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Inspection visit

Routine inspection

TEDENEK ELDER HOME 2License 15720928510 citations on this visit
10 citations recorded

Inspector’s narrative

What the inspector wrote

On 1/31/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced himself, stated the purpose of the visit, and was greet by Staff (S1) Yuliana Yap, LPA was granted entry. 4 residents were present during inspection. Licensee (A1) Shemeles Kabteneh arrived shortly after LPA’s arrival. LPA toured facility with L1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. A sample of resident’s medications were checked and observed kept locked in medication cabinet. Clients’ MARS was reviewed. Morphine Sulfate 20 MG/1ML SOL .25 ML (5MG) by mouth or under the tongue every 1 hour as needed for pain or shortness of breath was observed in the refrigerator unlocked and accessible. Fire extinguisher reviewed with a service date of: 3/1/24. Fire drill not completed and no record observed in facility. Cleaning chemicals was observed stored and locked in facility cabinet. Residents bedrooms observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 113.9 to 116.7 degrees in 2 bathrooms. Outside of facility toured. Outside observed free of debris. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. No thermometers observed in freezer or refrigerator, therefore no temperature was recorded during visit. Carbon monoxide were tested and observed to be operational. All clients’ files reviewed. 2 out of 4 residents is missing Consent for Medical treatment form. 3 out of 4 residents are missing the Appraisal Needs and Services form. 3 out of 4 residents are missing the Safeguard for Property Values form. All staff files were reviewed. Licensee is missing LIC-501 or Employee/License application, Medication Completion Certificate and a written copy of completed education. The following deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 2/14/25: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance-RCFE, Emergency and Disaster Plan (LIC 610E -RCFE), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A- RCFE) A copy of this report and appeal rights was provided to L1, whose signature on this form confirms receipt of this report.

Citations

10 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.

  • 1569.153(d)Type A

    Based on observation, interview, record review, the licensee did not comply with the section cited above in 3 out of 4 forms of resident's Safegaurd for Property Values missing in resident's files, which poses an immediate health, safety or personal rights risk to persons in care.

  • 1569.695(c)Type A

    Based on observation, interview, record review, the licensee did not comply with the section cited above in 1 out of 1 completed fire drill and Fire Drill log missing in faciliyt which poses an immediate health, safety or personal rights risk to persons in care.

  • 87405(d)(6)Type A

    Based on observation, interview, record review, the licensee did not comply with the section cited above in 1 out of 1 Licensee's proof of completed education missing in Licensee's file which poses an immediate health, safety or personal rights risk to persons in care.

  • 87406(a)(1)(B)Type A

    Based on observation, interview, record review, the licensee did not comply with the section cited above in 1 out of 1 certificate of completed medication training missing from Licensee's file which poses an immediate health, safety or personal rights risk to persons in care.

  • 87412(g)Type A

    Maintain personnel records at facility location

    Based on observation, interview, record review, the licensee did not comply with the section cited above in 1 out of 1 LIC-501 or Licensee Application missing in Licensee files which poses an immediate health, safety or personal rights risk to persons in care.

  • 87463(a)Type A

    Update reappraisal at required intervals

    Based on observation, interview, record review, the licensee did not comply with the section cited above in 3 out of 4 residents Appraisal for Needs and services missing in resident's files which poses an immediate health, safety or personal rights risk to persons in care.

  • 87465(h)(1)(A)Type A

    Based on observation, interview, ,record review, the licensee did not comply with the section cited above in 1 out of 1 medication Morphine Sulf 20 mg/1ml give .25ml by mouth or under tongue every hour as needed for pain or shorntess of breath was observed unlocked in refriderator which poses an immediate health, safety or personal rights risk to persons in care.

  • 87469(a)Type A

    Based on observation, interview, record review, the licensee did not comply with the section cited above in 2 out of 4 Consent for Medical Treatment forms missing from resident files, which poses an immediate health, safety or personal rights risk to persons in care.

  • 87506(b)(16)Type A

    Track resident cash safeguard records

    Based on observation, interview, record review, the licensee did not comply with the section cited above in 3 out of 4 residents are missing Safegaurd for Property Values in resident's files, which poses an immediate health, safety or personal rights risk to persons in care.

  • 87555(b)(21)Type A

    Food storage temperature control requirements

    Based on observation, interview, record review, the licensee did not comply with the section cited above in 2 out of 2 thermometers not observed in refrigerator and freezer, thus unable to obtain temperatures in refrigerator and freezer which poses an immediate health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the January 31, 2025 inspection of TEDENEK ELDER HOME 2?

This was an inspection of TEDENEK ELDER HOME 2 on January 31, 2025. 10 citations were issued: 10 Type A (serious).

Were any citations issued to TEDENEK ELDER HOME 2 on January 31, 2025?

Yes, 10 citations were issued (10 Type A, 0 Type B). The first citation was for: "Based on observation, interview, record review, the licensee did not comply with the section cited above in 3 out of 4 f..."

What type of inspection was this?

This was an inspection. Inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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