Inspection Reports for
Clearwater at North Tustin

The complaint investigation was triggered by allegations that staff neglect led to a resident sustaining pressure injuries, staff did not meet the resident's medical needs, staff denied the resident access to the telephone, and staff did not meet the resident's diapering needs. The pressure injury allegation was unsubstantiated due to conflicting information and lack of preponderance of evidence. The medical needs and telephone access allegations were unfounded. The diapering needs allegation was also unsubstantiated.

The investigation found conflicting information and insufficient evidence to substantiate the allegations of staff neglect causing pressure injuries and failure to meet diapering needs, resulting in these allegations being deemed unsubstantiated. The allegations that staff did not meet resident medical needs and denied telephone access were found to be unfounded. No citations were issued during the visit.

The complaint alleged that staff restricted Resident #1's visitors and did not provide privacy during visits on September 10 and 11, 2025. The investigation concluded the complaint was unfounded based on evidence including interviews and review of the resident's Advance Health Care Directive and physician's note.

The investigation found that the resident's Power of Attorney had authorized restrictions on visitors due to distress caused during visits, and the resident was incapable of making her own decisions. The complaint was determined to be unfounded.

The complaint was investigated through interviews with the administrator, six staff members, witnesses, and review of facility documentation. The allegation was unsubstantiated, meaning there was not a preponderance of evidence to prove the alleged violation occurred.

The investigation found that Resident #1 had multiple falls, including one on July 5, 2022, which resulted in serious injuries. Staff took appropriate steps to assist and call 911. The allegation of neglect or lack of supervision was deemed unsubstantiated due to insufficient evidence that staff caused or contributed to the fall.

The complaint alleged that a resident suffered a fall resulting in serious injuries due to lack of care and supervision. The investigation found no definitive supporting evidence or witness statements to substantiate neglect or lack of supervision. The allegation was unsubstantiated.

The investigation included interviews with the administrator, staff, and witnesses, as well as a review of facility documentation. It was determined that although the resident experienced a fall resulting in injuries, there was insufficient evidence to substantiate neglect or lack of supervision by the facility staff. The allegation was deemed unsubstantiated.

The complaint alleged that staff did not provide Resident 1's authorized representative with all progress notes for the first two months. The allegation was investigated and found to be unfounded.

The investigation found that the facility did not have progress notes for the first two months of the resident's stay, but all available progress notes were provided to the authorized representative. The allegation was deemed unfounded and dismissed.

The facility was found to be in good repair with no deficiencies noted. Resident rooms and common areas were clean and safe, infection control measures were in place, and emergency and safety equipment were operational. The facility met food supply requirements and COVID-19 mitigation plans were reviewed.

Staff #1, previously denied exemption and removed from the facility, was found still working at the facility. The staff member was immediately sent home and is no longer associated with the facility. No citations were issued at this time pending further information.

The facility was found to be in compliance with regulations, with no hazards or obstacles observed, operational safety equipment, and proper infection control measures. The facility is ready for licensure.

The applicant and administrator successfully completed the Component II evaluation, demonstrating understanding of facility operation, staff qualifications, program policies, and COVID-19 mitigation plan. No clients were in care at the time of the evaluation.