Routine inspection·July 22, 2021

On 7-22-21 Licensing Program Analysts (LPA)s Tirzah Hubbard and Avelina Martinez conducted an unannounced Annual visit. LPAs met with Administrator and Licensee Aurora Gatchalian to discuss the purpose of the visit. LPAs observed the facility in renovation. Administrator stated, "The facility has been in renovation for 2.5 weeks. The residents were transferred to Blessed Home for Seniors IV. A total of 3 residents were transferred. The families were not notified. Employees were transferred over to Blessed Care Home for Seniors IV. LPAs observed CCL has not been notified of the changes in renovation, staff transfer, and resident transfer. LPA Hubbard observed an email sent to LPA Yang 2/9/20. The email to LPA Yang contained questions about steps in renovating and transfer of residents and staff. LPA Yang requested a 60 day notice to residents family and CCL before renovation on 2/3/2020. LPA observed Administrator Aurora did not submit 60 day notice to CCL or Residents family. LPA Hubbard observed an email sent July 10,2020 from Administrator Aurora asking about renovation. The email did not contain renovation dates and transfer information for staff and residents. The email did not contain the requested 60 day notice to families or CCL.LPAs observed staff and residents were transferred over to Blessed Home for Seniors IV July 5, 2021. Census: 3 Continued... On 7-22-21 Administrator Aurora stated, Renovation start date: July 5, 2021 Renovation end date: July 22.2021 Residents and staff will be back into the facility on July 26, 2021. LPAs observed no finger print clearance for S1. LPAs observed no documentation of proof showing the residents family were notified within 60 days of renovation and return. LPA's requested Mitigation plan to be submitted to the department within 48 hours. Upon a file review the following items were discussed to be submitted with any changes annually: Licensing fees Criminal Record Clearances LIC536 Administrative Organization LIC309 Designation of Administrative Responsibility LIC308 Personnel Report LIC500 Qualifications of Administrator/Facility Manager- Administrator certificate Emergency Disaster Plan LIC610D Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, the following deficiencies are being cited on the attached 809D during this visit. Civil penalties shall be assessed when the licensee fails to correct the violation to Health and Safety Code Section 1569.605 following any appropriate extensions to the plan of correction due date. The Licensee was provided a copy of their rights (LIC9058) and their signature on this form acknowledges receipt of these rights. Exit interview held and a copy of report was given.