Inspection Report Summary
Most inspections at St. Lourdes Home found multiple deficiencies related primarily to medication management, unsecured hazardous items, and incomplete staff training. Several complaint investigations were substantiated, including one where a resident left the facility unassisted and sustained injuries due to unarmed exit alarms, and another involving medication given without a proper prescription. Civil penalties were assessed for repeat violations and immediate risks to resident health and safety, with the most recent inspection on August 13, 2025, identifying several serious deficiencies including unsecured medications and hazardous items, medication errors, and incomplete training. While issues have persisted over time, the facility has not faced license suspensions or revocations, and some complaint investigations were unsubstantiated. The record shows ongoing challenges mainly with environment safety and medication administration, with no clear pattern of improvement or decline.
Deficiencies per Year
8
6
4
2
0
High
Moderate
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 6
Aug 13, 2025
Visit Reason
The inspection was an unannounced annual required inspection conducted to evaluate compliance with licensing requirements at St. Lourdes Home.
Findings
The inspection identified multiple deficiencies including unsecured medications and hazardous items, incomplete staff training, medication administration errors, and incomplete resident medication records. Civil penalties were assessed for repeat violations and immediate risks to resident health and safety.
Severity Breakdown
Type A: 3
Type B: 3
Deficiencies (6)
| Description | Severity |
|---|---|
| Unsecured disinfectants, cleaning solutions, sharp objects, and other hazardous items posing immediate health and safety risks. | Type A |
| Medications stored in kitchen drawer without lock posing immediate health and personal rights risks. | Type A |
| Medication administration errors including missing medications, incorrect dosages, and unlisted supplements. | Type A |
| Staff lacking required postural support training for 2024. | Type B |
| Staff not completing required 40 hours of training within required timeframe. | Type B |
| Incomplete resident medication records not maintained as required. | Type B |
Report Facts
Civil penalty amount: 250
Civil penalty daily continuation: 100
Number of residents reviewed: 5
Number of staff files reviewed: 5
Number of residents interviewed: 4
Training hours required: 40
Training hours completed by staff S3: 16
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Justino Balintona | Licensee-Administrator | Met during inspection and involved in authorization and discussion of findings. |
| Alicia Delmundo | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Bennett Fong | Licensing Program Manager | Named as Licensing Program Manager on report. |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 2
Feb 28, 2025
Visit Reason
The inspection was conducted in response to an Unusual Incident Report regarding a resident (R1) who was found outside the facility with injuries after leaving unassisted.
Findings
The licensee failed to ensure auditory exit alarms were armed, allowing R1 to leave unnoticed and sustain injuries. Additionally, unlocked staff medications and disinfectant spray were found accessible, posing immediate risks to residents. Civil penalties were assessed for these deficiencies.
Complaint Details
The visit was triggered by a complaint in the form of an Unusual Incident Report about resident R1 leaving the facility unassisted and sustaining injuries. The complaint was substantiated by observations and interviews.
Severity Breakdown
Type A: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to ensure the facility has an auditory device or staff alert feature to monitor exits accessible to residents at risk for elopement, resulting in R1 leaving unnoticed and sustaining injuries. | Type A |
| Failure to secure disinfectants and staff medications, which were found unlocked and accessible, posing immediate risks to residents. This was a repeat violation. | Type A |
Report Facts
Civil penalty: 500
Civil penalty: 250
Daily civil penalty: 100
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Justino Balintona | Licensee-Administrator | Named in relation to the incident and inspection |
| Alicia Delmundo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Bennett Fong | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 6
Aug 7, 2024
Visit Reason
The inspection was an unannounced annual required inspection conducted to evaluate compliance with licensing regulations.
Findings
The inspection found multiple deficiencies including improper storage of hazardous items, expired and rotten food, medication discrepancies, maintenance issues, and the presence of a bedridden resident without appropriate fire clearance. Plans of correction were discussed with the licensee-administrator.
Severity Breakdown
Type A: 4
Type B: 2
Deficiencies (6)
| Description | Severity |
|---|---|
| Facility has a bedridden resident (R2) without a required bedridden fire clearance. | Type A |
| Hazardous items such as Raid insect killer, liquid sanitizer, automotive agents, and staff medications were stored in unlocked and accessible areas. | Type A |
| Rotten and expired food items including moldy vegetables and expired canned goods were found. | Type A |
| Medications administered without doctor's orders or with dosage discrepancies for several residents. | Type A |
| Maintenance issues including mildew on shower door, peeled varnish on cabinets, soiled bathtub, mold in refrigerator crispers, broken and missing drawer knobs, and rusted metal cart in yard. | Type B |
| Resident (R2) dependent on staff for all activities of daily living retained in facility without meeting health condition requirements. | Type B |
Report Facts
Civil penalty assessed: 500
Facility capacity: 6
Census: 6
Inspection start time: 1030
Inspection end time: 1830
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Justino Balintona | Licensee-Administrator | Met during inspection and discussed deficiencies and plans of correction |
| Alicia Delmundo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Bennett Fong | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 4
Capacity: 6
Deficiencies: 1
Dec 22, 2023
Visit Reason
The visit was an unannounced complaint investigation conducted in response to an allegation that staff dispensed medication that was not prescribed to a resident.
Findings
The investigation found that staff offered melatonin to a resident without a prescription, and the facility did not have a medical administrative record for that resident. The deficiency was substantiated and cited under Title 22 California Code of Regulations for failure to comply with medication administration requirements.
Complaint Details
The complaint was substantiated. The allegation was that staff dispensed medication not prescribed to a resident. The investigation confirmed this occurred with melatonin given without a prescription.
Deficiencies (1)
| Description |
|---|
| Failure to have a signed, dated written order from a physician for medication administered and lack of a label on the medication as required by CCR 87465(e). |
Report Facts
Capacity: 6
Census: 4
Deficiency Type: 1
Plan of Correction Due Date: Dec 23, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Justino Balintona | Administrator | Named as facility administrator present during investigation |
| Corazon Mariano | Caregiver | Met with Licensing Program Analysts during investigation |
| Laura Hall | Licensing Program Analyst | Conducted the complaint investigation |
| Harpreet Humpal | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 4
Aug 2, 2023
Visit Reason
The inspection was an unannounced annual required inspection conducted to evaluate compliance with licensing regulations at St. Lourdes Home.
Findings
The inspection found several deficiencies including unlocked cleaning agents posing safety risks, detached transition metal plate and wood plank creating potential hazards, incomplete staff training, and medication for a resident not listed on the current doctor's orders. Plans of correction were discussed and due dates set.
Severity Breakdown
Type A: 2
Type B: 2
Deficiencies (4)
| Description | Severity |
|---|---|
| Unlocked cleaning agents, disinfectants, wound and peritoneal cleansers accessible to clients posing immediate health and safety risks. | Type A |
| Medication for resident R5 not listed on the most current list of doctor's orders, posing immediate health and personal rights risks. | Type A |
| Transition metal plate and wood plank detached from flooring posing potential safety risks. | Type B |
| Three out of four staff did not have required annual training including dementia care and postural support training. | Type B |
Report Facts
Capacity: 6
Census: 5
Plan of Correction Due Date: Aug 3, 2023
Plan of Correction Due Date: Aug 16, 2023
Liability Insurance: 3000000
Staff Training Hours: 2
Staff Training Hours: 0
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Justino Balintona | Licensee-Administrator | Met during inspection and discussed findings |
| Alicia Delmundo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Bennett Fong | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 1
Aug 8, 2022
Visit Reason
The inspection was an unannounced annual infection control inspection conducted to evaluate compliance with licensing regulations and infection control standards.
Findings
The facility was found to have adequate food supplies, proper COVID-19 screening and PPE availability, and operational safety equipment. However, a deficiency was cited for storing toxic cleaning supplies in an unlocked kitchen cabinet, posing immediate safety risks to residents with dementia.
Deficiencies (1)
| Description |
|---|
| Bleach, Great Value All Purpose Cleaner with Bleach, ant & roach killer and Comet were found in an unlocked kitchen cabinet, posing immediate safety risks to persons in care. |
Report Facts
Hot water temperature: 114.7
Facility capacity: 6
Census: 6
Deficiency plan of correction due date: Aug 9, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Justino Balintona | Licensee-administrator | Met during inspection and discussed N95 fit testing |
| Alicia Delmundo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Bennett Fong | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 0
Sep 21, 2021
Visit Reason
The visit was an unannounced complaint investigation triggered by an allegation that staff was not allowing a resident's visitor into the facility.
Findings
The investigation found that the staff initially did not allow the visitor entry due to concerns about the visitor's identification and agency contact information. After verifying the legitimacy of the visitor's agency, the visitor was allowed entry. The allegation was unsubstantiated as there was no preponderance of evidence that a violation occurred.
Complaint Details
The complaint alleged that staff was not allowing a resident's visitor, identified as V1 from an advocacy agency, into the facility. The allegation was found unsubstantiated after investigation.
Report Facts
Capacity: 6
Census: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Justino Balintona | Licensee-Administrator | Named in investigation findings related to visitor entry |
| Alicia Delmundo | Licensing Program Analyst | Conducted the complaint investigation |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 5
Jul 13, 2021
Visit Reason
The inspection was an unannounced annual required infection control inspection conducted by the Licensing Program Analyst to assess compliance with regulations.
Findings
The facility was generally found to have sufficient supplies and safety measures in place, including COVID-19 protocols, but several deficiencies were noted including lack of N95 respirators and disposable gowns, missing face shields, staff not fit tested for N95 respirators, and bed frames and old mattress stored in the side yard posing safety risks.
Deficiencies (5)
| Description |
|---|
| Visitor's log has no columns to record temperature and contact information. |
| No supplies of N95 respirators and disposable gowns. |
| Licensee unable to locate their supply of face shields. |
| Staff not fit tested for N95 respirators. |
| Bed frames and old mattress in the side yard posing potential safety risks to persons in care. |
Report Facts
Capacity: 6
Census: 6
Liability insurance coverage: 3000000
Plan of Correction Due Date: Jul 27, 2021
Hot water temperature: 105
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Justino Balintona | Licensee-Administrator | Met with Licensing Program Analyst and discussed deficiencies and plan of correction |
| Alicia Delmundo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Bennett Fong | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Mar 15, 2021
Visit Reason
The visit was conducted as a case management follow-up related to concerns about a resident's medication and potential financial exploitation by an individual known to the resident.
Findings
The Licensing Program Analyst conducted interviews and requested documentation from the licensee-administrator to address concerns about medication administration and possible financial exploitation of a resident. A follow-up on submitted documents was scheduled.
Complaint Details
The visit was triggered by a complaint involving a resident (R1) whose medication was taken and concerns that an individual known to R1 was attempting to financially exploit him and become his caretaker.
Report Facts
Capacity: 6
Census: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Justino Balintona | Licensee-Administrator | Met with Licensing Program Analyst during the visit and requested to submit documents |
| Alicia Delmundo | Licensing Program Analyst | Conducted interviews and follow-up during the visit |
| Isaac Taggart | Licensing Program Manager | Named in the report header |
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