Facility Evaluation Report

Licensing Program Analyst (LPA) Evelin Rios conducted a Plan of Correction (POC) Visit. LPA Rios met with Licensee Josephine Miranda. Entrance interview was conducted. Purpose of the visit was explained.

LPA conducted a physical plant tour of the facility. LPA reviewed POCs that have not been completed. LPA provided Licensee a Non-Compliance Conference letter requesting the Licensee and Administrator to attend a meeting in the Woodland Hills South Regional Office (RO)

The following deficiency were not corrected:

Health and Safety Code 1569.605 : Licensee did not maintain liability insurance. POC has not been cleared as of POC due date 08/29/2025.

87615(a)(1) Prohibited Health Conditions : Licensee retained R1 who is not receiving hospice services and has a Stage 4 pressure injury . Licensee agreed to submit an exception letter to CCLD to retain resident with a prohibited health conditio n. Licensee failed to p ro vide exception letter by POC due date 08/12/25.

87202(a)(2) Fire Clearance: Facility has fire clearance for one (01) bedridden resident in room #3, and based on physician's reports the facility currently has two (02) bedridden residents. POC has not been cleared as of due date 08/11/2025.

The facility removed bed rails that extend the entire length of the bed for R1 and replaced them with half bed rails. Although a bed rail that extends from the head half the length of the bed and used only for assistance with mobility is allowed the facility has not obtained a written order from a physician indicating the need for the postural support.

Exit interview conducted. Deficiency cited (refer to LIC809-D). Civil Penalty Assessed for failure to correct (refer to LIC421FC). Appeals rights provided. Copy of report provided.