Victor Jem Happy Homes

Based on observation and record review the licensee did not comply with the section cited above in [2] out of [5] physician records did not have tuberculosis records, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in storing chemicals and detergetns in unlocked cabinets and lanudry room, which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in , where small insects were observed in the kitchen and dining room, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in using the garage space as intended. Garage is currently being used as an unpermitted Accessory Dwelling Unit (ADU) which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above in using the garage space as intended. which poses/posed a potential health, safety or personal rights risk to persons in care.

Incidental Medical and Dental Care:c) If the resident's physician has stated in writing... 2) Once ordered by the physician the medication is given according to the physician's directions.This requirement is not met as evidenced by: Based on record reviews and interviews, licensee did not comply with the section above failing to administer R1 eyedrops as prescribed. This poses an immediate health and safety risk to residents in care.

Residents shall be encouraged to maintain and develop their quality of life... The activities made available shall include: (1) Socialization to promote or enhance personal relationships. Activities may include, but are not limited, to:This requirement is not met as evidenced by: Based on LPAs observation, the licensee did not comply with the section cited above by not providing planned activities. During the visit conducted on 01/29/25, LPAs observed five out of five residents watching TV from 10:00am-4:30pm. This poses a potential health, safety risk and personal rights violation to residents in care.

The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.This requirement is not met as evidenced by: Based on inspection, and observation the Licensee did not ensure that the facility is safe and sanitary for wellbeing of residents and others. LPA observed cockroaches in the living room, dining room and kitchen areas. This poses a potential health, safety risk and personal rights violation to residents in care.

Incidental medical and dental Care: (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place...This requirement is not met as evidenced by: Based on observation and interview the licensee did not comply with the section cited above by not assuring medications for R5 and the Administrator are kept locked and inaccessible to residents which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review the licensee did not comply with the section cited above. There were no records for residents annual routine visit for 5 residents which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review the licensee did not comply with the section cited above. No medical assesment were observed which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review the licensee did not comply with the section cited above. No medical assesment were observed which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above. Bedrails in Room 1 were still in place without a physician order which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review the licensee did not comply with the section cited above. LPAs didn't observe any appraisals for 5 residents which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above. Medications were found on the kitchen floor and in the refrigerator without being in a locked container, which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above. Medication were stored in the fridge without being in a locked container which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review the licensee did not comply with the section cited above. No training records in file which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review the licensee did not comply with the section cited above. LPAs didn't observe any documentation regading emergency drills which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review the licensee did not comply with the section cited above. CPR training were observed for all three staff which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on obervations and record review the licensee did not comply with the section cited above. No activity calendar in place which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review the licensee did not comply with the section cited above. S3 is not associated with the facility which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review the licensee did not comply with the section cited above. Staff folders weren't available which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review the licensee did not comply with the section cited above. There were no records for residents annual routine visit for 5 residents which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review the licensee did not comply with the section cited above. Admission Agreements were incomplete which poses/posed a potential health, safety or personal rights risk to persons in care.

Resident Records. The licensee shall ensure that... current record is maintained... readily available.... This requirement is not met as evidenced by: Based on record review the licensee did not comply with the section cited above by not maintaining complete facility files for 5 out of 5 residents which poses a potential health, safety or personal rights risk to persons in care.

Personal Accommodations and Services: Living accommodations and grounds shall be related to the facility's function... This requirement is not met as evidenced by: Based on interview, the licensee did not comply with the section cited above by allowing staff to sleep in residents’ rooms, which poses a potential personal rights risk to persons in care.

Bed rails that extend the entire length of the bed are prohibited except for... hospice care and have a hospice care... This requirement is not met as evidenced by: Based on LPAs observation and record review, the licensee did not comply with the section cited above by not requesting an exception for a non hospice resident R3 to have a full bed rail. Moreover, no written Doctors' order was observed on file for R2's full bed rail and R1's and R5's 1/2 bed rails, which poses an immediate health and safety risk to persons in care.

80061(b) Reporting Requirements. Upon the occurrence…a report shall be made to the licensing agency..., a written report ...within seven days following the occurrence of such event.This requirement was not met as evidence by Based on file document review, the Licensee did not comply with the section cited above. Lincesee didn't submit a death report for R1 since they passed away on or around October or November 2023. This poses a potential health and safety risk to clients in care

This requirement is not met as evidenced by: Criminal Record Clearance. Prior to working, residing or volunteering in a licensed facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. This requirement was not met by evidence of: Based on records review Staff 1 and Staff 2 are not cleared.Civil penalties are being assessed in the amount of $500.00 for each staff.

Criminal Record Clearance. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 87355(c) This requirement was not met by evidence of: Based on records review S1 and S2 are NOT associated to this facility.Licensee shall ensure all staff are cleared and associated to the facility prior to beginning employment.

Termination of admission agreement upon death of resident; ...and refunds (c) A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual …responsible for the fees within 15 days after the personal property is removed. This requirement is not met as evidenced by; Based on the interviews and record review. The Licensee has not issue a refund of the prorated portion of the rent paid in advance. This poses potential risk to the personal rights of the residents in care.

Residents in all residential care facilities for the elderly shall have all of the following personal rights: (9) To have communications to the licensee from their representatives answered promptly and appropriately This requirement is not met as evidenced by;. Based on interviews, the Administrator did not respond to authorized representative.

87507 Admission Agreements; (g) Admission agreements shall specify the following: (5) Refund conditions. (A) Facility policy concerning refunds, including the conditions under which a refund for advanced monthly fees will be returned in the event of a resident’s death…This requirement is not met as evidenced by Based on interviews and record review the Licensee failed to assure that the admission agreement includes condition of refund upon death of the resident. R1’s admission agreement does not indicates the procedure of the refund of payments upon death of the resident. This poses potential risk to the personal rights of the residents in care.

Based on observation, the licensee did not comply with the section cited above as the smoke and carbon monoxide detectors in the hallway and rear exit are missing, which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above as the smoke detectors are not operational which poses an immediate health, safety or personal rights risk to persons in care.

Criminal Record Clearance(f)Violation of Section 87355(e)... an immediate asse- ssment of civil penalties of one hundred dollars($100) per violation per day... (1) Subsequent violations within a 12 month period will result in a civil penalty of $100 per violation per day for a maximum of 30 days. Based on interview and review of Guardian Background System Check facility staff S1 and S2 are not criminal background clearenced and association to this facility. No documentation has been submitted to Community Care Lisensing. This poses a potential risk to residents in care.

Incidental Medical and Dental Care(h)The following requirements shall apply to medications which are centrally stored(C) Because...dangers related to the medication itself(2)...medicines shall be kept in a safe and locked place that is not accessible to persons other than employees… Based on inspection LPA discovered that medication cabinet lock is broken, and medications are accessible to the residents.This poses a potential risk to resident in care.

All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working... in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c)... This requirement is not met as evidence by: Based on interview and review of licensing report summary staff #1 and #2 are not associated to the facility. No documentation to associate staffs has not been submitted. This poses a potential risk to residents in care.

Based on observation and record review the licensee did not comply with the section cited abovewhich poses/posed a potential health, safety or personal rights risk to persons in care.LPA did not observe a file for Administrator.

Based on observation the licensee did not comply with the section cited above. LPA observed the backyard had discarded furniture (shovels, gardening tools, pieces of wood, chairs) and other hazards.