HILLS OF BROADWAY, THE

Official classification

Type A

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 in which S1 does not have CPR training on file which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/08/2026 Plan of Correction Licensee will send LPA Simerly proof of CPR training by POC due date.

Official classification

Type A

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. 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 S1 did not have a health screening and TB test which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/08/2026 Plan of Correction Licensee will send LPA Simerly proof of health screening and TB test by POC due date.

Official classification

Type A

Official code

87468.1(a)(16)

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: (16) To receive or reject medical care or other services. 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 R2 did not have all prescribed medications at the facility which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/08/2026 Plan of Correction Licensee will send LPA Simerly proof of medication by POC due date.

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 in which medication was left unsecured in the kitchen island which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/08/2026 Plan of Correction Licensee will provide additional training to staff regarding securing medication and immediately lock up all medication. Proof of training will be sent to LPA Simerly by POC due date.

Official classification

Type B

Official code

87307(e)(1)

Regulation authority

CCR

What the official deficiency says

(e) The licensee shall supervise residents as needed and as determined by the resident's appraisal pursuant to Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, when residents are in proximity to or when there is use of the following items: (1) Ranges, ovens, heaters, fireplaces, wood stoves, inserts, and other heating devices. 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 stove knobs were left unsecured when not in use which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2026 Plan of Correction Licensee will secure or remove knobs to kitchen stove when not in use. Licensee will send proof to LPA Simerly by POC due date.

Official classification

Type B

Official code

1569.625(b)(1)

Regulation authority

HSC

What the official deficiency says

(1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on 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 in which S1, S2, and S3 did not have updated training which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2026 Plan of Correction Licensee will ensure all staff have updated training and send proof to LPA Simerly by POC due date.

Official classification

Type B

Official code

87465(a)(8)(A)

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: (A) A current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency. 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 in which the facility did not have a first aid kit which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2026 Plan of Correction Licensee will send proof of first aid kit at facility by POC due date.

Official classification

Type B

Official code

87507(c)

Regulation authority

CCR

What the official deficiency says

(c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident's representative, if any, and the licensee or the licensee's designated representative no later than seven days following admission. Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in R1 did not have a signed admission agreement which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2026 Plan of Correction Licensee will send proof of signed admission agreement to LPA Simerly by POC Due date.

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 in which the facility does not have documented drills on file which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2026 Plan of Correction Licensee will send proof of drills to LPA Simerly by POC due date.

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 observation and record review, the licensee did not comply with the section cited above in which R1 does not have doctors orders for half bed rails which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2026 Plan of Correction Licensee will remove the half bed rails or get an order from R1's doctor and send proof to LPA Simerly by POC due date.

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: 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 S1 did not have any training on file which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2026 Plan of Correction Licensee will send LPA proof of training for S1.

Official classification

Type A

Official code

87355(d)(3)

Regulation authority

CCR

What the official deficiency says

87355 (d) All individuals subject to criminal record review shall be fingerprinted... (3) The licensee shall submit these fingerprints to the California Department of Justice, along with... the Federal Bureau of Investigation... prior to the individual's employment, residence, or initial presence in the facility. (Cont'd) This requirement was not met as evidenced by: Based on LPA's file review and interviews, Staff #2 (S2) was not associated to the facility. This poses an immediate health and safety risk to persons in care

Official plan of correction

Licensee will associate S2 prior to LPA leaving the facility and will email LPA two of two staff personnel records by POC due date.

Deadline recorded: Jul 31, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87405

Regulation authority

CCR

What the official deficiency says

87405 Administrator - Qualifications and Duties: All facilities shall have a qualified and currently certified administrator ...When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for (Cont'd) management and administration of the facility as specified in this section... This requirement was not met as evidenced by: CCL did not receive notification regarding a new Administrator. This poses an immediate health and safety risk to persons in care.

Official plan of correction

Licensee will designate an Administrator and email LPA with documentation by POC due date.

Deadline recorded: Jul 31, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87507(f)

Regulation authority

CCR

What the official deficiency says

87507 Admission Agreement: (f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement was not evidenced by: Based on interviews conducted and records reviewed, the Licensee did not ensure that a refund was issued to Resident #1's responsible party after her death. This poses a potential health, safety, and personal rights risk to persons in care.

Official plan of correction

The Licensee stated that they will issue a refund to Resident #1's responsible party for the remaining twenty three of June 2025. The Licensees agreed to provide LPA proof of the refund via email or fax by POC due date.

Deadline recorded: Aug 7, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87213

Regulation authority

CCR

What the official deficiency says

87213 Finances: The licensee shall have a financial plan.. shall maintain adequate financial records; and shall submit such financial reports as may be required upon the written request of the licensing agency... This requirement was not evidenced by: Based on records reviewed and interviews conducted, the Licensees do not have a sufficient financial plan as they have a past due balance in their electricity bill and owe wages to two staff. This poses an immediate health, safety, and personal rights risk to persons in care.

Official plan of correction

The Licensees stated that they will provide LPAs a written financial plan on how they will address the past due balance in electricity and the owed wages to staff. The Licensees agreed to provide LPA the written plan via email or fax by POC due date.

Deadline recorded: Jul 30, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87213

Regulation authority

CCR

What the official deficiency says

87213 The licensee shall have a financial plan that [...] assures sufficient resources to meet operating costs for care of residents; shall maintain adequate finances. The requirement is not met as evidenced by: Based on interviews conducted, the Licensee did not ensure employees are receiving their paychecks timely or the full amount. This poses an immediate health and safety risk for persons in care.

Official plan of correction

AD stated licensee text AD back pay has begun and will be paid by tomorrow.

Deadline recorded: Jul 8, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87412(a)

Regulation authority

CCR

What the official deficiency says

87412(a) Personnel Records The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. The requirement is not met as evidenced by: Based on interviews conducted and observations, there is no evidence of personnel records for one out of two staff which poses a potential health and safety risk to persons in care.

Official plan of correction

AD stated staff records will be sent by end of today via email to LPA.

Deadline recorded: Jul 8, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(a)

Regulation authority

CCR

What the official deficiency says

87506(a) Resident Records The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. The requirement is not met as evidenced by: R1 does not have a complete record of the admission agreement, personal rights, appraisal, and identification page with poses a potential personal rights risk to persons in care.

Official plan of correction

AD stated all completed resident records will be sent to LPA via email by POC due date.

Deadline recorded: Jul 8, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87213

Regulation authority

CCR

What the official deficiency says

87213 The licensee shall have a financial plan that [...] assures sufficient resources to meet operating costs for care of residents; shall maintain adequate finances. Based on interviews conducted, the Licensee did not ensure employees are receiving their paychecks timely or the full amount. This poses an immediate health and safety risk for persons in care.

Official plan of correction

AD Carla Miranda stated Licensee Allen Medina would pay all back payments to staff by end of weekend 6/28/2026. AD to provide proof to LPA by POC due date.

Deadline recorded: Jun 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87213

Regulation authority

CCR

What the official deficiency says

87213 The licensee shall have a financial plan that [...] assures sufficient resources to meet operating costs for care of residents; shall maintain adequate finances. Based on interviews conducted, the Licensee did not ensure employees are receiving their paychecks timely or the full amount. This poses an immediate health and safety risk for persons in care.

Official plan of correction

Licensee Allen Medina stated an updated financial plan will be submitted to LPA by POC due date to ensure back pay is paid timely.

Deadline recorded: Jun 10, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.38(b)(1)

Regulation authority

HSC

What the official deficiency says

1569.38(b)(1) Posting of licensing reports A licensed residential care facility for the elderly shall provide written notice to a resident, the resident’s responsible party, if any, and the local long-term care ombudsman, within 10 days from the occurrence of either of the following...: The department commences proceedings to... revoke the license of the facility... The requirement is not met as evidenced by: Five responsible parties have not been notified of the proceedings which poses an immediate health and safety risk to persons in care.

Official plan of correction

AD stated all responsible parties and ombudsman will be notified by certified mail regarding the commencement of revocation. AD to submit proof to LPA by POC due date.

Deadline recorded: May 21, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.38(e)

Regulation authority

HSC

What the official deficiency says

1569.38(e) Posting of licensing reports Upon providing the notice described in subdivision (b), the licensed residential care facility shall also post a written notice, in at least 14-point type, in a conspicuous location in the facility, that may include posted... any other easily accessible location in the facility. The posting shall include all of the following information: The requirement is not met as evidenced by: LPA did not observe any posting regarding the revocation at the facility. This poses an immediate health and safety risk to persons in care.

Official plan of correction

AD stated the legal accusation document will be posted at the facility. AD to send photo of posting to LPA by POC due date.

Deadline recorded: May 21, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87213

Regulation authority

CCR

What the official deficiency says

87213 Finances The licensee shall have a financial plan that conforms to the requirements of Section 87155, Application for License, and that assures sufficient resources to meet operating costs for care of residents... This requirement is not met as evidenced by: Based on interviews conducted, the Licensee did not have an adequate financial plan in place to ensure staff are paid on schedule, This poses an immediate health and safety risk to persons in care. Civil Penalty Assessed.

Official plan of correction

Licensee Allen Medina stated he will provide proof of salary payments for all staff at the facility for the month of April through present to LPA by POC due date.

Deadline recorded: May 5, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87213

Regulation authority

CCR

What the official deficiency says

87213 Finances The licensee shall have a financial plan that conforms to the requirements of Section 87155, Application for License, and that assures sufficient resources to meet operating costs for care of residents... This requirement is not met as evidenced by: Based on interviews conducted, the Licensee did not have an adequate financial plan in place to ensure staff are paid on schedule, This poses an immediate health and safety risk to persons in care. Civil Penalty Assessed.

Official plan of correction

Licensee to submit a financial plan outlining how to meet the operating costs of the facility including paying wages to staff and forward proof to LPA by POC due date.

Deadline recorded: Apr 11, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

87355(e)(3) Criminal Record Clearance All individuals subject to a criminal record review... shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 87355(c) This requirement is not met as evidenced by: The licensee did not request or complete a transfer of one staff member's criminal record clearance which poses an immediate health and safety risk to persons in care.

Official plan of correction

LPA assisted with the transfer of the criminal record clearance during the visit.

Deadline recorded: Apr 2, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

87411(f) Personnel Requirements All personnel...shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening...performed by a physician... This requirement is not met as evidenced by: One staff member did not have evidence of a health screening which poses a potential health and safety risk to persons in care.

Official plan of correction

AD stated the health screening will be sent to LPA by POC due date.

Deadline recorded: Apr 15, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87213

Regulation authority

CCR

What the official deficiency says

87213 Finances The licensee shall have a financial plan that conforms to the requirements of Section 87155, ... shall submit such financial reports as may be required upon the written request of the licensing agency. The requirement is not met as evidenced by: Based on interviews conducted, the Licensee did not have an adequate financial plan in place to ensure staff are paid on schedule, Staff are still owed wages from the last pay period. This poses an immediate health and safety risk to persons in care. Civil Penalty Assessed.

Official plan of correction

Licensee to submit a financial plan outlining how to meet the operating costs of the facility including paying wages to staff and forward proof to LPA by POC due date.

Deadline recorded: Feb 27, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87213

Regulation authority

CCR

What the official deficiency says

87213 Finances The licensee shall have a financial plan that conforms to the requirements of Section 87155, ... shall submit such financial reports as may be required upon the written request of the licensing agency. The requirement is not met as evidenced by: The licensee agreed to provide documents requested by the Department by February 6, 2026 at 3pm. The licensee failed to provide documents by the agreed date which poses an immediate health and safety risk to persons in care.

Official plan of correction

Administrator Carla Miranda stated Licensee Allen Medina will provided all documents requested by the Department by end of day today. Licensee to provide proof to LPA by POC due date.

Deadline recorded: Feb 21, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

Liability insurance... all residential care facilities for the elderly... shall maintain liability insurance covering injury to residents and guests in the amount of... three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. The requirement is not met as evidenced by: The facility does not have evidence of current liability insurance which poses an immediate health and safety risk to persons in care.

Official plan of correction

Adminstrator Carla Miranda stated Licensee Maricel Nepomuceno has applied for liability insurance for the facility and will take affect by February 27, 2026. Licensee to provide proof to LPA by POC dude date.

Deadline recorded: Feb 21, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

87555(b)(26) General Food Service Requirements Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not met as evidenced by: LPA observed there is insufficient nonperishable food for a minimum of one week which poses an immediate health and safety risk to persons in care.

Official plan of correction

Administrator Carla Miranda placed an order of food during the visit.

Deadline recorded: Feb 21, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87303(b)(1)

Regulation authority

CCR

What the official deficiency says

87303(b)(1) Maintenance and Operation The facility shall heat rooms that residents occupy to a minimum of 68 degree F, (20 degrees C). This requirement is not met as evidenced by: LPA observed the temperature of the facility at 61 degrees F which poses an immediate health and safety risk to persons in care.

Official plan of correction

Adminstrator Carla Miranda stated an appointment for AC/Heating services will be made today for service today or tomorrow to repair the heating element. Adminstrator to provide proof of repair by POC due date.

Deadline recorded: Feb 21, 2026. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87555(b)(26)

Regulation authority

CCR

What the official deficiency says

87555(b)(26) General Food Service Requirements Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not met as evidenced by: LPA observed there is insufficient perishable food for a minimum of two days which poses an immediate health and safety risk to persons in care.

Official plan of correction

AD stated a food order been placed and will be delivered today. AD will send a picture of the food delivery along with receipt to LPA by POC due date.

Deadline recorded: Feb 6, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

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 LPA observation, sharps and chemicals were found unlocked under the kitchen sink cabinet which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 08/15/2025 Plan of Correction AD stated an in-service training will be completed and will send proof to LPA by POC due date.