Sweet Dreams Care Home Llc

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.This requirement is not met as evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above in that the facility does not obtain fire clearance document and allows staff to occupied the new bedroom and staff admitted they live in the bedroom since January and March 2026 which poses/posed a potential safety or personal rights risk.

Based on interview and record review, the licensee did not comply with the section cited above in that the facility is unable to provide the evidence of valid liability insurance which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in 1 out 3 clients, R1's centrally stored medication form is inaccurate and did not match with the medications which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on interview and record review, the licensee did not comply with the section cited above in that the facility has no emergency drill or fire alarm drill logs which poses/posed a potential health, safety or personal rights risk to persons in care.

87207 False Claims. No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility.This requirement is not met as evidenced by: Licensee and Administrator provided false or misleading statement regarding the facility and the service, The licensee and administrator stated that administrator will stay at the facility at 20 hours during business hours, but administrator is unable to be at the facility from 8:00AM - 5:00PM on Monday - Friday, this poses an potential health, safety or personal rights risk to persons in care..

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: On 09/11/25, During inspection, R1 to R3's prescribed medications were observed accessible/unlocked. Staff S1 and S2 had forgotten to locked it in the centrally stored cabinet after residents' administration. this poses an potential health, safety or personal rights risk to persons in care.

87463 Reappraisals. (e)The licensee shall immediately, or as soon as reasonably possible, bring any significant change in condition, as defined in Section 87101, Definitions, to the attention of the appropriate licensed medical professional and if applicable, other specialized care provider. Documentation of such communication shall be added to the resident's record and shall include:This requirement is not met as evidenced by: Administrator did not observed the resident R1's change in condition and did not update R1's care plan, this poses an potential health, safety or personal rights risk to persons in care.

87405 Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7)...(1) Knowledge of the requirements for providing care and supervision appropriate to the residents.This requirement is not met as evidenced by: Based on overall deficiencies cited, ADM made false statement, ADM did not assess resident's care needs, medication accessibility and not spending 20 hours in the facility. This poses an potential health, safety or personal rights risk to persons in care.

87411 - Personnel Requirements - (a) Facilitypersonnel shall at all times be sufficient innumbers, and competent to provide theservices necessary to meet resident needs.This requirement was not met as evidenced by: Based on interview with witnesses, staff S1 is unable to comprehend English, and inability to communicate in English wherein they had to use body language/gestures to communicate.

Based on observation, the licensee did not comply with the section cited above.LPA observed two sheds in the backyard were not locked and contained tools and other toxic materials such as; WD-40 and a paint can. While, touring , LPA observed next to the side of the home next to the garage/office, a gallon of windshield washer fluid accessible and a shovel. This poses an immediate health, safety or personal rights risk to persons in care.

87457 Pre-admission Appraisal - General (c)Prior to admission... resident's suitability for admission shall be completed... an appraisal of his/her individual service needs ...This requirement was not met as evidenced by; Based on interview and record review, ADM stated the facility did not document the pre-admission apprisal for resident R1. This poses a potential health, safety or personal rights risk to persons in care.

87202 Fire Clearance (a) All facilities shall maintain a fire clearance approved ... Prior to accepting or retaining any of the following types of persons,... obtain an appropriate fire clearance approved ... the State Fire Marshal. This requirement was not met as evidenced by Based on interviews and records reviewed, resident R1 is a bedridden resident who resides in bedroom #6. Based on a review of the facility's fire cleareance, bedroom #6 is not cleared for the use of a bedriddent resident. This poses a potential health, safety or personal rights risk to persons in care.

87205(a) Accountability of Licensee Governing Body (a) The licensee, whether an individual or entity ...shall excercise general supervision over the affairs of the licensed facility ... policies..in confrmance with these regulations and welfare of the individuals it serves: This requirement is not met as evidenced by: Based on interview, the LIC did not notify CCL of their prolong absence leaving the facility without proper general supervision to conform with regulations and welfare of the individualls in the facilty whic pose/poses a potential health, safety and personal rights

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Based on observation the LIC did not comply with the above by not maintaining the facility clean, sanitary and in good repair. LPAs observed piled up household items no longer in use,broken window glass, non-operating appliances, vehicle, and medical equipments and pile of woods.

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs... This requirement is not met as evidenced by: Based on interview and record review the LIC did not comply by not having sufficient personnel who are competent to provide necessary services. LPAs interviewed ADM/S1 and stated that he/she cover other staff breaks, and is the overnight staff. Based on review and assessment of LIC 500,

87507 Admission Agreements (d) The licensee shall retain in the resident's file the original signed and dated admission agreement and all subsequent signed and dated modifications.This requirement was not met as evidenced by; Based on record review, the facility did not have a copy of R3's admission agreement. LPA's asked ADM if she had the R3's admission agreement, and ADM stated she did not have a copy and cannot find it. This poses a potential heath, safety and personal rights risk to persons in care.

Based on interviews with 2 staff, staff confirmed that R1/R2 is in the office (converted garage). Staff stated the Licensee L1 did not have a key to open the office door while LPA was in the facility. This poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, a bathroom at the end of the hallway on the left hand side, adjecent to the laundry room, did not have a non-skid mat in the bathtub. This poses/posed a potential health, safety or personal rights risk to persons in care.

Based on interview with 2 staff members, the facility did not comply with their licensed capacity. The facility was over capacity by two residents. The facility providing misleading statements regarding the capacity.

Based on interviews with 2 staff, the facility currently has 8 residents. The facility is currently licensed for 6 residents. The facility is operating beyond the conditions and limitations specified on the license. This poses/posed a potential health, safety or personal rights risk to persons in care.

Based on interview with 2 staff, ADM and S1 admitted the facility is using the converted garage(office) as a bedroom for residents R1 & R2. This poses an immediate health, safety or personal rights risk to persons in care.

Based on interviews with facility staff, ADM and staff S1onfirmed the facility had residents R1 and R2 sleeping in the converted garage (office.) Staff also admitted that the facility was over capacity and had 8 residents, when the facility's capacity is 6 residents.