allegations—the resident had left the facility before the investigation was completed and no witnesses corroborated the claims.
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On October 2025, the reporting party (RP) stated that R1 reported a staff, S1, had punched R1 in the head with closed fist two times and grabbed the neck of R1's shirt and pulled R1. R1 further reported that S1 yelled at R1 and threatened to "beat him up". The administrator (ADM) stated that one of the staff reported to her that a police officer came due to the reported abuse. S1 was interviewed by the police officer and asked if R1 went out and fell outside the facility and interviewed S1 regarding the alleged abuse which S1 denied. ADM submitted a copy of SOC341 to the Department. SOC341 also indicated that on 9/22/25, R1 was 5150'd due to pulling of the hair of one of the staff. S1 denied the allegation. He stated the police officer came and he was not aware there's a complaint by R1 against him. He was asked if R1 went out that day and he told the police officer he does not know, because the residents can leave the facility. There were times when R1 left the facility at night and tell other residents when he leaves and S1 did room check. He was also asked if he ever hit R1 and he said he never did and that he's here to assist the residents. The other staff interviewed stated not observing S1 being physically and/or verbally abusive to R1. Some of these staff stated it is them who are at times hit by residents. The 4 residents (R2, R3, R4 and R5) stated not observing staff including S1 being physically and verbally abusive to R1. They stated S1 is a good staff. Review of 3 Unusual Incident Reports (UIRs) for incidents that happened on October 2025 showed R1 had 2 unwitnessed falls and an episode of seizure where R1 was sent out to the hospital. The hospital After Visit Summaries confirmed the incidents and one of these documents showed R1 sustained laceration of the scalp Based information gathered and due to R1 was no longer at the facility when LPA began the investigation, the above allegations are unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. No deficiency cited. Exit interview conducted and copy of this report provided.
2025-12-19Complaint InvestigationUnsubstantiatedNo findings
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All of the staff and residents interviewed including administrator stated not observing resident exposed self nor walk naked. They did not observed anyone urinates outside the facility. All 3 residents stated no one borrow money from them. One of these residents stated a resident borrowed cigarettes from him but it was his fault giving that resident. Two of the staff stated not hearing residents borrowed money from other residents while the other staff stated it is the residents' behavior borrowing money and cigarettes from each other. If this staff hears a resident borrows money from other resident, she tells the resident to wait for their money which comes every two weeks. ADM stated residents borrow money and cigarettes and does not think they feel harassed because it's their mutual behaviors. Based on information obtained, the allegation is unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No deficiency cited. Exit interview conducted and a copy of this report was provided.
2025-11-04Other VisitType A · 2 findings
Plain-language summary
During an unannounced annual inspection on November 4, 2025, inspectors found several safety and medication management issues: saline solution, chest rub, and nail polish remover left unlocked in residents' rooms; garden tools stored in a yard; and a resident receiving an outdated medication dosage while missing newly prescribed medications. The facility's buildings, fire safety equipment, food storage, hallways, and bathrooms were generally in good condition, though one bathroom's hot water measured 105 degrees Fahrenheit. The facility was cited for these deficiencies and given a deadline to submit corrections.
“Based on observation, the licensee did not comply with the section cited above in saline solution, chest rub and nail polish remover in residents' rooms, and shovels and rakes in Bldg B's yardvwhich pose an immediate health, safety and/or personal rights risks to persons in care. POC Due Date: 11/05/2025 Plan of Correction 1 2 3 4 Staff locked all the items. In addition, administrator to in-service the staff and submit copy of training topics with attendees signatures by 11/05/25.”
“Based on observation and record review, the licensee did not comply with the section cited above in not having some of the R2's medications and not administering the dosage for 1 of the medications listed on the After Visit Summary which pose an immediate health and/or personal rights risks to persons in care. POC Due Date: 11/05/2025 Plan of Correction 1 2 3 4 Administrator stated she'll obtain the current doctor's order. In addition, administrator to discontinue the administration of medication(s) no longer on the current order and obtain those listed which facility does not have. Proof to be submitted by 11/05/25.”
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On this day, November 4, 2025, at 10:15 p.m., Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual inspection. LPA met with House Manager Sally Espina and informed the reason for visit. LPA called and spoke over the phone with Haidie Bautista, administrator (ADM). ADM arrived at around 11:22 am. LPA started the inspection with house manager and continued with ADM. LPA inspected the 2 buildings (Bldg A and Bldg B) including but not limited to common areas, kitchens, dining areas, receiving room, library, bathrooms, shower rooms, porch, toilets, front, side and backyard. LPA selected for inspection 4 residents rooms in Bldg B and 5 in Buiding A. Fire extinguishers were observed fully charge with tags showed serviced May 12, 2025. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications was observed locked. Hallways, common areas, yards and porch were observed free of obstructions. Facility has smoke and carbon monoxide detectors that were tested and observed in operating condition. Hot water temperature in one of the bathrooms in Bldg A was tested and measured at 105 degrees Fahrenheit . Facility conducts di saster drills at least every quarter and records showed last conducted October 6, 2025. .....continued on 809C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LPA reviewed 5 residents and 5 staff files, and interviewed 3 residents. Medications were checked and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. Facility does not handle residents' cash resources. LPA observed the following: -at 10:55 am, saline solution in night stand drawer without lock in one of the residents' rooms. -at 11:08 am, chest rub in the night stand in another residents' room. -at 11:17 am, nail polish remover in other residents' room. -at 11:29 am, shovels and rakes in Bldg B's yard. -at 3:00 pm, resident (R2) has After Visit Summary dated 6/2025 with change in dosage of 1 medication but facility still administers the previous dosage. Also on the list are new/added medications but the facility does not have those medications. LPA received updated copies of the following documents: 1. LIC308 Designation of Facility Responsibility 2. LIC610E Emergency Disaster Plan 4. $3M liability insurance certificate Administrator to submit a copy of updated LIC500 Personnel Report by November 18, 2025. Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates, and any repeat violation within 12 month period may result in civil penalty.. Deficiencies and plan and proof of corrections were discussed with ADM. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.
2025-10-08Annual Compliance VisitType B · 2 findings
Plain-language summary
An inspector reviewed the facility's records after investigating a complaint and found that the facility failed to report three fall incidents from October 2025 that resulted in hospital visits, as well as an alleged abuse incident from October 2, 2025 that involved local law enforcement—the required incident reports were not submitted to the state licensing agency. The administrator acknowledged sending reports but they were not found in state records or the facility's files. The facility was cited for these violations, and the administrator was informed that repeat violations within 12 months could result in financial penalties.
“-This is requirement is not met as evidenced by: -Based on records review and interview, the licensee did not comply with the section above for not sending report for R1 for fall incidents and alleged abuse.”
“--This is requirement is not met as evidenced by: -Based on records review and interview, the licensee did not comply with the section above for not sending the SOC341 while posed a potential safety and personal rights risks to person in care.”
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While at the facility investigating a complaint (Control # 15-AS-20251007084713) and upon review of resident's (R1) file, Licensing Program Analyst (LPA) Delmundo observed 3 Hospital Discharge Summaries showing R1 was seen in the hospital due to fall incidents that happened this October 2025. LPA interviewed Haidie Bautista, administrator (ADM), who stated she sent Unusual Incident Reports (UIRs). LPA checked the Department's e-faxed documents and facility's e-fax folder and didn't see UIRs for the said incidents. LPA also learned from ADM that local law enforcement came to the facility October 2, 2025 due to an alleged abuse, and LPA has not receive the SOC341 nor the UIR from the facility. Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. Deficiencies were discussed with the administrator, and informed that any repeat violations within 12 month period may result in civil penalty. Exit interview conducted. Appeal Rights and copy of this report provided.
2025-07-10Complaint InvestigationUnsubstantiatedNo findings
Plain-language summary
A complaint was investigated alleging inappropriate contact between a staff member and a resident. The investigation included interviews with the resident, staff, other residents, and local law enforcement, but the evidence did not support the allegation—the resident gave inconsistent accounts, police closed their case, the accused staff member denied the claims, and no witnesses corroborated what was alleged. No violation was found.
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During the course of investigation, the Department obtained copies of LIC9020 Register of Facility Clients/Residents, staff roster and LIC624 Unusual Incident Report concerning resident (R1). Copies of R1’s following documents were also obtained: LIC602A Physician's Report; Preplacement Appraisal; LIC625 Appraisal/Needs and Services Plan; LIC9172 Functional Capability Assessment. Local law enforcement was also involved in the investigation and copy of police report was obtained and reviewed. The following were interviewed: RP on 6/09/25; staff (S2, S3, S4) and administrator (ADM) on 6/10/25; residents (R2, R3, R4) on 6/10/25; resident (R1) on 6/16/25; staff (S1) on 6/19/25. RP confirmed what R1 reported to RP. RP stated that R1 told RP about S1 telling R1 not to tell anyone what had happened. S1 asked R1 for R’s phone number as S1 said he was leaving the facility and wanted to keep in contact with R1 but R1 did not provide S1 with R1’s phone number. R1 was inconsistent with her statement to the Department. R1 stated that S1 gave R1 “a quick kiss” only and that there was no other inappropriate touching, and no part of S1’s body parts touched R1’s back. The Hayward Police Department closed their case due to R1 not wanting to make a statement. S1 denied all allegations of inappropriate touching. S1 stated he has showered and dried R1 multiple times without incident. S1 further stated that he has never said or done anything to upset R1 that would prompt this type of allegation, did not notice any changes in R1’s behavior during the week of the alleged incident, and R1 has never indicated that R1 was uncomfortable around him. The staff and residents interviewed said they never saw S1 act unusual or inappropriate around residents or R1. There were no staff or residents who could have witnessed the incident. The information gathered during investigation did not confirm the allegation, therefore the complaint is closed as unsubstantiated. A finding that a complaint is unsubstantiated means that there is not a preponderance of evidence to prove that the allegation and violation occurred. No deficiency cited. Exit interview conducted and a copy of this report provided.
2025-07-03Complaint InvestigationUnsubstantiatedNo findings
Plain-language summary
A complaint was investigated at this facility, but inspectors did not find enough evidence to substantiate the allegation. While the complaint may have had merit, the preponderance of evidence did not support it. An exit interview was conducted with facility management.
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. . . Continued from LIC 9099 Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it; therefore, the allegation is UNSUBSTANTIATED . Exit interview conducted and a copy of this report was provided.
2025-04-21Annual Compliance VisitNo findings
Plain-language summary
On April 21, 2025, inspectors conducted an unannounced health and safety check at the facility following a complaint. The inspector toured both houses and observed the kitchens, dining areas, living spaces, bedrooms, bathrooms, and outdoor areas, and found no violations.
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On 4/21/2025, at 12:45 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct a case management health and safety check as a result of a complaint (15-AS-20250417163152) received by the Department. The LPA met with Administrator Haidie Bautista and informed her of the reason for the visit. The LPA toured the interior and exterior of the facility with the House Manager (HM) Sally Estina. During the tour, the LPA observed the kitchens, dining rooms, living rooms, bedrooms, bathrooms, smoking area, and shared yard for both houses at 1641 and 1659 D Street. No citations were issued during the inspection. Exit interview conducted and a copy of this report was provided.
2025-03-25Complaint InvestigationUnsubstantiatedNo findings
Plain-language summary
An investigator looked into three complaints: that staff were restricting residents' phone use, restricting leisure activities like watching TV, and limiting meal variety. The investigator found no evidence to support any of the complaints—residents reported being allowed to use phones and watch TV, staff confirmed these activities were permitted, and the facility's food supplies and menus showed variety.
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Page 2 All 5 staff interviewed provided information on food/meal serve which were of different varieties. They serve corn dog only once or 2x a week. One out 3 residents interviewed provided information consistent with the information provided by the staff. One of the other resident stated food served is always good while the other one does not remember but not have issues/problems on the meals provided. Two other residents refused to be interviewed. ADM stated she does the grocery shopping online of different varieties from different grocery chains and whatever is not available she asks one of the staff to do in-person grocery shopping. LPA inspected the food supplies and copies of menus showed different varieties. Based on inspection and interviews and LPA unable to obtain information from 2 residents, the allegation is closed as unsubstantiated. Allegation: Facility staff are restricting resident's telephone use. LPA conducted inspection and observed both buildings with land line telephones. All 5 staff stated the residents are allowed to use the facility telephone. Two of these staff and ADM stated that for courtesy to other residents who also want to use telephone, they tell the residents to limit their calls to 10 minutes but they can come back to use the telephone again. One of the 5 staff and ADM also stated that the facility also gets incoming calls and at times may need to make emergency calls. One of the 3 residents stated not using the facility telephone because this resident has cell phone. The other 2 residents stated they are allowed to use and not told to limit their calls. The other 2 residents refused to be interviewed. Based on interviews, the allegation is unsubstantiated. Allegation: Facility staff are restricting resident's leisure time activities. RP stated that all electrical devices such as TV, radio, etc, have to be off at 9:00 p.m. to save electricity, even if they are used with a headset. .....continued on 9099 (page 3) 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 Page 3 During inspection, LPA observed residents in both buildings watching TV, while others doing activities coloring book in the dining area. All 5 staff interviewed stated residents are allowed to watch TV as they want. The TV is turned off at night when observed no resident is watching. ADM denied telling the residents to turn off the TV, radio or other electrical device at 9:00 pm to save on electricity. She only tells them to turn down and/or use headset. One out of 3 residents stated they are allowed to watch tv and staff ask to turn off at 8:00 pm but this resident stated still watches TV after 8:00 pm. One of these 3 stated residents are required to turn off the TV at 8:00 pm which is okay with this resident. The other resident stated staff allow them to watch as they want. LPA tried to interview the other 2 residents but they refused. Therefore, the allegation is unsubstantiated. Based on interviews and observation during investigation, the allegations are closed as unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. No deficiency cited. Exit interview conducted, and copy of this report provided.
2024-10-24Annual Compliance VisitType A · 5 findings
Plain-language summary
During a routine annual inspection on October 24, 2024, inspectors found several maintenance and medication management issues: a greasy kitchen range, loose vinyl flooring tiles, mildew in a shower with a broken faucet, and a chipped electrical outlet in a resident's room; additionally, medication records for two residents were incomplete or improperly documented, and one resident's prescribed medication was not available at the facility. The facility demonstrated good overall practices in fire safety, food storage, medication security, cleanliness of common areas, and emergency preparedness, but was cited for the deficiencies noted and required to submit a correction plan.
“Based on observation, the licensee did not comply with the section cited above in greasy cooking range and grease deposits in corner of flooring in the kitchen in Bldg A which pose a potential health, safety and/or personal rights risk to persons in care. POC Due Date: 11/07/2024 Plan of Correction 1 2 3 4 Corrected. Staff cleaned the range and kitchen floor.”
“Based on observation, the licensee did not comply with the section cited above in following which pose a potential health, safety and/or personal rights risks to persons in care: vinyl flooring tiles in Bldg B coming off; mildew in the shower and broken faucet in Bldg B; chipped electrical outlet plate in one of the resident's rooms in Bldg A. POC Due Date: 11/07/2024 Plan of Correction 1 2 3 4 Administrator have the shower cleaned, and faucet and electrical outlet replaced. Administrator to have the tiles replaced and submit pictures by 11/07/24:”
“Based on observation and record review, the licensee did not comply with the section when staff crossed-out one of resident's (R2) medications on the label which poses a potential health and/or personal rights risks to persons in care. POC Due Date: 11/07/2024 Plan of Correction 1 2 3 4 Administrator to in-service the staff and submit proof by 11/07/24.”
“Based on record review, the licensee did not comply with the section cited above in not having LIC622 for resident's (R1) medications filled on 10/02/24 & 10/21/24] which poses a potential health and/or personal rights risk to person in care. POC Due Date: 11/07/2024 Plan of Correction 1 2 3 4 Corrected. Administrator completed the LIC622.”
“Based on record review, the licensee did not comply with the section cited above in R1 having doctor's order for Ferrous Sulfate but facility does not have this medication which poses an immediate health risk to persons in care. POC Due Date: 10/25/2024 Plan of Correction 1 2 3 4 Administrator to check with the doctor and obtain the medication if still needed; otherwise, obtain discontinued order. Proof to be submitted by 10/25/24.”
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On this day, October 24, 2024, at 1:15 p.m., Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual inspection. LPA met with House Manager Sally Espina and Haidie Bautista, administrator, and informed the reason for visit. LPA started the inspection with house manager and continued with administrator. LPA inspected the 2 buildings (Bldg A and Bldg B) including but not limited to common areas, kitchens, dining areas, receiving room, library, bathrooms, shower rooms, toilets, front, side and backyard. LPA selected for inspection 4 residents rooms in Bldg B and 7 in Buiding A. Fire extinguishers were observed fully charge with tags showed serviced May 21, 2024. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications and medication carts were locked. All residents rooms, dining and common areas were equipped with electric fans. Hallways, common areas, yards and porch were observed free of hazards. Facility has smoke and carbon monoxide detectors that were observed functional. Hot water temperature in one of the bathrooms in Bldg A was tested and measured at 118.4 degrees Fahrenheit . Facility conducts disaster drills every quarter and records showed last conducted October 14, 2024. LPA reviewed 5 residents and 5 staff files, and interviewed 4 residents. Medications were checked and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. Facility does not handle residents' cash resources. .......continued on 809C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LPA observed the following: -at 1:30 p.m., greasy cooking range and grease deposits in the corner of flooring in the kitchen in Bldg A. -at 1:38 p.m., vinyl flooring tiles in Bldg B coming off. -at 1:40 p.m., mildew in the shower and broken faucet in Bldg B. -at 1:56 p.m., chipped electrical outlet plate in one of the resident's rooms in Bldg A. -at 5:15 p.m., resident's (R1) medications filled on 10/02/24 & 10/21/24 has no LIC622. R1 has doctor's order for Ferrous Sulfate but facility does not have this medication. -at 5:50 p.m., staff crossed-out one of resident's (R2) medications on the label. LPA received updated copies of the following documents: 1. LIC308 Designation of Facility Responsibility 2. LIC610E Emergency Disaster Plan 3. LIC9282 Infection Control Plan 4. $3M liability insurance certificate Administrator to submit a copy of updated LIC500 Personnel Report by 11/07/24. Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates, and any repeat violation within 12 month period may result in civil penalties. Deficiencies and plan and proof of corrections were discussed with the administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.
2023-11-10Annual Compliance VisitType A · 3 findings
Plain-language summary
This facility underwent an unannounced annual inspection on November 10, 2023, where inspectors found that overall conditions were good—fire safety equipment was maintained, bathrooms had proper water temperatures, medication storage was mostly secure, and common areas were hazard-free—but two violations were cited: medications were left in an unlocked staff room, and one staff member lacked required first aid and specialized care training certifications. The facility was required to submit a plan to correct these deficiencies and provide proof of corrections by specified deadlines.
“Based on record review and interview, the licensee did not comply with the section cited above for S3 not having the reqjuired training which poses a potential health, safety and/or personal rights risk to persons in care. POC Due Date: 11/24/2023 Plan of Correction 1 2 3 4 Administrator stated she'll have the staff trained. Proof to be submitted by 11/24/23.”
“Based on record review, the licensee did not comply with the section cited above for S3 not having first aid training which poses a potential health and/or safety risks to persons in care. POC Due Date: 11/24/2023 Plan of Correction 1 2 3 4 Administrator to have the staff trained and submit copy of certificate by 11/24/23.”
“Based on observation, the licensee did not comply with the section cited above for staff medications in unlocked which poses an immediate health and/or safety risks to persons in care. POC Due Date: 11/11/2023 Plan of Correction 1 2 3 4 Staff locked the room. In addition, administrator to in-service the staff and submit copy of training topic with attendees signatures by 11/11/23.”
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On this day, November 10, 2023, at 10:15 am, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual inspection. LPA met with staff, Efren Moreno, Sally Espina, Nangtin Lwin. LPA called and spoke over the phone with Haidie Bautista, administrator, and informed the reason for visit. Administrator arrived after several minutes. Facility has LIC9282 Infection Control Plan. LPA started the inspection with Sally Espina and continued with Haidie Bautista. LPA inspected the 2 buildings (Bldg A and Bldg B) including but not limited to common areas, kitchen, dining areas, receiving room, library, staff room, bathrooms, shower rooms, toilets and yard. LPA selected for inspection 3 residents rooms in each in Bldg A and Bldg B. Fire extinguishers were observed fully charge with tags showed serviced March 16. 2023. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications and medication carts were locked. All residents rooms, dining and common areas were equipped with electric fans. Hallways, common areas, yards and porch were observed free of hazards. Facility has smoke and carbon monoxide detectors that were observed functional. Hot water temperature in bathrooms in Bldg A and Bldg B was tested and measured at 119 and 120 degrees Fahrenheit. F acility conducts fire drills every quarter and records showed last conducted October 1, 2023. .......continued on 809C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LPA reviewed 5 residents and 3 staff files, and interviewed 3 staff and 3 residents. Medications were checked and compared with records. Facility does not handle residents' cash resources. Administrator to submit a copy of updated LIC500 Personnel Report by 11/24/23. Deficiencies are cited from Title 22 California Code of Regulations, and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates, and any repeat violation within 12 month period may result in civil penalties. -at 10:43 am, medications in unlocked staff room. -at 12:51 pm, staff S3 has no first aid and 4 hours postural support/restricted health/hospice care training. Deficiencies and plan and proof of corrections were discussed with the administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.
2023-07-19Other VisitType B · 2 findings
Plain-language summary
A routine annual inspection was conducted on July 19, 2023, which included a full tour of both buildings, review of resident and staff files, and checks of safety systems, medications, food storage, and living conditions. The inspector found that five residents had assessment documents that were over a year old, and one resident's assessment did not accurately reflect their actual abilities with eating. The facility was required to submit updated documentation and corrective action plans to address these deficiencies.
“Based on records review, the licensee did not comply with the section cited above. Four residents appraisals are over a year old which pose potentiial health and/or personal rights risk to persons in care. POC Due Date: 08/02/2023 Plan of Correction 1 2 3 4 Administrator stated she'll do the re-sppraisals and submit self-certification by 8/02/23.”
“Based on record review, the licensee did not comply with the section cited above. R4's LIC602A and reappraisal are over a year old. The LIC602A also indicated R4 is dependent on all ADLs; however, R4 can feed self. These pose potential health and/or personal rights risk to person POC Due Date: 08/02/2023 Plan of Correction 1 2 3 4 Administrator to set-up an appointment and have the LIC602A and appraisal updated. Proof to be submitted by 8/02/23.”
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On this day, July 19, 2023, at 1:00 p.m, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual inspection. LPA was granted entry by House Manager Sally Espina. LPA met with Haidie Bautista, administrator, and informed the reason for visit. Facility has LIC9282 Infection Control Plan. LPA toured the facility inside out with the administrator. LPA inspected the 2 buildings (Bldg A and Bldg B) including but not limited to common areas, kitchen, dining areas, receiving room, library in Bldg B, bathrooms, shower room, toilets and yard. LPA selected 3 and 2 residents rooms in Bldg A and Bldg B respectively for inspection. Fire extinguishers were observed fully charge with tags showed serviced March 16. 2023. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications and medication carts were locked. Cabinets/drawers for knives were locked. All residents rooms, dining and common areas were equipped with electric fans. Hallways, common areas, porch were observed free of hazards. Facility has smoke and carbon monoxide detectors that were observed functional. Hot water temperature in bathrooms in Bldg A and Bldg B were tested, and measured at 108.7 and 115 degrees Fahrenheit respectively. Facility conducts disaster drills, and records showed last conducted April 1, 2023. LPA reviewed 5 residents and 5 staff files, and interviewed 3 staff and 3 residents. Medications were checked and compared with records. Facility does not handle residents' cash resources. .......continued on 809C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LPA observed the following: -at 5:05 pm residents (R1, R2. R3, R4 and R5) Appraisal on file were over a year old. -at 5:15 pm, resident's (R4) LIC602A indicated dependent on others with all activities of daily living; however. R4 can feed self. LIC602A is over a year old. LPA received the following updated documents on this same day: 1. LIC308 Designation of Facility Responsibility 2. LIC610E Emergency Disaster Plan (9 pages) 3. Proof of $3M liability insurance coverage Administrator to submit copy of updated LIC500 Personnel Report by 8/02/23. Deficiencies are cited from Title 22 California Code of Regulations, and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates, and any repeat violation within 12 month period may result in civil penalties. Deficiencies and plan and proof of corrections were discussed with the administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.
2023-07-11Other VisitType B · 3 findings
Plain-language summary
During an investigation into a separate complaint, inspectors found that the facility failed to report a resident who left without permission in December 2022, and that two residents lacked required pre-admission and ongoing health assessments. The facility was cited for these violations and given a deadline to submit a plan showing how it will correct these issues.
“-This is requirement is not met as evidenced by: -Based on records review and interview, the licensee did not comply with the section above for not sending report for R1 when R1 AWOLed.”
“-This is requirement is not met as evidenced by: -Based on records review and interview, the licensee did not comply with the section above for not completing Pre-Admission Appraisal for R1 and R2,”
“- Based on records review and interview, the licensee did not comply with the section above for not bringing the changes and/or observation of R1 and R2's behaviors to the primary care phycian (pcp) and psychiatrist.”
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While at the facility investigating a complaint (Control # 15-AS-20230705170957), and upon review of Facility Notes and interview, Licensing Program Analyst (LPA) Delmundo learned and observed the following: 1. Resident (R1) AWOLed on December 26, 2022, and according to Haidie Bautista, administrator, during interview on this day, July 11, 2023, she did not submit Unusual Incident Report to the Department. 2. Residents (R1 and R2) exhibited behaviors. R1 was at John George for 3 months and was discharged back to the facility on June 21.2023. These 2 residents do not have Pre-Admission Appraisal nor Re-appraisals. Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates, and any repeat violation within 12 month period may result in civil penalties. Deficiencies plan and proof of correction were discussed with administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.
2 older inspections from 2022 are not shown in the free view.
2 older inspections from 2022 are not shown in the free view.
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