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Inspection visit

Routine inspection (multi-day)

SHALOM HOUSELicense 2168005031 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

At approximately 1:15 PM Licensing Program Analyst (LPA) Magdaleno arrived unannounced to conduct a Case Management - Annual Continuation for a required 1-year annual inspection started on 10/28/2025 and met with Licensee Maria Del Pilar De Olave. Facility is a Residential Care Facility for the Elderly (RCFE) with three (3) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for two (2), with one (1) Hospice resident currently in care, and is approved for four (4) non-ambulatory residents. At approximately 1:40 PM LPA conducted a review of three (3) resident records. All required documentation present. At approximately 2:00 PM LPA conducted review of three (3) staff records. All required documentation present. At approximately 2:30 PM LPA and Administrator conducted a spot check of medication and medication records. Medication is centrally stored and locked. Facility does not have a currently certified Administrator ( deficiency cited ). Licensee was provided with resources on renewing their Administrator certificate or hiring a new Administrator. LPA gathered updated copies of the following documents during this visit: Liability Insurance, LIC500 - Personnel Report, LIC308 - Designation of Responsibility, LIC610E - Emergency Disaster Plan Deficiencies are cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, or repeat violations within a 12-month period, may result in a civil penalty assessment. Appeal rights were provided. See LIC809D. Exit interview conducted with Licensee, whose signature on form confirms receipt.

Citations

1 citation 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

    Certified administrator requirements and substitute coverage

    87405 Administrator - Qualifications and Duties: (a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person...This requirement is not met as evidenced by: Licensee did not comply with the section cited above. Licensee did not ensure that they have an active Administrator Certificate which posed/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 February 26, 2026 inspection of SHALOM HOUSE?

This was an other inspection of SHALOM HOUSE on February 26, 2026. 1 citation were issued: 1 Type B.

Were any citations issued to SHALOM HOUSE on February 26, 2026?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "87405 Administrator - Qualifications and Duties: (a) All facilities shall have a qualified and currently certified admin..."

What type of inspection was this?

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

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.