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Inspection visit

Routine inspection

BURLINGAME SENIOR HOME 2License 4156006489 citations on this visit
9 citations recorded

Inspector’s narrative

What the inspector wrote

On February 13, 2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with Caregiver, Ligaya Munoz, and caregiver, Isabelita Nojadera. Administrator, Fereshteh Ehsanipour was not available to join the inspection. LPA explained the purpose of the visit. LPA toured the facility and grounds with caregiver. No accessible bodies of water or fire safety hazards observed. This is a single story facility with 6 resident bedrooms, 1 staff bedroom, 1 full bathroom and 5 half bathrooms.. LPA observed all 6 resident rooms; 1 with a full bathroom and 5 with half baths. Resident's rooms were observed to be private rooms. Bedrooms were equipped with the required furniture for resident to use, Bathrooms were equipped with grab bars, and non-skid mats. Hot water temperature was measured at 106- 110 degrees F. LPA toured the kitchen and observed 2 day perishable and 7 day non-perishable present. A comfortable temperature is maintained, lighting is sufficient for comfort. Centrally stored medications, toxins, and sharps were observed to be unlocked and accessible to residents. LPA reviewed centrally stored medication and observed 2 medications for resident #1 (R1) to be expired. LPA requests the following forms to be submitted to CCLD by 2/15/2024 LIC308 Designation of Administrative Responsibility LIC309 Administrative Organization Liability Insurance Administrator Certificate LPA was not able to complete the inspection today and will return on another day as the resident and staff records were locked and not accessible for review. According to the staff, they do not have access to the files and the administrator is the only one who has the keys to the files. 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 civil penalties. This report is reviewed and discussed with caregiver. A copy of this report and the appeal rights were provided.

Citations

9 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.

  • 80065(i)(2)Type A

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as S1 who was hired in March 2023 is not associated with the facility which poses an immediate health, safety or personal rights risk to persons in care.

  • 87113Type B

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA did not observed it was posted during tour which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87309(a)Type A

    Ensure hazardous items are locked and not unattended

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as chemicals stored underneath the kitchen sink were unlocked which poses an immediate health, safety or personal rights risk to persons in care.

  • 87465(h)(2)Type A

    Store centrally held medications in locked secure place

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as centrally stored medication observed to be not locked and accessible to residents in care which poses an immediate health, safety or personal rights risk to persons in care.

  • 87468.1(a)(2)Type A

    Safe, healthful, comfortable accommodations

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA observed 2 of resident #1's medications were expired which poses an immediate health, safety or personal rights risk to persons in care.

  • 87468(c)(2)Type B

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA did not observed it was posted during the tour and according to the administrator, it fell and was not reposted which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87468(c)(2)(A)Type B

    RCFE complaint poster posting requirements

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA did not observed it was posted during the tour and according to the administrator, it fell and was not re-posted which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87468(d)Type B

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as LPA did not observed it was posted during the tour and according to the administrator, it fell and was not reposted which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87755(c)Type A

    Authority to audit and copy facility records

    Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as resident and staff records/files were locked and inaccessible for LPA to review 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 February 13, 2024 inspection of BURLINGAME SENIOR HOME 2?

This was an inspection of BURLINGAME SENIOR HOME 2 on February 13, 2024. 9 citations were issued: 5 Type A (serious) and 4 Type B.

Were any citations issued to BURLINGAME SENIOR HOME 2 on February 13, 2024?

Yes, 9 citations were issued (5 Type A, 4 Type B). The first citation was for: "Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as S1 who..."

What type of inspection was this?

This was an 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.