Facility condition and maintenance
Cited in 3 reports, with 7 deficiencies in total.
PRN CARE HOME 2
112 CHESTNUT DR, Hercules CA 94547
8 bedsLatest official report Mar 24, 2026Licensed
Additional info
- Telephone
- (510) 281-0678
- Licensee
- PRN CARE HOME LLC
- Administrator
- HU, CHUNJIE
- Contact
- HU, CHUNJIE
- License first date
- Jan 25, 2021
- License effective date
- Jan 25, 2021
- District office
- OAKLAND ASC · (510) 286-4201
- Regional office
- 15
- Clients served
- 935 - ELDERLY
Summary
The available records show 9 Type A and 25 Type B deficiencies for this facility.
- Most recent inspection
- Mar 24, 2026
- Most recent deficiency
- Mar 24, 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 17 Contra Costa County facilities licensed for 7 to 15 beds, except where too few exist to state one — those come from facilities with 7 or more beds.
In the available public five-year record, CCLD published 5 reports for this facility: 5 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 9 Type A and 25 Type B deficiencies.
3 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 5
- Recorded deficiencies
- 34
- Type A deficiencies
- 9
- Type B deficiencies
- 25
- Substantiated complaints
- 0
- Repeated topics
- 6
Fewer than the typical 9
1 in the last 12 months
Well above the typical 7
8 in the last 12 months
Well above the typical 1
3 in the last 12 months
Well above the typical 4
5 in the last 12 months
Fewer than the typical 1
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.
Staffing, personnel, and training
Cited in 3 reports, with 4 deficiencies in total.
Fire safety and emergency preparedness
Cited in 3 reports, with 3 deficiencies in total.
Hazardous items and storage
Cited in 3 reports, with 3 deficiencies in total.
Food service
Cited in 2 reports, with 3 deficiencies in total.
Licensing and administration
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
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 by having unlocked knives, scissors, lysol in an unlocked drawer located in the kitchen which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 03/26/2026 Plan of Correction Administrator agreed to read and understand regulation, self-certify and conduct inservice training with staff and submit sign in sheet with attendies by the POC date. Administrator locked sharps during visit.
Corrective action observedRecorded in report dated Mar 24, 2026
Plan of correction recorded
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 medicaction 3 unknown pills, Pepto Bismol, and Calmoseptine cream located in the kitchen which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 03/26/2026 Plan of Correction Administrator agreed to read and understand regulation, self-certify and conduct inservice training with staff and submit sign in sheet with attendies by the 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)(5)
- Regulation authority
- CCR
What the official deficiency says
(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. 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 prepoured medication which poses an immediate health and safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/26/2026 Plan of Correction Administrator agreed to read, self-certify and conduct in-service training wiht staff submit the sign in sheet to the department 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
- 87305(a)
- Regulation authority
- CCR
What the official deficiency says
(a) Prior to construction or alterations, all facilities shall obtain a building permit. 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 building a building located in the backyard without a permit which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 04/01/2026 Plan of Correction Administrator agreed to submit an LIC200 and an updated facility sketch to the department 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
- 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 debris, wood planks, rake, buckets, sink located on both sideyard and backyard which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 04/08/2026 Plan of Correction Administrator agreed to have the debris, wood planks, rake, buckets sink located on the sideyard hauled away and submit photos to the department 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
- 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 observation and record review, the licensee did not comply with the section cited above by not having the Co-Administrators file/records located at the facility which poses a potential health and safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 04/08/2026 Plan of Correction Administrator agreed to have a copy of the Co-Administrator and all staff files/records at the facility at all times. Administrator will read understand regulation and self-certify and submit certification to the department by the POC date.
Plan of correction recorded
Correction not verified in available records
Medical and dental careType B
- Official classification
- Type B
- Official code
- 87465(a)(8)
- Regulation authority
- CCR
What the official deficiency says
(8) If a facility has no medical unit on the grounds, a complete first aid kit shall be maintained and be readily available in a specific location in the facility. The kit shall be a general type approved by the American Red Cross, or shall contain at least 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 by not maintaining a complete first aid kit at the facility which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 04/08/2026 Plan of Correction Administrator agreed to read understand regulation self certify and submit a photo of a completed first aid kit to the department by the POC date.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 87203
- Regulation authority
- CCR
What the official deficiency says
87203 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 having a fire extinguisher without a service tag which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 04/01/2026 Plan of Correction Administrator agreed to service fire extinguisher or purchase a new one and submit a photo to the department by the POC date.
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) 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 by having knife, meat clever and scissors unlocked in a kitchen drawer which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/28/2025 Plan of Correction Administrator locked knives and scissors during visit. DEFICIENCY CLEARED DURING VISIT.
Official record says corrected or clearedRecorded in report dated Jan 27, 2025
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
(a) 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 by having bathroom #1 sink dirty and floor needs to be swept. Bathroom #2 shower floor needs repair which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/31/2025 Plan of Correction Co-Administrator agreed to clean the bathroom and repair bathroom # 2 shower floor and submit photos 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
- 87305(a)
- Regulation authority
- CCR
What the official deficiency says
(a) Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above building two (2) rooms located in the backyard and one (1) room in the garage without obtaining a building permit which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/10/2025 Plan of Correction Administrator agreed to provide a permit or submit a form 200 and updated facility sketch to the Department 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)(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 and record review, the licensee did not comply with the section cited above by having two staff without CPR/First Aid training working and Administrator out of town which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/10/2025 Plan of Correction Co-Administrator agreed to get CPR/First Aid training for him and staff working submit photo copies to the Department by the POC date.
Plan of correction recorded
Correction not verified in available records
Food serviceType B
- Official classification
- Type B
- 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 by having expired food in the refrigerator with an odor which poses a potential health and safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 01/30/2025 Plan of Correction Administrator agreed to clear all expired foods from the refrigerator and submit photos to the Department by the POC date.
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 the kitchen are not clean and a glue trap with incest on it which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/10/2025 Plan of Correction Administrator agreed to clean the kitchen and submit photos to the Department 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
- 1569.625(B)(2)
- Regulation authority
- CCR
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 by not having documents for annual training which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/10/2025 Plan of Correction Administrator has agreed to obtain training documents for staff's annual training and submit a copy to CCLD 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
- 87212(c)
- Regulation authority
- CCR
What the official deficiency says
87212 Emergency Disaster Plan (c) Emergency exiting plans and telephone numbers shall be posted. This requirement was not met as evidenced by: 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 by not having a current Emergency and Disaster Plan which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/10/2025 Plan of Correction Administrator agreed to update post and submit a copy of Emergency and Disaster Plan (610E) to the Department by the POC date.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 87203
- Regulation authority
- CCR
What the official deficiency says
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 fire extinguishers did not have any inspection tags or purchase receipt taped on cylinder to show date of purchase or when last inspected which posed a potential Health & Safety risk to residents in care.
Official plan of correction
POC Due Date: 01/30/2025 Plan of Correction Administrator agreed to have fire extinguisher serviced or purchase a new extinguisher and provide a copy of the purchase receipt or service tag to the Department 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
- 87307(d)(4)
- Regulation authority
- CCR
What the official deficiency says
(4) Stairways, inclines, ramps and open porches and areas of potential hazard to residents with poor balance or eyesight shall be made inaccessible to residents unless equipped with sturdy hand railings and unless well-lighted. 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 dust pan, portable bed, pipes, wood, table, mixer, chairs, walker, paint, Lysol, boxes, water cooler, Ortho groundclear, boxes of cement, open can of food, hoses, toilet, cement blocks, shovel, large tree branch and ladder located in the back yard which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/10/2025 Plan of Correction Administrator agreed to remove all items and put them in storage to be inaccessible to residents in care and submit photos to the department 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
- 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 of four staff files, the licensee did not comply with the section cited above in having incomplete employee files for 3 of 3 employees records reviewed which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/10/2025 Plan of Correction Administrator agrees to read the regulation review and update all employee files and provide a checklist and a sample of all required documents for each file to the Department by POC date.
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 by having sharps, eye drops, scrubbing bubbles, fish oil, laundry detergent, Lysol accessible to residents in care which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/05/2024 Plan of Correction Administrator removed chemicals and locked the sharps drawer. Deficiencies cleared during visit.
Official record says corrected or clearedRecorded in report dated Jan 4, 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 by having shovel, hedge cutters, saw, ladder, sledge hammer, paint, propane, and pick axe which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/23/2024 Plan of Correction Administrator agreed to put items in storage no later then the POC date and submit photos of correction to CCLD.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87305(a)
- Regulation authority
- CCR
What the official deficiency says
Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above building two (2) rooms located in the backyard and one (1) room in the garage without obtaining a building permit which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/23/2024 Plan of Correction Administrator agreed to submit a form 200 and a new updated facility sketch to CCLD no later then 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)(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, interview and record review the licensee did not comply with the section cited above by not having proof of Administrator or staff with CPR/first aid on duty which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/11/2024 Plan of Correction Administrator agreed to read, understand regulation and provide CCLD with self certification no later then the 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 observation, interview and record review, the licensee did not comply with the section cited above by not maintaining the Administrators and staff files at the facility which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 01/11/2024 Plan of Correction Administrator agreed to read, understand regulation and provide CCLD with self certification and a copy of all files required staff/residents no later then the POC date.
Plan of correction recorded
Correction not verified in available records
Food serviceType B
- Official classification
- Type B
- 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 by having expired and freezer burned foods which poses a potential health and safety or risk to persons in care.
Official plan of correction
POC Due Date: 01/11/2024 Plan of Correction Administrator agred to get rid of expired and freezer burned food and replinish perishable and non-perishable food and send a photo to CCLD no later then the POC date.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 87203
- Regulation authority
- CCR
What the official deficiency says
87203 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. The fire extinguisher is missing the service tag, which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 01/11/2024 Plan of Correction Administrator will ensure fire extinguisher is serviced and submit proof of serviced extinguisher tag to CCL by POC date.
Plan of correction recorded
Correction not verified in available records
Inspection
Fire safety and emergency preparednessType A
- Official classification
- Type A
- Official code
- 87203(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 and record review, the licensee did not comply with the section cited above by not having the fire extinguisher serviced, and locking the front door with a prohibited lock which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/03/2023 Plan of Correction Administrator will remove the prohibited lock on the front door and provide CCLD with photos no later than POC date. Administrator will service or purchase a new fire extinguisher no later than the POC date and provide CCLD with photos. Civil penalty of $500 is being assessed.
Plan of correction recorded
Correction not verified in available records
Dementia careType A
- Official classification
- Type A
- Official code
- 87705(f)(1)(2)(3)
- Regulation authority
- CCR
What the official deficiency says
87705 Care of Persons with Dementia (f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). (2) Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. (3) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the administrator had over the counter medication and cleaning supplies such as scrubbing bubbles, fabuloso, laundry detergent, febreez over the counter medications fish oil, CoQ10, vitamins, and lysol in a unlocked garage. Administrator also had an unlocked drawer with knives accessible to residents which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/03/2023 Plan of Correction Administrator will read and understand the regulation and conduct an in-service training with staff and provide CCLD with a signed list of attendees no later than the POC date.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87305(a)
- Regulation authority
- CCR
What the official deficiency says
Added room without permit 87305(a) Alterations to Existing Building or New Facilities (a) Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation licensee did not comply with the section cited above by making alterations to the garage by adding a room which poses a potential health and safety risk to residents in care.
Official plan of correction
POC Due Date: 02/16/2023 Plan of Correction Administrator will submit a LIC200 along with a new facility sketch to CCL no later than the POC date. Civil penalty of $500 is being assessed.
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
87303(a) Maintenance and Operation (a) 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 was not met as evidence by: This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation licensee did not comply with the section cited above by having, shovel, bed frames, dolly, toilet top, wood shelves, mirror, Weed B Gone, chairs, window and other items located in the backyard which poses a potential health and safety risk to residents
Official plan of correction
POC Due Date: 03/02/2023 Plan of Correction Administrator agreed remove all items shovel, bed frames, dolly, toilet top, wood shelves, mirror, Weed B Gone, chairs, window from the backyard and provide photos to CCLD no later than the POC date. Repeat Civil penalty of $500 is being assessed.
Plan of correction recorded
Correction not verified in available records
Inspection
Fire safety and emergency preparednessType A
- Official classification
- Type A
- 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 record review, the licensee did not comply with the section cited above by locking side gate which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 06/24/2022 Plan of Correction Staff removed lock during inspection. Deficiency cleared during visit. Civil penalty of $500 is being assessed.
Official record says corrected or clearedRecorded in report dated Jun 23, 2022
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
87309 Storage Space (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 the garage door unlocked and accessible to residents which poses an immediate health and safety risk to persons in care.
Official plan of correction
POC Due Date: 06/24/2022 Plan of Correction Administrator agreed to turn the door knob on the garage door around to lock from the outside in to the home and provide photos to CCLD no later then the CCLD no later then the POC date.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87305(a)
- Regulation authority
- CCR
What the official deficiency says
Added room without permit 87305(a) Alterations to Existing Building or New Facilities (a) Prior to construction or alterations, all facilities shall obtain a building permit. 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 adding a room without a permit which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 08/01/2022 Plan of Correction Administrator will submit approved permit from the local county department along with a new facility sketch to CCL no later than 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(a)
- Regulation authority
- CCR
What the official deficiency says
Maintenance and Operation 87303(a) (a) 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 by having materials bedframe, mattress, 2 toilet seats, rat trap, wire, rake, wood panel, dolly, shovels building materials window, which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 08/01/2022 Plan of Correction Administrator will remove building materials bedframe, mattress, 2 toilet seats, rat trap, wire, rake, wood panel, dolly, shovels, window from the backyard and will provide pictures to CCL no later than the POC date.
Plan of correction recorded
Correction not verified in available records
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.
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