075601062-4-30-2024-15-AS-LAWN-D4TVLE-20240430163151

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 075601062
Report Date: 04/30/2024
Date Signed: 04/30/2024 04:32:03 PM

Document Has Been Signed on 04/30/2024 04:32 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME:	BETTER LIVING CARE HOME		FACILITY NUMBER:	075601062
ADMINISTRATOR:	GALERA, ANABELLE & RUDOLPH		FACILITY TYPE:	740
ADDRESS:	106 VIVIAN DRIVE		TELEPHONE:	(925) 674-8820
CITY:	PLEASANT HILL	STATE: CA	ZIP CODE:	94523
CAPACITY:	8	CENSUS: 8	DATE:	04/30/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Rudolph & Anabelle Galera, Licensees/Administrators		TIME COMPLETED:	04:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 04/30/2024 at 1:15 PM, Licensing Program Analyst (LPA) Lori Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregivers, Caysha Meltel and Montealto Nemsio and explained the purpose of the visit. Caysha phoned the Licensee/Administrator, Anabelle Galera to inform. Licensee/Administrator, Rudy Galera arrived shortly. Licensee/Administrator, Anabelle arrived approx. an hour later. The facility’s fire clearance was approved for eight (8) residents in which all may be non-ambulatory. Hospice waiver approved for four (4) residents. Administrator's Certificate #6014138740 and 6014136740 expired 02/23/24 and 02/24/24 but are currently being renewed. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 11 total bedrooms which 8 bedrooms are occupied by the residents and 3 bedrooms is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathrooms was measured at 104.5 and 109.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. LIC809-C Continued...

SUPERVISOR'S NAME: Bennett Fong	TELEPHONE: (510) 725-7919
LICENSING EVALUATOR NAME: Lori Alexander-Washington	TELEPHONE: (510) 285-3934
LICENSING EVALUATOR SIGNATURE:	DATE: 04/30/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/30/2024 04:32 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: BETTER LIVING CARE HOME	FACILITY NUMBER: 075601062
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/30/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

87608(a)(5)(A)

Postural Supports

(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above in by not having an official Doctor's order by Licensed Health Professional for 1/2 rail bed and/or hospital bed for R1, R2, R4, R5, R6, R7 which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/14/2024
	Plan of Correction
1 2 3 4	Administrators agrees to get Doctor's orders for R1, R2, R4, R5, R6 and R7 and submit to CCLD by POC due date.

Type B

Section Cited

CCR

87705(c)(6)

Care of Persons with Dementia

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (6) Appraisals are conducted on an ongoing basis pursuant to Section 87463, Reappraisals. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in by not having updated Appraisal Needs and Services (ANS) for R1, R6 and R7 which poses a potential health and safety risk to persons in care.
	POC Due Date: 05/07/2024
	Plan of Correction
1 2 3 4	Administrators agrees to updated ANS for Residents listed above and submit copies to CCLD by POC due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Bennett Fong	TELEPHONE: (510) 725-7919
LICENSING EVALUATOR NAME: Lori Alexander-Washington	TELEPHONE: (510) 285-3934
LICENSING EVALUATOR SIGNATURE:	DATE: 04/30/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: BETTER LIVING CARE HOME	FACILITY NUMBER: 075601062
	VISIT DATE: 04/30/2024

NARRATIVE

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LIC809-C Continued...

Smoke and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 10/03/23. Emergency Disaster Plan was last posted on 09/23. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 01/25/24.

LPA reviewed 8 residents records. LPA reviewed 6 staff records and 6 of 6 have current first aid training and associated to the facility.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties.

Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 05/07/2024:

LIC 308 Designation of Administrative Responsibility
LIC 309 Administrative Organization
LIC 500 Personnel Report
LIC 610E Emergency Disaster Plan
Liability Insurance

Exit interview conducted. Appeal Rights and a copy of this report provided.

SUPERVISOR'S NAME: Bennett Fong	TELEPHONE: (510) 725-7919
LICENSING EVALUATOR NAME: Lori Alexander-Washington	TELEPHONE: (510) 285-3934
LICENSING EVALUATOR SIGNATURE:	DATE: 04/30/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024

LIC809 (FAS) - (06/04)

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