Fire safety and emergency preparedness
Cited in 4 reports, with 8 deficiencies in total.
ST. ANTHONY'S RESIDENTIAL CARE HOME
2661 LAKEVIEW DR., San Leandro CA 94577
6 bedsLatest official report Jul 1, 2026Licensed
Additional info
- Telephone
- (510) 908-1027
- Licensee
- WILSON, JOSEPHINE B.
- Administrator
- WILSON, JOSEPHINE B.
- Contact
- WILSON, JOSEPHINE B.
- License first date
- May 26, 2021
- License effective date
- May 26, 2021
- District office
- OAKLAND ASC · (510) 286-4201
- Regional office
- 15
- Clients served
- 983 - RCFE / DEMENTIA
Summary
The available records show 14 Type A and 25 Type B deficiencies for this facility.
View enforcement record- Most recent inspection
- Jul 1, 2026
- Most recent deficiency
- Apr 8, 2025
17 later reports, from Aug 8, 2025 through Jul 1, 2026, recorded no deficiencies, though the records do not say whether they were follow-ups.
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 24 reports for this facility: 23 inspections, 0 complaint investigations, and 1 licensing or administrative record.
Those records contain 14 Type A and 25 Type B deficiencies.
10 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 23
- Recorded deficiencies
- 39
- Type A deficiencies
- 14
- Type B deficiencies
- 25
- Substantiated complaints
- 0
- Repeated topics
- 6
More than the typical 4
15 in the last 12 months
Well above the typical 4
0 in the last 12 months
Well above the typical 1
0 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 3 reports, with 7 deficiencies in total.
Facility condition and maintenance
Cited in 2 reports, with 8 deficiencies in total.
Staffing, personnel, and training
Cited in 2 reports, with 4 deficiencies in total.
Licensing and administration
Cited in 2 reports, with 3 deficiencies in total.
Admission, assessment, and eviction
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
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
Background checksType A
- Official classification
- Type A
- Official code
- 1569.17(c)(1)(A)
- Regulation authority
- HSC
What the official deficiency says
(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 facility. 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 which 1 out of 6 staff members were not fingerprint cleared to facility which poses an immediate safety risk to persons in care.
Official plan of correction
POC Due Date: 04/09/2025 Plan of Correction Licensee agrees to have staff fingerprinted and associated with the facility on or before the due date.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87412(f)
- Regulation authority
- CCR
What the official deficiency says
(f) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements: 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 which 2 out of 6 staff members had missing files which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 04/15/2025 Plan of Correction The licensee agrees to provide 2 out of the 6 staff files records to CCLD on or before the due date.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 1569.69(a)(3)
- Regulation authority
- HSC
What the official deficiency says
(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: (3) An employee shall be required to complete the training requirements for hands-on shadowing training described in this subdivision prior to assisting any resident in the self-administration of medications. The training and instruction described in this subdivision shall be completed, in their entirety, within the first two weeks of employment. 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 which 3 out of 6 staff members did not have hands-on training with self-administrating medications which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 04/15/2025 Plan of Correction The licensee agrees to provide documentation of 3 out of 6 staff self-administrating medication training completed to CCLD on or before the due date.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87463(b)
- Regulation authority
- CCR
What the official deficiency says
(b) The reappraisal shall document significant changes in the resident's physical, mental, cognitive, behavioral, or functional condition, including those required to be documented as specified in Section 87466, Observation of the Resident. 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 which 5 out of 6 residents did not have a completed and updated Appraisal Needs and Services care plans from 2024 or started for 2025 which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 04/15/2025 Plan of Correction The licensee agrees to provide documentation of Appraisal needs and services care plan of 5 out of 6 residents to CCLD on or before the due date.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 1569.695(a)
- Regulation authority
- HSC
What the official deficiency says
(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following: 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 which the facility did not have an Emergency Disaster plan posted or in records which posed a safety risk to persons in care.
Official plan of correction
POC Due Date: 04/15/2025 Plan of Correction DEFICIENCY CLEARED DURING VISIT.
Official record says corrected or clearedRecorded in report dated Apr 8, 2025
Plan of correction recorded
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 observation, the licensee did not comply with the section cited above in which the facility did not have any proof of fire drills being conducted in 2024 or 2025 which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 04/15/2025 Plan of Correction Licensee attests to schedule drills for a minimum of one (1) year on calendar on or before the due date.
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 observation, the licensee did not comply with the section cited above in which 5 out of 5 of the staff did not complete the annual training during 2024 and no other training has been done for 2025 which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 04/15/2025 Plan of Correction The licensee agrees to provide documentation of annual training to CCLD on or before the due date.
Plan of correction recorded
Correction not verified in available records
Inspection
No deficiencies recorded in this report
Inspection
Fire safety and emergency preparednessType A
- Official classification
- Type A
- Official code
- 87202(a)(1)
- Regulation authority
- CCR
What the official deficiency says
(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: (1) Nonambulatory persons. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in that facility has all non-ambulatory residents when the license is fire cleared for all ambulatory which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/29/2025 Plan of Correction On or before the due date, the Licensee shall complete and submit an LIC 200 for a change in ambulatory status. Additionally, an informal conference with CCLD will be scheduled at a later time.
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 that LPAs observed unlocked cabinets with sharp knives inside. LPAs also observed unlocked outdoor cabinet with a gallon of deadweed brew, Resolve stain carpet cleaner, and two gallons of open paint which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/29/2025 Plan of Correction DEFICIENCY CLEARED DURING VISIT.
Official record says corrected or clearedRecorded in report dated Mar 28, 2025
Plan of correction recorded
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. The current license with a Hayward address was incorrectly posted, which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 03/28/2025 Plan of Correction DEFICIENCY CLEARED DURING VISIT.
Official record says corrected or clearedRecorded in report dated Mar 28, 2025
Plan of correction recorded
Licensing and administrationType B
- Official classification
- Type B
- Official code
- 1569.618(c)(3)
- Regulation authority
- HSC
What the official deficiency says
(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. 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 that LPAs observed that 0/6 staff members did not have there CPR/First Aid Certificates updated which poses a health, and safety risk to persons in care.
Official plan of correction
POC Due Date: 04/04/2025 Plan of Correction Administrator shall provide proof that first aid training has been scheduled on or before the end of April 2025 for all staff.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87458(c)(5)
- Regulation authority
- CCR
What the official deficiency says
(c) The medical assessment shall include, but not be limited to: (5) The determination whether the person is ambulatory or nonambulatory as defined in Section 87101, Definitions, or bedridden as defined in Health and Safety Code section 1569.72. The assessment shall indicate whether nonambulatory status is based upon the resident's physical condition, mental condition, or both. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. 0 of 6 residents had medical assessments completed within 12 months, which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 04/04/2025 Plan of Correction On or before the due date the Licensee shall schedule or provide proof of an updated medical assessment for all six of the residents.
Plan of correction recorded
Correction not verified in available records
Inspection
Facility condition and maintenanceType A
- Official classification
- Type A
- Official code
- 87307(d)(6)
- Regulation authority
- CCR
What the official deficiency says
(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having a bike lock keeping the emergency exit gate locked which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/31/2024 Plan of Correction The facility agrees to remove the lock. Proof of correction will be sent to CCLD by POC date.
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) 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 by having chemicals left out in the residents bathroom which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/31/2024 Plan of Correction The facility will remove the cleaning chemicals and secure them in a locked location. Proof of correction will be sent to CCLD by POC date. Civil penalty of $1000 is assessed for repeat violation.
Plan of correction recorded
Correction not verified in available records
Hazardous items and storageType A
- Official classification
- Type A
- Official code
- 87309(a)(1)
- 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. (1) Storage areas for poisons, and firearms and other dangerous weapons shall be locked. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having knifes left in an unlocked drawer in the kitchen which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/27/2024 Plan of Correction The facility will remove the knifes and secure them in a locked location. Proof of correction will be sent to CCLD by POC date. Civil penalty of $1000 is assessed for repeat violation.
Plan of correction recorded
Correction not verified in available records
Hazardous items and storageType A
- Official classification
- Type A
- Official code
- 87309(b)
- Regulation authority
- CCR
What the official deficiency says
(b) Medicines shall be stored as specified in Section 87465(c) and separately from other items specified in (a) above. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having medications left out which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/28/2024 Plan of Correction The facility will remove the medications and secure them in a locked location. Proof of correction will be sent to CCLD by POC date.
Plan of correction recorded
Correction not verified in available records
Medication handling and storageType A
- Official classification
- Type A
- Official code
- 87465(h)(2)
- Regulation authority
- CCR
What the official deficiency says
(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. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having the medication cabinet unlocked which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/24/2024 Plan of Correction POC cleared during visit.
Official record says corrected or clearedRecorded in report dated May 24, 2024
Plan of correction recorded
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 87202(a)
- Regulation authority
- CCR
What the official deficiency says
(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by allowing staff to live in the shed that does not have fire clearances which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/31/2024 Plan of Correction The facility agrees to remove staff from shed and request a new fire clearance before anyone lives in there. Proof of correction will be sent to CCLD by POC date.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87303(a)
- Regulation authority
- CCR
What the official deficiency says
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. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above because there was a mouse in the garage of the facility which poses/posed a potential health, safety or personal rights risk to persons in care. mouse
Official plan of correction
POC Due Date: 06/07/2024 Plan of Correction Licensee agrees to have a pest control company treat facility for pests. Proof of correction will be sent to CCLD by POC date. Civil penalty of $1000 is assessed for repeat violation.
Plan of correction recorded
Correction not verified in available records
Food serviceType B
- Official classification
- Type B
- Official code
- 87555(b)(27)
- Regulation authority
- CCR
What the official deficiency says
(b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having fruit flies in the kitchen which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/07/2024 Plan of Correction Licensee agrees to have a pest control company treat facility for pests. Proof of correction will be sent to CCLD by POC date
Plan of correction recorded
Correction not verified in available records
Inspection
No deficiencies recorded in this report
Inspection
Facility condition and maintenanceType A
- Official classification
- Type A
- Official code
- 87303(f)(2)
- Regulation authority
- CCR
What the official deficiency says
(f) Solid waste shall be stored and disposed of as follows: (2) Syringes and needles are disposed of in accordance with the California Code of Regulations, Title 8, Section 5193 concerning bloodborne pathogens. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having 2 water bottles filled with syringes under the kitchen sink unlocked which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/28/2024 Plan of Correction Administrator agreed to read the regulation and dispose of the syringes according to the CCR Title 8, Section 5193 concerning blood borne pathogens and send self certification to CCL by the POC date. DEFICIENCY CLEARED DURING CONTINUATION VISIT.
Official record says corrected or clearedOn or before Jan 26, 2024
Plan of correction recorded
Facility condition and maintenanceType A
- Official classification
- Type A
- Official code
- 87307(e)
- Regulation authority
- CCR
What the official deficiency says
(e) Facilities providing services to residents who have physical or mental disabilities shall assure the inaccessibility of fishponds, wading pools, hot tubs, swimming pools or similar bodies of water, when not in active use by residents, through fencing, covering or other means. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having the swimming pool unlocked which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/28/2024 Plan of Correction Administrator will read, understand the regulation and conduct an in-service training pertaining to 87307(e) and submit a certificate of completion with log of all staff participants, to CCL by POC date. DEFICIENCY CLEARED DURING CONTINUATION VISIT.
Official record says corrected or clearedOn or before Jan 26, 2024
Plan of correction recorded
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 by having disinfectants, cleaning solutions throughout the facility in the kitchen bedrooms, bathrooms laundry room, all unlocked and assesable to residents which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/28/2024 Plan of Correction Administrator/Manager will read and understand regulation conduct an inservice with all staff and submit documents of all attendies to CCL by the POC date. DEFICIENCY CLEARED DURING CONTINUATION VISIT.
Official record says corrected or clearedOn or before Jan 26, 2024
Plan of correction recorded
Hazardous items and storageType A
- Official classification
- Type A
- Official code
- 87309(a)(1)
- 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. (1) Storage areas for poisons, and firearms and other dangerous weapons shall be locked. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having scissors, hammer, wire cutters, Paint, power tools, chain saw, knives, fire place prongs, poly stain throughout the facility located in the office, sitting room, and dining room which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/28/2024 Plan of Correction Administrator/Manager will read and understand regulation conduct an inservice with all staff and submit documents of all attendies to CCL by the POC date. DEFICIENCY CLEARED DURING CONTINUATION VISIT.
Official record says corrected or clearedOn or before Jan 26, 2024
Plan of correction recorded
Hazardous items and storageType A
- Official classification
- Type A
- Official code
- 87309(b)
- Regulation authority
- CCR
What the official deficiency says
(b) Medicines shall be stored as specified in Section 87465(c) and separately from other items specified in (a) above. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having medication stored in a cabinet unlocked, medication found in residents rooms, and medication in drawer in the kitchen, medication in an unlocked office which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/28/2024 Plan of Correction Administrator/Manager agreed to read regulation and conduct inservice with all staff handling medication. Remove all medication from unlocked areas such as the unlocked office, medication in drawers in the kitchen, medication in residents rooms and put a lock on the cabinet containing medication submit photos of all medication locked in a locked cabinet by the POC date. DEFICIENCY CLEARED DURING CONTINUATION VISIT.
Official record says corrected or clearedOn or before Jan 26, 2024
Plan of correction recorded
Fire safety and emergency preparednessType A
- Official classification
- Type A
- Official code
- 87203
- Regulation authority
- CCR
What the official deficiency says
Fire Safety. All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by -Fire Extinguisher noted to not have any indication of when last serviced which poses an immediate health and safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 01/28/2024 Plan of Correction Administrator/Manager shall ensure that, facility fire extinguisher is serviced at least annually. This will ensure that fire extinguisher is functioning properly in the event of a fire emergency. Administrator shall have fire extinguisher serviced or purchase a new one and submit proof by POC date. DEFICIENCY CLEARED DURING CONTINUATION VISIT.
Official record says corrected or clearedOn or before Jan 26, 2024
Plan of correction recorded
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87303(a)
- Regulation authority
- CCR
What the official deficiency says
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. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above having a leaking refridgrator with the seal on the freezer loose, a freezer located in the garage that needs to be cleaned which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed to replace broken refridgerator and clean freezer located in the garage and submit photos of the receipt for new refridgerator and cleaned freezer to CCL by POC date.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87303(a)(1)
- Regulation authority
- CCR
What the official deficiency says
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. (1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above having stains in the bathtub and shower floors located in bedroom #6 which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed to clean the bathtub and shower floors and submit photos to CCL by the POC date.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87303(c)
- Regulation authority
- CCR
What the official deficiency says
(c) All window screens shall be clean and maintained in good repair. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by having widow screens maintained which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed to replace the torn window screens and submit photos to CCL by the POC date.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87311
- Regulation authority
- CCR
What the official deficiency says
All facilities shall have telephone service on the premises. Facilities with a capacity of sixteen (16) or more persons shall be listed in the telephone directory under the name of the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above by not having telephone service at the facility which poses a potential health and safety to persons in care.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed to get telephone service at the facility and submit phone number and a copy of the invoice to CCL by the POC date.
Plan of correction recorded
Correction not verified in available records
Licensing and administrationType B
- Official classification
- Type B
- Official code
- 1569.618(c)
- Regulation authority
- HSC
What the official deficiency says
(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: 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 by not having a staff schedule or LIC 500 or staff documents which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed to provide a copy of the LIC 500 via email by POC date.
Plan of correction recorded
Correction not verified in available records
Licensing and administrationType B
- Official classification
- Type B
- Official code
- 1569.618(c)(3)
- Regulation authority
- HSC
What the official deficiency says
(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. 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 by not having a copy of staff CPR documents which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed to read regulation conduct an inservice training on HSC 1569.618(c)(3). Ensure that 1 staff has CPR and first aid training on duty at all times. Submit a copy of staff CPR/First Aid card and a list of all staff that attended inservice training to CCL by POC date.
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
(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 by not having staff files maintained at the facility which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed to read regulation and create staff files and submit copies of each staff file to CCL by the POC date
Plan of correction recorded
Correction not verified in available records
Not classified in the sourceType B
- Official classification
- Type B
- Official code
- 1569.267(d)
- Regulation authority
- HSC
What the official deficiency says
(d) The licensee shall provide initial and ongoing training for all members of its staff to ensure that residents’ rights are fully respected and implemented. 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 by not having any traing documents for staff maintained at the facility which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed to submit all staff current training to CCL by POC date.
Plan of correction recorded
Correction not verified in available records
Records and plan of operationType B
- Official classification
- Type B
- Official code
- 87506(b)
- Regulation authority
- CCR
What the official deficiency says
(b) Each resident's record shall contain at least 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 by having incomplete resident files which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed to read regulation and complete resident files and send a copy of all resident files to CCL by POC date.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 1569.695(a)(1)
- Regulation authority
- HSC
What the official deficiency says
(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following: (1) Evacuation procedures, including identification of an assembly point or points that shall be included in the facility sketch. 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 by not having a current emergency and disaster plan at the facility which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed to complete emergency and disaster plan and evacuation procedure plan and submit a copy to CCL by POC date.
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 record review, the licensee did not comply with the section cited above by not conducting quarterly drills document which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed to conduct emergency drills, chart and submit documents to CCL by the POC date.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87411(g)
- Regulation authority
- CCR
What the official deficiency says
Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall: Request a transfer of a criminal record clearance 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 by having staff (facility Manager) working in the facility unassociated which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/31/2024 Plan of Correction Administrator shall contact CCL directly to verify any and all staff members have been associated to the facility prior to starting work. Administrator to read, understand, and implement regulatory requirement and self certify understanding and submit to CCL by POC date.
Plan of correction recorded
Correction not verified in available records
Records and plan of operationType B
- Official classification
- Type B
- Official code
- 87208(A)(7)
- Regulation authority
- CCR
What the official deficiency says
87208((A) Building(s) to be occupied, including a floor plan that describes the capacities of the buildings for the uses intended...7)Sketches, showing dimensions, of the following: This requirement was not met as evidence by: Deficient Practice Statement Based on LPA observation licensee did not comply with the section cited above by staff sleeping in a pool/storage makeshift bedroom being used for accommodation. Which poses a potential health and safety risk to residents.
Official plan of correction
POC Due Date: 02/16/2024 Plan of Correction Administrator/Manager agreed not to allow staff to sleep in the pool/storage room. Facility will submit a written addendum to their operating plan describing how the pool/storage room will be utilized as intended to CCLD by POC date.
Plan of correction recorded
Correction not verified in available records
Enforcement records
Revocation Action Pending
Pleading date: Jun 22, 2026 · Case closed: No
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