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Inspection visit

Follow-up on corrections

GOLDEN LEAF MANORLicense 1976063061 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Elena Mallett and LPA Cynthia Chan conducted an unannounced Case Management visit and met with Staff Adrianne Gray. Per Staff Gray, Licensee Percy Olidan is in the Phillipines on a personal matter. The purpose of today's visit was discussed. During the 12/11/25 Annual Continuation visit LPA did not include observations in a deficiency statement for a citation issued. The deficiency will be cited today detailing LPA's observations in the deficiency statement. LPA Mallett observed centrally stored medication for all 3 residents. However, the pills had been prepared in advance and stored in a container other than the original container.See 809-D During the visit today 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 staff office. All staff rooms were locked as well. Deficiencies per California Code of Regulations Title 22 was cited today. An exit interview was conducted and copy of this Licensing Report along with Appeal Rights were provided to Staff Adrianne Gray.

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. 1 citation were issued: 1 Type A (serious).

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

Yes, 1 citation was issued (1 Type A, 0 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.