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Inspection visit

Follow-up on corrections

GOLDEN LEAF MANORLicense 1976063063 citations on this visit
3 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analysts (LPAs) Cynthia Chan and Elena Mallett conducted a case management visit for a health and safety check. LPAs arrived unannounced and met with staff, Adrianne Gray. The purpose of the visit was explained. Per staff, licensee Percy Olidan is in the Philippines on a personal matter. The licensee did not inform LPA of the absence and the designation of facility responsibility. Licensee's administrator's certificate has not been renewed, and there is no coverage by a designated substitute who shall have qualifications adequate to manage the facility. LPA conducted a walk through of the facility. Food supplies appear sufficient for the census. LPA could not review residents’ file due to files being in a locked office to which staff did not have a key to access the room. The other 2 staff rooms were locked and could not gain access to check on smoke detectors. Deficiencies are being cited today. An exit interview was held. A copy of this report and appeal rights were given to staff A. Gray and emailed to the licensee.

Citations

4 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.

  • 87405(a)Type B

    87405 Administrator - Qualifications and Duties (a) All facilities shall have qualified and currently certified administrator. When the administrator is not in the facility, there shall be coverage by a designated substitute...This requirement is not met as evidenced by: Based on interview and record review, there is no qualified administrator for this facility and there is no designated substitute in place while the administrator is not in the facility which poses a potential health and safety risk to residents in care.

  • 87506(d)Type B

    87506 Resident Records (d) All resident records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying.This requirement is not met as evidenced by: Based on observation, the staff office was locked and staff did not have the key to access files which poses a potential health and safety risk to residents in care.

  • 87755(a)Type B

    87755 Inspection Authority of the Licensing Agency (a) Any duly authorized officer, employee or agent of the licensing agency ...enter and inspect the entire premise of any place providing services at any time...This requirement is not met as evidenced by: Based on observation, LPA did not have access to the staff office and 2 staff rooms, which poses a potential health and safety risk to residents in care.

  • 87465(h)Type A

    CCR 87465(h)The following requirements shall apply to medications which are centrally stored:(5)Each resident's medication shall be stored in its origally recieved container.No medications shall be transferred between containers. This above requirement was not met as evidenced by Based on observation,3 out of 3 residents, Residents #1-#3, medication was pre prepared and stored in pillboxes to be dispensed outside of their original container.

FAQ · About this visit

Common questions about this visit

What happened during the December 19, 2025 inspection of GOLDEN LEAF MANOR?

This was a other inspection of GOLDEN LEAF MANOR on December 19, 2025. 3 citations were issued: 3 Type B.

Were any citations issued to GOLDEN LEAF MANOR on December 19, 2025?

Yes, 3 citations were issued (0 Type A, 3 Type B). The first citation was for: "87405 Administrator - Qualifications and Duties (a) All facilities shall have qualified and currently certified administ..."

What type of inspection was this?

This was a other inspection. other 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.