Inspection visit

Routine inspection (multi-day)January 24, 2025

FAMILY SENIOR CARE HOME ILicense 4352028765 citations on this visit

5 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced case management for annual continuation from 1/23/2025. LPA Rai met with Administrator, Elizabeth Bautista and stated the purpose of today's visit. The hot water temperature in the bathroom sink ranged from 105.1 - 105.3 degrees F. Fire extinguisher was observed and inspected on 1/24/2025. Facility smoke detectors and carbon monoxide detectors were in working condition. The last disaster drills were conducted on 1/7/2025 and 1/9/2025. LPA Rai reviewed facility records for 2 staff and 2 residents. LPA Rai observed resident R2 with a full bed rail. ADM stated R2 was not receiving Hospice care at this time. LPA Rai reviewed R2's facility file and R2 did not have a written physician's order for full bed rail or half bed rail. ADM stated she will work with R2's physician to obtain a written physician's order for half bed rail and remove the full bed rail from R2's bed. LPA Rai observed R3, R4, and R5 with half bed rails who are not receiving Hospice care at this time. LPA Rai reviewed R3, R4 & R5's facility file and they did not have a written order from physician for using a half-bed rail for mobility use. ADM stated she will work with the resident's physician's to obtain a written physician's order for half-bed rails. LPA Rai reviewed R5's facility file and reviewed a medical assessment conducted on 6/13/2023 and ADM stated R5 was not recently seen by physician. ADM will work with R5's responsible party and physician for R5 to receive an annual routine visit with physician. Continuation on LIC 809-D, Page 1 of 2. Page 2 of 2. LPA Rai reviewed R5's Appraisal/Needs and Services Plan was not signed by R5's responsible party. ADM stated to work with R5's responsible party and a signed copy of the document will be added to R5's file. LPA Rai observed 2 bottles of OTC medications in R2's room and 1 bottle of prescription medication in R4's room. LPA Rai reviewed Physician's Report for R2 and R4 and both residents cannot store medications on their own and require medications to be centrally stored at the facility. ADM removed the items during the visit and placed medications in the medication cabinet. LPA Rai reviewed resident medications and central stored medication records. Deficiencies were cited per California Code of Regulations, Title 22. See LIC 809-D. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report was reviewed with Administrator Elizabeth Bautista and a copy of the report was provided. Appeal Rights were provided.

Citations

5 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.

87463(f)Type B
87463 Reappraisals (f) The licensee shall ...communicate with the resident and,... the resident's representative, about any significant change in condition and the recommendation... Documentation of such communication shall be added to the resident’s record. This requirement is met as evidenced by:Based on record review of R5's Appraisal/Needs and Services Plan was not signed by R5's responsible party which poses/posed a potential health, safety or personal rights risk to persons in care.
87463(h)Type B
Annual routine visit with medical professional
87463 Reappraisals (h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment.This requirement is not met as evidenced by: Based on record review, R5's file contained a medical assessment completed on 6/13/2023 and there was no other documentation of R5 receiving an annual routine visit with R5's physician which poses/posed a potential health, safety or personal rights risk to persons in care.
87465(h)(2)Type B
Store centrally held medications in locked secure place
87465 Incidental Medical and Dental Care (h) (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.This requirement is not met as evidenced by: Based on observation and record review, 3 medication bottles were not kept in a safe and locked place which is not accessible to persons other than employees which poses/posed a potential health, safety or personal rights risk to persons in care.
87608(a)(3)Type B
Maintain physician order documentation in resident record
87608 Postural Supports (a)(3)A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record....This requirement is not met as evidenced by: Based on observation and record review, 3 out of 5 residents used a half bed rail and did not have a written order from a physician on file which poses/posed a potential health, safety or personal rights risk to persons in care.
87608(a)(5)(B)Type B
87608 Postural Supports (a)(5)(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care...This requirement is not met as evidenced by: Based on record review and observation, R2 has a bed rail that extended the entire length of the bed and R2 is not receiving hospice care at this time 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 January 24, 2025 inspection of FAMILY SENIOR CARE HOME I?

This was an other inspection of FAMILY SENIOR CARE HOME I on January 24, 2025. 5 citations were issued: 5 Type B.

Were any citations issued to FAMILY SENIOR CARE HOME I on January 24, 2025?

Yes, 5 citations were issued (0 Type A, 5 Type B). The first citation was for: "87463 Reappraisals (f) The licensee shall ...communicate with the resident and,... the resident's representative, about ..."

What type of inspection was this?

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

SourceView on CCLD View original report

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Data from CCLD public records. Last updated June 8, 2026. If you believe any information is inaccurate, report it here.

Routine inspection (multi-day)·January 24, 2025