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Inspection visit

Routine inspection

TLC HOME CARE VLicense 41560117510 citations on this visit
10 citations recorded

Inspector’s narrative

What the inspector wrote

LPA Audrey Jeung toured facility and grounds, including detached storage building. There are 6 private bedrooms--all with private half or full bathrooms and all with direct exits to outside--staff room, shower room, living room, dining room, and kitchen. There are 3 beds in staff room. Clothes washer and dryer are located in one car garage. The backyard is level, fenced and mostly paved. Medications and toxins are secured in locked cabinets in kitchen and hallway, respectively. There are no accessible bodies of water or fire safety hazards observed. Carbon monoxide detector is tested and operable. Hot water temperature is tested at 106 degrees in client bathroom #3. Medications and sharps are stored appropriately and inaccessible to clients, a comfortable room temperature is maintained, and lighting is sufficient for safety. First-aid kit is maintained and complete. Perishable and non-perishable fruits, vegetables and protein are maintained, as well as supplies of bed and bath linens and hygiene products. A Disaster and Mass Casualty Plan is posted. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as staff records. Client files are reviewed. Centrally Stored Medications Records may be reviewed at a later date, due to time constraints. Joebelle Paymuo is a certified RCFE administrator (x 4/26) that oversees facility operations. The following licensing forms are requested to be completed and submitted to CCLD BY 4/11/25: - Personnel Report (LIC500) - Proof of current liability insurance Emergency Disaster Plan (revised 9 page LIC610-E signed and dated on page 9) is given to LPA today. Deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed and cited on following pages. Also, see Technical Advisory Notes--3 pages.

Citations

10 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.

  • 1569.69(a)(2)Type B

    Based on staff record review, the licensee did not comply with the section cited above, as there is no evidence that staff received medications training. This poses 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, the licensee did not comply with the section cited above, as spray bottle of Mold and Mildew cleaner stored in common bath/shower room, accessible to clients. This poses an immediate health, safety or personal rights risk to persons in care.

  • 87457(c)Type B

    Complete admission suitability appraisal

    Based on record review of clients, the licensee did not comply with the section cited above in 3 out of 6 client files reviewed, which poses a potential health, safety or personal rights risk to persons in care.- Appraisals are incomplete or not maintained for clients #3, #5, #6.

  • 87468.1(a)(1)Type A

    Dignity in personal relationships

    Based on observation, the licensee did not comply with the section cited above in 1 out of 6 client rooms, which poses an immediate health, safety or personal rights risk to persons in care.There is a video "nanny cam" in room #2 so staff can monitor client. Device also allows for audio monitoring.

  • 87468(b)(1)(A)Type B

    Signed rights acknowledgement in resident record

    Based on clients' record review, the licensee did not comply with the section cited above in 4 out of 6 client records reviewed, which poses a potential health, safety or personal rights risk to persons in care.Personal Rights froms are missing or incomplete for clients #1, #3, #4, #5.

  • 87608(a)(3)Type B

    Maintain physician order documentation in resident record

    Based on clients' record review, the licensee did not comply with the section cited above, as there are no MD orders for half bed rails for client #2 and #3. This poses a potential health, safety or personal rights risk to persons in care.

  • 87411(f)Type B

    Health screening and fitness requirements

    Based on staff record review, the licensee did not comply with the section cited above in 3 out of 5 staff files reviewed, which poses a potential health, safety or personal rights risk to persons in care.- Health screenings and/or TB test results are not maintained for staff #2, #3, #4.

  • 1569.625(b)Type B

    Based on absence of staff training records, the licensee did not comply with the section cited above, as there is no documentation that 3 out of 4 staff have received required 40 hours of initial training, which poses a potential health, safety or personal rights risk to persons in care.

  • 1569.625(b)(2)Type B

    Based on staff record review, the licensee did not comply with the section cited above, as there is no evidence that Staff #5 has received at least 20 hours of annual training. This poses a potential health, safety or personal rights risk to persons in care.

  • 87633(b)(1-7)Type B

    Based on clients record review, the licensee did not comply with the section cited above, as there is no hospice care plan for client #5, which poses 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 March 28, 2025 inspection of TLC HOME CARE V?

This was an inspection of TLC HOME CARE V on March 28, 2025. 10 citations were issued: 2 Type A (serious) and 8 Type B.

Were any citations issued to TLC HOME CARE V on March 28, 2025?

Yes, 10 citations were issued (2 Type A, 8 Type B). The first citation was for: "Based on staff record review, the licensee did not comply with the section cited above, as there is no evidence that sta..."

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.