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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603156
Report Date: 12/13/2024
Date Signed: 12/17/2024 03:16:13 PM

Document Has Been Signed on 12/17/2024 03:16 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SENIOR CARE & COMFORT LIVINGFACILITY NUMBER:
374603156
ADMINISTRATOR/
DIRECTOR:		LOGALLA, BRANDONFACILITY TYPE:
740
ADDRESS:1019 GREENFIELD DRIVETELEPHONE:
(619) 334-3775
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 6CENSUS: 5DATE:
12/13/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Licensee Brandon LogallaTIME VISIT/
INSPECTION COMPLETED:
05:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced Annual Inspection continuation visit. The Annual Inspection started on 11/22/2024. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Licensees Brandon and Winnie Logalla.

According to the facility’s license, the facility serves six (6) non-ambulatory elderly residents, age 60 and above. During today’s visit, LPA observed five (5) residents at the facility, of which three (3) were non-ambulatory and two (2) were ambulatory.

LPA, accompanied by Licensee Brandon Logalla, toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was 70 F. Hot water taps accessible to clients in bathroom #1 were 119.5 F and 119.2 F.

No pools or bodies of water were observed on the premises. Per Brandon Logalla, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility.

LPA interviewed staff and residents and reviewed staff and resident records/files. LPA’s interviews with residents did not raise any licensing concerns. The files which LPA reviewed contained required documents. Licensee is currently in the process of purchasing active business liability insurance and will submit proof to the CCLD office within 14 business days. (CONTINUED ON NEXT PAGE, LIC 809C)
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE: DATE: 12/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2024
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 12/17/2024 03:16 PM - It Cannot Be Edited


Created By: Liliana Silveira On 12/13/2024 at 04:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SENIOR CARE & COMFORT LIVING
FACILITY NUMBER: 374603156

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/13/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87555(b)(9)
General Food Service Requirements
(b) The following food service requirements shall apply: (9) Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observations, the licensee did not comply with the section cited above in 4 out of 10 objects which poses/a potential health, safety or personal rights risk to 5 persons in care.
POC Due Date: 01/03/2025
Plan of Correction
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Licensee will purchase storage containers, clips and labels and will properly store and label all food.
Type B
Section Cited
CCR
87555(b)(23)
General Food Service Requirements
(b) The following food service requirements shall apply: (23) All readily perishable foods or beverages capable of supporting rapid and progressive growth of micro-organisms which can cause food infections or food intoxications shall be stored in covered containers at appropriate temperatures.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation, the licensee did not comply with the section cited above in 2 out of 10 objects , which posed a potential health, safety or personal rights risk to 5 persons in care.
POC Due Date: 01/03/2025
Plan of Correction
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Licensee will properly store food in labeled containers and will create a checklist. Food will be checked every 5 days to ensure there is no spoiled food and marked on the checklist.
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:Robyn Clark
LICENSING EVALUATOR NAME:Liliana Silveira
LICENSING EVALUATOR SIGNATURE:
DATE: 12/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/13/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/17/2024 03:16 PM - It Cannot Be Edited


Created By: Liliana Silveira On 12/13/2024 at 04:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SENIOR CARE & COMFORT LIVING
FACILITY NUMBER: 374603156

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/13/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87555(b)(26)
General Food Service Requirements
(b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observations, the licensee did not comply with the section cited above in 2 out of 2 counts, of non-perishable and perishable food items, which posed a potential health, safety or personal rights risk to 5 persons in care.
POC Due Date: 01/03/2025
Plan of Correction
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Licensee will purchase 2 days worth of perishable food items and 7 days worth of non-perishable food items.
Type B
Section Cited
CCR
87555(b)(27)
General Food Service Requirements
(b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observations, the licensee did not comply with the section cited above in 1 count which posed a potential health, safety or personal rights risk to 5 persons in care.
POC Due Date: 01/03/2025
Plan of Correction
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Licensee will ensure that the kitchen is cleaned daily and free of any perishable foods or trash that can attract insects. Also, all opened food items will be clipped and closed properly.
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:Robyn Clark
LICENSING EVALUATOR NAME:Liliana Silveira
LICENSING EVALUATOR SIGNATURE:
DATE: 12/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/13/2024


LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 12/17/2024 03:16 PM - It Cannot Be Edited


Created By: Liliana Silveira On 12/13/2024 at 04:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SENIOR CARE & COMFORT LIVING
FACILITY NUMBER: 374603156

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/13/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87625(b)(3)
Managed Incontinence
(b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observations, the licensee did not comply with the section cited above in 3 out of 3 bedrooms which poses a potential health, safety or personal rights risk to 5 persons in care.
POC Due Date: 01/03/2025
Plan of Correction
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Licensee will replace carpet and any other items in the bedrooms that are causing odors.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Robyn Clark
LICENSING EVALUATOR NAME:Liliana Silveira
LICENSING EVALUATOR SIGNATURE:
DATE: 12/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/13/2024


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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: SENIOR CARE & COMFORT LIVING
FACILITY NUMBER: 374603156
VISIT DATE: 12/13/2024
NARRATIVE
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(CONTINUED FROM PAGE ONE, LIC 809) There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. Confidential records were stored in locked areas.

During the walk through in the kitchen LPA observed that there were cooking & dining equipment and utensils present. During the inspection, LPA observed that there was not enough food to meet Title 22 Regulations for 2 days of perishable food items, and at least 7 days of non-perishable food items. LPA also observed that food items in the refrigerator and cupboards required proper storage, and the kitchen required cleaning. Licensee Brandon Logalla immediately corrected the issues and implemented a new system to ensure that the facility meets food standard requirements.

Licensee Logalla also reported that the carpets in the bedrooms will be replaced with floor due to old age and odor issues.

Note: LPA left the facility to take a 1 hour lunch break and returned to complete the inspection.

Five (5) deficiencies and were cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D pages). Two (2) technical violations were also issued. A Plan of Correction was jointly developed with the Licensee for all deficiencies. An exit interview was conducted with Mr. Logalla, to whom a copy of this report, the LIC 809-D pages, the LIC 9102 AN pages and the Licensee/Appeal Rights (LIC9058 03/22) were provided. Signature below confirms receipt of the documents.

SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2024
LIC809 (FAS) - (06/04)
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