Inspection Report
Annual Inspection
Census: 3
Capacity: 6
Deficiencies: 1
Dec 3, 2024
Visit Reason
The visit was an unannounced required comprehensive annual inspection conducted by Licensing Program Analyst Raquel Hernandez to evaluate compliance with Community Care Licensing regulations.
Findings
The facility was found to be operating within its approved capacity and in generally good repair with sufficient staffing and supplies. However, one deficiency was cited related to failure to document PRN medication administration and resident responses in the Medical Administration Record (MAR).
Deficiencies (1)
| Description |
|---|
| Failure to ensure Resident #1, Resident #2, and Resident #3 daily medications and PRN medications were documented and response recorded in the Medical Administration Record (MAR). |
Report Facts
Licensed capacity: 6
Current census: 3
Deficiencies cited: 1
Plan of Correction Due Date: Dec 4, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Raquel Hernandez | Licensing Program Analyst | Conducted the inspection and cited deficiency |
| Efren Malagon | Licensing Program Manager | Supervisor overseeing the inspection |
| Enrico Gad | Administrator/Director | Facility administrator named in report |
| Miriam Nauseda | Licensee | Facility licensee met during inspection and responsible for plan of correction |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 3
Nov 28, 2023
Visit Reason
The inspection was an unannounced annual inspection conducted to evaluate the facility's compliance with regulatory requirements.
Findings
The facility was generally found to be clean, in good repair, and compliant with many operational and safety standards. However, deficiencies were cited including an unlocked pool gate posing an immediate safety risk, lack of current liability insurance coverage, and improper handling of over-the-counter medications without physician orders.
Severity Breakdown
Type A: 1
Type B: 2
Deficiencies (3)
| Description | Severity |
|---|---|
| Swimming pools and other bodies of water shall be fenced and in compliance with state and local building codes. The pool gate was observed unlocked, posing an immediate health and safety risk. | Type A |
| Facility failed to provide proof of current liability insurance coverage as required, posing a potential health, safety, or personal rights risk. | Type B |
| Over-the-counter medications were listed on the centralized medicine list and administered without physician's written order, posing a potential health and safety risk. | Type B |
Report Facts
Capacity: 6
Census: 4
Deficiencies cited: 3
Liability insurance coverage amount: 1000000
Liability insurance coverage amount: 3000000
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Enrico Gad | Administrator | Named in relation to lack of proof of liability insurance and providing updated physician reports |
| Miriam Nauseda | Facility staff who was notified and immediately locked the unlocked pool gate |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Oct 21, 2022
Visit Reason
An unannounced annual inspection was conducted for infection control at Miriam's Homecare Facility.
Findings
The facility was found to be in compliance with no citations issued. A technical advisory was given recommending staff undergo N95 Fit Testing to prevent infection spread. Fire alarms, carbon monoxide alarms, locked pool and jacuzzi, and proper signage were all observed to be in working order.
Report Facts
Facility capacity: 6
Current census: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Enrico Gad | Administrator | Named as facility administrator |
| Miriam Nauseda | Licensee | Met with inspectors and identified as licensee |
Inspection Report
Original Licensing
Census: 5
Capacity: 6
Deficiencies: 0
Oct 11, 2021
Visit Reason
An announced pre-licensing inspection was conducted to complete the pre-licensing inspection and Comp III for the facility.
Findings
The facility was found to be in compliance with Title 22 Regulations, with all features meeting required standards including safety equipment, medication storage, and resident accommodations.
Report Facts
Water temperature range: 112.8
Water temperature range: 119.3
Facility capacity: 6
Resident census: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Enrico Gad | Administrator | Met with Licensing Program Analyst during inspection and participated in facility tour |
| Jesse Gardner | Licensing Program Analyst | Conducted the pre-licensing inspection |
| Miriam Nauseda | Licensee | Met with Licensing Program Analyst during inspection and participated in facility tour |
Inspection Report
Original Licensing
Census: 6
Capacity: 6
Deficiencies: 0
Aug 31, 2021
Visit Reason
The visit was conducted as part of the original licensing process (CHOW application) for Miriam's Homecare LLC to evaluate compliance with California Code Title 22 Regulations and readiness for licensing.
Findings
The applicant/administrator successfully completed the Component II interview, demonstrating understanding of facility operations, admission policies, staffing, emergency preparedness, complaints reporting, and pre-licensing readiness. Identification was verified and required documentation was obtained.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Enrico Gad | Administrator | Applicant/licensee and administrator who participated in the Component II interview. |
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