Hartnell Home Care

On 5/7/2025 at 11am Licensing Program Analysts (LPA) K. Nguyen conducted an unannounced Case Management visit because on 5/6/25 LPA received information by the Regional Office upon the Administrator did not report or submit a death report to licensing. LPA were greeted by care staff Evangeline Fernadez and explained the purpose of the visit. LPA asked to contact Administrator (ADM), Victoria Puruganan via telephone. ADM was not able to meet LPA and asked for Jezrael Pascual to assist LPA and sign the report. LPA confirmed with ADM at around 1:34pm R1 passed away on 3/29/2025 under hospice care, but did not report to licensing because ADM stated that she thought that if the resident is under hospice care, then she doesn’t need to report. ***An immediate $250.00 civil penalty will be assessed on today's date for reported violation within 12month*** Exit interview conducted. A copy of the LIC421FC, this report and appeal rights provided.

On 10/2/2025 at 3:00 pm, Licensing Program Analysts (LPAs) K. Nguyen and P. Manalo conducted an unannounced Case Management visit to follow up on R1 status. LPAs met with care staff and Renato Tisico, explaining the purpose of the visit. LPA spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. LPA toured the facility and observed that the facility do not have any resident. LPAs interviewed staff 1(S1) stated that ADM gave them until Saturday morning 10/4/25 to move out of the facility. An exit interview is conducted, and a copy of this report is provided.

On 9/25/2025 at 3:55 pm, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced Case Management visit to follow up on R1 status. LPA met with care staff and Renato Tisico, explaining the purpose of the visit. LPA spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. LPA toured the facility and observed that the facility only has R1 residing at the facility. LPA tried to reach out to the R1 family multiple times and left messages. LPA spoke with ADM regrading R1 status. ADM stated that they are actively searching for facilities, however the monthly rate that R1 pay is too low. An exit interview is conducted, and a copy of this report is provided via email.

On 9/16/2025 at 1:30 pm, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced Case Management visit to deliver a formal letter to the Licensee; however, LPA could not reach the licensee. LPA met with care staff and Renato Tisico, explaining the purpose of the visit. LPA spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. LPA toured the facility and observed that the facility only has R1 residing at the facility. LPA tried to reach out to the R1 family multiple times and left messages. LPA provides a copy of the letter Intended to Licensee to Renato care staff. An exit interview is conducted, and a copy of this report is provided.

On 9/10/2025 at 9:00 am, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced Case Management visit for an health and safety checked. LPA met with care staff and Renato Tisico, explaining the purpose of the visit. LPAs spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. LPA toured facility and observed that facility only have R1 residing at the facility. R1 is receiving home health services (once a week). LPA tried to reached out to R1 family multiplies times, and left messages. An exit interview is conducted copy of this report is provided.

On 9/4/2025 at 9:00 am, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced Case Management visit for an health and safety checked. LPA met with care staff and Renato Tisico, explaining the purpose of the visit. LPAs spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. LPA toured facility and observed that facility only have R1 residing at the facility. R2 moved out on 9/3/23 and R3 moved out on 8/30/25. LPA spoke with R1 brother and provided resources and education upon facility placement. An exit interview is conducted copy of this report is provided.

On 8/25/2025 at 12:50 pm, Licensing Program Analysts (LPAs) K. Nguyen and P. Manalo conducted an unannounced Case Management visit for an overdue payment of the facility license. LPAs met with care staff and Renato Tisico, explaining the purpose of the visit. LPAs spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. ADM was about to show proof that ADM paid the overdue fee on 8/25/25. An exit interview is conducted copy of this report is provided.

On 8/25/2025 at 1:20 pm, Licensing Program Analysts (LPAs) K. Nguyen and P. Manalo conducted an unannounced Case Management visit to check in with residents(R), residents' family members, and POA. LPAs met with care staff and Renato Tisico, explaining the purpose of the visit. LPAs spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. An exit interview is conducted copy of this report is provided.

On 8/25/2025 at 12:20 pm, Licensing Program Analysts (LPAs) K. Nguyen and P. Manalo conducted an unannounced Case Management visit requesting documents from the facility. LPAs met with care staff and Renato Tisico, explaining the purpose of the visit. LPAs spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. LPAs requested for complete resident(R) files of R1, R2, R3, R4, and R5. ADM will submit documents by 8/29/25. An exit interview is conducted copy of this report is provided.

On 8/25/2025 at 10:30 am, Licensing Program Analysts (LPAs) K. Nguyen and P. Manalo conducted an unannounced POC Case Management visit. LPAs met with care staff and Renato Tisico, explaining the purpose of the visit. LPAs spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. Upon reviewing R1 files, there are missing documents, including but not limited to: - Incomplete physician report - Needs and Service plan A civil penalty on today's date is assessed for $300 due to failure to correct from 8/23/25 to 8/25/25. An exit interview is conducted a copy of this report is provided with an appeal right.

On 12/17/2024 at 10:20 AM Licensing Program Analysts (LPAs) L. Alexander and K. Nguyen arrived unannounced to conduct a Case Management visit. LPAs met with Caregivers, Paciencia, Winnie and Cesar. House Manager, Jezrael Pascual , arrived approximately, 1 hour later. Administrator, Victoria Puruganan was not available. While LPA L. Alexander and K. Nguyen was conducting a complaint investigation (15-AS-20241213161313 ) on 12/17/2024. During investigation LPAs observed a chain lock attached to the inside door. LPAs advised caregivers that a chain lock can't not be attached and hooked on the doors in preventing residents from leaving out the door. The deficiencies were 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. A copy of this report and appeal rights provided

On 8/20/2025 at 3:30 pm, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced POC Case Management visit. LPA met with care staff, Renato Tisico, and explained the purpose of the visit. LPA spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. ADM was able to provide POC for liability insurance for this facility. The liability effective date for Hartnell is August 12, 2025, to August 12, 2026. LPA cleared the deficiency. An exit interview is conducted a copy of this report is provided.

On 8/06/2025 at 9:00 am, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced Case Management Health Check visit. LPA met with care staff, Renato Tisico, and explained the purpose of the visit. LPA spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. During the health and safety check, LPA observed a total of 2 staff members assisting 2 residents at the facility. LPA toured the facility with care staff, including the bedrooms, kitchen, bathroom, and common areas. Residents in care appear to be safe, and there are no imminent health/safety concerns on today's date. No deficiencies were cited during the health and safety check. An exit interview was conducted, and a copy of this report was provided via email.

On 8/20/2025 at 12:30 pm, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced Case Management visit. LPA met with care staff, Renato Tisico, and explained the purpose of the visit. LPA spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. During the visit, LPA observed that the facility had admitted a new resident (R). LPA spoke with ADM regarding the R1 record. ADM stated that the R1 record is not complete; however, it will be complete by Friday. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview conducted, and a copy of the report and appeal rights provided.

On 07/31/2025 at 2:00 PM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a POC visit. LPA spoke with Administrator (ADM) Victoria Puruganan and explained the purpose of the visit via phone. ADM gave verbal permission for the Care staff, Renato L. Tisico, to sign the report. The administrator failed to provide POC during the POC visit. - 87623 Indwelling Urinary Catheter - §1569.625 Staff training ***An immediate $200.00 civil penalty will be assessed on today's date for failure to correct *** Exit interview conducted. A copy of the LIC421FC, this report, and appeal rights are provided.

On 7/30/2025 at 10 am, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced Case Management visit to review residents’ (R) files. LPA informed Administrator, Victoria Puruganan, of the purpose of the visit. Victoria Puruganan arrived approximately 1 hour later. LPA obtained R1, R2, and R3 physician reports, identification, and emergency information. LPA obtained facility liability documentation. There is no deficiency during this visit. Exit interview conducted and a copy of this report provided.

On 7/31/2025 at 9:30 am, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced Case Management visit. LPA met with care staff, Renato Tisico, and explained the purpose of the visit. LPA spoke with Administrator (ADM) Victoria Puruganan via phone and received verbal permission for care staff to sign the report. LPA reviewed and confirmed that the facility liability insurance expired that LPA obtained on 7/30/2025 via email; however, after the file review showed that ADM submitted the facility property insurance for the facility. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview conducted, and a copy of the report and appeal rights provided.

On 07/17/2025 at 4:30 PM, Licensing Program Analysts (LPAs) L. Alexander and K. Nguyen arrived unannounced to conduct a Plan of Correction (POC) visit. LPAs met with caregivers, Renato & Zenaida Tisico and explained the purpose of the visit. Zenaida phoned Administrator, Victoria Puruganan to inform. Victoria Puruganan arrived approximately 1 hour later. On 07/16/2025, LPAs conducted an Annual Inspection visit in which deficiencies were cited. The POC due date was 07/17/2025. Administrator failed to submit the POC by the due date and this is why LPAs came to make a POC visit. Deficiency not cleared: CCR 87202(a)(2) Fire Clearance: for having Resident, R2, in a bedroom without fire clearance for bedridden. Administrator will send LIC 200 and facility sketch to CCLD. Immediate Civil Penalties in the total amount of $500.00 is assessed today for failure to meet POC date for deficiency The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. A copy of this report, appeal rights provided and LIC421IM provided.

On 5/7/2025 while conducting a Case Management Licensing Program Analysts (LPA) K. Nguyen reviewed residents files, shows R1 and R2 files are incomplete. The deficiencies were 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. A copy of this report and appeal right provided.

On 5/7/2025 while conducting a Case Management Licensing Program Analysts (LPA) K. Nguyen reviewed resident files and interviewed staffs, shows that prior to hospitalization R1 have a wound located on the left side of R1 hip. The deficiencies were 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. A copy of this report and appeal right provided.

On 07/17/2025 at 5:30 PM, Licensing Program Analysts (LPAs) L. Alexander and K. Nguyen arrived unannounced to conduct a case management visit. LPAs met with Administrator, Victoria Puruganan, and explained the purpose for the visit. While LPA L. Alexander was at the facility for a complaint investigation (#15-AS-20250715161132), the following deficiency was observed. After reviewing Guardian system, LPA L. Alexander observed staff (S) S1, S2 and S3 was fingerprint cleared, but not associated to the facility. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiency may result in civil penalties. Exit interview conducted. A copy of this report, LIC421BG, and appeal rights provided.

During the investigation, LPAs reviewed the staff schedule (LIC500). LPAs reviewed the Residents' files. LPAs interviewed Resident 1 (R1), Resident 3 (R3), Administrator (ADM), Staff 1 (S1), Staff 2 (S2), Staff 3 (S3), Staff 4 (S4), Staff 5 (S5), and Staff 6 (S6). R1 and R3 stated that there are always staff at the facility. R1 stated R1 heard from R1 room that staff are redirecting R3 back to R3 room, because R3 tends to yell and open other residents' rooms. R1 states “There are night staff at all times”. R3 states, “The facility does not have an issue with staff at night”. S1 and S2 are live-in care staff, and S1 is the main care staff for the night shift. LPAs interviewed S3, S4, S5, and S6 via phone; all stated that they are S1 and S2 staff relieved on their days off. Based on interviews, the facility is ensuring adequate staffing during the night shifts. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is unsubstantiated. An exit interview is conducted, and a copy of this report is provided.

On 12/17/2024 at 10:20 AM Licensing Program Analysts (LPAs) L. Alexander and K. Nguyen arrived unannounced to conduct a Case Management visit. LPAs met with Caregivers, Paciencia, Winnie and Cesar. House Manager, Jezrael Pascual , arrived approximately, 1 hour later. Administrator, Victoria Puruganan was not available. While LPA L. Alexander and K. Nguyen was conducting a complaint investigation(15-AS-20241213161313) on 12/17/2024. During record review LPAs observed Resident (R) R1 and R2 did not have a current annual medical assessment and Appraisal Needs and Services (ANS) within the last year. Staff stated that R1 was admitted to hospice care on 12/10/2024 and there were no updated ANS documenting change of conditions. LPAs observed that R3 who has a diagnosis of Dementia does not have an updated ANS on file. LPAs obtained the following documents: admission agreement and hospice care admission for R1 and Physician's Report for R4. The deficiencies were 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. A copy of this report and appeal rights provided

During an complaint investigation (15-AS-20241213161313) on 12/17/24. While doing files reviewed Licensing Program Analysts (LPAs) K. Nguyen and L. Alexander discovered R1 had a fall back in October 17, 2024 that led R1 to the emergency room, which facility failed to report to CCLD. LPAs tried to contact Administrator, but was not able due to phone went to voicemail. ADM gave permission for Jezrael to sign the report. *An immediate $250.00 civil penalty will be assessed on today's date for reported violation within 12month. * Exit interview conducted. A copy of the LIC421FC, this report and appeal rights provided.

During a complaint investigation (15-AS-20241213161313) on 12/17/24. During staff interview Program Analysts (LPAs) K. Nguyen and L. Alexander discovered Administrator (ADM) Victoria Puruganan is not at the facility a minimum of 20 hours a week according to Administrator qualification. LPAs reviewed LIC 500 indicates ADM are present at the facility from Monday- 9am-3pm, Tuesday- 8am-2pm, Wed 9am-2pm, and as needed. Staffs stated within the month of November ADM showed up a maximum of three time. ADM gave permission for Jezrael to sign the report from the beginning of the visit. *An immediate $250.00 civil penalty will be assessed on today's date for reported violation within 12month. * Exit interview conducted. A copy of the LIC421FC, this report and appeal rights provided.

During an complaint investigation (15-AS-20241213161313) LPAs K. Nguyen and L. Alexander observed that facility do not have a minimum of one week non- perishables food supply. LPAs tried to contact Administrator, but was not able due to phone went to voicemail. ADM gave permission for Jezrael to sign the report. LPAs requested Administrator to submit on weekly basic of groceries receipt and photo of all food supplies to CCLD starting from the week 12/23/24: No deficiency were cited at this time. Exit interview is conducted and a copy of this report is provided.

On 07/24/2024 at 9:45am, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced 1-Year required inspection. LPA met with Nelai Punzalan, Caregiver, and explained the purpose of the visit. Victoria Puruganan, Administrator was not available during the inspection. Jezrael Pascual, Facility Manager later arrived at 12:10pm. The Administrator currently holds a certificate (#6019519740) that expires on 10/24/2024. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA got verbal permission for Facility Manager to sign the report. LPA toured the facility with Caregiver including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of five (5) total bedrooms which one (1) bedroom is occupied by staff, and two (2) bathrooms. No bodies of water observed. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguishers were last serviced on 08/16/2023. Emergency Disaster Plan was posted. First aid kit was observed to be complete. LPA reviewed five (2) residents file and four (2) staff files the files reviewed were complete. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

Allegation: Facility staff are not providing assistance to residents when needed- Unsubstantiated During the course of investigation, LPAs reviewed files and conducted interviews with residents/ staffs. LPAs observed three residents and three staffs at the facility. It was alleged Facility staff are not providing assistance to residents when needed, however LPAs interviewed residents two out of two indicated that staff are providing them with assistance they need, and when they needed. LPAs interviewed three staff 3 out of 3 stated they assisted residents with, bathing, changing, cooking, laundry, Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Exit interview is conducted and a copy of this report is provided.

LPA K. Nguyen conducted an unannounced case management visit to serve an immediate exclusion order to staff S1. LPA K. Nguyen first spoke privately with Administrator/ Licensee, Victoria Puruganan to explain the situation - providing her with a copy of the Order to Executive Director of Immediate Exclusion. According to Administrator/ Licensee S1 never came back in the facility from the time that he was involved in some illegal cases sometime in 2014. Administrator/ Licensee never seen S1 since 2014. LPA K. Nguyen reviewed this report with Administrator/ Licensee, and a copy of this report is provided via email.