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Inspection visit

Follow-up on corrections

ALEXO MANOR INCLicense 1976099192 citations on this visit
2 citations recorded

Inspector’s narrative

What the inspector wrote

In conjunction with control number 31-AS-20250428084431 complaint visit, Licensing Program Analyst (LPA) Evelin Rios did an unannounced CASE MANAGEMENT - Deficiencies visit. A case management report is being issued today in conjunction to the complaint visit report for observed deficiencies not related to complaint. LPA met with Rocela Molina - Lead Caregiver. Interview with staff revealed there was a staff #1 (S1) who provided care to residents in the facility. Review of S1's record and Guardian Background Check revealed S1 is not fingerprinted cleared. Review of five (05) out of (05) resident records revealed resident #4 (R4) had after visit paperwork from emergency room visits. According to the Lead Caregiver, R4 had medical emergencies that required the facility to contact 911 on separate occasions. Review of Community Care Licensing Division (CCLD) records revealed the facility had not submitted Unusual Incident/Injury Report to CCLD. Review of R1's record revealed the facility submitted Unusual Incident/Injury Reports from 02/05/2025 to 04/07/2025 to Long Term Care Ombudsman about R1's ongoing interactions involving certain facility staff. Review of Community Care Licensing Division (CCLD) records revealed the facility had not submitted Unusual/Injury Incident Reports to CCLD. Deficiencies observed and cited (Refer to LIC 809-D). Exit Interview Conducted / Appeal Rights Discussed / A Copy of Report Issued.

Citations

3 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.

  • 87211(a)(1)Type B

    (a) Each licensee shall furnish to the licensing agency... the following:(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence...This requirement is not met as evidenced by: Based on interviews and record review the licensee did not comply with the section cited above, in incidents involving R4 and R1 not reported to CCLD within seven days of occurrence which poses a potential health, safety or personal rights risk to persons in care.

  • 87355(d)(3)Type A

    (d) All individuals subject to a criminal record review shall be fingerprinted...(3) The licensee shall submit these fingerprints to the California Department of Justice... prior to the individual's employment, residence, or initial presence in the facility. This requirement is not met as evidenced by: Based on interviews and record review the licensee did not comply with the section cited above, in one staff identified was not fingerprint cleared for the facility. This poses an immediate health, safety or personal rights risk to persons in care.

  • 87507(a)Type B

    87507 Admission Agreements(a) The licensee shall complete an individual written admission agreement, as defined in Section 87101(a), with each resident or the resident's representative, if any. This requirement is not met as evidenced by: Based on interviews, and record review Licensee failed to complete a written admission agreement with R1 for this facility with admission 10/01/2024 which 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 6, 2025 inspection of ALEXO MANOR INC?

This was a other inspection of ALEXO MANOR INC on May 6, 2025. 2 citations were issued: 1 Type A (serious) and 1 Type B.

Were any citations issued to ALEXO MANOR INC on May 6, 2025?

Yes, 2 citations were issued (1 Type A, 1 Type B). The first citation was for: "(a) Each licensee shall furnish to the licensing agency... the following:(1) A written report shall be submitted to the ..."

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.