Begonia Residential Care Home

At approximately 9:30AM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a Required 1 Year annual inspection and met with Staff Members, Lutgarda Marquez, Caregivers and explained the purpose of the visit. Jovita Bollisos, Administrator arrived at approximately 9:45AM. LPA conducted a tour of the facility and observed the following: the facility consists of 4 bedrooms 3 bedrooms are occupied by residents and 1 is occupied by staff and 2 shared bathrooms. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. There is a sufficient supply of hygiene products, paper products, and linens available for residents use. LPA reviewed 6 Residents records. LPA reviewed 3 staff files. Administrator's Certificate (6011284740) was current with an expiration date of 10/26/26. 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 Facility's fire extinguishers were observed to be full. Smoke detectors and carbon monoxide detectors were tested and operational. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility has a surety bond effective 6/1/24 to 6/1/27 and Liability Insurance effective 7/07/25 to 7/7/26. Deficiencies observed by LPA during tour: · At 10:30AM LPA observed molded fruit in the plastic bag in the refrigerator. · At 10:35AM LPA observed unlocked medication inside RM 1. . At 10:40AM LPA observed staff using RM1 closet to store their personal belongings. · At 10:45AM LPA observed unlocked chemical cleaning in the bathroom cabinet and backyard. . At 11:30AM LPA observed staff files are incomplete during files review. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. A copy of this report and appeal rights provided.

At approximately 10:00AM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a Required 1 Year annual inspection and met with Staff Members, Ellen Salazar, Caregivers and explained the purpose of the visit. Jovita Bollisos, Administrator arrived at approximately 10:30AM. LPA conducted a tour of the facility and observed the following: the facility consists of 4 bedroom and 2 bathrooms. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. There is a sufficient supply of hygiene products, paper products, and linens available for clients use. LPA reviewed 6 Clients records, which were all complete. LPA reviewed a sample of staff records. LPA reviewed 5 staff files. Staff files were complete. Administrator's Certificate# (6011284740) was current with an expiration date of 10/26/26. Facility's fire extinguishers were last inspected 7/15/2024. Smoke detectors and carbon monoxide detectors were tested and operational. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility have a surety bond effective 6/1/24 to 6/1/27. 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 on LIC809C. Deficiencies observed by LPA during tour: · At 12:30PM LPA observed 3 knives, and 1 scissors unlocked located in the kitchen. · At 12:55PM LPA observed open packages of ham, cheese, Ect, and vegetables that are dried inside the refrigerator. · At 1:00PM LPA observed mouse or rat droppings underneath the sink cabinet. · At 1:10PM LPA observed prescribe medication unlocked in the refrigerator, kitchen cabinet, and bathroom. · At 1:25PM LPA observed emergency exit is being blocked in resident room. · At 1:35PM LPA observed unlocked and located, Lysol wipes in the kitchen area, and bleach underneath the sink. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. A copy this report and appeal rights provided.

At approximately 9:45AM, Licensing Program Analysts (LPAs) Carol Fowler and Tonica Syess-Gibson arrived unannounced to conduct a Required 1 Year annual inspection and met with Staff Members, Delia Martinez, Caregivers. Maria Janice Vizcarra, acting Administrator arrived at approximately 11:05AM. LPA conducted a tour of the facility and observed the following: the facility was clean and at a comfortable temperature with all exits free from obstruction. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. There is a sufficient supply of hygiene products, paper products, and linens available for resident use. Medication was centrally stored and secure. LPA reviewed 4 of 6 resident records, which were all complete. LPA reviewed a sample of staff records. LPA reviewed 3 staff files. Staff files were complete. Administrator's Certificate# (6011284740) was current with an expiration date of 10/26/2024 The facility conducted fire and evacuation drill on 1/21/2024. Facility's fire extinguishers were last inspected 12/13/2023. Smoke detectors and carbon monoxide detectors were tested and operational. The amount of fresh and non-perishable foods are within regulation. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit. 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 LPAs requested the following documents to update facility file: · Designation of Facility Responsibility (LIC 308) · Control of Property · Emergency Disaster Plan (LIC 610D) · Updated Liability Insurance Facility Documents to be submitted to Community Care Licensing (CCL) by due date of Friday, 02/21/2024. Deficiencies observed by LPA during tour: At 10:00AM LPAs observed 3 scissors unlocked located in the kitchen. At 10:49AM LPAs observed glade in bedroom #2. At 10:50AM LPAs observed unlocked scissors in china cabinet, first-aid cabinet unlocked. At 10:55AM LPAs observed unlocked located in the garage All and Gain laundry detergent, Lysol wipes. At 11:06AM LPAs observed unlocked storage unit with paint, drill, bundo, weed eater, wood planks and ladder in the backyard. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC-809 & 809C, LIC-809D (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to staff.

On 2/3/2023 at 9:40 AM, Licensing Program Analyst (LPA) P. Watson arrived unannounced to conduct an annual Infection Control Inspection. LPA met with Administrator, Jovita Bolloso and explained the purpose of the visit. During the Infection Control Inspection, LPA toured facility with Jovita including but not limited to front entrance, hand washing stations, bedrooms, common areas, kitchen, and backyard. Facility has a sufficient two day perishable and one week non-perishable food supply. Visitors policy is posted on the front entrance. 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. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Common touched surfaces are disinfected at least once daily. Bathrooms are equipped with liquid soap, paper towel and trash bins with touchless lids. Facility staff were observed to be wearing proper PPE. 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. Smoke and carbon monoxide detectors were observed and maintained. First Aid kit was complete. Fire extinguisher was observed serviced. LPA observed facility passages inside and out free of obstruction. Continue to 809 C 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 The following deficiency was observed during inspection: -At 11:05 AM LPA observed hot water in the shared bathroom measure at 148 degrees F. The following deficiency was observed (see LIC809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in Civil Penalties. Exit interview conducted and a copy of this report provided along with Appeal rights.