Follow-up·January 27, 2025

At approximately 12:45PM, Licensing Program Analysts (LPAs) Felias and Madaleno, arrived unannounced to conduct a Case Management - Other Visit and met with Administrator, Mary Jane Miranda. The purpose of today's visit is to follow up on a Type A deficiency and address staffing concerns that were identified during the facility's annual visit on 01/17/2025. During visit conducted on 01/17/2025, the Department cited the facility for not having current first aid/CPR certifications for 3 of 4 staff members. Licensee was to submit proof of scheduled training date to CCL (Community Care Licensing) by 01/18/2025. Administrator provided email proof to LPAs that CPR certificates were sent on 01/18/2025 to the Regional Office. Deficiency cleared during visit. LPAs also identified staffing concerns. During visit on 01/17/2025, Facility's personnel report indicated that there are 4 staff members employed at facility - the Licensee, the Administrator, 1 caregiver, and 1 on-call caregiver. During today's visit, LPAs were provided with an updated personnel report which indicated that 6 staff members were employed at the facility - the Licensee, the Administrator, 2 caregivers, and 2 on-call caregivers. LPAs reviewed resident files. Review of files indicated that 2 of 3 residents are on hospice. 2 of 3 residents also have a dementia diagnosis. Files showed that none of the residents require a two-person assist, but all 3 residents require at least one person for assistance with their activities of daily living. Interview with Administrator stated that they are the only full-time caregiver at this time, as the Licensee only comes to the facility once in a while and the other 4 caregivers are considered to be on-call. Administrator stated that they are the only full-time caregiver, and fulfill their Administrator duties later in the afternoon when it is less busy. LPAs discussed the importance of the Administrator being able to perform their Administrator duties as required separate from caregiver duties (deficiencies cited, LIC809D, regulation 87411(a) and 87405(a)). Per discussion with Administrator, their husband, Dave Miranda, will be taking over as Administrator of the facility, and they will become a full-time caregiver. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC809D (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.