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Inspection visit

Routine inspection

ELDERLY INN IV, THELicense 3427004161 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on November 4, 2025 to conduct a Required-1 Year Inspection utilizing the inspection tool. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are five (5) bedrooms and four (4) bathrooms for resident use. LPA observed bedrooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition and properly maintained. Hot water temperature was observed to be 106 degrees F. LPA checked the kitchen area for the ability to prepare and store food. Care home has required two (2) day perishable and seven (7) day non-perishable food supply on cite. LPA observed the backyard and perimeter of the care home to be free of clutter and debris. LPA observed smoke detectors and carbon monoxide detectors to be operational in the care home. First aid kit is maintained and ready for emergency use. LPA reviewed three (3) residents' medications. LPA reviewed six (6) resident files and two (2) staff files. Facility has a current copy of certificate of liability insurance and LPA requested a copy. As a result of this visit, a deficiency was cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Deficiency is listed on 809-D pages. Exit interview was conducted. A copy of this report and appeal rights were provided. Signatures on these forms acknowledges receipt of these documents.

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.

  • 87465(h)(2)Type A

    Based on LPA's observations, the facility did not ensure that all centrally stored medications were stored in a safe and locked place that is 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 4, 2025 inspection of ELDERLY INN IV, THE?

This was a inspection inspection of ELDERLY INN IV, THE on November 4, 2025. 1 citation were issued: 1 Type A (serious).

Were any citations issued to ELDERLY INN IV, THE on November 4, 2025?

Yes, 1 citation was issued (1 Type A, 0 Type B). The first citation was for: "Based on LPA's observations, the facility did not ensure that all centrally stored medications were stored in a safe and..."

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