Inspection visit

complaintApril 12, 2023

BELROSE CARE HOME IIILicense 0756013201 citation on this visit

1 citation recorded

Inspector’s narrative

What the inspector wrote

On 04/12/2023 at 8:00 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct a complaint inspection. LPA explained purpose of the visit to Caregiver Evangeline Polito, who toured facility with LPA. Licensee Rosa Junsay arrived at 10:50 AM. At 8:15 AM, LPA observed furniture matching that sent by Complainant in resident R1's room. When asked, Caregiver Polito confirmed that it was used to block R1's exit from the bed at night. Based on the data collected by observation and interview, the preponderance of evidence standard has been met; therefore, the above allegation has been found to be SUBSTANTIATED. Deficiency cited per Title 22 California Code of Regulations is listed on the LIC9099-D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report provided via email.

Citations

3 citations recorded^*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

87468.1(a)(3)Type B
87468.1 Personal Rights of Residents in All Facilities (a) Residents ... shall have all of the following personal rights: (3) To be free from ... interfering with daily living functions such as ... elimination.This requirement was not met as evidenced by: Based on observation and interview, the licensee blocked resident R1's ability to leave her bed to use the bathroom, which did not comply with the section cited above, which posed a potential health, safety or personal rights risk to persons in care.
87411(g)(1)Type A
87411 Personnel Requirements - General (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall: (1) Obtain a California clearanceThis requirement was not met as evidenced by: Based on observation and record review, the licensee did not have a physician's order for a bed railing for R1, which posed a potential health, safety or personal rights risk to persons in care.
87608(a)(3)Type A
87608 POSTURAL SUPPORTS (a) ... 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.This requirement was not met as evidenced by: Based on observation and record review, the licensee did not have a physician's order for a bed railing for R1, which posed a potential health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the April 12, 2023 inspection of BELROSE CARE HOME III?

This was a complaint inspection of BELROSE CARE HOME III on April 12, 2023. 1 citation were issued: 1 Type B.

Were any citations issued to BELROSE CARE HOME III on April 12, 2023?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "87468.1 Personal Rights of Residents in All Facilities (a) Residents ... shall have all of the following personal rights..."

What type of inspection was this?

This was a complaint inspection. Complaint inspections are triggered when someone reports a concern about the facility to CCLD.

SourceView on CCLD View original report

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Data from CCLD public records. Last updated May 25, 2026. If you believe any information is inaccurate, report it here.

complaint·April 12, 2023