Inspection visit

Routine inspectionJanuary 17, 2025

CARE CHARLIZELicense 30600630617 citations on this visit

17 citations recorded

Inspector’s narrative

What the inspector wrote

On this day Licensing Program Analysts (LPAs) Andrea Mendevil and Fred Arias made an unannounced visit to conduct a required annual visit. LPAs were greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for 4 non-ambulatory residents, 2 ambulatory residents which one can be bedridden. Facility has an approved hospice waiver for 4 residents and the home currently has 6 residents. Administrator (AD) Adriel Pao arrived shortly to help conduct facility inspection. AD Pao has a valid certificate that expires on July 19,2026. The facility is currently remodeling the kitchen and it is not available for use. LPAs along with staff Joy toured the facility at 8:25 AM. LPA toured the physical plant, checked food service, facility documentation and the first aid kit. The home consists of 6 resident bedrooms, living room, dining room, and kitchen as well as 2 restrooms and 1 staff room. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 116.4 degrees F and 117.5 degrees F in all restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. LPA observed sharps unlocked in a cabinet in the living room during today's visit. Perishable and non-perishable food supply was checked and not adequately stocked at time of visit. Smoke detectors tested operational during today's visit. Fire extinguishers were fully charged. LPAs reviewed the infection control and emergency disaster plans and plans are complete and thorough. Facility has never conducted quarterly emergency drills. Outside grounds were toured. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. First aid kit did not contain all required items and missing tweezers. Facility conducts activities in the form of exercise and movies. There is no shaded outdoor seating for residents. One out of two exit gates is blocked by construction debris. CONTINUED ON LIC 809C DATED 1/17/2025. LPA observed the emergency food and water supply. There was no emergency water supply during the visit. LPAs reviewed six resident files and three staff files. The staff has not completed the required annual training for 2024 or 2025. Physician's reports were missing for 2 out of 6 residents. There are no reappraisals for 2 out of 2 dementia residents. Bed rail orders were missing for 3 out of 4 residents. The facility temperature measured 66 degrees F during today's visit. LPAs reviewed medication storage and administration. Medications are stored in a locked closet and in the kitchen refrigerator. Based on the observations made during today’s visit, 17 deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided.

Citations

17 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.

1569.695(a)(2)Type A
Based on LPA observation and staff interview, there is no emergency water supply which poses an immediate health, safety or personal rights risk to persons in care.
87456(a)(3)Type A
Obtain and evaluate recent medical assessment
Based on record review, there was not physician's report available for R2 which poses an immediate health risk to persons in care.
87463(a)Type A
Update reappraisal at required intervals
Based on record review, no pre appraisal has been completed for R2 which poses an immediate health risk to persons in care.
87463(b)Type A
Document required significant condition changes
Based on records review, no reappraisals have been conducted for R4 and R6 diagnosed with dementia since 2020 which poses an immediate health risk to persons in care.
87465(a)(8)(E)Type B
Based on LPA observation, tweezers are missing from the first aid kit which poses a potential health, safety or personal rights risk to persons in care.
87608(a)(3)Type A
Maintain physician order documentation in resident record
Based on record review, R2,R5, and R6 do not have a valid rail order from their physician in their records which poses an immediate safety risk to persons in care.
1569.695(c)Type A
Based on record review, the facility has never completed an emergency drill which poses an immediate safety risk to persons in care.
87219(h)(2)Type B
Based on LPA observation, there is no shaded outdoor space for residents to rest which poses a potential health, safety or personal rights risk to persons in care.
87303(a)Type A
Maintain facility in clean, safe, sanitary condition
Based on LPA observation, one out of two exit gates is blocked by constrution debris which poses an immediate safety risk to persons in care.
87303(b)(1)Type A
Heat occupied rooms to minimum temperature
Based on LPA observation, the temperature in the facility measured 66 degrees F based on the information showed in the facility thermostat which poses an immediate health rights risk to persons in care.
87309(a)Type A
Ensure hazardous items are locked and not unattended
Based on LPA observation, sharps were found in an unlocked cabinet in the living room which poses an immediate health, safety or personal rights risk to persons in care.
87465(d)(3)Type A
Record dose details and resident medication response
Based on LPA observation and staff interview, PRN usage for R4 is being provided but not being tracked which poses an immediate health risk to persons in care.
87465(h)(2)Type A
Store centrally held medications in locked secure place
Based LPA observation medications were store in the refrigerator next to the kitchen without any locks which poses an immediate safety risk to persons in care.
87506(b)(11)Type A
Based on records review, no physician's report was available to review for R5 which poses an immediate health risk to persons in care.
87555(b)(22)Type A
Based on LPA observation, kitchen utensils and cookingware are being washed outside with a garden hose onto a table which poses an immediate health risk to persons in care.
87555(b)(26)Type A
Onsite food stock levels for nonperishables and perishables
Based on LPAs observation, there is not enough perishable food for a minimum of two days which poses an immediate health risk to persons in care.
87211(g)Type A
Based on AD interview, the AD has been working for the licensee since August of 2024 and the Department was never notified which poses an immediate safety risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the January 17, 2025 inspection of CARE CHARLIZE?

This was an inspection of CARE CHARLIZE on January 17, 2025. 17 citations were issued: 15 Type A (serious) and 2 Type B.

Were any citations issued to CARE CHARLIZE on January 17, 2025?

Yes, 17 citations were issued (15 Type A, 2 Type B). The first citation was for: "Based on LPA observation and staff interview, there is no emergency water supply which poses an immediate health, safety..."

What type of inspection was this?

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

SourceView on CCLD View original report

Next steps

If this is your facility,claim this pageand correct anything the record gets wrong. Free.

Researching this visit professionally?Book a 15-minute calland we will walk through what we have on file.

Data from CCLD public records. Last updated July 20, 2026. If you believe any information is inaccurate, report it here.

Routine inspection·January 17, 2025