Comfort Home Ii
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.
652 Vanessa Drive · San Mateo, 94402
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
Severity1thWeighted citations per bed
Repeats100thRepeat deficiencies as share of total
Frequency0thDeficiencies 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
Comfort Home Ii scores D. Better than 34% of comparable California RESIDENTIAL CARE ELDERLY facilities. Severity: bottom 1%. Repeats: top 0%. Frequency: bottom 0%.
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
↑ worseningWeighted severity score per month · 24 months
Weighted score (24mo)
181
Last citation
Nov 25
Finding distribution
37 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 6 licensed beds:
One qualified staff member must be on call and physically on premises at all times overnight.
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
- 415600011
- License type
- RESIDENTIAL CARE ELDERLY
- License status
- LICENSED
- License expires
- Not yet indexed
- Licensed beds
- 6
- Operator
- Caingcoy, Rufina Marzan
Inspections & citations
3
reports on file
37
total deficiencies
10
Type A (actual harm)
InspectionNovember 17, 2025Type A14 deficiencies
Plain-language summary
A routine inspection of this 6-bed memory care home found the facility, grounds, bedrooms, bathrooms, kitchen, and emergency plans in order, with appropriate food supplies, first-aid supplies, and hygiene items available. The inspector reviewed staff criminal clearances and client files and found no safety hazards. The facility was cited for deficiencies in California regulations, which are detailed in the accompanying report.
View full inspector notes
LPA Audrey Jeung toured facility and grounds-- except detached storage shed, which is not accessible--for this 6 bed RCFE, consisting of 5 client bedrooms, staff room with 1 bed, 2 full bathrooms, kitchen, living/dining room, office/storage room, and 1-car garage, where there is an adjoining storage room. The backyard is level, fenced and paved. Washer and dryer are located outside of kitchen in covered alcove. There are no accessible bodies of water or fire safety hazards observed. Hot water temperature is tested in common bathroom. Food supply and first-aid kit are inspected, and hygiene items for general use are maintained. Client files are reviewed. An Emergency Disaster Plan is posted. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as required staff records. No one is receiving hospice services at this time. Jenilee Patalot is a certified RCFE administrator (x 8/27) that oversees facility operations. The following forms are requested to be completed and returned to CCL by 12/1/25: • LIC 999 Facility Sketch, with room numbers • LIC 500 Personnel Report Deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed and cited on following pages. See also Technical Advisory Note--1 page.
Regulation
(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…
Inspector finding
Based on observation, the licensee did not comply with the section cited above, as hot water temperature tested at 129 degrees in main client bathroom, which poses an immediate health, safety or personal rights risk to persons in care. This was cited during last annual inspection on 11/5/24. POC Due Date: 11/18/2025 Plan of Correction 1 2 3 4 Hot water temperature will be lowered and maintained within range of 105 - 120 degrees F. Proof of correction to be sent to CCLD BY DUE DATE.
Regulation
(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage.
Inspector finding
Based on observation, the licensee did not comply with the section cited above, as cleaning products are stored in unlocked lower kitchen cabinet, which poses an immediate health, safety or personal rights risk to persons in care. This was observed and cited on 11/5/24. POC Due Date: 11/17/2025 Plan of Correction 1 2 3 4 Kitchen cabinet was locked in LPA's presence. Deficiency corrected and cleared.
Regulation
(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.
Inspector finding
Based on observation, the licensee did not comply with the section cited above as staff medications are stored in unlocked hall closet and clients' medications are stored in unlocked kitchen cabinet, accessible to clients. This poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 11/17/2025 Plan of Correction 1 2 3 4 Staff medications were relocated to staff room and kitchen cabinet where clients' medications are stored was locked in LPA's presence. Defi…
Regulation
INCIDENTAL MEDICAL CARE A record of centrally stored prescription medications for each resident shall be maintained and include names of the resident for whom prescribed, prescribing physician and pharmacist, drug name, strength and quantity, dates filled, started & expiration, prescription number and instructions:
Inspector finding
Based on absence of Centrally Stored Medication Records, the licensee did not comply with the section cited above, which poses an immediate health, safety or personal rights risk to persons in care. This was cited previously on 11/5/24. POC Due Date: 11/18/2025 Plan of Correction 1 2 3 4 Copies of current Centrally Stored Medications Records for 5 clients will be sent to CCLD BY DUE DATE.
Regulation
(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after e…
Inspector finding
Based on review of staff records, the licensee did not comply with the section cited above in 2 out of 5 records reviewed, which poses a potential health, safety or personal rights risk to persons in care. There are no health screenings and TB test results maintained for staff #3 and #4. This was observed and cited previously on 3/11/25. POC Due Date: 12/01/2025 Plan of Correction 1 2 3 4 Health screenings and TB test results for staff #3 and #4 will be sent to CCLD BY DUE DATE.
Regulation
(c) An Infection Control Plan shall be developed by the licensee and shall be included in the Plan of Operation required by Section 87208.
Inspector finding
Based on absence of Infection Control Plan, the licensee did not comply with the section cited above, which poses a potential health, safety or personal rights risk to persons in care. - Infection Control Plan is not maintained. POC Due Date: 12/01/2025 Plan of Correction 1 2 3 4 Infection Control Plan shall be maintained at facility and updated copy to be sent to CCLD BY DUE DATE.
Regulation
On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,00…
Inspector finding
Based on absence of proof of liability insurance, the licensee did not comply with the section cited above, which poses a potential health, safety or personal rights risk to persons in care. - Facility does not maintain proof of current liability insurance. POC Due Date: 12/01/2025 Plan of Correction 1 2 3 4 Proof of current liability insurance will be sent to CCLD BY DUE DATE, and copy shall be maintained in facility.
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 records review, the licensee did not comply with the section cited above in 2 out of 5 staff records reviewed, which poses a potential health, safety or personal rights risk to persons in care. - There is no proof of annual 8 hours of dementia training and 4 hours of restricted health conditions, hospice care and postural supports training for staff #1 and #3. This was cited on 3/11/25. Civil penalty of $250 is assessed today and will continue to accrue at $100/day until corrected an…
Regulation
(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements:
Inspector finding
Based on records review, the licensee did not comply with the section cited above in 2 out of 5 staff records reviewed, which poses a potential health, safety or personal rights risk to persons in care. - There is no proof that staff #1 and staff #3 received annual 8 hours of medication training. POC Due Date: 12/01/2025 Plan of Correction 1 2 3 4 Proof of required annual medications training for staff #1 and #3 will be sent to CCLD BY DUE DATE
Regulation
(a) A licensee of a facility that has internet service shall provide at least one internet access device, such as a computer, smart phone, tablet, or other device, that can support real-time interactive applications, is equipped with videoconferencing technology, including microphone and camera functions, and is dedicated for resident use.
Inspector finding
Based on observation, the licensee did not comply with the section cited above, as there is no dedicated internet capable device for resident use, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 12/01/2025 Plan of Correction 1 2 3 4 A dedicated internet capable device for residents will be maintained in facility, and proof of correction to be sent to CCLD BY DUE DATE.
Regulation
(b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises.
Inspector finding
Based on observation, the licensee did not comply with the section cited above, as there are no canned fruits maintained for 7-day supply and not enough fresh vegetables and protein for 2-day supply. This poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/19/2025 Plan of Correction 1 2 3 4 Proof that at least a 7 day supply of canned fruits and 2-day supply of fresh vegetables and protein are maintained will be sent to CCLD BY DUE DATE
Regulation
(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, th…
Inspector finding
Based on records review, the licensee did not comply with the section cited above in 1 out of 5 client records reviewed, which poses a potential health, safety or personal rights risk to persons in care. - Appraisal for client #5 is dated 4/2024 POC Due Date: 12/01/2025 Plan of Correction 1 2 3 4 Complete and signed reappraisal for client #5 will be sent to CCLD BY DUE DATE.
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 records review, the licensee did not comply with the section cited above, as quarterly Emergency Disaster drills are not documented adequately. This poses a potential health, safety or personal rights risk to persons in care. This deficiency was cited on 11/5/24 and 3/11/25 and not corrected. POC Due Date: 12/01/2025 Plan of Correction 1 2 3 4 Disaster drill documentation shall be revised and submitted to CCLD BY DUE DATE.
Regulation
(f) A facility shall have both of the following in place: (2) A set of keys available to facility staff on each shift for use during an evacuation that provides access to all of the following:
Inspector finding
A. All occupied resident units; B. All facility vehicles; C. All facility exit doors; D. All facility cabinets, cupboards or files that contain elements of the emergency and disaster plan, including, but not limited to, food supplies and protective shelter supplies. Based on absence of spare set of emergency keys, the licensee did not comply with the section cited above, which poses a potential health, safety or personal rights risk to persons in care. - Facility does not maintain a spare e…
InspectionMarch 11, 2025Type A4 deficiencies
Inspector: Audrey Jeung
Plain-language summary
This was a follow-up inspection on March 18, 2025 to verify that the facility had corrected deficiencies found during an annual inspection in November 2024. The inspector met with the administrator and confirmed that corrections had been made; the facility was asked to submit documentation of its plan for caring for bedridden residents and its emergency disaster plan by the inspection date.
View full inspector notes
LPA Jeung met with administrator Jennilee Patalot to follow up on plans of correction submitted to CCLD in response to annual inspection of 11/5/2024. Acknowledgement of correction is issued today--1 page. Deficiencies are recited per California Code of Regulations, Title 22, on a following page. The following information is requested to be submitted to CCLD BY 3/18/25: -- Bedridden plan of operation -- Emergency Disaster Plan (9 page LIC610D signed and dated)
Regulation
POSTURAL SUPPORTS A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order.
Inspector finding
This requirement is not met, as MD orders for half bed rails for clients #1 and #2 are not maintained. Licensee failed to ensure that MD orders are maintained for those who have half bed rails, which poses a potential health, safety or personal rights risk to clients in care.
Regulation
PERSONNEL REQUIREMENTS Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement was not met, as proof of current first aid training for staff #6 was not received nor maintained. Licensee failed to
Inspector finding
ensure that all caregivers have current first aid training, which poses a potential health, safety or personal rights risk to clients in care.
Regulation
PERSONNEL RECORDS The licensee shall maintain documentation that an administrator has met the certification requirements specified in Section 87406 or the recertification requirements in Section 87407. This requirement is not met, as proof of recertification of RCFE administrator
Inspector finding
was not received. Licensee failed to ensure that there is a certified RCFE administrator managing facility, which poses a potential health, safety or personal rights risk to clients in care. On 12/2/24, confirmatiion that Ms. Patalot registered for 40 hour RCFE administrator classes was submitted to CCLD
Regulation
PERSONNEL RECORDS The licensee shall ensure that personnel records are maintained on ... each employee. Each personnel record shall contain ...a health screening as specified in Section 87411, Personnel Requirements - General. This requirement was not met, as health
Inspector finding
screening and/or TB test results are not maintained for Staff #4, which poses a potential health, safety or personal rights risk to clients in care.
InspectionNovember 5, 2024Type A19 deficiencies
Inspector: Audrey Jeung
Plain-language summary
A routine inspection of this six-bed home found that the facility's physical space, grounds, safety features, food supplies, and resident files were in order, but identified deficiencies in staffing qualifications: both individuals listed as administrators have expired certifications and the facility must submit required documentation by the deadline to address this issue. One resident is currently receiving hospice care. The inspectors also noted violations of state regulations that are detailed in a separate report.
View full inspector notes
LPA Audrey Jeung toured facility and grounds--including detached storage shed--for this 6 bed RCFE, consisting of 5 client bedrooms, staff room with 1 bed, 2 full bathrooms, kitchen, living/dining room, office/storage room, and 1-car garage. The backyard is level, fenced and paved. Washer and dryer are located outside of kitchen in covered alcove. There are no accessible bodies of water or fire safety hazards observed. Hot water temperature is tested in common bathroom. Food supply and first-aid kit are inspected, and hygiene items for general use are maintained. Client files are reviewed. An Emergency Disaster Plan is posted. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as required staff records. There is one resident receiving hospice services at this time. There are no RCFE certified administrators associated with facility: Rufina Caingcoy and Jenilee Patalot have expired RCFE administrator certifications. The following forms are requested to be completed and returned to CCL by 10/29/24: • LIC 308 Designation of Administrative Responsibility • LIC 500 Personnel Report Deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed and cited on following pages. See also Technical Advisory Notes--6 pages.
Regulation
(b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include the following:
Inspector finding
Based on client records review, the licensee did not comply with the section cited above, as client #5 is receiving hospice care, but there is no hospice care plan maintained. This poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 Hospice care plan for client #5 will be maintained and copy will be sent to CCLD BY DUE DATE.
Regulation
(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…
Inspector finding
Based on observation, the licensee did not comply with the section cited above, as hot water temperature tested at 133 degrees in client bathroom. This poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 11/06/2024 Plan of Correction 1 2 3 4 Hot water temperature will be lowered and maintained between 105 and 120 degrees. Proof of correction to be sent to CCLD BY DUE DATE.
Regulation
(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.
Inspector finding
Based on observation, the licensee did not comply with the section cited above, as Lysol, Zep liquid cleaner and Bona floor cleaner are stored in unlocked cabinet in common bathroom and two containers of Zerex anti-freeze auto coolant, paint can, and multiple containers of cleaning products are observed on backyard patio. This poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 11/05/2024 Plan of Correction 1 2 3 4 Cleaners stored in bathroom were remove…
Regulation
(d) The licensee shall maintain documentation that an administrator has met the certification requirements specified in Section 87406, Administrator Certification Requirements or the recertification requirements in Section 87407, Administrator Recertification Requirements.
Inspector finding
Based on absence of current administrator certificates and confirmation from staff, the licensee did not comply with the section cited above, as there is no one currently who maintains a current RCFE administrator certificate. RCFE administrator certificates for Staff #1 and #2 expired in 2018 This poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 11/06/2024 Plan of Correction 1 2 3 4 Plan to obtain RCFE administrator certification will be sent to CC…
Regulation
INCIDENTAL MEDICAL CARE 87465 (h)(6) A record of centrally stored prescription medications for each resident shall be maintained and include names of the resident for whom prescribed, prescribing physician and pharmacist, drug name, strength and quantity, dates filled, started & expiration, prescription number and instructions:
Inspector finding
Based on absence of Centrally Stored Medications Records, the licensee did not comply with the section cited above , as record of centrally stored medications is not maintained. This poses an immediate health, safety or personal rights risk to persons in care. POC Due Date: 11/06/2024 Plan of Correction 1 2 3 4 Centrally Stored Medications Records shall be completed, maintained at facility, and copies sent to CCLD BY DUE DATE.
Regulation
(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff.
Inspector finding
Based on client records review, the licensee did not comply with the section cited above in 3 out of 5 client records reviewed, which poses an immediate health, safety or personal rights risk to persons in care. - There are no client records maintained for clients #3, #4, #5. POC Due Date: 11/06/2024 Plan of Correction 1 2 3 4 Clients' records will be maintained on site. Proof of correction to be sent to CCLD BY DUE DATE.
Regulation
POSTURAL SUPPORTS A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order.
Inspector finding
Based on clients records review, the licensee did not comply with the section cited above in 5 out of 5 records reviewed, which poses a potential health, safety or personal rights risk to persons in care. - All residents have half bed rails on their beds, and there are no MD orders on file POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 Written MD orders for half bed rails will be sent to CCLD BY DUE DATE for ALL residents.
Regulation
The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
Inspector finding
Based on observation, the licensee did not comply with the section cited above, as backyard is strewn with items: metal shelving, suitcase, 7 large plastic storage boxes with lids, electric fireplace mantle, plastic sheeting, boxes of toys, 5-gallon water containers, bicycles, exercise equipment, plastic garbage containers. Backyard fence is missing several boards. This poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/26/2024 Plan of Correction 1 …
Regulation
(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction.
Inspector finding
Based on observation, the licensee did not comply with the section cited above, as side yard on east side is not easily accessible because barbecue grill, compressor tank, exercise bicycle and cabinet partially obstruct passageway to gate. This poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 Side passageways will be cleared and free of obstructions. Proof of correction to be sent to CCLD BY DUE DATE.
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 staff records review, the licensee did not comply with the section cited above in 2 out of 5 records reviewed, as health screening and/or TB test results are not maintained for Staff #3 and #4 which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 Current health screenings and/or TB test results for staff #3 and #4 will be sent to CCLD BY DUE DATE
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 staff records review, the licensee did not comply with the section cited above in 2 out of 5 records reviewed, which poses a potential health, safety or personal rights risk to persons in care. - There is no documentation that Staff #5 and #6 have received 4 hours of training on postural supports, restricted health conditions and hospice care, and 8 hours of dementia care training. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 Proof of training on postural supports, restricted …
Regulation
(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross.
Inspector finding
Based on staff records review, the licensee did not comply with the section cited above in 2 out of 5 records reviewed, which poses a potential health, safety or personal rights risk to persons in care. - There is no evidence that Staff #5 and #6 have current first aid training. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 Proof of current 1st aid training for staff #5 and #6 will be sent to CCLD BY DUE DATE
Regulation
(c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of his/her individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations.
Inspector finding
Based on client records review, the licensee did not comply with the section cited above in 3 out of 5 records reviewed, which poses a potential health, safety or personal rights risk to persons in care. - There are no appraisals on file for clients #3, #4, #5. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 Updated appraisals for clients #3, #4, #5 will be signed, dated, and copies sent to CCLD BY DUE DATE.
Regulation
(a) Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment.
Inspector finding
Based on client records review, the licensee did not comply with the section cited above in 3 out of 5 records reviewed, which poses a potential health, safety or personal rights risk to persons in care. - There are no MD assessments maintained for clients #3, #4, #5. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 MD assessments and TB test results for clients #3, #4, #5 will be sent to CCLD BY DUE DATE.
Regulation
(a) The licensee shall complete an individual written admission agreement, as defined in Section 87101(a), with each resident or the resident's representative, if any.
Inspector finding
Based on client records review, the licensee did not comply with the section cited above in 4 out of 5 records reviewed, which poses a potential health, safety or personal rights risk to persons in care. - There are no admission agreements maintained for clients #3, #4, #5, and admission agreement for client #1 is not signed. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 Completed and signed admission agreements will be maintained for ALL residents. Copies of RATE page and SIGNATURE pa…
Regulation
(a) The licensee shall ensure that a current register of all residents in the facility is maintained and contains the following updated information:
Inspector finding
Based on client records review, the licensee did not comply with the section cited above, as roster of current residents is not maintained. This poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 Register of current residents shall include the resident's name and ambulatory status as specified in Sections 87506(b)(1) and (b)(10); information on the resident's attending physician as specified in Section 87506(b)(7);…
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 absence of documentation and confirmation by staff, the licensee did not comply with the section cited above, as there is no documentation of disaster drills available for review. This poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 Documentation of disaster drills conducted will be sent to CCLD BY DUE DATE.
Regulation
(e) A facility shall have all of the following information readily available to facility staff during an emergency:
Inspector finding
Based on client records review, the licensee did not comply with the section cited above, as there is no documentation available to staff for 3 residents, in the event of an emergency. This poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 (1) A resident roster with the date of birth for each resident. (2) Anappraisal of resident needs and services plan for each resident. (3) A resident medication list for resident…
Regulation
(3) Ensuring that the use of oxygen equipment meets the following requirements: (B) “No Smoking-Oxygen in Use” signs shall be posted in the appropriate areas.
Inspector finding
Based on observation, the licensee did not comply with the section cited above, as there are no oxygen in use signs posted at entrance doors or bedroom doors for 3 residents who have oxygen in their rooms. This poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/26/2024 Plan of Correction 1 2 3 4 Oxygen in use signs will be posted outside of facility entrances and outside of bedroom doors. Proof of correction will be sent to CCLD BY DUE DATE.
Federal summary
CMS Care CompareNot a CMS-certified facility
California RCFEs (residential care facilities for the elderly) are licensed by the state, not by CMS. CMS data only applies to skilled nursing facilities or to CCRCs that operate a licensed SNF wing.
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