Inspection
No deficiencies recorded in this report
NAGOMI HOME LLC
1128 N FAIRVALLEY AVE, Covina CA 91722
6 bedsLatest official report Jun 1, 2026Licensed
Additional info
- Telephone
- (626) 404-8798
- Licensee
- NAGOMI HOME LLC
- Administrator
- AYABE, TOKIE
- Contact
- AYABE, TOKIE
- License first date
- Jun 4, 2021
- License effective date
- Jun 4, 2021
- District office
- MONTEREY PARK ASC · (323) 980-4934
- Regional office
- 28
- Clients served
- 985 - RCFE / HOSPICE
Summary
The available records show 2 Type A and 2 Type B deficiencies for this facility.
- Most recent inspection
- Jun 1, 2026
- Most recent deficiency
- May 13, 2025
1 later report, on Jun 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 1,564 Los Angeles County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 6 reports for this facility: 6 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 2 Type A and 2 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 6
- Recorded deficiencies
- 4
- Type A deficiencies
- 2
- Type B deficiencies
- 2
- Substantiated complaints
- 0
- Repeated topics
- 0
More than the typical 4
1 in the last 12 months
More than the typical 1
0 in the last 12 months
Most this size have none
0 in the last 12 months
Most this size have none
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.
No topic repeats in the last 36 months
No deficiency topic appears in more than one report during that window. This does not establish that nothing repeated earlier in the five-year record, and it is not a statement about current conditions.
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 LPA observed cleaning suppliies under bathroom #1 sink and in unlocked closet, LPA also observed two pairs of scissors in unlocked kitchen drawers which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/14/2025 Plan of Correction Administrator removed items at time of visit. Administrator will conduct training on section 87309(a) with all staff and submit training to LPA by poc due date.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87412(a)(11)
- 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: (11) A health screening as specified in Section 87411, Personnel Requirements - General. This requirement is not met as evidenced by: Deficient Practice Statement Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: Plan of Correction
Plan of correction recorded
Correction not verified in available records
Health conditions and treatmentsType B
- Official classification
- Type B
- Official code
- 87608(a)(5)(A)
- Regulation authority
- CCR
What the official deficiency says
(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. This requirement is not met as evidenced by: Deficient Practice Statement Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: Plan of Correction
Plan of correction recorded
Correction not verified in available records
Records and plan of operationType A
- Official classification
- Type A
- Official code
- 87208(a)
- Regulation authority
- CCR
What the official deficiency says
87208 Plan of Operation (a) The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation and may be cited for not doing so pursuant to Health and Safety Code section 1569.49. The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain 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 facility did not have a current plan of operation avaliable along with R4 R5 both have a severe neurological impairment anf the facility has not been approved for a Dementia Care waiver which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 05/20/2025 Plan of Correction Licensee/Administrator agrees to supply the department with an updated Plan of Operationto include Dementia Care and request a Dementia Care Waiver by POC due date.
Plan of correction recorded
Correction not verified in available records
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
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