Records and plan of operation
Cited in 2 reports, with 2 deficiencies in total.
SAN DIMAS ADVENTIST HOME CARE
1136 N. SAN DIMAS AVENUE, San Dimas CA 91773
6 bedsLatest official report Oct 27, 2025Licensed
Additional info
- Telephone
- (909) 971-9769
- Licensee
- SAN DIMAS ADVENTIST HOME CARE
- Administrator
- JASAIEL DE LEON
- Contact
- JASAIEL DE LEON
- License first date
- Oct 31, 2006
- License effective date
- Oct 31, 2006
- District office
- MONTEREY PARK ASC · (323) 980-4934
- Regional office
- 28
- Clients served
- 985 - RCFE / HOSPICE
Summary
The available records show 1 Type A and 10 Type B deficiencies for this facility.
- Most recent inspection
- Oct 27, 2025
- Most recent deficiency
- Aug 11, 2024
1 later report, on Oct 27, 2025, 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 5 reports for this facility: 5 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 1 Type A and 10 Type B deficiencies.
1 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 5
- Recorded deficiencies
- 11
- Type A deficiencies
- 1
- Type B deficiencies
- 10
- Substantiated complaints
- 0
- Repeated topics
- 1
More than the typical 4
1 in the last 12 months
Well above 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.
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
Resident rightsType B
- Official classification
- Type B
- Official code
- 87468(b)(1)(A)
- Regulation authority
- CCR
What the official deficiency says
(b) At the time the admission agreement is signed, a resident and the resident's representative shall be personally advised of and given a copy of: (1) The personal rights of residents specified in Sections 87468.1, Personal Rights of Residents in All Facilities and 87468.2, Additional Personal Rights of Residents in Privately Operated Facilities, as applicable to the facility. (A) The licensee shall have each resident and the resident's representative sign a copy of these rights, and the signed copy shall be included in the resident's record. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, R1, R2,and R3 the licensee did not comply with the section cited above in 3 out of 4 residents which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/19/2024 Plan of Correction Licensee will have forms signed 8/19/2024 and send proof via email to LPA Ramirez.
Plan of correction recorded
Correction not verified in available records
Records and plan of operationType B
- Official classification
- Type B
- Official code
- 87506(b)(9)
- Regulation authority
- CCR
What the official deficiency says
(b) Each resident's record shall contain at least the following information: (9) Name, address and telephone number of physician and dentist to be called in an emergency. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, R1's emergency contact info was incomplete, the licensee did not comply with the section cited above in 1 out of 4 residents which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/19/2024 Plan of Correction Licensee will have this form completed by 8/19/2024
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, proof of documentation could not be furnished, the licensee did not comply with the section cited above in 4 out of 4 residents which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/19/2024 Plan of Correction Licensee will conduct drill by 8/19/24 and send proof to LPA Ramirez via email.
Plan of correction recorded
Correction not verified in available records
Dementia careType B
- Official classification
- Type B
- Official code
- 87705(j)
- Regulation authority
- CCR
What the official deficiency says
(j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, bedroom#1 auditory device was is disrepair, the licensee did not comply with the section cited above in 2 out of 4 residents which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/11/2024 Plan of Correction Licensee repaired during visit. No further action required.
Official record says corrected or clearedOn or before Aug 11, 2024
Plan of correction recorded
Inspection
Records and plan of operationType B
- Official classification
- Type B
- Official code
- 87208(a)(12)
- Regulation authority
- CCR
What the official deficiency says
(a) Each facility shall have and maintain a current, written definitive plan of operation. 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: (12) The Infection Control Plan pursuant to Section 87470. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview the licensee did not comply with the section cited above. Facility does not have current infection control plan which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 10/13/2023 Plan of Correction Administrator will complete infection control plan and send it to LPA by POC date.
Plan of correction recorded
Correction not verified in available records
Inspection
Medical and dental careType A
- Official classification
- Type A
- Official code
- 87465(e)
- Regulation authority
- CCR
What the official deficiency says
87465 Incidental Medical and Dental Care (e)For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank, maintained in the residents file, and a label on the medication... 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 in 2 out of 5 resident medications were not properly labeled, which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 11/05/2022 Plan of Correction The licensee will place a label on 3 medications that were observed to not have a label for 2 of 5 residents. A picture of the proper labels on medications and medication records will be provided to LPA via email by the POC due date.
Plan of correction recorded
Correction not verified in available records
Dementia careType B
- Official classification
- Type B
- Official code
- 87705(5)
- Regulation authority
- CCR
What the official deficiency says
87705 Care of Persons with Dementia (5)Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. 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 in 2 out of 2 residents with dementia did not have an annual medical assessment and reappraisal done, which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 11/25/2022 Plan of Correction Licensee will obtain a medical assessment and reappraisal done for 2 residents with dementia and will provide copies of Physician's Report and Appraisal to LPA via email by POC due date.
Plan of correction recorded
Correction not verified in available records
Inspection
Resident rightsType B
- Official classification
- Type B
- Official code
- 87468.1(a)(2)
- Regulation authority
- CCR
What the official deficiency says
(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Staff should conduct routine symptom screening (+/- temperature and symptom check) at entry for all staff, residents, and visitors. Staff did not assess LPA or visitor observed entering the facility.
Official plan of correction
POC Due Date: 12/08/2021 Plan of Correction Staff will be trained on these COVID-19 procedures. Proof of training will be submitted by 12/8/21.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87411(a)
- Regulation authority
- CCR
What the official deficiency says
(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Facility should have a sign-in policy for all visitors to ensure compliance with central entry point for symptom screening and to record contact information (for reporting requirements to public health officer and contact tracing). Facility did not require LPA or another visitor to sign-in at the time of the visit.
Official plan of correction
POC Due Date: 12/08/2021 Plan of Correction Staff will be trained on these COVID-19 procedures. Proof of training will be submitted by 12/8/21.
Plan of correction recorded
Correction not verified in available records
Health conditions and treatmentsType B
- Official classification
- Type B
- Official code
- 87606(f)(1)
- Regulation authority
- CCR
What the official deficiency says
(f) To accept or retain a bedridden person, a facility shall ensure the following: (1) The facility's Plan of Operation includes a statement of how the facility intends to meet the overall health, safety and care needs of bedridden persons. This requirement is not met as evidenced by: Deficient Practice Statement Based on observations and records reviewed, the licensee did not comply with the section cited above in 1 out of 5 residents which poses a potential health, safety or personal rights risk to persons in care. Resident #1's (R1) physician's report indicates R1 is bedridden. R1 was also observed and was not able to reposition in bed. R1 is currently on hospice. Facility does not have a bedridden plan of operation and does not have the required training on file for staff regarding bedridden residents.
Official plan of correction
POC Due Date: 12/08/2021 Plan of Correction Facility will submit a bedridden plan of operation and will submit plan for approval by 12/8/21. Staff were provided with a copy of Title 22 Regulations regarding bedridden residents.
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
(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 observations and records reviewed, the licensee did not comply with the section cited above in 2 out of 5 resident records which poses a potential health, safety or personal rights risk to persons in care. Resident #1 (R1) and Resident #2 (R2) were observed having half-length bed rails on their beds. Resident files were reviewed and R1 and R2 did not have physician's orders for the postural supports.
Official plan of correction
POC Due Date: 12/08/2021 Plan of Correction Facility will obtain physician's orders for bed rails for both residents. Physician's orders will be submitted to the department for review.
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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