Deficiencies (last 4 years)
Deficiencies (over 4 years)
1.5 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
63% better than California average
California average: 4 deficiencies/yearDeficiencies per year
8
6
4
2
0
Census
Latest occupancy rate
50% occupied
Based on a August 2025 inspection.
This facility has shown a decline in demand based on occupancy rates.
Census over time
Inspection Report
Annual Inspection
Census: 3
Capacity: 6
Deficiencies: 5
Date: Aug 22, 2025
Visit Reason
The inspection was an unannounced Required - 1 Year Visit to evaluate compliance with licensing requirements at Kimberly's Elder Kare Kottage.
Findings
The inspection found the facility generally clean and safe with functioning smoke and carbon monoxide detectors, adequate food supplies, and proper bathroom conditions. However, deficiencies were noted including a sliding glass door that did not properly close or lock and a hole in one resident bedroom wall, posing safety risks. Additionally, some staff records were incomplete and one resident medication record had an incorrect prescription number.
Deficiencies (5)
Sliding glass door did not completely close and lock, requiring two staff to operate.
A hole about 3 inches in diameter was observed in one resident bedroom wall.
Resident R1 had the wrong prescription number for one medication.
Staff S1 was missing a Health Screening Form.
Staff S2 was missing a current first aid certification.
Report Facts
Census: 3
Total Capacity: 6
Plan of Correction Due Date: 1
Resident Records Reviewed: 3
Staff Records Reviewed: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Marrufo | Licensing Program Analyst | Conducted the inspection and cited deficiencies |
| Elizabeth Gonzalez | Staff member met during inspection and report review | |
| Kendall Hall | Administrator/Director | Facility administrator/director named in report header |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 0
Date: Jan 18, 2025
Visit Reason
The visit was an unannounced follow-up complaint investigation regarding an allegation that staff interfered with the Long Term Care Ombudsman's facility visit in May 2023.
Complaint Details
The complaint alleged that staff interfered with the Long Term Care Ombudsman's visit in May 2023. The Ombudsman confirmed they were asked to leave during that visit but subsequent visits found no issues. Staff reported intervening to protect residents' privacy when photos were taken without permission. The allegation was unsubstantiated due to lack of sufficient evidence.
Findings
The investigation included interviews and record reviews and found no preponderance of evidence to prove the alleged violation occurred. The allegation was determined to be unsubstantiated and no deficiencies were cited.
Report Facts
Facility capacity: 6
Resident census: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Arvin Villanueva | Licensing Program Analyst | Conducted the complaint investigation visit |
| Kendall Hall | Administrator | Facility administrator present during the visit and involved in the investigation |
| Annabelle Esperanza | Facility staff present during the visit and involved in the investigation | |
| Stephen Richardson | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Date: Aug 7, 2024
Visit Reason
The visit was an unannounced required 1-year annual inspection of Kimberly's Elder Kare Kottage facility conducted by Licensing Program Analysts.
Findings
The inspection found the facility to be in compliance with all applicable regulations, with no deficiencies cited. The facility was clean, safe, and well-maintained, with proper documentation and emergency plans in place.
Report Facts
Capacity: 6
Census: 4
Food supply duration: 2
Food supply duration: 7
Hot water temperature: 106
Facility temperature: 76
Fire extinguisher last serviced: Dec 1, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Annabelle Esperanza | Administrator | Met with Licensing Program Analysts during inspection |
Inspection Report
Complaint Investigation
Census: 4
Capacity: 6
Deficiencies: 1
Date: Jul 26, 2024
Visit Reason
An unannounced complaint visit was conducted to deliver findings related to complaint control #26-AS-20220831120143 regarding failure to report an incident where a resident was sent to the emergency room due to a UTI.
Complaint Details
Complaint control #26-AS-20220831120143 was investigated and substantiated with findings of failure to report a resident's emergency room visit due to UTI.
Findings
The Licensing Program Analyst found that the facility did not report an incident to Licensing involving a resident sent to the emergency room due to a UTI, constituting a deficiency of California Code of Regulations, Title 22, LIC809-D.
Deficiencies (1)
Failure to report an incident to Licensing which poses an immediate health, safety or personal rights risk to persons in care.
Report Facts
Capacity: 6
Census: 4
Deficiencies cited: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Grace Donato | Licensing Program Analyst | Conducted the complaint visit and authored the report |
| Annabelle Esperanza | Administrator | Met with Licensing Program Analyst during the visit |
| Jackie Jin | Licensing Program Manager | Supervisor named in the report |
Inspection Report
Complaint Investigation
Census: 4
Capacity: 6
Deficiencies: 0
Date: Jul 26, 2024
Visit Reason
An unannounced complaint investigation visit was conducted in response to multiple allegations including pressure injuries, medication refusal, failure to notify authorized representatives timely, residents left unsupervised, and visitor restrictions.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included resident sustained multiple pressure injuries, staff refusal to administer medication, failure to notify authorized representatives timely, residents left unsupervised, and staff restricting visitors. Interviews and records showed some concerns but no preponderance of evidence to prove violations.
Findings
The investigation found that although some allegations such as pressure injuries and medication administration were partially supported by interviews and records, overall there was insufficient evidence to substantiate the complaints. The department determined the allegations were unsubstantiated after reviewing interviews, records, and visitation logs.
Report Facts
Capacity: 6
Census: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Grace Donato | Licensing Program Analyst | Conducted the complaint investigation visit |
| Jackie Jin | Licensing Program Manager | Named as Licensing Program Manager on report |
| Annabelle Esperanza | Administrator | Facility administrator met during investigation |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Date: Aug 3, 2022
Visit Reason
The visit was an unannounced annual inspection focusing on infection control conducted by the Licensing Program Analyst.
Findings
The facility was found to be in compliance with no deficiencies cited. Infection control measures were observed including symptom screening, PPE availability, and staff training. Advisory notes were provided.
Report Facts
Perishable food supply: 2
Non-perishable food supply: 7
Facility temperature: 72
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Annabelle Esperanza | Administrator | Met with Licensing Program Analyst during inspection |
| Christine Dolores | Licensing Program Analyst | Conducted the annual inspection |
| Sarah Yip | Licensing Program Manager | Named in report header |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Date: Aug 25, 2021
Visit Reason
An unannounced annual required inspection was conducted by Licensing Program Analysts to evaluate compliance with regulations.
Findings
The facility was toured inside and outside, with observations of infection control measures including PPE supplies, sanitation, and COVID-19 mitigation plans. No deficiencies were cited during the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kendall Hall | Administrator | Met with Licensing Program Analysts during the inspection. |
| Christine Dolores | Licensing Program Analyst | Conducted the inspection. |
| Marybeth Donovan | Licensing Program Analyst | Conducted the inspection. |
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