Facility condition and maintenance
Cited in 2 reports, with 2 deficiencies in total.
K & J RESIDENTIAL CARE HOME-HAYWARD
838 W. SUNSET BLVD., Hayward CA 94541
5 bedsLatest official report Jan 14, 2026Licensed
Additional info
- Telephone
- (510) 363-9387
- Licensee
- LIANG, KSAI
- Administrator
- BROWN, ELTON
- Contact
- BROWN, ELTON
- License first date
- Jan 26, 2022
- License effective date
- Jan 26, 2022
- District office
- OAKLAND ASC · (510) 286-4201
- Regional office
- 15
- Clients served
- 983 - RCFE / DEMENTIA
Summary
The available records show 6 Type A and 11 Type B deficiencies for this facility.
- Most recent inspection
- Jan 14, 2026
- Most recent deficiency
- Jan 14, 2026
No later report is available, so the records do not show what happened afterward.
What Type A and Type B mean
- Type A
- Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
- Type B
- Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.
Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.
At a glance
Counts cover the five-year public record. Typical figures are the median for the 152 Alameda County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 7 reports for this facility: 5 inspections, 0 complaint investigations, and 2 licensing or administrative records.
Those records contain 6 Type A and 11 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 5
- Recorded deficiencies
- 17
- Type A deficiencies
- 6
- Type B deficiencies
- 11
- Substantiated complaints
- 0
- Repeated topics
- 2
More than the typical 4
1 in the last 12 months
Well above the typical 4
2 in the last 12 months
Well above the typical 1
2 in the last 12 months
Well above the typical 2
0 in the last 12 months
Most this size also have none
0 in the last 12 months
Last 36 months
Repeated topics
Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.
Hazardous items and storage
Cited in 2 reports, with 2 deficiencies in total.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Inspection
Facility condition and maintenanceType A
- Official classification
- Type A
- Official code
- 87303(e)(2)
- Regulation authority
- CCR
What the official deficiency says
(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 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in hot water at 124 degrees Fahrenheit which poses an immediate health, safety and/or personal rights risks to persons in care.
Official plan of correction
POC Due Date: 01/15/2026 Plan of Correction Corrected. Temperature was adjusted to 115 degrees Fahrenheit while LPA was at the facility.
Plan of correction recorded
Correction not verified in available records
Hazardous items and storageType A
- Official classification
- Type A
- Official code
- 87309(a)
- Regulation authority
- CCR
What the official deficiency says
(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. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in gardening spray, gallon of paint in the front yard, and floor cleaning spray in the backyard which pose an immediate health, safety and/or personal rights risks to persons in care.
Official plan of correction
POC Due Date: 01/15/2026 Plan of Correction Administrator stated he will in-service the staff and submit copy of training topic with attendees' signatures by 1/15/26.
Plan of correction recorded
Correction not verified in available records
Inspection
Food serviceType A
- Official classification
- Type A
- Official code
- 87555(b)(8)
- Regulation authority
- CCR
What the official deficiency says
(b) The following food service requirements shall apply: (8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in the following which pose an immediate health and/or personal rights risk to persons in care: :rotten lettuce, zucchini with mold, expired bacon bits and parmesan cheese.
Official plan of correction
POC Due Date: 02/27/2025 Plan of Correction Staff discarded the items. In addition, administrator to in-service the staff and submit copy of training topic with attendees signatures by 2/27/25.
Plan of correction recorded
Correction not verified in available records
Records and plan of operationType B
- Official classification
- Type B
- Official code
- 87506(a)
- Regulation authority
- CCR
What the official deficiency says
87506 Resident Records (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. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in not recording R1's medications on LIC622 which poses a potential personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/05/2025 Plan of Correction Administrator to have medications recorded and submit proof by 3/12/25.
Plan of correction recorded
Correction not verified in available records
Inspection
Medical and dental careType A
- Official classification
- Type A
- Official code
- 87465(a)(6)
- Regulation authority
- CCR
What the official deficiency says
(6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on reord review, the licensee did not comply with the section cited above in R2's doctor's order for some of the mediations not having dosage and dosage of 1 medication not longer consistent with what the facility has on hand which pose an immediate health risks to persons in care.
Official plan of correction
POC Due Date: 02/10/2024 Plan of Correction Administrator to obtain complete updated order and sbumit copy by 2/10/24.
Plan of correction recorded
Correction not verified in available records
Medication handling and storageType A
- Official classification
- Type A
- Official code
- 87465(c)(2)
- Regulation authority
- CCR
What the official deficiency says
(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above for the following: R1 has 15 medications on the doctor's order on file; however, R1 has only 7 medications on facility's hand, of which 1 is not on the order; R3's medications order on file for 17 meds but facility only has 11 on hand; facility administer's R3's Vit D3 less than th dosage prescribed. These pose an immediate health risks to persons in care.
Official plan of correction
POC Due Date: 02/10/2024 Plan of Correction Administrator to do the following and submit proof by 2/10/24: 1.Obtain doctor's order or discontinued order. 2. Administer the correct dosage for Vit D3 to R3.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87463(c)
- Regulation authority
- CCR
What the official deficiency says
(c) The licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff, and a representative of the resident's home health agency, if any, when there is significant change in the resident's condition, or once every 12 months, whichever occurs first, as specified in Section 87467, Resident Participation in Decision Making. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in R1's LIC625 Appraisal/Needs and Service Plan over a year old.which poses a potential health risk to persons in care.
Official plan of correction
POC Due Date: 02/23/2024 Plan of Correction Administrator to update the LIC625 and submit copy by 2/23/24..
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87458(c)
- Regulation authority
- CCR
What the official deficiency says
87458 Medical Assessment (c) The licensee shall obtain an updated medical assessment when required by the Department. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in R1 and R2’s LIC602A Physician Report over a year old which pose a potential health risks to persons in care.
Official plan of correction
POC Due Date: 02/23/2024 Plan of Correction Administrator to obtain updated LIC602As. Self-certification to be submiitted by 2/23/24.
Plan of correction recorded
Correction not verified in available records
Health conditions and treatmentsType B
- Official classification
- Type B
- Official code
- 87608(a)(3)
- Regulation authority
- CCR
What the official deficiency says
87608 Postural Supports (a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions. (3) 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. -This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above in R1 and R5's bed rails not having doctor's order on file which pose a potential health, safety and/or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/01/2024 Plan of Correction Administrator stated he'll obtain doctor's orders. Copies to be submitted by 2/23/24.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87459(a)
- Regulation authority
- CCR
What the official deficiency says
87459 Functional Capabilities (a) The facility shall assess the person's need for personal assistance and care by determining his/her ability to perform specified activities of daily living...... This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in R5’s LIC9172 having contradicting information on eating and reposition which poses a potential personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/23/2024 Plan of Correction Administrator to update the LIC9172 and submit by 2/23/24.
Plan of correction recorded
Correction not verified in available records
Inspection
Hazardous items and storageType A
- Official classification
- Type A
- Official code
- 87309(a)
- Regulation authority
- CCR
What the official deficiency says
(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. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above for unlocked cleaning supplies, knives and peelers, alcohol and ointment which pose immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 01/26/2024 Plan of Correction Administrator locked the items, In addition, adminstrator to do in-service training and submit copy of training topic with attendees signatures by 1/26/24.
Plan of correction recorded
Correction not verified in available records
Not classified in the sourceType B
- Official classification
- Type B
- Official code
- 87113
- Regulation authority
- CCR
What the official deficiency says
The license shall be posted in a prominent location in the licensed facility accessible to public view. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above for not posting the license which poses a potential personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/08/2024 Plan of Correction Administrator stated he'll post the license. Picture to be submitted by 2/08/24.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87303(e)(2)
- Regulation authority
- CCR
What the official deficiency says
(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 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above for hot water at 121 degrees Fahrenheit which poses a potential safety and/or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/08/2024 Plan of Correction Administrator to adjust the temperature to Regulations range and submit proof by 2/08/24.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 1569.625(b)(2)
- Regulation authority
- HSC
What the official deficiency says
(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 subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above for S3 not completed the required hours of training which poses a potential safety and/or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/08/2024 Plan of Correction Administrator stated he'll have the staff complete the training. Proof to be submitted by 2/08/24.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 1569.695(c)
- Regulation authority
- HSC
What the official deficiency says
(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, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above for not conducting the drills as required which poses potential safety and/or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/08/2024 Plan of Correction Administrator to have the drills conducted and keep record. Self-certification to be submitted by 2/08/24.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87411(f)
- Regulation authority
- CCR
What the official deficiency says
87411 Personnel Requirements - General (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 employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition....... This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above for S1, S2 and S3 not having LIC503, and S1 and S3 no TB test on file which pose a potential health and/or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/08/2024 Plan of Correction Administratot stated he'll have the documents completed and staff TB tested. Self-sertification to be submitted by 2/08/24.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87412(a)
- Regulation authority
- CCR
What the official deficiency says
87412 Personnel Records (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: This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above for S1 and S3 not having LIC501 on file which pose potential personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/08/2024 Plan of Correction Administrator stated he'll have the records completed. Self-certication to be submitted by 2/08/24.
Plan of correction recorded
Correction not verified in available records
Licensing recordNot an inspection of the operating facility
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Licensing recordNot an inspection of the operating facility
No deficiencies recorded in this report
Source and limits
California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.
Read the data methodology