Senior Care Records.

Facility Evaluation Report

Amethyst Care Home of Fullerton, Fullerton12/04/2024Licence 306005594

Capacity6
Census6
Date signed12/04/2024 04:06:06 PM
The inspector’s account

This unannounced POC inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of verifying correction of deficiencies issued during the Required – 1 Year Inspection conducted on October 28, 2024. LPA met with Staff #1 (S1) Flordeliza Villena and discussed the purpose of the inspection. Administrator (AD) Charesa Reyes appeared via telephone.

During the inspection, LPA and S1 toured the facility and observed the following:

Type A Violation cited under Health & Safety Code Section 1569.605 pertaining to liability insurance has not been cleared. During today’s inspection, AD was not able to provide proof of liability of insurance. Civil penalties for repeat violations are being assessed.

Type B Violation cited under California Code of Regulations (CCR) Title 22, Section 87205(b) pertaining to the licensee corporation being suspended has not been cleared. During today’s inspection, LPA reviewed California Secretary of State documents showing that the licensee corporation is still suspended and AD has not submitted any proof that the Revivor process has been initiated. Civil penalties for failure to correct are being assessed.

Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Civil penalties for repeat violations and failure to correct are being assessed. See LIC421FC. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction