Inspection visit

Routine inspection (multi-day)September 8, 2023

ST MATTHEWS HOME FOR THE ELDERLY IILicense 1986028769 citations on this visit

9 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) V. Maldonado made a subsequent visit to the facility for the purpose of completing the required annual inspection, using the Care Compliance and Regulatory Enforcement (CARE) Tool to evaluate the facility. LPA met with caregiver, Nenita Capistrano and explained the purpose for the visit. During today's visit, LPA Maldonado observed the following: At 10:14AM, (4) staff files were reviewed for required documentation. It was discovered that Staff# 1-2 (S1-S2) files did not have health screenings and proof of completed required annual training. It was also discovered that files for Staff# 3-5 (S3-S5) were not available for LPA to inspect. Per S1, files for S3-S5 are with S3 and S3 is currently on vacation. At 10:20AM, S1 confirmed with LPA that S4-S5 are currently employed at the facility and their work schedule is 7AM-7PM, Saturday and Sunday, but may sometimes alternate depending on the need for staff. After review of the Facility Personnel Report Summary, it was noted that S4-S5 are not associated to the facility. LPA Maldonado was also unable to determine who the administrator for the facility is, as per licensing records, Rebecca Sinclair is listed as the Administrator, but staff Michelle Aguirre has informed LPA during the annual inspection in 2022 that she is the Administrator. The licensing agency has not been provided records to request a change in administrator, and there is no proof of a current and valid administrator certificate at the facility or file for an administrator available for LPA to inspect. Six (6) resident medications and Centrally Stored Medication and Destruction Records were inspected and reviewed. It was determined that medications are documented properly and administered as prescribed. (Report Continued on LIC809-C...) LPA attempted to conduct interviews with (6) residents, however was unable to due to cognitive impairments, unresponsive to LPA, and/or sleeping. (2) staff interviews were conducted with available staff. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies were observed during today's visit and will be cited on the LIC809-D pages. Additionally, Immediate Civil Penalties will be issued in the amount of $1,500 were issued today, for repeat violations within a 12-month period and for staff who are not associated and working at the facility. An exit interview was conducted with caregiver Nenita Capistrano and a copy of the report and appeal rights were provided.

Citations

9 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.

1569.605Type B
Based on observation and record review, the licensee did not comply with the section cited above in providing licensing with a copy of their current and valid liability insurance information, which poses a potential health, safety or personal rights risk to persons in care.
1569.618(a)Type A
Based on observation and record review, the licensee did not comply with the section cited above in having the administrator being present at the facility during normal working hours, which poses an immediate health, safety or personal rights risk to persons in care.
87208(a)(7)(A)Type B
Based on observation, interview, and record review, the licensee did not comply with the section cited above in submitting a change of facility sketch for the room proposed for staff use, which poses a potential health, safety or personal rights risk to persons in care.
87355(e)(2)Type A
Based on observation, interview, and record review, the licensee did not comply with the section cited above in 2 staff not being associated to the facility, which poses an immediate health, safety or personal rights risk to persons in care.
87412(a)Type B
Based on observation, interview, and record review, the licensee did not comply with the section cited above in 3 of 5 staff files were not maintained on the administrator and 2 staff, which poses/posed a potential health, safety or personal rights risk to persons in care.
87412(a)(11)Type B
Based on observation and record review, the licensee did not comply with the section cited above in 2 avilable staff files did not have health screenings, which poses a potential health, safety or personal rights risk to persons in care.
87412(a)(13)(B)1Type A
Based on observation, interview, and record review, the licensee did not comply with the section cited above in maintaining proof of a current and valid adminstrator certificate available at the facility, which poses an immediate health, safety or personal rights risk to persons in care.
87412(c)Type B
Based on observation and record review, the licensee did not comply with the section cited above in 2 available staff files reviewed did not have proof of required staff training and orientation, which poses a potential health, safety or personal rights risk to persons in care.
87412(f)Type B
Based on observation, interview, and record review, the licensee did not comply with the section cited above in making available staff records for 3 of 5 staff, 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 September 8, 2023 inspection of ST MATTHEWS HOME FOR THE ELDERLY II?

This was a other inspection of ST MATTHEWS HOME FOR THE ELDERLY II on September 8, 2023. 9 citations were issued: 3 Type A (serious) and 6 Type B.

Were any citations issued to ST MATTHEWS HOME FOR THE ELDERLY II on September 8, 2023?

Yes, 9 citations were issued (3 Type A, 6 Type B). The first citation was for: "Based on observation and record review, the licensee did not comply with the section cited above in providing licensing ..."

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 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 (multi-day)·September 8, 2023