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Inspection visit

Routine inspection

ADELYA SENIOR HOMELicense 3060047121 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

On February 18, 2026, at 8:20 AM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim was greeted and granted entry by Caregiver (CG) Imelda Martinez. LPA Kim spoke with Licensee (LI) Lawrence Lindsey over the phone and explained the purpose of the visit. LI Lindsey said they could not attend today’s visit and CG Martinez can sign on their behalf for the report. The facility is licensed to operate for six (6) nonambulatory residents and has a hospice waiver for four (4) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: one (1) staff bedroom, four (4) resident bedrooms, two (2) bathrooms, living area, dining area, kitchen, outdoor covered patio, and an attached two car garage. LPA Kim toured inside and outside of the physical plant with CG Martinez. There were no bodies of water or obstructions in the facility. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident's personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, and Resident Room 4. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 105.0 degrees F. A comfortable temperature of 74 degrees F was maintained in the facility. LPA Kim observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food both were available and maintained properly. Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were operable. A working telephone (657-444-9507) remains available. Emergency food, emergency water, and emergency supplies are stored in the garage. The facility has one (1) fire extinguisher that is charged and mounted next to the kitchen. LPA Kim conducted an audit of resident files (R1-R4), staff files (S1-S3), and medication and medication administration record. LPA observed R1 diagnosed with dementia with a Physician’s report signed and dated on February 14, 2025, R3 diagnosed with dementia signed and dated on August 29, 2022. LPA observed S1 and S2 had their CPR and First aid training expired on March 22, 2025. LPA Kim conducted interviews with two (2) staff and one (1) resident. A deficiency was cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. LPA observed S1 and S2 did not have a valid CPR and First aid training at the time of visit. S1's and S2’s CPR and First Aid training expired on March 22, 2025. Technical violation was issued at the time of the visit for R1 and R3 being diagnosed with dementia and not having a current physician’s report. R1’s physician report was dated on February 14, 2025, and R3’s was dated on August 29, 2022. An exit interview was conducted, and a copy of this report, LIC809D, LIC9102, LIC811 and appeal rights were provided to Caregiver Imelda Martinez.

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.

  • 1569.618(c)(3)Type B

    Based on observation, interviews, and record review, the licensee did not comply with the section cited above. LPA observed S1's and S2's CPR/First Aid training expired on March 22, 2025. 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 February 18, 2026 inspection of ADELYA SENIOR HOME?

This was a inspection inspection of ADELYA SENIOR HOME on February 18, 2026. 1 citation were issued: 1 Type B.

Were any citations issued to ADELYA SENIOR HOME on February 18, 2026?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "Based on observation, interviews, and record review, the licensee did not comply with the section cited above. LPA obse..."

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 CCLDView original report

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