Inspection Reports for Kalynna Home

CA, 94531

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Inspection Report Annual Inspection Census: 5 Capacity: 6 Deficiencies: 0 Sep 10, 2025
Visit Reason
The visit was an unannounced annual required inspection conducted by the Licensing Program Analyst to evaluate compliance with licensing requirements.
Findings
The facility was found to be in compliance with no deficiencies cited. The inspection included a tour of the facility, review of staff and resident files, and verification of emergency and infection control plans.
Report Facts
Staff files reviewed: 2 Resident files reviewed: 5 Fire extinguishers purchase date: Aug 27, 2025 Hot water temperature: 110 Facility temperature: 75 PPE supply duration: 30 Perishable food supply duration: 2 Non-perishable food supply duration: 7
Employees Mentioned
NameTitleContext
Raufat IkharoAdministratorMet with Licensing Program Analyst during inspection and identified as infection control leader
Daisy PanlilioLicensing Program AnalystConducted the inspection visit
Bennett FongLicensing Program ManagerNamed in report as Licensing Program Manager
Inspection Report Complaint Investigation Census: 5 Capacity: 6 Deficiencies: 1 Mar 7, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that staff did not ensure a resident's wound care needs were met, resulting in hospitalization.
Findings
The investigation substantiated that staff failed to provide adequate wound care and supervision to a resident, resulting in the resident being hospitalized twice due to worsening pressure injuries. An immediate civil penalty of $500 was assessed. Another allegation regarding improper food service was found to be unsubstantiated.
Complaint Details
The complaint alleged that staff did not ensure the resident's wound care needs were met, resulting in hospitalization. The allegation was substantiated based on interviews, record reviews, and observations. The resident developed stage 3 and later stage 4 pressure injuries due to inadequate repositioning and care. The allegation regarding improper food service was unsubstantiated.
Severity Breakdown
Type A: 1
Deficiencies (1)
DescriptionSeverity
To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs.Type A
Report Facts
Immediate civil penalty: 500 Facility capacity: 6 Resident census: 5
Employees Mentioned
NameTitleContext
Daisy PanlilioLicensing Program AnalystConducted the complaint investigation and authored the report.
Bennett FongLicensing Program ManagerOversaw the complaint investigation.
Raufat IkharoAdministratorFacility administrator interviewed during investigation and named in findings.
Inspection Report Complaint Investigation Census: 5 Capacity: 6 Deficiencies: 0 Feb 13, 2025
Visit Reason
The inspection was an unannounced Health and Safety check conducted due to the department receiving a priority 2 complaint.
Findings
During the health and safety check, the Licensing Program Analyst observed 2 staff members and 5 residents, toured the facility, and found no imminent health or safety concerns. No deficiencies were cited during the inspection.
Complaint Details
The visit was triggered by a priority 2 complaint. No deficiencies were cited, indicating no substantiated violations.
Report Facts
Staff members observed: 2 Residents observed: 5
Employees Mentioned
NameTitleContext
Daisy PanlilioLicensing Program AnalystConducted the unannounced Health and Safety check
Raufat IkharoAdministratorFacility administrator met during the inspection
Inspection Report Annual Inspection Census: 5 Capacity: 6 Deficiencies: 5 Aug 30, 2024
Visit Reason
The inspection was an unannounced annual required inspection conducted to evaluate compliance with licensing regulations at Kalynna Home.
Findings
The inspection identified several deficiencies including a broken front gate, unlocked bleach in the bathroom, one staff member not fingerprint cleared and associated with the facility resulting in an immediate civil penalty of $500, and personnel records not being available or maintained at the facility.
Severity Breakdown
Type A: 1 Type B: 3
Deficiencies (5)
DescriptionSeverity
Broken front gate
Unlocked bleach in bathroom
One staff not fingerprint cleared & associated to facility (Immediate civil penalty of $500 assessed during visit)Type A
Personnel records not available for inspection at facility during visitType B
Personnel records not maintained at facilityType B
Report Facts
Civil penalty amount: 500 Census: 5 Total capacity: 6
Employees Mentioned
NameTitleContext
Raufat IkharoAdministratorMet during inspection and named as infection control leader
Daisy PanlilioLicensing Program AnalystConducted the inspection
Bennett FongLicensing Program ManagerSupervisor overseeing the inspection
Inspection Report Annual Inspection Census: 6 Capacity: 6 Deficiencies: 2 Sep 1, 2023
Visit Reason
The inspection was an unannounced annual required inspection conducted to evaluate compliance with licensing regulations and facility safety standards.
Findings
The inspection found the facility generally compliant with infection control and safety measures, but two deficiencies were noted: an expired fire extinguisher without a current inspection tag and a broken freezer/refrigerator in the kitchen.
Deficiencies (2)
Description
Expired Fire Extinguisher (no inspection tag; purchased 10/08/21)
Broken freezer / refrigerator in kitchen
Report Facts
Capacity: 6 Census: 6 POC Due Date: Sep 15, 2023
Employees Mentioned
NameTitleContext
Raufat IkharoAdministratorMet with Licensing Program Analyst during inspection and agreed to plans of correction
Daisy PanlilioLicensing Program AnalystConducted the inspection and authored the report
Bennett FongLicensing Program ManagerSupervisor overseeing the inspection
Inspection Report Routine Census: 3 Capacity: 6 Deficiencies: 0 Sep 14, 2022
Visit Reason
The visit was an unannounced infection control inspection conducted as a required one-year routine check.
Findings
The inspection found no deficiencies. The facility had appropriate infection control measures, sufficient food and medication supplies, and an emergency plan including infection control. Updated documents were requested for submission.
Report Facts
Food supply duration: 2 Food supply duration: 7 Medication supply duration: 30
Employees Mentioned
NameTitleContext
Raufat IkharoAdministratorFacility administrator present during inspection
Irene LondonAdministratorMet with Licensing Program Analyst during inspection
Kristine EmanuelStaffMet with Licensing Program Analyst during inspection
Daisy PanlilioLicensing Program AnalystConducted the infection control inspection
Bennett FongLicensing Program ManagerNamed in report header
Inspection Report Annual Inspection Census: 3 Capacity: 6 Deficiencies: 0 Oct 5, 2021
Visit Reason
The inspection was an infection control annual inspection conducted to evaluate COVID-19 mitigation practices and overall facility compliance.
Findings
No deficiencies were cited during this visit. The facility had a COVID-19 mitigation plan in place, adequate PPE supplies, proper emergency/disaster plans, and maintained safe environmental conditions including fire safety and infection control measures.
Report Facts
Capacity: 6 Census: 3 Emergency food supplies: 7 Emergency food supplies: 2 Facility room temperature: 74

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