Abounding Peace Elderly Care Ii.

On 4/17/26 at 11:40am Licensing Program Analyst (LPA) Kevin Gould arrived at Abounding Peace Elderly Care II for the purpose of conducting a required 1 year annual inspection. LPA met with Staff, Adi Lina and together conducted a tour of the home. LPA and Administrator evaluated the physical plant to ensure the health and safety of the residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor and clean. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA observed the closet door in bedroom 105 is in need of repair, an exterior door handle is in need of replacement and the side gate is in need of repair as it is barely hanging onto the post and is difficult to open. LPA measured the water temperature, temperature measured at 108 degrees F which meets the 105-120 degree Fahrenheit regulation. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications secure from residents. LPA observed facility staff are not disposing of syringes as required by regulations and disposing of syringes in municipal garbage bins. Per California Code of Regulations, Title 22 the following deficiencies are cited during today's inspection. An exit interview was conducted, and a copy of this report and appeal rights were left at the facility.

On 2/12/26 at 9:30am, Licensing Program Analyst (LPA) Kevin Gould conducted a case management deficiencies inspection to address deficiencies of facility operation while conducting an unannounced case management inspection. LPA met with Administrator Una Waqalala. LPA observed the following: Expired canned goods and perishable food supplies such as milk and items that are required to be refrigerated after opening were stored in cabinet such as jelly and BBQ sauce. LPA also observed medications stored in one of the refrigerators that were unsecured from residents and stored with resident's food supply. LPA observed one resident's medication was mixed with hot chocolate and was unaware medications were being administered. LPA observed no physician's order and this was confirmed by the administrator and staff member (S1) who hid medications in hot chocolate. In discussions with S1 it was determined they did receive training in medications but did not take any exam to verify competency of medication administration per regulations. Additionally, LPA observed one staff member (S2) not associated to the facility. LPA confirmed the individual has a criminal record clearance but was to associated to the facility. Per the California Code of Regulations, Title 22, The following deficiencies are cited. An immediate civil penalty was also issued. Exit interview conducted and a copy of this report and appeal rights were provided.

On 8/28/25 at 9:30am, Licensing Program Analysts (LPAs) Kevin Gould and Cynthia Tamayo conducted an unannounced Case management inspection to deliver an immediate exclusion for a staff member associated to this facility. LPAs met with staff member Veniana Banuve to discuss the purpose of our visit. LPAs served the facility an immediate exclusion order for staff member R1 (See confidential names list, LIC 811 dated 8/28/25. LPAs obtained a current staff roster dated 2/28/25 to verify R1 is not currently on the schedule. LPAs observed there were three staff members listed on the schedule or present at the facility who did not have a criminal record clearance or associated to the facility. Per California code of Regulations, Title 22, the following deficiency is cited. An immediate civil penalty was issued during today's inspection. Exit interview conducted and a copy of this report and appeal rights were left at the facility.

On 04/18/2024 at 8:30 AM, Licensing Program Analyst (LPA) Pang Lee and Support staff (SS) Perla Mancillas arrived at the facility to conduct an unannounced annual inspection. LPA and SS met with direct care staff, Veniana Banuve and explained the purpose of the visit. Direct care staff called administrator, Una Wagalala. LPA and SS was informed that administrator is not able to join the visit and that direct care staff Veniana will assist with today’s visit. Administrator certificate # is 6056441740 and will expire on 07/08/2024. The current census is 13 with 3 facility staff. This facility is a single story building licensed to serve fifth teen (15) non-ambulatory residents and approved for 1 hospice residents. LPA and SS inspected the physical plant including but not limited to the common area, kitchen, dining area, residents’ bedrooms, residents’ bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. It was observed the facility was free of odor, clean and in good repair. LPA and SS observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA and SS observed residents’ room 101 was occupied by two facility staff which does not reflect the facility sketch and fire clearance. LPA and SS observed a folded roll out bed in residents’ room 102. It was learned that a staff sleeps on the roll out bed either in the activity room or the living room. It was also observed that the resident bathroom inside bedroom 102 is locked during the day and open for resident’s use at night due to the toilet leaking. LPA Lee did not observed any leak in the bathroom during today's visit. LPA and SS toured the kitchen and observed the pantry locked and not accessible to residents at this time. The facility had sufficient seven day non-perishable food supplies. It was observed that two day perishable food supplies were not sufficient for 13 residents in care. Hot water temperature was measured at 130.1 degrees Fahrenheit in resident bathroom sink, which is not within the required regulation of 105 to 120 degrees Fahrenheit. 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 Grab bars and non-slip mat were observed to be stable and in good repair at this time. Smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in kitchen and was last serviced on 04/03/2024. LPA and SS observed the facility has a has a public telephone in the kitchen and the facility has the required posters posted. The facility has an infection control plan and an emergency disaster plan. Facility thermostat observed at 72 degrees Fahrenheit. LPA and SS observed toxins located in the hallway closet and kept locked and inaccessible to residents. LPA and SS observed sharp knives kept locked and inaccessible to residents. LPA and SS checked medication storage and found medication to be locked away and inaccessible to residents. LPA and SS reviewed and compared 4 medication administration record (MAR) along with residents’ medications. Records reviewed indicated that 1 out of 4 MAR log was inaccurate. Three out of 9 medication instruction did not have the current instruction information. The first aid kit was checked, and it was missing the thermometer. LPA Lee requested resident and staff files for review. LPA Lee reviewed 6 out of 13 resident files and 3 staff files and they were complete. LPA Lee reviewed staff criminal record clearances and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared and associated to the facility. The following documents will be email to LPA Lee ( pang.lee@dss.ca.gov ) by 04/26/2024 by 5:00 PM by end of day: (1) LIC 308 Designation of Administrative Responsibility (2) LIC 500 Personnel Report (3) Copy of Administrator Certificate (4) LIC 610 Emergency Disaster Plan (5) Proof of Current Liability Insurance As a result of this annual visit, the facility is not in compliance with Title 22 Regulation, and the deficiencies can be found on the LIC 809 D page. An exit interview was conducted, and a copy of these LIC 809 reports, LIC 809-D page, and Appeals rights were provided to the facility staff Veniana Banuve.

S1 said that E1 was present at the facility for one day to clean out a resident’s room while they were in the process of moving out. S1 said the resident moved out in mid-September 2022. S3 described E1 as a staff member. LPA Moleski reviewed an email sent by E1 on August 17, 2023 asking staff to deliver a billing agreement to a former resident. LPA Moleski interviewed seven residents’ responsible parties. Of these, responsible parties for R4, R6, R9, R10, R11, and R13 said they had been in contact with E1. The department has determined the following as it relates to the allegation that the facility allowed an excluded person to facilitate operations: Based on interviews and record review, the above allegation is SUBSTANTIATED. A finding that the complaint allegation is substantiated means that the allegation is valid because the preponderance of evidence standard has been met. This facility is being cited per 22 CCR Section 87355(e)(1). An immediate civil penalty in the amount of $100 per day for one day, for a total of $100, was assessed. An exit interview was held and a copy of this report and appeal rights were left with Banuve.