California Mentor-marineview 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.
2420 Marineview Drive · San Leandro, 94577
Record last updated April 20, 2026.

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Quick facts
Memory care context
California Mentor-Marineview Home is a California-licensed RCFE with a memory care designation, licensed for 4 residents and operated by National Mentor Healthcare, LLC. California Title 22 requires facilities serving dementia residents to meet specific standards under §87705 and §87706, covering individualized care plans, staff training, and resident supervision. CDSS cited this facility under §87705 or §87706 (dementia-care regulations) at least once during the inspection period on file. State records show 20 inspection reports, 7 total deficiencies — 3 Type A (actual harm) and 4 Type B (potential for harm) — and 7 complaints investigated. The most recent inspection occurred on 2026-02-13.
Questions to ask on your tour
Based on California Mentor-marineview Home's state inspection record.
The facility has 3 Type A deficiencies on file, indicating actual harm to residents — what were the specific circumstances of each citation, and what corrective actions were implemented?
Seven complaints were filed with CDSS during the inspection period — what were the subjects of those complaints, and how many were substantiated?
The facility was cited under §87705 or §87706 for dementia care — what was the specific violation, and how have dementia care practices changed since that citation?
With 4 Type B deficiencies (potential for harm) on record, what systemic changes has National Mentor Healthcare implemented at this location to prevent similar issues?
Given the facility's 4-bed capacity, how does the operator ensure continuity of care when the assigned caregiver is unavailable due to illness or emergency?
State records
California CDSS · Community Care Licensing Division- License number
- 019200737
- License type
- RESIDENTIAL CARE ELDERLY
- License status
- LICENSED
- License expires
- Not yet indexed
- Licensed beds
- 4
- Operator
- National Mentor Healthcare, Llc
Inspections & citations
20
reports on file
8
total deficiencies
3
Type A (actual harm)
1
dementia-care citations
Other visitFebruary 13, 2026No deficiencies
Inspector notes
On 2/13/2026 at 12:30 PM, Licensing Program Analyst (LPA) Y. Brown conducted an unannounced Case Management visit regarding an incident that was reported to CCLD on 1/6/2026. LPA met with Precious Yepez, Program Director and explained the purpose of the visit. The incident of missed medication occurred on 1/5/2026. Program Director (PD) stated that they were the only staff that was able to pass out medication since the other two staff on shift were registry staff. PD stated that they don't remember why the medication was missed and might have been busy with other tasks. The deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted with Precious. A copy of the appeal rights and this report was provided.
Other visitFebruary 13, 2026· UnsubstantiatedNo deficiencies
Inspector: Yasamin Brown
Unsubstantiated — CDSS investigated and did not find violations.
Inspector notes
Continued from LIC9099. Allegation: Staff is violating resident's personal rights Finding: Unsubstantiated Interview with the reporting party (RP) revealed that R1 has never requested only a women staff to help them with their ADLS (activities of daily living) but they are concerned that R1 only prefers certain staff members. RP stated that it depends on R1's mood on how they react to certain staff members. W1 stated that R1 has expressive behaviors towards different staff but has no issue with the specific gender of staff to help them. W2 stated that R1 has never talked to them about wanting only a women staff. Interview with S1 and S2 revealed that R1 has never requested or asked for a specific gender to help them but R1 has behaviors towards different staff members depending on their mood. LPA reviewed R1's IPP and LIC602 and there were no indications or orders that stated that R1 needs to only be helped by a specific gender. Based on interviews and record review during visit, the allegation that staff at the facility are not monitoring resident's blood pressure was found to be unsubstantiated. A finding that a 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 with Precious and copy of this report provided.
ComplaintFebruary 3, 2026· UnsubstantiatedNo deficiencies
Inspector: Yasamin Brown
Unsubstantiated — CDSS investigated and did not find violations.
Inspector notes
Continued from LIC9099. Allegation: Staff did not ensure the heater was not in disrepair Finding: Unsubstantiated Interview with staff revealed that the heater was working on and off around 12/4/2025 but the staff provided residents with space heaters. Interview with staff revealed that the breaker got fixed on 12/7/2025. LPA observed that the heater was functional and working during visit. Allegation: Staff did not ensure the shower had hot water Finding: Unsubstantiated Interview with staff revealed that the facility has two showers. S1 stated that the second shower has warm water but it takes time to warm up. S1's interview revealed that the residents use the first shower since the water does not take long to warm up but both showers have warm water. Interview with staff revealed that no residents missed any of their shower times. Allegation: Staff did not ensure they were not without electricity Finding: Unsubstantiated Interview with staff revealed that the facility's electricity went out for about an hour and a half on 12/6/2025. LPA observed that the facility has a generator. Interviews with staff revealed that the entire neighborhood's electricity shut off that day. LPA observed that the facility has emergency flashlights. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED . No deficiencies are being cited on this date. Exit interview conducted with Precious and a copy of this report provided. 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 Allegation : Staff did not accompany resident to the ER Finding: Substantiated RP stated that R1 did not have a staff to accompany them to the ER and R1 is unable to advocate for themselves. A review of R1's IPP (Individual Program Plan) indicated that R1 would need direct assistance in an emergency, as R1 is Deaf and nonverbal. R1's IPP also states that R1 would not be able to communicate with emergency personnel on their own. Interview with staff revealed that there was not adequate staff available to go with R1 to the hospital at the time. Based on LPAs information obtained during investigation, the preponderance of evidence standard has been met, therefore, the above allegations are found to be SUBSTANTIATED . California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC9099D. Exit interview was conducted with Precious and Appeal Rights was provided.
Other visitJanuary 16, 2026No deficiencies
Inspector: Allison O'Hollaren
Inspector notes
On 04/23/2021 Licensing Program Analyst (LPA) Allison O'Hollaren conducted an unannounced case management visit regarding a self reported incident. Due to the Shelter in Place set forth by the Governor on March 17, 2020, LPA was not able to conduct the visit in person. The visit was performed by telephone. LPA spoke with Administrator, Joe Farrish. During the phone call LPA spoke and reviewed incident with Administrator. Administrator confirmed that R1 was not given a dosage of medication on 04/05/2021. The error was discovered the following day on 04/06/2021. The following deficiency was cited from the California Code of Regulations, Title 22. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report emailed.
Other visitDecember 26, 2025No deficiencies
Inspector notes
On 1/16/2026 at 3:00 pm, Licensing Program Analyst (LPA) Y. Brown conducted an unannounced Case Management visit regarding an incident that was reported to CCLD on 1/15/2026. LPA met with Renny Manansala, Administrator and explained the purpose of the visit. S2 submitted an incident report that stated R1 alleges S5 has been sexually abusing R1 to the department on 1/15/2026. The incident report states that the incident happened on 1/13/2026. LPA interviewed Staff (S1) and Resident (R1) during visit. S1 stated that the incident has been reported to Adult Protective Services (APS) and the Local Police Department was contacted. S1 stated that the police have started their own investigation and told the facility to hold off on their internal investigation at this time. S1 stated that S5 has been put on administrative leave. LPA was unable to interview S5 at this time. During Visit, LPA obtained the following resident records: R1's LIC 602 (Medical Assessment), Hospice Care Plan, ID &Emergency form, Face Sheet, IPP, IBSP and incident report. LPA also collected the Adult Protective Services (APS) report. 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 from LIC809. No deficiencies cited during the visit. LPA will conduct further investigation and will return if needed. Exit interview conducted with Renny and a copy of this report provided.
ComplaintDecember 26, 2025No deficiencies
Inspector notes
On 2/13/2026 at 11:30 AM, Licensing Program Analyst (LPA) Y. Brown arrived unannounced to conduct a Case Management visit. LPA met with Precious Yepez, Program Director and explained the purpose of the visit. While LPA Y. Brown was conducting a complaint investigation (15-AS-20251217090546) on 12/17/2025 during file review and interview LPA discovered: 1. The facility did not submit any incident reports in regards to the facility not having electricity and the heater not working. The deficiency was observed (see LIC809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted with Precious and a copy of this report and appeal rights provided.
Other visitNovember 14, 2025No deficiencies
Inspector notes
On 04/22/2025, at 9:00 AM, Licensing Program Analysts (LPAs) Y. Brown and J. Sampair arrived unannounced to conduct an investigation of complaint 15-AS-20250414141712. The LPAs met with Administrator Maehellena Harlan and informed her of the reason for the visit. LPA Brown observed the following: -At 10:15 AM, hot water temperate in the ki tchen was measured at 150.3 Degrees Fahrenheit. -At 10:35 AM, during record review it was discovered that the proper documentation for change of administrator has not submitted to the Department . Deficiency is cited from Title 22 California Code of Regulations, and listed on 809-D. Failure to submit proof of correction by plan of correction due date and any repeat violation may result in civil penalty. Deficiency and plan and proof of correction were discussed with the administrator. Exit interview conducted. Appeal Rights and copy of this report provided.
InspectionSeptember 19, 2025No deficiencies
Inspector notes
On 11/14/2025 at 10:45 AM, Licensing Program Analysts (LPAs) Y. Brown and K. Nguyen arrived unannounced to conduct a Case Management visit. LPA met with Precious Yepez, Program Director. While LPAs were conducting a complaint investigation ( #15-AS-20251107121710) on 11/14/2025, During interview, S1 stated that the facility is short staffed however, management has been conducting interviews and hiring regarding the short-staffing. LPAs requested the following document: Staff schedule and updates on any new hires on staffing submitted to CCLD by 11/21/2025. LPAs discussed with S1 that all times on the staff schedule that are empty needs to be indicated with a staff member. Exit interview conducted with Precious Yepez and a copy of this report provided.
ComplaintApril 22, 2025No deficiencies
Inspector: Kelly Nguyen
Inspector notes
On 8/5/22 at 2:10 PM, Licensing Program Analysts (LPAs) K. Nguyen and L. Francisco arrived unannounced to conduct Infection Control Inspection. LPAs met with Direct Support Professional, Lucky Amenaghawon, and explained the purpose of the visit. Joseph Farrish Administrator later arrived at 2:42pm during the visit. LPA continued the inspection with Joseph. During the Infection Control Inspection, LPA toured facility including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and backyard. Facility has a sufficient of 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. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 8/12/2022: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610D Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate Exit interview conducted. A copy of this report is provided
Other visitApril 22, 2025No deficiencies
Inspector notes
On 12/26/2025 at 11:45 AM, Licensing Program Analyst (LPA) Y. Brown arrived unannounced to conduct a case management visit. LPA met with Program Supervisor Tahmeya Stover. During the course of investigation for complaint (#15-AS-20251216100733), the following deficiency was observed: 1) LPA reviewed Guardian and observed S1 was not fingerprint cleared or associated to the facility. Civil penalty of $500 is being assessed on today's visit. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties. Exit interview conducted with Tahmeya and a copy of this report, civil penalty, and appeal rights provided.
ComplaintDecember 20, 2024· UnsubstantiatedNo deficiencies
Inspector: James Sampair
Unsubstantiated — CDSS investigated and did not find violations.
Inspector notes
... Continued from LIC 9099 The complaint alleges that staff do not properly clean the home. The LPAs inspected the facility and found that the home was properly cleaned. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove them; therefore, the allegation is UNSUBSTANTIATED. Exit interview conducted and a copy of this report was provided.
Other visitDecember 20, 2024· UnsubstantiatedNo deficiencies
Inspector: Yasamin Brown
Unsubstantiated — CDSS investigated and did not find violations.
Inspector notes
Continued from LIC9099. The interview with the RP/Complainant revealed that the smell coming from the staff member does not interfere with work or with the clients. The interview with S1/ADM revealed that they have never smelled an odor at the facility and it revealed that there were no concerns with a smell coming from a staff member at the facility. The interview with S2 revealed that there weren't any smells coming from a staff member that was hindering the safety of clients. The interview with S3 revealed that they have never smelled any odor coming from staff members and has worked all shift times. The interview with S4 revealed that they have never smelled any odor coming from a staff member that would interfere with work. LPA attempted to interview clients but was unable to due to clients being non-verbal. Based on interviews with staff and clients and observations during visit, the allegation that staff does not ensure facility is kept free of mal odors was found to be unsubstantiated. A finding that a 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 with Tahmeya and copy of this report provided.
InspectionOctober 7, 2024Type A5 deficiencies
Inspector notes
On 09/19/2025 at 11:30 AM, Licensing Program Analyst (LPA) Y. Brown conducted an unannounced annual 1-year required inspection. LPA met with LVN/ Care Staff Ruth Duffy and explained the purpose of the visit. Ruth phoned the Program Director (PD) Precious Yepez. PD arrived to the facility at around 12:00 PM. The facility’s fire clearance was approved for four (4) residents, four (4) may be non-ambulatory. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area, garage, and back yard. The facility consists of four (4) bedrooms and two (2) bathrooms. All indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature for residents is maintained at 73 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the resident. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for residents. Smoke detectors and carbon monoxide combination were in operating condition during visit. Fire extinguisher was last purchased on 8/4/2025. First aid kit was observed to be complete. LPA reviewed five (5) staff and three (3) resident records. LPA reviewed a sample of medication. Continued 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 from LIC809...) LPA observed that the Emergency Disaster Plan was last reviewed on 7/26/2025. The following forms will be updated and submitted to CCLD by 9/26/2025: LIC610D: Emergency disaster plan LIC500: (Personnel Record) THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 3:00 pm, LPA observed missing 20 hours of annual training from 0/5 staff members. At 3:15 pm, LPA observed missing first aid certifications from 3/5 staff members. At 3:30 pm, LPA observed no current administrator at the facility. At 3:35 pm, LPA observed that 2/5 staff members were not fingerprint cleared or associated to the facility. At 4:30 pm, LPA observed that there wasn't an updated quarterly fire drill conducted. At 5:00 pm, LPA observed that the hot water temperature in the shared resident restroom was measured at 139.4 degrees Fahrenheit. *An immediate civil penalty of $1250.00 will be assessed on today's date. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of the appeal rights, LIC421FC, LIC421BG and this report provided.
(c)(1)(A) Subsequent to initial licensure, a person specified in subdivision (b) who is not exempted from fingerprinting shall obtain either a criminal record clearance or an exemption, pursuant to subdivision (f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in a…
Based on observation, interview, and record review, the licensee did not comply with the section cited above in not having S1 and S2 fingerprinted and associated to the facility which poses an immediate health, safety or personal rights risk to persons in care POC Due Date: 09/22/2025 Plan of Correction 1 2 3 4 By POC date, Licensee agreed to have S1 and S2 fingerprinted and associated to the facility and submit copy of fingerprint document to CCLD.
(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 in that S1, S2, S3, S4 and S5 had missing 20 hr annual training which poses a potential health and safety risk to persons in care. POC Due Date: 09/26/2025 Plan of Correction 1 2 3 4 By POC date, Administrator agreed to submit documentation of completed 20 hr annual training to CCLD.
(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross.
Based on record review, the licensee did not comply with the section cited above in that 3/5 staff members did not have first aid certification on file which poses an immediate health and safety risk to persons in care. POC Due Date: 10/03/2025 Plan of Correction 1 2 3 4 By POC date, the Administrator agrees to schedule all staff members to recieve first aid training and submit documentation of first aid certifications to CCLD by POC date.
(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 file review, the licensee did not comply with the section cited above in that the facility did not have a current fire drill since the last drill was conducted in 2023 which poses a potential health and safety rights risk to persons in care. POC Due Date: 09/26/2025 Plan of Correction 1 2 3 4 By POC date, the Administrator has agreed to conduct emergency disaster fire drills quarterly and will send a copy of the most recent drill to CCLD by POC date. Administrator has agreed to conduc…
(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degre…
Based on observation the licensee did not comply with the section cited above as water temperature observed at 139.4 degrees Fahrenheit which poses an immediate health and safety risk to persons in care. POC Due Date: 09/22/2025 Plan of Correction 1 2 3 4 By POC date, the administrator agrees to submit weekly temperate checks and send a copy via email. Administrator agrees to submit proof of maintence staff adjusting the water temperate between 105 and 120 degrees Fahrenheit and submit to CCLD…
ComplaintMay 3, 2024· UnsubstantiatedNo deficiencies
Inspector: Alicia Delmundo
Unsubstantiated — CDSS investigated and did not find violations.
Inspector notes
During the course of investigation, LPA obtained copies of staff schedule, lists of facility residents and staff, and reviewed residents' records. LPA obtained copies of residents' including but not limited to the following documents: LIC601 Identification and Emergency Information; LIC602A Physician's Report; Annual Review. LPA also obtained copy of Community Outings Record, LIC501 Personnel Record and LIC500 Personnel Report. LPA interviewed resident on 3/16/22 and staff (S1, S2, S3, S4, S5, S6 and interim administrator) on 3/16/22, 12/19/24 and 12/20/24. S1 stated he could have drove the van and taken the resident out for community outings but denied the allegation and stated not working for DoorDash. Three of the staff stated not working on 3/08/22 while the other staff stated seeing the paper. Another staff also stated seeing the paper with S1's name on it but would not say it's a receipt but the paper appeared to be a computer print out. The interim administrator (ID) stated that the paper was given to her on 3/10/22 and that the paper does not have a letter head so she was not sure if it's a blank statement but it has S1's name, date and time, and DoorDash transaction in it. The ID stated she conducted an internal investigation and that S1 denied the allegation. The ID further stated it's unknown if S1 was just transferring money to S1's account. LPA interviewed one resident who stated not knowing R1 and S1. Due to medical diagnosis, LPA was not able to obtain information from the other 3 residents. Review of Community Outing showed R1 went for an outing on 3/08/22; however, the paper with DoorDash transaction was dated 3/04/22. Based on information gathered and LPA unable to obtain information from 3 residents due to medical diagnosis, the allegation is closed a 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 copy of this report provided.
ComplaintApril 13, 2023· UnsubstantiatedNo deficiencies
Inspector: Jill Clancy-Czuleger
Unsubstantiated — CDSS investigated and did not find violations.
Inspector notes
...Continued from LIC 9099 On the allegation facility staff did not seek timely medical attention for the residents. Based on record review and interviews the facility did schedule medical visits for both R1 and R2 when they got their respiratory infections along with follow up visits when the infections were not clearing up. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided.
ComplaintMarch 27, 2023· SubstantiatedCitation on file
Inspector: Leslie Ibo
Substantiated — CDSS found a violation and issued a citation. Full citation details are on file with the state.
InspectionAugust 5, 2022Type A2 deficiencies
Inspector: David Doidge
Inspector notes
On 10/07/2024 at 08:30 AM, Licensing Program Analysts (LPAs) David Doidge and James Sampair arrived unannounced to conduct the Required Annual Inspection. Upon entry, LPAs stated the purpose of the visit to Nena Gibson Program Supervisor and Area Director Rosemary Maurilio arrived at 10:00 AM. LPAs toured the facility including but not limited to bedrooms, bathrooms, dining area, activity rooms, kitchen, common areas, and outdoor area. Smoke detectors and carbon monoxide detectors were fully functional. Fire extinguishers were observed to be full and last serviced on 08/28/2024. Temperature in the facility was measured at 72.0 degrees Fahrenheit at 08:53 AM and facility cited for hot water measured at 127.7 degrees Fahrenheit at 8:53 AM. The LPAs observed required postings in the facility, including the Complaint Poster, Ombudsman and Personal Rights posters, and the Theft and Loss Policy. Grab bars for each toilet and shower were installed. Non-skid mats were observed. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. Indoor and outdoor passages were free of obstruction. One week of nonperishable and 2 days of perishable food supplies were available. 1 A-Type citation issued and 1 B-Type citation issued. Exit interview conducted and a copy of this report provided.
(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degre…
Based on observation the licensee did not comply with the section cited above as water temperature observed at 127.7 degrees Fahrenheit which poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 10/08/2024 Plan of Correction 1 2 3 4 Bring water temperature to between 105 and 120 degrees Fahrenheit and submit proof to LPA D. Doidge
(h) Outdoor facility space used for resident recreation and leisure shall be completely enclosed by a fence with self-closing latches and gates, or walls, to protect the safety of residents.
Based on observation, the licensee did not comply with the section cited above as gate does not self close, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 10/14/2024 Plan of Correction 1 2 3 4 Install self closing mechanism for exterior gate and submit proof to LPA D. Doidge
Other visitApril 19, 2022No deficiencies
Inspector: Alicia Delmundo
Inspector notes
While at the facility for other reason, Licensing Program Analyst (LPA) Delmundo learned from Area Director (AD) Rosemary Maurillo that the facility has a new administrator (ADM), Maehellena Harlan, who started sometime in November 2023. However, upon checking the roster from Guardian Portal, ADM is not on the list of employees associated to this facility. Guardian Portal showed ADM is fingerprint cleared. 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 and any repeat violation within 12 month period may result in civil penalty. Deficiency and plan and proof of correction were discussed with AD and over the phone with ADM. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.
Other visitAugust 13, 2021No deficiencies
Inspector: Catherine Lin
Inspector notes
On 4/19/22 at approximately 2:55pm, Licensing Program Analysts (LPAs) C. Lin and K. Nguyen arrived an unannounced case management visit regarding the self-report incident report dated on 3/29/22 for medicine error to resident. LPAs met with LVN Joseph Gapasin and explained the purpose of visit. Based on observation, interview and record review, LPAs observed that resident did miss two doses of medicine on 3/27/22 and 3/28/22, however, resident has no change in health condition because of it. LVN admitted that training has not been provided to staff after the incident occurred. The deficiencies were observed and indicated in LIC 809D, and cited from the California Code of Regulations. Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted with LVN. LIC809D, Appeal Rights and a copy of this report provided.
Other visitApril 23, 2021No deficiencies
Inspector: Leslie Ibo
Inspector notes
On 8/13/2021, Licensing Program Analyst (LPA) Leslie Ibo conducted a Case Management visit with S1 & S2 in relation to the special incident report received on 7/26/2021, S3 missed to give R1’s prescribed medication. Incident report stated that on 7/25/2021 S3 did not give R1’s medication on time. R1’s physician was informed, per doctor’s instruction, continue medication for the next dose (8:00PM on 7/25/2021). Facility Administrator re-trained S3 & other staffs. LPA requested for the following documents but not limited to, Medication Administration record for R1, LIC500, residents’ roster and training documentation. Deficiency was cited from the California Code of Regulations, Title 22. Exit interview conducted. Appeal Rights and a copy of report 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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