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Inspection visit

Routine inspection

FIVE STAR RCFE 1 INCLicense 3427013871 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

On 03/19/2026 Licensing Program Analyst (LPA) Shakaricka Hughes arrived at the facility to conduct an unannounced annual inspection. LPA Hughes met with the facility administrators Jayson and Amy Caridad. The current census is 5 with 3 facility staff. This facility is a single story building licensed to serve (6) ambulatory and non-ambulatory residents. LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility to be free of odor, clean and in good repair. LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. Hot water temperature was measured at 113.2 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Grab bars and non-slip mat were observed to be stable and in good repair at this time. Smoke and carbon monoxide detectors are in compliance with fire safety.  The fire extinguisher is located in the entry way and was last serviced on 08/03/2025. LPA observed the facility has a public telephone in the kitchen area and the facility has the required posters posted. Facility thermostat was observed at 76 degrees Fahrenheit. LPA observed toxins and sharp knives located in the kitchen cabinet kept locked and inaccessible to residents. Continuation 809-C LPA checked medication storage and found medication to be locked away and inaccessible to residents. LPA reviewed 2 out of 5 residents medications and the medication administration record (MAR) was complete. The first aid kit was checked and contained the required components. LPA requested resident and staff files for review. LPA reviewed 5 out of 5 resident files and they were complete. LPA reviewed 3 staff files, and the files were observed incomplete as (3) facility staff CPR certification records were not made available during the visit. LPA reviewed staff criminal record clearances, and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared. The following documents will be email to LPA by 3/27/2026 (1) LIC 308 Designation of Administrative Responsibility (2) Copy of Administrator Certificate (3) LIC 610 Current Emergency Disaster Plan (4) Proof of Current Liability Insurance (5) LIC 500 Current Personnel Report As a result of this annual visit, the facility is not in compliance with Title 22 Regulations, and the deficiency can be found on the LIC 809-D page. An exit interview was conducted with the administrators and a copy of these LIC 809 reports, LIC 809-D page, and Appeals rights were provided to the facility.

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 records review, the licensee did not comply with the section cited above in 3 out of 3 counts which poses a potential health and safety risk to persons in care. During staff records review, LPA did not observe documentation of current CPR training for 3 facility staff.

FAQ · About this visit

Common questions about this visit

What happened during the March 19, 2026 inspection of FIVE STAR RCFE 1 INC?

This was a inspection inspection of FIVE STAR RCFE 1 INC on March 19, 2026. 1 citation were issued: 1 Type B.

Were any citations issued to FIVE STAR RCFE 1 INC on March 19, 2026?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "Based on records review, the licensee did not comply with the section cited above in 3 out of 3 counts which poses a pot..."

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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