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Inspection visit

Routine inspection

FIVE STAR CARE HOMELicense 4152016256 citations on this visit
6 citations recorded

Inspector’s narrative

What the inspector wrote

On July 18, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual inspection. LPA met with Caregiver, Rolly Bautista and explained the purpose of the visit. LPA toured the facility inside and outside including all of resident rooms, common areas & kitchen. The indoor and outdoor passageway was free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a single story facility. There are six resident bedrooms and one staff bedroom. All resident rooms were observed to be clean and odor-free with half bathrooms. LPA observed two full bathrooms equipped with grab bars, non-skid mats, and in good repair. Water temperature throughout the facility measured between 107-110 degrees F. Extra linen was observed to be present. First aid kit was observed to be complete. Dining room was observed free from tripping hazards. A comfortable temperature is maintained and lighting is sufficient for comfort. LPA observed seven day non-perishables but not two day perishables. Medications, sharps, and chemicals were observed unlocked an accessible to residents in care. Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of March 2025. Emergency drills are being conducted every three month. LPA reviewed 5 resident records and 5 staff records. Medication review was done and all medications are accounted for. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in additional civil penalties. This report is reviewed and discussed with the Administrator. A copy of this report and the appeal rights were provided.

Citations

6 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.

  • 87309(a)Type A

    Ensure hazardous items are locked and not unattended

    Based on observations, LPA observed the medications, sharps and chemicals unlocked and accessible to residents in care which poses an immediate health, safety or personal rights risk to persons in care.

  • 87506(a)Type B

    Maintain separate complete record for each resident

    Based on 5/5 resident records reviewed, the service plans were not completed and were not signed by residents/resident's responsible party which poses/posed a potential health, safety or personal rights risk to persons in care.

  • Separate storage for cleaning chemicals

    Based on observations, LPA observed chemicals in a cabinet with food in the garage which poses an immediate health, safety or personal rights risk to persons in care.

  • Onsite food stock levels for nonperishables and perishables

    Based on observations, facility does not have a two day supply of perishables which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87458(a)Type A

    Obtain baseline medical assessment before resident admission

    Based on residents file reviewed, LPA observed one resident (R1) to not have a physician's report in the file which poses an immediate health, safety or personal rights risk to persons in care.

  • Maintain admission agreement and appraisal

    Based on 5/5 resident record reviewed,, 5/5 resident files reviewed did not have signed pre-admissions appraisal which poses/posed a potential health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the July 18, 2025 inspection of FIVE STAR CARE HOME?

This was an inspection of FIVE STAR CARE HOME on July 18, 2025. 6 citations were issued: 3 Type A (serious) and 3 Type B.

Were any citations issued to FIVE STAR CARE HOME on July 18, 2025?

Yes, 6 citations were issued (3 Type A, 3 Type B). The first citation was for: "Based on observations, LPA observed the medications, sharps and chemicals unlocked and accessible to residents in care w..."

What type of inspection was this?

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

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