Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 3
Jul 29, 2025
Visit Reason
The inspection was an unannounced required annual inspection conducted to evaluate compliance with licensing requirements for Serenity Board and Care Facility.
Findings
The facility was generally clean and well-maintained, with some deficiencies noted including rodent droppings in a kitchen closet, unsecured pre-poured medications in a kitchen drawer, and structural issues such as dry rot on the wooden deck ramp and fence needing repair. The licensee took immediate action to correct the medication drawer locking issue and plans to address other deficiencies within specified timeframes.
Severity Breakdown
Type A: 1
Type B: 2
Deficiencies (3)
| Description | Severity |
|---|---|
| Closet off of kitchen found to have rodent droppings. | Type B |
| Top drawer on left hand side of range in kitchen used to store pre-poured medications, which is not allowed. | Type A |
| Drawer containing medications has locking function but was found not locked, making medications accessible to residents. | Type B |
Report Facts
Deficiencies cited: 3
Capacity: 6
Census: 6
Water temperature: 122.7
Water temperature: 108.6
Water temperature: 109.7
Fire extinguisher inspection date: Jun 16, 2025
Disaster drill date: Jun 15, 2025
Plan of Correction Due Date: Jul 30, 2025
Plan of Correction Due Date: Aug 12, 2025
Plan of Correction Due Date: Jul 29, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Helen Trinidad | Administrator | Met with Licensing Program Analyst during inspection and discussed facility plans |
| Christi Coppo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Victoria Bertozzi | Licensing Program Manager | Oversaw licensing program and signed report |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 1
Aug 1, 2024
Visit Reason
The inspection was an unannounced required annual inspection conducted to evaluate compliance with licensing regulations for Serenity Board and Care Facility.
Findings
The facility was found to be clean, well-maintained, and compliant with most regulations, including food safety, fire safety, and medication storage. However, a deficiency was cited for allowing an individual (S1) to reside in the facility without completed fingerprint clearance, posing an immediate health and safety risk.
Deficiencies (1)
| Description |
|---|
| S1 was found residing in the facility without fingerprint clearance, which is still 'in process' due to a DOJ delay, violating criminal record clearance requirements. |
Report Facts
Staff records reviewed: 5
Resident records reviewed: 6
Fire extinguisher last inspection date: Jul 23, 2024
Facility capacity: 6
Current census: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Helen Trinidad | Administrator | Met with Licensing Program Analyst during inspection; named in fingerprint clearance deficiency |
| Christi Coppo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Victoria Bertozzi | Licensing Program Manager | Supervisor of the inspection |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 1
Aug 25, 2023
Visit Reason
An unannounced annual required inspection was conducted to evaluate compliance with regulations at Serenity Board and Care Facility.
Findings
The facility was generally compliant with regulations including safety, hygiene, and staff training; however, a deficiency was found related to the centrally stored medication log not being current for two residents' medications.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to maintain a current Centrally Stored Medication Log as required by CCR 87465(a)(6), posing a potential health, safety, or personal rights risk to persons in care. | Type A |
Report Facts
Deficiencies cited: 1
Capacity: 6
Census: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Joel Trinidad | Licensee | Named in medication log deficiency and facility administrator |
| Marisol Cuadra | Licensing Program Analyst | Conducted the inspection |
| Bethany Moellers | Licensing Program Manager | Supervisor of the inspection |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Jun 16, 2022
Visit Reason
The inspection was an unannounced Required-1 Year Inspection conducted to evaluate the facility's compliance with licensing regulations.
Findings
No deficiencies were cited during the inspection. The facility was found to have appropriate infection control measures, secured medications, functioning exit alarms, and updated emergency contact information.
Report Facts
Capacity: 6
Census: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Joel Trinidad | Administrator | Facility administrator present during inspection and exit interview |
| Erik Gonzalez Campos | Licensing Program Analyst | Conducted the inspection |
| Kimberley Mota | Licensing Program Manager | Named in report header |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Jul 27, 2021
Visit Reason
The inspection was an unannounced annual inspection focused on Infection Control procedures and practices at the facility.
Findings
The facility was found to be compliant with infection control protocols, including PPE availability, staff training, and COVID-19 mitigation measures. No deficiencies were cited during this inspection.
Report Facts
Capacity: 6
Census: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Joel Trinidad | Licensee/Administrator | Met with Licensing Program Analyst during inspection |
| Erik Gonzalez Campos | Licensing Program Analyst | Conducted the annual inspection |
| Kimberley Mota | Licensing Program Manager | Named in report header and footer |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 0
Feb 12, 2021
Visit Reason
The inspection was an unannounced complaint investigation triggered by an allegation that the facility failed to provide a refund upon a resident's death.
Findings
The investigation found that the facility did issue a refund check within the 15 days required by regulation and determined the allegation was unfounded.
Complaint Details
The complaint alleged that after resident R1 passed away on 12/21/20, the facility removed R1's personal belongings but did not issue a refund. The complaint was found to be unfounded.
Report Facts
Facility capacity: 6
Census: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kimberley Mota | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Joel Trinidad | Licensee | Facility representative met during investigation |
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