Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Sep 11, 2024
Visit Reason
The inspection was an unannounced annual required visit conducted to evaluate compliance with regulatory requirements for the Pebble Brook Senior Home Care facility.
Findings
The facility was found to be clean, well-maintained, and in compliance with regulations. No deficiencies were issued during the inspection. All staff had required clearances and certifications, and the facility met food supply and safety requirements.
Report Facts
Residents receiving hospice services: 2
Residents receiving home health services: 2
Fire extinguishers: 2
Hot water temperature: 112
Hot water temperature: 113
Food supply - perishable: 2
Food supply - non perishable: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Winston Falcon | Administrator | Administrator present during inspection and named in report |
| Javina George | Licensing Program Analyst | Conducted the inspection |
| Maria Guiterrez | Caregiver | Greeted and granted entry to Licensing Program Analyst |
| Tricia Danielson | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Sep 28, 2023
Visit Reason
The visit was an unannounced annual inspection to ensure the facility is following California Code of Regulations, Title 22, Division 6.
Findings
The facility was found to be in compliance with no deficiencies observed. Infection control, physical plant safety, personnel records, client records, food service, health-related services, and disaster preparedness were all satisfactory.
Report Facts
Capacity: 6
Census: 5
Food supply: 7
Food supply: 2
Bathroom temperature: 108.6
Facility temperature: 73
Last fire drill date: Sep 3, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Winston Falcon | Administrator | Met during inspection and participated in exit interview |
| Cheryl Goodrich | Licensing Program Analyst | Conducted the inspection |
| Jazmond D Harris | Licensing Program Manager | Named in report |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Sep 1, 2022
Visit Reason
An unannounced annual inspection was conducted focusing on infection control at Pebble Brook Senior Home Care Facility.
Findings
The facility was found to have adequate infection control measures including Covid-19 postings, hand hygiene supplies, PPE availability, and cleaning protocols. No deficiencies were noted during the visit.
Report Facts
Staff present: 3
Residents present: 6
Capacity: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Winston Falcom | Administrator | Met with Licensing Program Analyst during inspection and informed of visit purpose |
| Chinwe Nwogene | Licensing Program Analyst | Conducted the inspection visit |
| Deborah Mullen | Licensing Program Manager | Named in report header |
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