Jla Healthcare Services Llc
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.
1185 Acacia Street · Montara, 94037
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
Severity39thWeighted citations per bed
Repeats100thRepeat deficiencies as share of total
Frequency25thDeficiencies 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
Jla Healthcare Services Llc scores C. Better than 55% of comparable California RESIDENTIAL CARE ELDERLY facilities. Severity: 39th percentile. Repeats: top 0%. Frequency: 25th percentile.
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
↓ improvingWeighted severity score per month · 24 months
Weighted score (24mo)
62
Last citation
Jun 25
Finding distribution
11 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 24 licensed beds:
One awake caregiver must be on duty, plus one additional caregiver on call who can respond within 10 minutes.
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
- 415601129
- License type
- RESIDENTIAL CARE ELDERLY
- License status
- LICENSED
- License expires
- Not yet indexed
- Licensed beds
- 24
- Operator
- Jla Healthcare Services Llc
Inspections & citations
14
reports on file
12
total deficiencies
8
Type A (actual harm)
Other visitJune 19, 2025Type A2 deficiencies
Plain-language summary
This was a routine unannounced inspection in June 2025 where the facility was found to meet requirements in most areas—the building, resident rooms, kitchen, bathrooms, temperature controls, fire safety equipment, medications, and staff training records were all in order. One deficiency was cited, though the specific details are not described in this summary. The administrator was informed of the findings.
View full inspector notes
On June 19, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual visit. LPA met with Administrator, Eloisa Bustamante and explained the purpose of the visit. LPA toured the facility inside and outside including all of resident rooms, common areas & kitchen. The indoor and outdoor passageway was free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a single story facility. LPA observed a random sample of resident rooms and observed required furniture. LPA observed 2- days perishables and 7- days of non-perishables. Toilet, hand washing and bathing areas were observed clean and odor-free. Shower room was observed equipped with non-skid mats and grab bars. Comfortable temperature is maintained and lighting is sufficient for comfort. Extra linen was observed present. Medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. Water temperature throughout the facility measured between 105-119 degrees F. Hot water temperature in the kitchen and bathroom were measured at 108-117 degrees Fahrenheit. Fire extinguishers were checked and last inspected on 4/22/2024. Dining room was observed free from tripping hazards. Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of April 2025. LPA reviewed 5 resident records and 4 staff records. Resident records are updated, complete and signed. Staff records have training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. 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. Report is reviewed with Administrator and a copy is provided.
Regulation
(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…
Inspector finding
Based on record review, Resident 1's (R1's) physician's report states R1 is bedridden and resides in Room #104, however the room is not approved for bedridden which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 06/20/2025 Plan of Correction 1 2 3 4 Licensee/administrator shall reach out to the fire department by 6/20/25, and notify them of R1 being bedridden. Licensee/administrator shall submit a new LIC200 with a new floor plan indicating what roo…
Regulation
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening as specified in Section 87411, Personnel Requirements - General.
Inspector finding
Based on record reviewed, 3/5 staff did not have health screening which includes TB testing which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 06/20/2025 Plan of Correction 1 2 3 4 Licensee/administrator shall ensure all staff members have health screening that are completed, including TB testing. Licensee/administrator shall submit a plan in writing to ensure health screenings are completed for each staff.
ComplaintDecember 9, 2024No deficiencies
Inspector: Murial Han
Plain-language summary
This was a complaint investigation into concerns about the facility's bankruptcy affecting resident care. Inspectors interviewed staff members, residents, and a family member, and all reported that care quality and services remained unchanged and that staff pay continued on schedule. No violation was found.
View full inspector notes
LPA interviewed four staff members and all them stated that they were informed of the bankruptcy by the administrator and they did not experience any changes with caring for the residents and their pay reminded accurate and on time. LPA interviewed two residents and both of them reported that they were being well cared for and they did not notice any changes with the services that they were receiving. LPA interviewed a responsible party who visited the facility on a regular basis and he/she did not notice any changes with the level of care that his/her loved one was receiving due to the bankruptcy. Based on observation and interviews, this allegation is deemed to be unfounded. The agency has investigated the allegation and we have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. This report is reviewed and discussed with the administrator. A copy is provided.
InspectionNovember 6, 2024No deficiencies
Inspector: Murial Han
Plain-language summary
On November 6, 2024, inspectors conducted a follow-up visit to investigate an incident from October 8 where one resident reported being hit by another resident in a room with no witnesses. The facility assessed the resident who reported being hit, found no injuries, notified the resident's family and physician, and began hourly safety checks on both residents involved. At the time of the inspection visit, both residents appeared calm and comfortable, no further incidents had occurred, and no violations were found.
View full inspector notes
On 11/6/2024, Licensing Program Analyst (LPA), Murial Han conducted an unannounced case management visit to follow-up on an incident that was reported by the facility. LPA met with the administrator and explained the purpose of today's visit. On 10/8/2024, the facility reported that resident #1 (R1) reporting that resident #2(R2) hit him/her in the room and there was no witness. The facility completed a change of condition for R1 and reported the alleged incident to R1's responsible party, the Ombudsman and the physician. In addition, the facility completed an assessment for R1 and no injuries were noted. The facility also started hourly rounds on R1 and R2 to ensure their safety. During today's visit, LPA observed R1 and R2 were pleasant and calm and the administrator reported that there were no more reporting of the alleged incident. According to the administrator, both residents were new to the facility when this alleged incident was report and they are adjusting well now. No deficiency is cited today. This report is reviewed and discussed with the administrator.
Other visitJune 17, 2024Type A7 deficiencies
Inspector: Murial Han
Plain-language summary
During a routine annual inspection on June 17, 2024, inspectors found the facility's living spaces, bathrooms, kitchen, and outdoor areas clean and well-maintained, with adequate food supplies, working plumbing and heating, proper safety equipment like grab bars and fire extinguishers, and secure storage for medications and chemicals. Staff and resident files were reviewed, and hot water temperatures were checked and found appropriate. The facility was cited for one deficiency related to state regulations, and the administrator was given until June 24, 2024 to submit required documentation and correct the issue.
View full inspector notes
On June 17, 2024 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA was met with the administrator, Loi Bustamante and LPA explained the purpose of the visit. LPA toured the facility inside out and inspected the living room, dining area, kitchen, bedrooms, bathrooms, and backyard. The indoor and outdoor passageways were free of obstruction. A tour of resident's room was conducted and observed to have sufficient furniture and furnishings. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Toilet, hand washing and bathing areas were observed clean and in operating condition. Showers were observed equipped with non-skid mats and grab bars. Comfortable temperature is maintained and lighting is sufficient for comfort. Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time. Residents observed to have a call pendant for assistance, Central storage for medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. Hot water temperature in the kitchen and bathroom were measured at 108-117 degrees Fahrenheit. Fire extinguishers were checked and last inspected on 4/22/2024. A review of (5) resident files was conducted and noted on the LIC 858. A review of (5) staff files was conducted and noted on the LIC 859. The following documents were requested submitted to CCL by 6/24/24: - Control of Property, LIC 500, Liability Insurance, Administrator Certification 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 administrator. A copy of this report and the appeal rights were provided.
Regulation
(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill,…
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as facility was not able to provide documents to proof that emergency drills were conducted accordingly which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 06/18/2024 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure compliance and will provide an in-service on drills. The administrator will provide a copy of the p…
Regulation
(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivisi…
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed 1 staff did not have records to proof that required training was completed which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/24/2024 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure compliance and will provide a copy of the plan and training records to CCL by 6/24/2024.
Regulation
(b) Each resident's record shall contain at least the following information: (15) The admission agreement and pre-admission appraisal, specified in Sections 87507, Admission Agreements and 87457, Pre-admission Appraisal.
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as 1 resident's admission agreement was blank and not signed by the resident and/ the responsible party which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/24/2024 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure compliance and will provide a copy of the plan and the completed admission agreement to CCL b…
Regulation
(a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (3) Obtain and evaluate a recent medical assessment.
Inspector finding
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed 1 resident did not have a copy of the medical/physician's assessment which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/24/2024 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure compliance and will provide a copy of the plan and a copy of the physician's order to CCL by 6/24/2024.
Inspector finding
87411 Personnel Requirements - General Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed 4 out of 5 staff's personnel files did not have health screening and 2 out of 5 staff did not have TB records which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 06/18/2024 Plan of Correction 1 2 3 4 The administrator will develop a plan to ensure…
Inspector finding
87608 Postural Supports Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed 4 out of 5 residents have half bedrails installed on their bed and the facility was not able to provide a copy of the physician's order for such device which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 06/18/2024 Plan of Correction 1 2 3 4 The administrator wil…
Inspector finding
§1569.69 Employees assisting residents with self-administration of medication; training requirements Deficient Practice Statement 1 2 3 4 Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed a caregiver/med tech's training record was expired on 6/5/2024 which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 06/24/2024 Plan of Correction 1 2 3 4 The administrator will devel…
ComplaintJanuary 18, 2024No deficiencies
Inspector: Murial Han
Plain-language summary
A complaint was investigated regarding a resident's death. After reviewing hospital records and the death certificate, the Department found no violation — the facility had appropriately sought medical help when the resident's health changed, and the death was not questionable. The findings were discussed with the facility administrator.
View full inspector notes
The Department has completed the investigation and based on hospital records and R1's death certificate, R1's death was not questionable and the facility seek for proper medical assistance when R1 had a change in health condition. Based on the above information, the Department has found that this allegation to be UNFOUNDED, meaning that this allegation was false, could not have happened and/or is without a reasonable basis. Report is reviewed with administrator Loi Bustamante and a copy is provided.
Other visitNovember 27, 2023No deficiencies
Inspector: Jaime Vado
Plain-language summary
The state visited the facility to make corrections to inspection records from November 2023. The administrator reviewed the amended documents with the inspector, and no new violations were found.
View full inspector notes
On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced case management - other visit to amend LIC9099 and LIC9099A reports dated from 11/21/2023. LPA met with administrator Eloisa Bustamante and explained the purpose of today's visit. LPA discussed the amendments made and reviewed the amended documents with her. No new citations issued. Report is reviewed with Eloisa.
ComplaintNovember 21, 2023· SubstantiatedType A1 deficiency
Inspector: Jaime Vado
Regulation
Personal Rights of Residents in All Facilities - (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons.
Inspector finding
This regulation was not met as evidenced by: Per video evidence received it was observed that residents were being recorded/broadcasted and posted onto a public social media platform without consent. S1 was interviewed and S1 confirmed posting the video to S1's social media account. S1 did not observe residents’ personal rights and accorded their dignity as staff videotaped residents and posted the video in Facebook/social media
Other visitAugust 2, 2023Type A1 deficiency
Inspector: Murial Han
Plain-language summary
During a complaint investigation, inspectors found that two staff members without proper training were performing daily blood sugar testing on a resident, which requires a qualified healthcare professional. The facility's administrator acknowledged this practice but the staff were not identified as having the appropriate credentials for this task. The facility was cited for this deficiency and told that failure to correct it could result in penalties.
View full inspector notes
On August 2, 2023 Licensing Program Analysts (LPA) Murial Han conducted an unannounced complaint visit in reference to complaint # 14-AS-2023726130737. LPA met with administrator and explained the purpose of the visit. During the course of the complaint investigation, 2 facility staff stated that they were administering resident #1 (R1)'s glucose finger sticks on a daily basis and this was acknowledged by the administrator. LPA reviewed both facility staff personnel files and observed both of them are not identified as an appropriate skilled professional. Deficient is cited under California Health and Safety Code on the LIC 809D as the facility failed to ensure the glucose testing is performed by an appropriate skilled professional. Failure to correct the deficiencies may result in civil penalties. Report was discussed and reviewed with administrator. A copy of this report and the Appeal Rights is provided.
Regulation
87628 Diabetes..(a)The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood..or has it administered by an appropriately skilled professional.
Inspector finding
This requirement is not met as evidenced by facility staff who are not identified as appropriate skilled professionals are administering the daily glucose finger stick checks for R1 posed an immediate health risk for residents in care.
Other visitNovember 1, 2022No deficiencies
Inspector: Komal Charitra
Plain-language summary
On November 1, 2022, a licensing analyst visited the facility to deliver findings from a complaint that had been made at the facility's previous location before it moved. The analyst met with the administrator to review the complaint findings and provided a copy of the report.
View full inspector notes
On November 1, 2022, Licensing Program Analyst (LPA) Komal Charitra complaint collateral visit to deliver findings deliver findings to a complaint received under Licensee's previous address. LPA met with Administrator, Eloisa Bustamante and explained the purpose of the visit. LPA Charitra delivered findings regarding a complaint made at Licensees previous facility #415601068 which is now closed and moved to this location. Report is reviewed with Administrator and a copy is provided.
InspectionNovember 1, 2022Type A1 deficiency
Inspector: Komal Charitra
Plain-language summary
During an unannounced visit on November 1, 2022, the facility was found to have two staff members who were fingerprint cleared but not properly registered with the state as working at this facility, meaning they should not have been providing care to residents. The facility was assessed a $200 civil penalty ($100 per staff member) for this violation. The administrator was notified of the finding and given information about appeal rights.
View full inspector notes
On November 1, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced case management visit. LPA met with Administrator, Eloisa Bustamante and explained the purpose of the visit. During complaint control # 14-AS-20220607085541, the Department found that Staff #1 (S1) and Staff #2 (S2) was not fingerprint cleared and associated to the facility, however was providing care and supervision to residents in care. During the visit, LPA spoke to the administrator and reviewed facility personnel records. Based on the records reviewed, it was observed that S1 and S2 are fingerprint cleared, however are not associated to the facility. A civil penalty of $100.00 for EACH individual is being assessed during the visit = $200.00. Deficiency of the Residential Care Elderly California Code of Regulations, Title 22, Division 6 is observed and cited on a LIC 809D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with Administrator and a copy is provided with appeals rights. Civil penalty is provided as well.
Regulation
Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) Violation of this regulation is evidenced by:
Inspector finding
Based on records review, facility failed to request a transfer of criminal record clearance for S1 which poses an immediate health and safety risk to residents in care. On 11/1/2022, LPA confirmed with Administrator that S1 and S2 is still employed with facility and is providing care and supervision to residents. In addition, LPA observed S1 and S2 during the visit providing care and supervision.
Other visitOctober 7, 2022No deficiencies
Inspector: Jaime Vado
Plain-language summary
A state investigator visited the facility to deliver findings from a complaint made about the previous location where this facility was operating before it moved. The investigator found no violations, and no citations were issued.
View full inspector notes
On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint collateral visit to deliver findings in the above received allegations. LPA met with licensee Eloisa Bustamante and explained purpose of today's visit. LPA is delivering the findings regarding a complaint made at her previous facility #415601068 which is now closed and moved to this location. LPA discussed and made observations on this day. LPA discussed the report findings with the licensee and provided copies of the findings today. No citations issued. Report reviewed with licensee.
Other visitAugust 15, 2022No deficiencies
Inspector: Jaime Vado
Plain-language summary
A licensing official visited the facility to discuss findings from a complaint made about the licensee's previous location, which has since closed and relocated. The complaint stemmed from a dispute between the landlord and licensee at the prior facility. No violations were found, and no citations were issued.
View full inspector notes
On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint collateral visit to deliver findings in the above received allegations. LPA met with licensee Eloisa Bustamante and explained purpose of today's visit. LPA is delivering the findings regarding a complaint made at her previous facility #415601068 which is now closed and moved to this location. LPA discussed the circumstances which may have caused the complaint to be made to the Department. She says it was a dispute between landlord and licensee but clarified the circumstances surrounding her previous facility. LPA discussed the report findings with the licensee and provided copies of the findings today. No citations issued. Report reviewed with licensee.
Other visitMay 31, 2022No deficiencies
Inspector: Murial Han
Plain-language summary
This was a pre-licensing inspection visit on May 31, 2022, where inspectors toured the facility and found it clean and well-maintained, with comfortable lighting and temperature, proper bathroom safety features including grab bars and non-skid mats, and functioning fire safety equipment including smoke detectors, sprinklers, and carbon monoxide detectors. The inspectors recommended immediate licensure based on their findings.
View full inspector notes
On 5/31/2022, at 10:30am, Licensing Program Analyst (LPA) Murial Han conducted a follow-up pre-licensing inspection. LPA met with administrators, Jerome Leonard and Eloisa Bustamante and explained the purpose of today's visit. Administrators provided a tour of the facility and LPA observed the entire facility to be cleaned and tidy. The resident's rooms are spacious and a few of them are equipped with furniture. The common areas- dinning room, hallway, and activity rooms appeared to be bright and the overall lighting and temperature are comfortable. LPA observed bathrooms and showrooms are cleaned, and sanitary. The shower tubs have non-skid mats and grab bars. The entire facility is hardwired with smoke detectors, fire sprinkler system, and fire panel. The fire panel was last inspected on 3/1/2022 and fire extinguishers were last inspected on 3/21/2022 and had passed all inspections conducted by Hue & Cry Inc. Carbon Monoxide detector is observed to be fully functional. Comp III orientation was given to the Administrators, Jerome Leonard and Eloisa Bustamante Pre-Licensing is now complete. Immediate Licensure is recommended pending final approval from the Central Applications Bureau. Exit interview conducted with administrators. A copy of the report is provided.
ComplaintMay 19, 2022No deficiencies
Inspector: Murial Han
Plain-language summary
This was a pre-licensing inspection of a new facility on May 19, 2022, before it admitted residents. The inspector found the facility had adequate food storage, first aid supplies, and safety postings, but identified several cleaning and maintenance issues including white powder and black particles throughout multiple rooms, rust and stains on shower tubs, foggy windows, and unopened non-skid mats that should have been in use. The facility scheduled professional cleaning for May 22, 2022, and the inspector planned a follow-up inspection to verify the issues were resolved.
View full inspector notes
On 5/19/22 at 10:00AM, Licensing Program Analyst (LPA), Murial Han met with the Administrators, Jerome Leonard and Eloisa Bustamante to conduct an announced Pre-Licensing inspection. LPA observed the indoor and the outdoor passageways are free of obstruction. Ms. Bustamante provided a tour of the facility. This is a single level facility. There is no residents during the time of the inspection. LPA observed good lighting and comfortable temperature in the facility. LPA observed sufficient hygiene and cleaning supplies. Three trash cans in the kitchen have tight fitting, and foot operated lids. The refrigerator was measured at 39 degrees Fahrenheit (F) and the freezer was measured at -7 degrees F. LPA observed sufficient amount of non-perishable food, utensils, cooking wares and cleaning supplies. The first aid kit was inspected to be adequate. LPA observed adequate postings including CCL complaint poster, resident's rights, resident council rights, the emergency disaster plan, facility theft and lost program. LPA observed some COVID-19 signs within the facility but recommended to post hand washing instruction signs by the hand washing stations, and additional COVID-19 signs. The facility has a spacious a dining room and a theater. A few resident's rooms were equipped with beds and furniture. 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 bathroom sinks temperature measured at 106- 116 degrees Fahrenheit (F) and the main shower room was measured at 107 degrees Fahrenheit (F). Pre-Licensing is incomplete during this inspection due to the following area of concerns: - LPA observed the overall facility required cleaning as there were white powder and black particles identified in resident's room, bathrooms, shower room, dining room, kitchen, and hallways. - LPA observed 3 non-skid mats were unopened next to the shower rooms - LPA observed brown and rusty stains on the shower tubs - LPA observed black stains inside the shower tubs - LPA observed blurry and foggy windows throughout the facility - LPA observed a mental bed frame with 2 mattresses positioned on the floor in room 103 - Facility has a laundry but no dryer and washer The administrator acknowledged the above findings and stated that a professional cleaning crew is scheduled to come on May 22, 2022 for deep cleaning. A follow-up pre-licensing inspection will be scheduled. Exit interview conducted with administrator, Eloisa Bustamante and Jerome Leonard A copy of this report is provided.
Federal summary
CMS Care CompareNot a CMS-certified facility
California RCFEs (residential care facilities for the elderly) are licensed by the state, not by CMS. CMS data only applies to skilled nursing facilities or to CCRCs that operate a licensed SNF wing.
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