Inspection visit

Routine inspectionNovember 14, 2024

MC BOARD & CARELicense 33641308626 citations on this visit

26 citations recorded

Inspector’s narrative

What the inspector wrote

On 11/14/2024 at 10:30 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. At the time of the visit there were two (2) staff present, and five (5) residents present. Licensee/Administrator Maria Aguilar was contacted and informed of the visit. Licensee/Administrator Aguilar arrived during the visit. LPA Brown explained the purpose of the visit to Licensee/Administrator Aguilar. The facility is a six (6) bedroom, two (4) bathroom home with a kitchen/dining area, living room, and an attached garage. The facility is licensed for a capacity of six (6) non-ambulatory residents, one resident (1) can be bedridden. The current census is five (5) residents. LPA Brown was accompanied by Licensee/Administrator Aguilar to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant : The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to interior passageway, however LPA Brown observed obstructions to exterior passageways as evidenced of broken bed, household appliances, and other woods and metals observed. Deficiency will be issued. The facility is maintained at a comfortable temperature of 73 degrees Fahrenheit. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown observed sufficient furniture and lighting throughout the facility. LPA Brown measured and observed the water temperature in the residents/staffs shared bathroom to be at 106 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Postings such as the facility license, personal rights, the CCLD complaint poster, ombudsman poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were not kept inaccessible to residents in care as evidenced of two (2) sharp scissors in the kitchen drawer, not locked and accessible to residents in care. ***Continuation in LIC809C*** ***Amended Copy of LIC809** Also, LPA Brown observed Resident #4 (R4) has two (2) bottles of cleaning solutions in R4 closet, not locked and accessible to R4. Deficiency will be issued. Moreover, LPA Brown observed the facility fence side gate in disrepair. Deficiency will be issued. LPA Brown observed three (3) window screens in disrepair. Technical Violation will be issued. LPA Brown observed no non-skid mat in Resident #2 (R2) bathroom. Deficiency will be issued. In addition, LPA Brown observed no night lights maintained in hallways and passages to non-private bathrooms. Deficiency will be issued. Furthermore, LPA Brown observed that the facility added one (1) room in the living room and per documents review and staff interview, the facility did not obtain a building permit prior to the alteration made at the facility and no letter was submitted to CCLD. Deficiency will be issued. Also, LPA Brown observed first aid kit at the facility but no first aid manual approved by the American Red Cross, the American Medical Association or a state of federal health agency. Deficiency will be issued. There was a designated storage space for resident/staff files. Medications are kept inside the medication cabinet in the kitchen inaccessible to residents, however LPA Brown observed Resident #4 (R4) pre-poured medication at the facility. Deficiency will be issued. In addition, LPA Brown observed Resident #1 (R1) with half bed rail but per documents review and staff interview, R1 does not have a written order from R1 Physician indicating the need for half bed rail for mobility. Deficiency will be issued. Food Service : Seven (7) days non-perishable and two (2) days perishable food supply observed at the facility. Care & Supervision : LPA Brown observed that the facility does not have a staff scheduled to work the night shift, awake and on duty as required for facility with dementia residents. Deficiency will be issued. Record Review : LPA reviewed three (3) resident files for admission agreements, updated physician reports, pre-placement appraisals, needs and services plans and centrally stored medications list. LPA Brown observed that R1, R2 and R3 do not have the required pre-admission appraisal maintained in their facility file. Deficiency will be issued. Moreover, LPA Brown observed that R2 and R3 do not have a completed Preplacement Needs and Services Plan/Care Plan (LIC625) as evidenced of missing resident/responsible party signature in R2 and R3 form LIC625. Deficiency will be issued. To add to that, LPA Brown observed Resident #2 (R2) was admitted at the facility without medical assessment/physician report signed by a physician made within last year. Deficiency will be issued. Also, LPA Brown observed that Resident #2 (R2) Physician Report does not have the required physician's primary diagnosis and secondary diagnosis. Deficiency will be issued. ***Continuation in LIC809C*** Also, LPA Brown observed Resident #1(R1) and Resident #3 (R3) Physician Report (LIC602) were incomplete as evidenced of missing ambulatory status of R1 and R3 in their form LIC602. Deficiency will be issued. LPA Brown observed that Resident #1 (R1) and Resident #2 (R2) do not have record of dosages of their medications that are centrally stored maintained at the facility. Deficiency will be issued. LPA reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with tuberculosis (TB) test results. LPA Brown observed that Staff #2 (S2) and Staff #3 (S3) do not have the required Health Screening Report. Deficiency will be issued. LPA Brown observed that S2 and S3 do not have the required Tuberculosis (TB) Test and TB Test Result. Deficiency will be issued. LPA Brown observed that S2 and S3 did not receive the required training in First Aid from persons qualified by such agencies as the American Red Cross. LPA Brown observed that S2 and S3 did not complete the required six (6) hours of dementia training before S2 and S3 work independently with residents. Deficiency will be issued. LPA Brown observed that S2 and S3 Deficiency will be issued. did not complete the required remaining six (6) hours within the first four (4) weeks of employment. Deficiency will be issued. During medication audit, LPA Brown observed that staff at the facility did not assist Resident #1 (R1) twelve (12) medications, Resident #2 (R2) three (3) medications for one (1) day and Resident #3 (R3) eight (8) medications for three (3) days and three (3) medications for eleven (11) days. Deficiency will be issued. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), LIC809D, LIC9102 and Appeal Rights were discussed and provided to LIcensee/Administrator Maria Aguilar.

Citations

26 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.

1569.625(b)(1)Type A
Based on observation, interview, record review, the licensee did not comply with the section cited above by not ensuring that Staff #2 (S2) and Staff #3 (S3) complete the required six (6) hours of dementia training before S2 and S3 work independently with residents which poses an immediate health, safety or personal rights risks to resident in care.
1569.626(a)(1)Type A
Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that Staff #2 (S2) and Staff #3 (S3) complete the required additional six (6) hours of dementia training that must be completed within the first four weeks of employment which poses an immediate health, safety or personal rights risk to persons in care.
1569.695(a)(2)Type B
Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that the facility has the required emergency supplies, emergency food and emergency water which poses a potential health, safety or personal rights risk to persons in care.
1569.695(c)Type B
Based on observation, interview, record review, the licensee did not comply with the section cited above by not conducting the required emergency drill at the facility at least quarterly which poses a potential health, safety or personal rights risk to persons in care.
1569.695(d)Type B
Based on observation, interview and record review, the licensee did not comply with the section cited above by not reviewing the plan annually and not signing the Emergency Disaster Plan as required with signature date which poses a potential health, safety or personal rights risk to persons in care.
87303(a)Type B
Based on observation, interview and record review), the licensee did not comply with the section cited above by not ensuring that the facility side fence gate is in good repair which poses a potential health, safety or personal rights risk to persons in care.
87303(e)(5)Type B
Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that there's a non-skid mat in Resident #2 (R2) bathroom which poses a potential health, safety or personal rights risk to persons in care.
87305(a)Type B
Based on observation, interview, record review, the licensee did not comply with the section cited above by not obtaining the required building permit for the alteration made at the facility as evidenced of one (1) bedroom added in the living room which poses a potential health, safety or personal rights risk to persons in care.
87307(d)(5)Type B
Based on observation, interview, record review, the licensee did not comply with the section cited above by not ensuring that night lights are mainatined in hallways and passages to nonprivate bathrooms which poses a potential health, safety or personal rights risk to persons in care.
87307(d)(6)Type B
Based on observation, interview, record review, the licensee did not comply with the section cited above by not ensuring that there's no obstructions to exterior passageways as evidenced of broken bed, household appliances, and other woods and metals observed which poses a potential health, safety or personal rights risk to persons in care.
87309(a)Type A
Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that the two (2) bottles of cleaning solutions in Resident #4 (R4) closet, are locked and were not accessible to R4cwhich poses an immediate health, safety or personal rights risk to persons in care.
87411(c)(1)Type A
Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensurimng that Staff #2 (S2) and Staff #3 (S3) receive the required First Aid Training from persons qualified by such agencies as the American Red Cross which poses an immediate health, safety or personal rights risk to persons in care.
87412(a)(11)Type A
Based on observation, interview, and record review, the licensee did not comply with the section cited above by not ensuring that Staff #2 (S2) and Staff #3 (S3) complete the required Health Screening Report which poses an immediate health, safety or personal rights risk to persons in care.
87412(a)(12)Type A
Based on observation, interview and record review), the licensee did not comply with the section cited above by not ensuring that Staff #2 (S2) and Staff #3 (S3) complete the required Tuberculosis (TB) test and have the required TB Test result maintained in their facility file which poses an immediate health, safety or personal rights risk to persons in care.
87456(a)(2)Type B
Based on observation, interview and record review, the licensee did not comply with the section cited above by not performing the required Pre-Admission Appraisal for Resident #1 (R1), Resident #2 (R2) and Resident #3 (R3) which poses a potential health, safety or personal rights risk to persons in care.
87457(c)Type B
Based on observation, interview, record review, the licensee did not comply with the section cited above by not ensuring that Resident #2 (r2) and Resident #3 (R3) have the required Preplacement Needs and Services Plan which poses a potential health, safety or personal rights risk to persons in care.
87458(a)Type A
Based on observation, interview and record review, the licensee did not comply with the section cited above by not obtaining Resident #2 (R2) medical assessment or physician report prior to R2 admission at the facility and must have physician signature made within last year which poses an immediate health, safety or personal rights risk to persons in care.
87458(b)(1)Type B
Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that Resident #1 (R1) has the complete Physician Report with the required primary diagnosis and secondary diagnosis which poses a potential health, safety or personal rights risk to persons in care.
87458(b)(5)Type B
Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that Resident #1 (R1) and Resident #3 (R3) have a complete Physician Report with the required ambulatory status which poses a potential health, safety or personal rights risk to persons in care.
87465(a)(6)Type A
Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that Resident #1 (R1), Resident #2 (R2) have the required Centrally Stored Medication List maintained in their facility file which poses an immediate health, safety or personal rights risk to persons in care.
87465(a)(8)(A)Type A
Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that the facility has the current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency which poses an immediate health, safety or personal rights risk to persons in care.
87465(h)(5)Type A
Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that medications shall not be gtransferred between containers as evidenced of pre-poured meications observed at the facility for Resident #4 (R4) which poses an immediate health, safety or personal rights risk to persons in care.
87608(a)(5)(A)Type B
Based on observation, interview and record review, the licensee did not comply with the section cited above aloowing Resident #1 (R1) to have a half bed rail and not ensuring that R1 has a written order from R1 Physician indicating the need for half bed rail for mobility which poses a potential health, safety or personal rights risk to persons in care.
87633(a)(2)Type A
Based on observation, interview, and record review, the licensee did not comply with the section cited above by exceeding the approved waiver issued by CCLD as evidenced of three (3) residents observed on hospice care during the visit which poses an immediate health, safety or personal rights risk to persons in care.
87705(c)(4)(A)Type A
Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that there's a staff scheduled to work the night shift, awake and on duty as required for facility with dementia residents which poses an immediate health, safety or personal rights risk to persons in care.
87705(f)(1)Type A
Based on observation, interview, record review, the licensee did not comply with the section cited above by not ensuring that the two (2) sharp scissors observed in the kitchen cabinet were locked and not accessible to residents in care which poses an immediate health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the November 14, 2024 inspection of MC BOARD & CARE?

This was a inspection inspection of MC BOARD & CARE on November 14, 2024. 26 citations were issued: 13 Type A (serious) and 13 Type B.

Were any citations issued to MC BOARD & CARE on November 14, 2024?

Yes, 26 citations were issued (13 Type A, 13 Type B). The first citation was for: "Based on observation, interview, record review, the licensee did not comply with the section cited above by not ensuring..."

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 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·November 14, 2024