Inspection visit

Routine inspectionMay 1, 2023

CELEBRITY CARE HOMELicense 1976069347 citations on this visit

7 citations recorded

Inspector’s narrative

What the inspector wrote

On 5/1/2023, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced annual required visit using the new CARE Inspection Tool. LPA met with licensee/administrator Carmelita Bautista and explained the purpose of today’s visit. The facility is licensed to operate for four (4) non-ambulatory and two (2) bedridden elderly residents ages 60 and above. The facility is approved for (3) hospice residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: three (3) residents' bedrooms, one (1) staff bedroom with ensuite bathroom, (1) common bathroom, living area, dining area, kitchen, and outside covered patio. LPA and licensee toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 113.1 F. A comfortable temperature of 76 degrees was maintained in the facility. LPA observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, and toxins were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The facility has (2) fire extinguishers that was charged, smoke detectors, and carbon monoxide were operable. LPA reviewed Medication Administration Records (MAR) revealed accurate and maintained in order. The facility conducted a Fire/Safety Drill on 4/22/2023. A working telephone (310-830-8366) remains available. Evaluation Report Continues on LIC 809-C Advisory Note - Technical Assistance was issued, please see LIC9102-AN. LPA observed the following deficiencies: Cooking stains on Kitchen cabinets, walls, floor, and appliances; floor and counter tops are not clean; retaining wall is leaning. Undisposed used sharps No medical assessment for R1 No Preplacement appraisal for all five residents Items which pose danger to residents with dementia Incomplete resident records- no personal no SCR, No TB Incomplete personnel records - S1 & S4 Auditory devices inoperable Deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Exit interview conducted. Appeal rights and a copy of this report was provided to Carmelita Bautista.

Citations

7 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.

87303(a)Type B
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. LPA Montoya observed cooking oil stains in the kitchen on cabinets, walls, ceiling and appliances; LPA observed dark spots on the kitchen counter top and floor; dishwasher is not in good repair; and the eastside retaining wall is leaning towards the walkway.This poses a potential health, safety or personal rights risk to persons in care.
87303(f)(2)Type B
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. LPA Montoya observed sharp objects in sharp container. Administrator stated one resident uses syringes/needles. Administrator understands that used sharps are supposed to be disposed once a week but during today's visit, administrator admitted it has been two weeks since facility disposed used sharps. This poses a potential health, safety or personal rights risk to persons in care.
87412(a)Type B
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. Per LPA Montoya's review of personnel records, S1 and S4 have incomplete records. This poses a potential health, safety or personal rights risk to persons in care.
87456(a)(2)Type B
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. LPA did not observe a pre-admission appraisal conducted for all five residents. This poses a potential health, safety or personal rights risk to persons in care.
87458(a)Type B
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. LPA did not observe a documentation of medical assessment for R1 prior to admission. R1 was admitted on 4/19/2023. This poses a potential health, safety or personal rights risk to persons in care.
87705(f)(1)Type A
Based on observation) (interview) (record review), the licensee did not comply with the section cited above. LPA observed a knife and a pair of scissors in a drying dish rack in the kitchen readily accessible to residents with dementia. LPA observed a kitchen drawer for sharp items is open and readily accessible.This poses an immediate health, safety or personal rights risk to persons in care.
87705(j)Type B
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. LPA observed auditory devices on the main door, sliding door by the kitchen and R4's bedroom are inoperable. Administrator stated the devices need new batteries. This poses 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 May 1, 2023 inspection of CELEBRITY CARE HOME?

This was a inspection inspection of CELEBRITY CARE HOME on May 1, 2023. 7 citations were issued: 1 Type A (serious) and 6 Type B.

Were any citations issued to CELEBRITY CARE HOME on May 1, 2023?

Yes, 7 citations were issued (1 Type A, 6 Type B). The first citation was for: "Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. LPA Mont..."

What type of inspection was this?

This was a inspection inspection. inspection inspections are conducted by CCLD as part of their licensing oversight.

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.

Routine inspection·May 1, 2023