Inspection Reports for
Astoria Park Senior Living
925 E Villa St, Pasadena, CA 91106, United States, CA, 91106
Back to Facility ProfileDeficiencies (last 5 years)
Deficiencies (over 5 years)
12.8 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
220% worse than California average
California average: 4 deficiencies/yearDeficiencies per year
24
18
12
6
0
Occupancy
Latest occupancy rate
68% occupied
Based on a March 2026 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy rate over time
Inspection Report
Complaint Investigation
Census: 150
Capacity: 220
Deficiencies: 1
Date: Mar 16, 2026
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2026-02-23 alleging that staff were not meeting residents' bathing needs.
Complaint Details
The complaint was substantiated. The allegation that staff were not meeting residents' bathing needs was confirmed through interviews and facility record reviews.
Findings
The investigation found that facility staff were not meeting residents' bathing needs, with staff missing at least one bathing session last week. The allegation was substantiated and deficiencies were cited according to California Code of Regulations and Health and Safety Code.
Deficiencies (1)
Personal assistance and care as needed by the resident such as bathing was not provided as required, evidenced by staff and residents' interviews indicating missed bathing at least once last week.
Report Facts
Capacity: 220
Census: 150
Plan of Correction Due Date: Mar 17, 2026
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Maria Teresita Capito Quizon | Administrator | Met with Licensing Program Analyst during investigation and named in findings discussion |
| Bonnie Tao | Licensing Evaluator | Conducted the complaint investigation visit |
| Fernando Fierros | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 146
Capacity: 220
Deficiencies: 1
Date: Feb 23, 2026
Visit Reason
An unannounced complaint investigation was conducted due to allegations that staff were not meeting residents' bathing needs at Astoria Park Senior Living Facility.
Complaint Details
The complaint was substantiated based on resident and staff interviews, facility tours, and record reviews. The allegation that staff were not meeting residents' bathing needs was confirmed.
Findings
The investigation found that 10 out of 10 residents needing bathing assistance corroborated the allegation that staff did not provide bathing as scheduled. Staff interviews showed 3 out of 4 staff confirmed residents were not bathed as scheduled, and some residents' clothes appeared unclean, indicating failure to meet bathing needs. The allegations were substantiated.
Deficiencies (1)
Failure to provide personal assistance and care such as bathing as scheduled, posing a potential health and safety risk to residents.
Report Facts
Residents interviewed needing bathing assistance: 10
Staff interviewed: 4
Capacity: 220
Census: 146
Plan of Correction Due Date: Feb 27, 2026
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Maria Teresita Capito Quizon | Administrator | Met with Licensing Program Analyst during investigation and named in findings. |
| Bonnie Tao | Licensing Program Analyst | Conducted the complaint investigation. |
| Fernando Fierros | Supervisor | Supervisor overseeing the investigation. |
Inspection Report
Complaint Investigation
Census: 149
Capacity: 220
Deficiencies: 0
Date: Feb 12, 2026
Visit Reason
This was an unannounced complaint investigation visit triggered by allegations received on 2026-02-08 regarding staff treatment of residents, laundry services, safeguarding of personal belongings, and addressing changes in residents' conditions.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff not treating residents with dignity and respect, inadequate laundry services, failure to safeguard personal belongings, and not addressing changes in resident condition. Interviews and observations did not corroborate these allegations.
Findings
The investigation found no evidence to substantiate the allegations. Resident and staff interviews, facility tours, and record reviews indicated that residents were treated with dignity and respect, laundry services were adequately provided, personal belongings were safeguarded, and changes in residents' conditions were properly addressed.
Report Facts
Residents interviewed: 11
Staff interviewed: 6
Resident census: 149
Facility capacity: 220
Resident notes dates: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Maria Teresita Capito Quizon | Administrator | Met with Licensing Program Analyst during the investigation and participated in exit interview |
| Bonnie Tao | Licensing Program Analyst | Conducted the complaint investigation visit |
| Fernando Fierros | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 149
Capacity: 220
Deficiencies: 0
Date: Feb 12, 2026
Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations received on 2026-02-08 regarding staff treatment of residents, laundry services, safeguarding of personal belongings, and addressing changes in residents' conditions.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff not treating residents with dignity and respect, inadequate laundry services, failure to safeguard personal belongings, and not adequately addressing changes in residents' conditions. Interviews and observations did not support these allegations.
Findings
The investigation included resident and staff interviews, facility tours, and record reviews. The allegations were found to be unsubstantiated as most residents and staff did not corroborate the complaints, and observations indicated residents were treated with dignity, laundry services were adequate, personal belongings were safeguarded, and changes in residents' conditions were properly addressed.
Report Facts
Residents interviewed: 11
Staff interviewed: 6
Resident notes dates: Documentation dates of resident's condition changes: 01/11/26, 01/16/26, 01/21/26, 01/28/26
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Maria Teresita Capito Quizon | Administrator | Met with Licensing Program Analyst during the investigation and participated in exit interview |
| Bonnie Tao | Licensing Program Analyst | Conducted the complaint investigation visit |
| Fernando Fierros | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 150
Capacity: 220
Deficiencies: 1
Date: Feb 9, 2026
Visit Reason
The inspection was a case management visit conducted in conjunction with a complaint regarding a staff member working without proper association to the facility.
Complaint Details
The visit was triggered by a complaint with control #28-AS-20251007152115 regarding a staff member working without proper association and clearance.
Findings
The facility was found to have a staff member (S1) who worked from February 2025 to 10/16/2025 without being fully associated or eligible to work due to an ineligible fingerprint submission related to a prior criminal record denial, posing an immediate health and safety risk to residents.
Deficiencies (1)
Staff member worked at the facility while not being fully associated or eligible due to an ineligible fingerprint submission, violating criminal record clearance requirements.
Report Facts
Census: 150
Total Capacity: 220
Plan of Correction Due Date: Feb 10, 2026
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Maria Quizon | Executive Director | Met with during inspection |
| Erik Zaragoza | Licensing Program Analyst | Conducted the case management visit and authored the report |
| David Sicairos | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 150
Capacity: 220
Deficiencies: 0
Date: Feb 9, 2026
Visit Reason
The inspection was an unannounced complaint investigation visit conducted to investigate allegations that staff touched a resident inappropriately and made inappropriate comments to a resident.
Complaint Details
The complaint involved allegations that Staff #1 inappropriately touched Resident #1 in a sexual manner and made sexually inappropriate comments to the resident. Multiple staff and residents denied the allegations, and a police investigation found insufficient evidence to press charges. The allegations were determined to be unsubstantiated.
Findings
The investigation found insufficient evidence to substantiate the allegations of inappropriate touching and inappropriate comments by staff towards residents. Interviews with staff, residents, and a police report did not corroborate the allegations, resulting in an unsubstantiated finding.
Report Facts
Capacity: 220
Census: 150
Number of residents interviewed: 13
Number of staff interviewed: 6
Number of residents denying allegations: 10
Number of residents denying inappropriate touching: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Erik Zaragoza | Licensing Program Analyst | Conducted the complaint investigation visit and delivered findings |
| Stephanie Funderburg | Administrator | Facility administrator named in the report |
| Karine Tovmasian | Admissions Coordinator | Met with the evaluator during the investigation |
| Maria Quizon | Executive Director | Met with the evaluator during the investigation |
| David Sicairos | Supervisor | Supervisor named in the report |
Inspection Report
Complaint Investigation
Census: 150
Capacity: 220
Deficiencies: 0
Date: Feb 9, 2026
Visit Reason
The inspection visit was an unannounced complaint investigation conducted in response to allegations that staff touched a resident inappropriately and made inappropriate comments to a resident.
Complaint Details
The complaint involved allegations that Staff #1 inappropriately touched Resident #1 in a sexual manner and made sexually inappropriate comments. Multiple interviews with staff, residents, and a police detective revealed no corroboration of these allegations. The investigation concluded the allegations were unsubstantiated due to lack of sufficient evidence.
Findings
The investigation found insufficient evidence to substantiate the allegations. Interviews with staff, residents, and a police report did not corroborate the claims, resulting in the allegations being unsubstantiated.
Report Facts
Capacity: 220
Census: 150
Number of residents interviewed: 13
Number of staff interviewed: 6
Number of residents denying allegation: 10
Number of residents denying inappropriate touching: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Erik Zaragoza | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Stephanie Funderburg | Administrator | Facility administrator named in the report |
| Karine Tovmasian | Admissions Coordinator | Met with Licensing Program Analyst during investigation |
| Maria Quizon | Executive Director | Met with Licensing Program Analyst during investigation |
| Douglas Real | Investigations Branch Investigator | Conducted initial interviews and investigation related to allegations |
Inspection Report
Complaint Investigation
Census: 150
Capacity: 220
Deficiencies: 1
Date: Feb 9, 2026
Visit Reason
A case management visit was conducted in conjunction with a complaint regarding a staff member (S1) who was working at the facility without being fully associated and eligible to work, as revealed by a record review on the Guardian website.
Complaint Details
The visit was triggered by a complaint with control #28-AS-20251007152115 regarding Staff #1's unauthorized work status due to an ineligible fingerprint submission and prior denial of criminal record exemption.
Findings
The investigation found that Staff #1 worked at the facility from February 2025 to October 16, 2025, while not being fully associated or eligible due to an ineligible fingerprint submission related to a prior criminal record exemption denial, posing an immediate health and safety risk to residents.
Deficiencies (1)
Staff member worked at the facility while not being fully associated or eligible due to an ineligible fingerprint submission, violating criminal record clearance requirements.
Report Facts
Census: 150
Total Capacity: 220
Plan of Correction Due Date: Feb 10, 2026
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Maria Quizon | Executive Director | Met with during inspection |
| Erik Zaragoza | Licensing Program Analyst | Conducted the case management visit and authored the report |
| David Sicairos | Licensing Program Manager | Named in the report |
Inspection Report
Complaint Investigation
Census: 150
Capacity: 220
Deficiencies: 0
Date: Jan 30, 2026
Visit Reason
An unannounced complaint investigation visit was conducted regarding the allegation that staff were not allowing a resident to leave the facility.
Complaint Details
The complaint alleged that staff did not allow Resident #2 to leave the facility with Resident #1 and treated them without dignity. The allegation was unsubstantiated after review of staff interviews, resident interviews, care plans, physician's reports, and facility policies.
Findings
The investigation found insufficient evidence to substantiate the allegation. Staff denied the claim, stating residents are allowed to leave if they choose, but some have restrictions based on doctor's orders and family authorization. Interviews and documentation supported that residents are free to come and go, with safety restrictions applied as appropriate.
Report Facts
Census: 150
Total Capacity: 220
Residents interviewed: 15
Residents stating they can leave anytime: 11
Residents restricted by doctor: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Bennette Pena | Licensing Program Analyst | Conducted the complaint investigation visit |
| Maria Quizon | Executive Director | Met with Licensing Program Analyst during the investigation and received the report |
Inspection Report
Complaint Investigation
Census: 150
Capacity: 220
Deficiencies: 0
Date: Jan 30, 2026
Visit Reason
An unannounced complaint investigation visit was conducted regarding the allegation that staff were not allowing a resident to leave the facility.
Complaint Details
The complaint alleged that staff did not allow Resident #2 to leave the facility with Resident #1 and treated them without dignity. The allegation was unsubstantiated due to lack of sufficient evidence.
Findings
The investigation found insufficient evidence to corroborate the allegation. Staff denied the claim, stating residents are allowed to leave if they choose, but some have restrictions based on doctor's orders and family authorization. Interviews and documentation supported that residents are free to come and go, with some residents restricted from leaving unassisted for safety reasons.
Report Facts
Capacity: 220
Census: 150
Residents interviewed: 15
Residents stating they can leave: 11
Residents restricted by doctor: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Bennette Pena | Licensing Program Analyst | Conducted the complaint investigation visit |
| Maria Quizon | Executive Director | Met with Licensing Program Analyst during investigation |
Inspection Report
Complaint Investigation
Census: 150
Capacity: 220
Deficiencies: 0
Date: Dec 29, 2025
Visit Reason
The visit was an unannounced complaint investigation conducted in response to a complaint received on 2025-06-26 regarding allegations of staff providing unwashed utensils, not attending to resident calls for assistance, and failing to keep the facility free of pests.
Complaint Details
The complaint was unsubstantiated. Allegations included staff providing unwashed utensils, not attending to resident calls for assistance, and failure to keep the facility free of pests. Investigations included interviews with residents and staff, observations, and review of pest control invoices and work orders. No evidence was found to support the allegations.
Findings
The investigation found no evidence to support the allegations. Interviews with residents and staff, observations, and document reviews indicated that utensils were properly cleaned, staff generally responded to resident calls for assistance within an average of 10-15 minutes, and the facility maintained pest control with no significant pest issues observed.
Report Facts
Resident count: 150
Facility capacity: 220
Resident interviews: 11
Staff interviews: 7
Pest control treatments frequency: 1
Pest spray requests: 4
Resident call system tests: 4
Calls responded within average time: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Luis DeLeon | Licensing Program Analyst | Conducted the complaint investigation and observations |
| Stephanie Funderburg | Administrator | Facility administrator met during the investigation |
| Michelle Castillo | Business Office Manager | Met with Licensing Program Analyst during subsequent complaint visit |
| Fernando Fierros | Supervisor | Supervisor overseeing the licensing evaluation |
| Maria Quizon | Executive Director | Participated in exit interview at conclusion of investigation |
Inspection Report
Complaint Investigation
Census: 150
Capacity: 220
Deficiencies: 0
Date: Dec 29, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to a complaint received on 2025-06-26 regarding allegations of staff providing unwashed utensils, not attending to resident calls for assistance, and failure to keep the facility free of pests.
Complaint Details
The complaint was unsubstantiated. Allegations included staff providing unwashed utensils, failure to attend resident calls for assistance, and failure to keep the facility free of pests. Investigations included interviews with residents and staff, observations, and review of pest control records. No evidence was found to substantiate the allegations.
Findings
The investigation found no evidence to support the allegations. Interviews with residents and staff, observations, and document reviews indicated that utensils were properly cleaned, staff generally responded to resident calls for assistance within an average of 10-15 minutes, and the facility maintained pest control with no significant pest issues observed.
Report Facts
Capacity: 220
Census: 150
Resident interviews: 11
Staff interviews: 7
Pest control treatments frequency: 1
Estimated days for completion: 90
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Luis DeLeon | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator present during inspection |
| Michelle Castillo | Business Office Manager | Met with Licensing Program Analyst during subsequent complaint visit |
| Maria Quizon | Executive Director | Participated in exit interview |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 0
Date: Dec 23, 2025
Visit Reason
The visit was an unannounced complaint investigation conducted to investigate an allegation that staff did not ensure residents' personal property was safely secured, specifically that Resident 1's personal belongings were stolen.
Complaint Details
The complaint alleged that staff did not ensure residents' personal property was safely secured and that Resident 1's personal belongings were stolen. The allegation was unsubstantiated after investigation.
Findings
The investigation found no preponderance of evidence to substantiate the allegation. Interviews with the administrator, staff, and residents denied the allegation, and no reports of missing personal belongings were confirmed. The allegation was determined to be unsubstantiated.
Report Facts
Capacity: 220
Census: 147
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Nune Margaryan | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator involved in the investigation |
| Maria Quizon | Administrator | Met with Licensing Program Analyst during the visit and assisted with the investigation |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 0
Date: Dec 23, 2025
Visit Reason
The visit was conducted as a complaint investigation following a complaint received on 2025-12-17 alleging that staff did not ensure residents' personal property was safely secured.
Complaint Details
The complaint alleged that staff did not ensure residents' personal property was safely secured, specifically that Resident 1's personal belongings were stolen. The allegation was unsubstantiated after investigation.
Findings
The investigation found no preponderance of evidence to substantiate the allegation that residents' personal belongings were stolen or not safely secured. Interviews with the administrator, staff, and residents denied the allegation, and no missing items were reported.
Report Facts
Census: 147
Total Capacity: 220
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Nune Margaryan | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator interviewed during the investigation |
| Maria Quizon | Administrator | Met with Licensing Program Analyst during the visit |
Inspection Report
Complaint Investigation
Census: 149
Capacity: 220
Deficiencies: 0
Date: Dec 22, 2025
Visit Reason
An unannounced complaint investigation was conducted to investigate the allegation that staff do not prevent a resident from pulling the fire alarm.
Complaint Details
The complaint was unsubstantiated due to insufficient evidence to prove the alleged violation occurred. Interviews with staff and residents did not identify the person setting off the fire alarm.
Findings
The investigation found insufficient evidence to substantiate the allegation. Staff and residents confirmed hearing the fire alarm, but the person responsible was not identified. The Executive Director plans to implement staff refresher training and install alarm covers to prevent recurrence.
Report Facts
Staff interviewed: 5
Residents interviewed: 10
Capacity: 220
Census: 149
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alberto Lopez | Licensing Program Analyst | Conducted the complaint investigation |
| Maria Quizon | Executive Director | Met with Licensing Program Analyst and discussed the investigation |
| Stephanie Funderburg | Administrator | Facility administrator named in the report |
| Lisa Hicks | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 149
Capacity: 220
Deficiencies: 0
Date: Dec 22, 2025
Visit Reason
An unannounced complaint investigation was conducted to investigate the allegation that staff do not prevent a resident from pulling the fire alarm at Astoria Park Senior Living Facility.
Complaint Details
The complaint alleged that staff do not prevent a resident from pulling the fire alarm. The allegation was unsubstantiated due to insufficient evidence despite interviews with staff and residents.
Findings
The investigation found insufficient evidence to substantiate the allegation. Staff and residents confirmed hearing the fire alarm, but the person responsible was not identified. The Executive Director plans to implement staff refresher training and install alarm covers to prevent recurrence.
Report Facts
Staff interviewed: 5
Residents interviewed: 10
Capacity: 220
Census: 149
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alberto Lopez | Licensing Program Analyst | Conducted the complaint investigation |
| Maria Quizon | Executive Director | Met with Licensing Program Analyst and discussed the investigation |
| Stephanie Funderburg | Administrator | Facility administrator named in report header |
| Lisa Hicks | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 0
Date: Dec 20, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations that staff do not safeguard resident's personal belongings and do not respond to calls from resident's representative in a timely manner.
Complaint Details
The complaint was unsubstantiated. Allegations included staff not safeguarding resident's personal belongings, specifically missing prescription glasses, and staff not responding timely to calls from a resident's representative. Interviews and records showed no preponderance of evidence to support the allegations.
Findings
The investigation found insufficient evidence to substantiate the allegations. Interviews with staff, residents, and witnesses, as well as document reviews, indicated that the alleged violations did not occur or could not be proven.
Report Facts
Capacity: 220
Census: 147
Staff interviewed: 6
Residents interviewed: 5
Witnesses interviewed: 3
Days to call back representative: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Christian Gutierrez | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator interviewed during investigation |
| David Sicairos | Supervisor | Supervisor named in report |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 0
Date: Dec 20, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations that staff do not safeguard resident's personal belongings and do not respond to calls from resident's representative in a timely manner.
Complaint Details
The complaint was unsubstantiated. Allegations included staff not safeguarding resident's personal belongings, specifically missing prescription glasses, and delayed response to calls from a resident's representative. Interviews and records showed no preponderance of evidence to support these claims.
Findings
The investigation found insufficient evidence to substantiate the allegations. Interviews with staff, residents, and witnesses, as well as document reviews, indicated that the alleged violations did not occur or could not be proven.
Report Facts
Capacity: 220
Census: 147
Staff interviewed: 6
Residents interviewed: 5
Witnesses interviewed: 3
Staff statements regarding callbacks: 7
Staff statements regarding glasses behavior: 4
Residents stating no missing items: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Christian Gutierrez | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator interviewed regarding allegations |
| David Sicairos | Supervisor | Supervisor named in the report |
Inspection Report
Complaint Investigation
Census: 146
Capacity: 220
Deficiencies: 0
Date: Dec 16, 2025
Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations received on 2025-12-11 regarding facility plumbing maintenance and staff treatment of residents.
Complaint Details
The complaint alleged that staff did not ensure facility plumbing was in good repair and that staff did not treat residents with respect. After interviews with staff and residents and a facility tour, the allegations were unsubstantiated due to lack of evidence.
Findings
The investigation found no evidence to substantiate the allegations. Plumbing was found to be in good repair with timely maintenance, and staff were reported and observed to treat residents with respect.
Report Facts
Capacity: 220
Census: 146
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Irra | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator named in the report |
| Maria Quizon | Facility representative met during the investigation and exit interview |
Inspection Report
Complaint Investigation
Census: 146
Capacity: 220
Deficiencies: 0
Date: Dec 16, 2025
Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations received on 2025-12-11 regarding facility plumbing repair issues and staff disrespect towards residents.
Complaint Details
The complaint alleged that staff did not ensure facility plumbing was in good repair and that staff did not treat residents with respect. After investigation, including interviews and facility tour, these allegations were found to be unsubstantiated.
Findings
The investigation found no evidence to substantiate the allegations. Staff and resident interviews, as well as a facility tour, revealed no plumbing issues or disrespectful behavior by staff. The allegations were determined to be unsubstantiated.
Report Facts
Capacity: 220
Census: 146
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Irra | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator named in the report |
| Maria Quizon | Met with the Licensing Program Analyst during the visit and received the report | |
| Wei Siew Ho | Supervisor | Supervisor named in the report |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 0
Date: Dec 13, 2025
Visit Reason
Unannounced complaint investigation visit conducted in response to multiple allegations including insect infestation, overcharging a resident, delayed medical attention, refusal to assist with insurance application, poor food quality, inadequate housekeeping, and disrespectful treatment of residents.
Complaint Details
The complaint investigation was unsubstantiated based on interviews with 6 staff and 11 residents, facility tours, and document reviews. Allegations included failure to keep the facility free of insects, overcharging a resident, failure to seek timely medical attention, refusal to assist with insurance applications, poor food quality, inadequate housekeeping, and disrespectful treatment. No evidence was found to support these claims.
Findings
The investigation found no sufficient evidence to substantiate any of the allegations. Facility inspections, staff and resident interviews, and document reviews did not support claims of insect infestation, overcharging, delayed medical care, refusal of insurance assistance, poor food quality, inadequate housekeeping, or disrespectful treatment. The toilet in one resident's private bathroom was found inoperable during a prior visit and cited.
Report Facts
Residents interviewed: 11
Staff interviewed: 6
Resident rooms inspected: 8
Resident rooms inspected: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Tena Herrera | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Stephanie Funderburg | Administrator | Facility administrator named in the report |
| Stasha Provitt | Community Liaison Director | Met with Licensing Program Analyst during investigation |
| David Sicairos | Supervisor | Supervisor named in the report |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 0
Date: Dec 13, 2025
Visit Reason
Unannounced complaint investigation visit conducted due to multiple allegations received regarding facility conditions and staff conduct at Astoria Park Senior Living Facility.
Complaint Details
The complaint investigation was unannounced and addressed allegations such as insect infestation, overcharging a resident, delayed medical attention, refusal to assist with insurance applications, poor food quality, inadequate housekeeping, and disrespectful treatment of residents. All allegations were found unsubstantiated based on interviews, file reviews, and observations.
Findings
The investigation found insufficient evidence to substantiate the allegations including insect infestation, overcharging residents, delayed medical attention, refusal to assist with insurance, poor food quality, inadequate housekeeping, and disrespectful treatment of residents. The toilet in a resident's private bathroom was found inoperable and cited during an initial visit.
Report Facts
Capacity: 220
Census: 147
Staff interviewed: 6
Residents interviewed: 11
Resident rooms inspected: 8
Resident rooms inspected: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Tena Herrera | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Stephanie Funderburg | Administrator | Facility administrator named in the report |
| Stasha Provitt | Community Liaison Director | Met with Licensing Program Analyst during the investigation |
| David Sicairos | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 1
Date: Dec 12, 2025
Visit Reason
The inspection visit was conducted as a Case Management visit due to a deficiency observed during a complaint investigation for complaint control number 28-AS-20251210121051.
Complaint Details
The visit was complaint-related, triggered by complaint control number 28-AS-20251210121051. A deficiency was substantiated regarding the non-operational toilet in Room #116.
Findings
During the complaint investigation, the Licensing Program Analyst observed that the toilet in Room #116 was completely off and in the shower, not in operating condition. The facility's Maintenance Director explained that a plumber was scheduled to repair the clogged toilet on the day of the visit, but the toilet remained unrepaired at the conclusion of the inspection.
Deficiencies (1)
Toilet in Room #116 was not in operating condition, being completely off and in the shower, violating CCR 87303(e)(6) regarding maintenance and operation of plumbing fixtures.
Report Facts
Capacity: 220
Census: 147
Plan of Correction Due Date: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Castillo | Maintenance Director | Provided information about the toilet repair during the inspection |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 1
Date: Dec 12, 2025
Visit Reason
The inspection visit was conducted as a Case Management visit due to a deficiency observed during a complaint investigation related to complaint control number 28-AS-20251210121051.
Complaint Details
The visit was complaint-related for complaint control number 28-AS-20251210121051. A deficiency was substantiated regarding the non-operational toilet in Room #116.
Findings
During the complaint investigation, the Licensing Program Analyst observed that the toilet in Room #116 was completely off and located in the shower, not in operating condition. The facility's Maintenance Director explained that a plumber was scheduled to repair the clogged toilet on the day of the visit, but it remained unrepaired at the conclusion of the inspection.
Deficiencies (1)
Toilet in Room #116 was not in operating condition, being completely off and in the shower, violating CCR 87303(e)(6) regarding maintenance and operation of plumbing fixtures.
Report Facts
Capacity: 220
Census: 147
Plan of Correction Due Date: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Castillo | Maintenance Director | Provided explanation about the clogged toilet in Room #116 |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 1
Date: Dec 6, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2025-11-19 regarding staff not responding timely to a resident's call button and leaving a resident on the floor for an extended period.
Complaint Details
The complaint investigation was substantiated for allegations that staff did not respond timely to a resident's call button and left the resident on the floor for an extended period. The allegation regarding inadequate staffing was unsubstantiated. The investigation included interviews with staff and residents, review of call light logs, and facility schedules.
Findings
The investigation substantiated that staff did not respond timely to a resident's call pendant after a fall, resulting in the resident spending between 9 minutes 11 seconds and 24 minutes 17 seconds on the floor, which is unreasonable and poses a health and safety risk. Another allegation regarding inadequate staffing was unsubstantiated based on staff interviews and schedule review.
Deficiencies (1)
Failure to meet night supervision requirements by not having at least one awake employee on duty from 10:00 p.m. to 6:00 a.m. as required for facilities caring for 16 to 100 residents.
Report Facts
Call light response time: 9.1833
Call light response time: 24.2833
Deficiencies cited: 1
Census: 147
Total capacity: 220
Staff interviewed: 7
Residents interviewed: 11
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alberto Lopez | Licensing Program Analyst | Conducted the complaint investigation and made unannounced visits |
| Stasha Provitt | Community Liaison Director | Met with Licensing Program Analyst during investigation and exit interview |
| Karine Tomassian | Admissions Coordinator | Met with Licensing Program Analyst during investigation |
| Stephanie Funderburg | Administrator | Facility administrator named in report header |
| Lisa Hicks | Supervisor | Supervisor named in report |
Inspection Report
Complaint Investigation
Capacity: 220
Deficiencies: 0
Date: Dec 5, 2025
Visit Reason
An unannounced complaint investigation visit was conducted regarding allegations that staff were retaliating against a resident and not ensuring timely meal provision.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff retaliation against a resident and failure to provide meals in a timely manner. Resident and staff interviews, personnel file reviews, and observations did not support the allegations.
Findings
The investigation found no preponderance of evidence to substantiate the allegations. Interviews with residents and staff did not corroborate claims of retaliation or untimely meal service. No deficiencies were cited.
Report Facts
Capacity: 220
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Ramirez | Licensing Program Analyst | Conducted the complaint investigation visit |
| Maria Quizon | Administrator | Met with the evaluator during the investigation |
| Fernando Fierros | Supervisor | Supervisor overseeing the investigation |
| Stephanie Funderburg | Administrator | Named as facility administrator in report header |
Inspection Report
Complaint Investigation
Capacity: 220
Deficiencies: 0
Date: Dec 5, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit conducted on 12/05/2025 regarding allegations that staff were retaliating against a resident and not ensuring timely meal provision.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff retaliation against a resident and failure to provide meals in a timely manner. Resident and staff interviews, personnel file reviews, and observations did not support the allegations.
Findings
The investigation found no preponderance of evidence to substantiate the allegations. Interviews with residents and staff did not corroborate claims of retaliation or untimely meal service. No deficiencies were cited.
Report Facts
Capacity: 220
Residents interviewed: 9
Staff interviewed: 6
Meal delivery time: 4
Meal delivery time: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Ramirez | Licensing Program Analyst | Conducted the complaint investigation visit |
| Maria Quizon | Administrator | Met with investigator during visit |
| Fernando Fierros | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 20
Capacity: 220
Deficiencies: 3
Date: Dec 2, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations of staff neglect, lack of supervision, failure to address a resident's change in medical condition, failure to seek timely medical attention, and failure to ensure adequate liquid intake for a resident.
Complaint Details
The complaint investigation was substantiated. Allegations included staff neglect resulting in pressure injuries, lack of supervision leading to falls, failure to address a resident's change in medical condition, failure to seek timely medical attention, and failure to ensure adequate liquid intake. Evidence supported neglect and inadequate care resulting in multiple pressure injuries and dehydration.
Findings
The investigation substantiated multiple allegations including staff neglect causing pressure injuries, lack of timely medical care, failure to address a resident's change in condition, and inadequate supervision leading to falls. The resident developed stage 3 and 4 pressure injuries and dehydration while at the facility. Several deficiencies were cited related to these findings.
Deficiencies (3)
Persons who require health services for or have a health condition shall not be admitted or retained in a residential care facility for the elderly: (1) Stage 3 and 4 pressure injuries.
Residents in all residential care facilities for the elderly shall have the right to receive or reject medical care or other services; failure to provide timely medical care for pressure injuries.
Personnel shall at all times be sufficient in numbers and competent to provide the services necessary to meet resident needs.
Report Facts
Capacity: 220
Census: 20
Civil penalty: 500
Deficiency count: 3
Plan of Correction Due Dates: Due dates include 2025-12-03, 2025-12-10, and 2025-12-16 for various deficiencies
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alberto Lopez | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Stephanie Funderburg | Administrator | Facility administrator interviewed during investigation |
| Michelle Castillo | Business Office Manager | Facility staff member interviewed during investigation and exit interview |
| Maria Quizon | Administrator | Facility representative present at exit interview |
| Lisa Hicks | Supervisor | Supervisor overseeing licensing evaluation |
Inspection Report
Complaint Investigation
Census: 149
Capacity: 220
Deficiencies: 1
Date: Nov 22, 2025
Visit Reason
The inspection was conducted as a complaint investigation related to observations during record review, specifically concerning medication log discrepancies.
Complaint Details
The complaint investigation found that staff marked medication as given to a resident (R1) who was not present in the facility on the date of 11/01/2025, indicating inaccurate recordkeeping.
Findings
The licensing analyst observed that a medication log was marked as given for a resident who was not present in the facility, resulting in a citation being issued for noncompliance with recordkeeping requirements.
Deficiencies (1)
Failure to maintain a separate, complete, and current resident record, specifically medication logs not accurately reflecting administration.
Report Facts
Facility capacity: 220
Resident census: 149
Plan of Correction due date: Nov 28, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Christian Gutierrez | Licensing Program Analyst | Generated the case management deficiencies report and conducted the complaint investigation |
| David Sicairos | Licensing Program Manager | Named in the report as Licensing Program Manager |
| Stephanie Funderburg | Administrator | Facility administrator mentioned in relation to the deficiency and plan of correction |
| Stasha Provitt | Community Director | Met with during the inspection |
Inspection Report
Complaint Investigation
Census: 149
Capacity: 220
Deficiencies: 1
Date: Nov 22, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that staff were not administering residents' medications as prescribed.
Complaint Details
The complaint was substantiated based on interviews and record reviews. It was found that R1 did not receive medication despite documentation, and was given discontinued medication. Staff acknowledged medication errors during interviews.
Findings
The investigation substantiated the allegations that a resident (R1) did not receive medication as documented and was given discontinued medication. Medication errors and discrepancies were found in all five residents checked during random medication audits.
Deficiencies (1)
Failure to ensure R1 received prescribed medication due to absence from facility and administration of discontinued medication, posing immediate risk to health and safety.
Report Facts
Census: 149
Total Capacity: 220
Deficiency Count: 1
Plan of Correction Due Date: Nov 23, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Christian Gutierrez | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Stephanie Funderburg | Administrator | Named in relation to medication error findings |
| Stasha Provitt | Community Director | Assisted with the complaint investigation visit |
| David Sicairos | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Census: 149
Capacity: 220
Deficiencies: 1
Date: Nov 22, 2025
Visit Reason
The inspection was conducted as a complaint investigation related to observations during record review concerning medication administration.
Complaint Details
The visit was complaint-related under complaint control 28-AS-20251104120932. The complaint was substantiated by observation of medication log discrepancies.
Findings
The licensing analyst observed that a medication log was marked as given for a resident who was not present in the facility, resulting in a citation being issued for incomplete and incorrect recordkeeping posing a potential risk to resident safety.
Deficiencies (1)
Failure to maintain a separate, complete, and current record for each resident, specifically medication logs incorrectly marked as given when the resident was not present.
Report Facts
Deficiencies cited: 1
Plan of Correction due date: Nov 28, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Christian Gutierrez | Licensing Program Analyst | Generated the case management deficiencies report and conducted the complaint investigation |
| David Sicairos | Licensing Program Manager | Named in the report as licensing program manager |
| Stephanie Funderburg | Administrator | Facility administrator mentioned in relation to the deficiency and plan of correction |
| Stasha Provitt | Community Director | Met with during the inspection |
Inspection Report
Complaint Investigation
Census: 151
Capacity: 220
Deficiencies: 0
Date: Nov 6, 2025
Visit Reason
The visit was conducted to investigate a complaint alleging that staff handled a resident in a rough manner, following an initial complaint received on 2025-10-15.
Complaint Details
The complaint alleging rough handling of a resident by staff was investigated through interviews with staff S1-S4 and residents R1-R11. No evidence was found to substantiate the allegation, and the complaint was deemed unsubstantiated.
Findings
Interviews with staff and residents revealed no evidence to support the allegation. Residents and staff stated that no rough handling occurred, and the allegation was determined to be unsubstantiated.
Report Facts
Census: 151
Total Capacity: 220
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met during the investigation and provided statements regarding the allegation |
| Glenn Trueman | Licensing Evaluator | Conducted the complaint investigation |
Inspection Report
Complaint Investigation
Census: 152
Capacity: 220
Deficiencies: 0
Date: Nov 4, 2025
Visit Reason
The visit was an unannounced complaint investigation conducted to investigate the allegation that staff did not prevent a physical altercation between residents in care.
Complaint Details
The complaint alleged that on 10/25/2025, Resident #1 yelled at and slapped Resident #2, and staff did not intervene to prevent the altercation. Interviews with staff and residents, as well as file reviews, did not corroborate the allegation. The complaint was determined to be unsubstantiated.
Findings
The investigation found insufficient evidence to substantiate the allegation that staff failed to prevent a physical altercation between residents. Multiple staff and residents denied the occurrence of the incident, and staff training on de-escalation was reviewed.
Report Facts
Capacity: 220
Census: 152
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Executive Director | Met with during investigation and named in the report |
| Daniel Konishi | Licensing Program Analyst | Conducted the complaint investigation |
| David Sicairos | Supervisor | Named as supervisor in the report |
Inspection Report
Complaint Investigation
Census: 151
Capacity: 220
Deficiencies: 1
Date: Oct 20, 2025
Visit Reason
The inspection visit was an unannounced complaint investigation triggered by an allegation that staff mismanaged a resident's medication.
Complaint Details
The complaint was substantiated. The allegation was that staff mismanaged a resident's medication. The investigation found that Resident #1 missed a dose on 5/18/25 due to a MAR system glitch. Interviews and medication reviews supported this finding.
Findings
The investigation substantiated the allegation that Resident #1 missed a dose of routine medication on 5/18/2025 due to a glitch in the Medication Administration Record system. No other medication errors were found among 15 residents reviewed, and 10 of 11 residents interviewed denied the allegation.
Deficiencies (1)
Failure to assist residents with self-administered medications as needed, evidenced by Resident #1 missing a dose of Riboflavin medication on 5/18/25 due to a MAR glitch.
Report Facts
Census: 151
Total Capacity: 220
Residents' medications reviewed: 15
Residents interviewed: 11
Staff interviewed: 4
Plan of Correction Due Date: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with during investigation and confirmed in-service training on medication |
| Tena Herrera | Licensing Program Analyst | Conducted the complaint investigation visit |
| David Sicairos | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 151
Capacity: 220
Deficiencies: 0
Date: Oct 20, 2025
Visit Reason
An unannounced visit was conducted to investigate a complaint alleging that staff handled a resident in a rough manner.
Complaint Details
The complaint alleged that staff handled a resident in a rough manner. After interviews with staff and residents, and review of records, there was no preponderance of evidence to prove the alleged violation occurred. The allegation was unsubstantiated.
Findings
The investigation found no evidence to support the allegation; multiple residents and staff interviews indicated that staff treated residents with respect and no rough handling was observed. The allegation was determined to be unsubstantiated.
Report Facts
Capacity: 220
Census: 151
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with during investigation and exit interview |
| Glenn Trueman | Licensing Program Analyst | Conducted the complaint investigation |
Inspection Report
Complaint Investigation
Census: 153
Capacity: 220
Deficiencies: 0
Date: Oct 7, 2025
Visit Reason
An unannounced visit was conducted to investigate a complaint alleging that staff were not following proper eviction procedures, specifically that the facility administrator verbally gave a resident a 3-day notice to quit.
Complaint Details
The complaint alleged improper eviction procedures, specifically a verbal 3-day notice to quit given by the administrator. The allegation was unsubstantiated after investigation.
Findings
The investigation included interviews with staff and residents, and review of resident records. All interviewed staff and residents denied the allegation. Documentation showed only overdue rent notices were provided, and the resident was capable of making decisions. There was insufficient evidence to substantiate the allegation, which was determined to be unsubstantiated.
Report Facts
Capacity: 220
Census: 153
Rent amount: 1420.07
Payment amount: 500
Payment offer: 1000
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Named in relation to eviction procedure allegation and investigation |
| Alberto Lopez | Licensing Program Analyst | Conducted the complaint investigation |
| Michelle Castillo | Business Office Manager | Met with evaluator during investigation |
Inspection Report
Annual Inspection
Census: 153
Capacity: 220
Deficiencies: 6
Date: Oct 6, 2025
Visit Reason
An unannounced required 1-year annual inspection was conducted to evaluate compliance with licensing requirements for the Residential Care for Elderly facility serving residents aged 60 and over, including a Memory Care Unit for cognitively impaired residents.
Findings
The inspection found multiple deficiencies including failure to fill certain resident medications, maintenance and cleanliness issues in the Memory Care Unit, missing 'No Smoking-Oxygen In Use' signs in rooms with oxygen tanks, expired or missing staff first aid/CPR training, and lack of mattress pads on most resident beds. Plans of correction were requested with due dates ranging from 10/07/2025 to 11/03/2025.
Deficiencies (6)
Resident R1's Acidolphilus Tablet, Calcium 600-Vit D3 500, Clobetasol .05%, Aquaphor 41% ointment medications have not been filled.
Memory Care Unit patio door inoperable, room 152 bathtub faucet leaking, MCU public bathroom door in disrepair, room 132 bathroom wall drywall in disrepair and missing blinds, room 133 missing medicine cabinet mirror.
Room 148 had a soiled incontinence pad on the entrance, MCU public bathroom had feces on toilet, blood on bed/sheets in room 141, MCU shower room floor had feces, and MCU rooms were not clean.
Majority of 26 inspected primarily shared rooms did not have mattress pads on resident beds.
Staff members S3, S5, S7, S8 do not have current 1st Aid/CPR training on file or it is expired.
Rooms 130 and 133 had oxygen tanks but no 'No Smoking-Oxygen in Use' signs posted.
Report Facts
Staff count: 90
Residents receiving hospice services: 12
Residents receiving home health services: 59
Medication supply: 30
Fire clearance capacity: 104
Fire clearance capacity: 116
Hospice waiver capacity: 25
Fire inspection date: Apr 30, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Noemi Galarza | Licensing Program Analyst | Conducted the inspection and signed the report |
| Lisa Hicks | Licensing Program Manager | Supervisor and licensing program manager named in the report |
| Michelle Castillo | Business Office Manager | Facility representative met during inspection and during exit interview |
| Stephanie Funderburg | Administrator | Facility administrator named in the report |
Inspection Report
Complaint Investigation
Census: 154
Capacity: 220
Deficiencies: 0
Date: Sep 23, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2025-04-11 regarding staff supervision, personal hygiene, food service, and timely medical attention for residents at Astoria Park Senior Living Facility.
Complaint Details
The complaint included allegations that staff were not properly supervising a fall-risk resident, not meeting residents' personal hygiene needs, not providing adequate food service, and not seeking timely medical attention for a resident. All allegations were found to be unsubstantiated based on interviews, observations, and file reviews.
Findings
After interviews with staff and residents, file reviews, and observations, there was insufficient evidence to substantiate any of the allegations. The investigation concluded that staff were providing appropriate supervision, personal hygiene assistance, adequate food service, and timely medical attention to residents.
Report Facts
Staff interviewed: 8
Residents interviewed: 10
Falls incident report dates: SIR dated 2/17/25, 3/4/25, and 4/6/25 related to resident falls
Care plan date: Resident care plan finalized in January 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Facility administrator involved in the investigation and tour |
| Sanjay Vaid | Licensing Program Analyst | Evaluator who conducted the complaint investigation |
| Ruth Villa | Wellness Director | Met with evaluator and participated in facility tour |
| Mena Marrisa | Wellness Director | Provided resident and staff rosters and assisted with file reviews |
| Fernando Fierros | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Follow-Up
Census: 152
Capacity: 220
Deficiencies: 1
Date: Sep 19, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on observations made during a complaint investigation visit on 2025-09-02.
Complaint Details
The visit was a follow-up to a complaint investigation conducted on 2025-09-02 regarding missing medications for residents.
Findings
A deficiency was cited due to the licensee's failure to ensure that Resident #2 had routine and as needed medications available, posing an immediate risk to health, safety, and personal rights. Residents reported not needing to ask for the medications, and one resident refused to talk to the Licensing Program Analyst.
Deficiencies (1)
Based on medication review and document review, licensee did not ensure that Resident #2 had routine and as needed medication which poses an immediate risk to the health, safety, and personal rights of the persons in care.
Report Facts
Census: 152
Total Capacity: 220
Plan of Correction Due Date: Sep 20, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the unannounced case management visit and medication review. |
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during the visit and explained the reason for the visit. |
Inspection Report
Follow-Up
Census: 152
Capacity: 220
Deficiencies: 1
Date: Sep 19, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on observations made during a complaint investigation visit on 2025-09-02.
Complaint Details
The visit was a follow-up to a complaint investigation conducted on 2025-09-02 regarding medication availability for residents.
Findings
The facility was found to have deficiencies related to medication availability for certain residents, specifically missing routine and as-needed medications, posing an immediate risk to health and safety. A deficiency was cited under Title 22 regulations.
Deficiencies (1)
Based on medication review and document review, licensee did not ensure that Resident #2 had routine and as needed medication which poses an immediate risk to the health, safety, and personal rights of the persons in care.
Report Facts
Census: 152
Total Capacity: 220
Plan of Correction Due Date: Sep 20, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during inspection |
| Mary G Flores | Licensing Program Analyst | Conducted the unannounced case management visit and medication review |
| Wei Siew Ho | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 152
Capacity: 220
Deficiencies: 0
Date: Sep 2, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that facility staff did not provide medications as prescribed, failed to provide assistance with activities of daily living, and retaliated against a resident.
Complaint Details
The complaint investigation was triggered by allegations of medication non-administration, failure to assist with activities of daily living, and retaliation against a resident. After investigation, all allegations were determined to be unsubstantiated.
Findings
The investigation included interviews with residents and staff, medication checks, and document reviews. All allegations were found to be unsubstantiated due to lack of preponderance of evidence, with residents and staff confirming medication administration and assistance with activities of daily living were provided as required, and no retaliation was observed.
Report Facts
Residents interviewed: 8
Staff interviewed: 6
Medication checks: 8
Capacity: 220
Census: 152
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Evaluator | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator present during investigation and exit interview |
| Michelle Castillo | Business Office Manager | Met with Licensing Evaluator during investigation |
Inspection Report
Complaint Investigation
Census: 151
Capacity: 220
Deficiencies: 0
Date: Aug 8, 2025
Visit Reason
An unannounced complaint investigation visit was conducted regarding the allegation that staff prohibit a resident from leaving the facility.
Complaint Details
The complaint alleged that staff prohibit resident #1 from leaving the facility. The allegation was unsubstantiated after investigation, with no evidence proving the violation occurred.
Findings
The investigation found that resident #1 may not leave the facility unassisted as per physician's report. Interviews with staff and residents mostly denied the allegation. The facility offers community outings and in-house activities. The allegation was unsubstantiated due to lack of preponderance of evidence. No deficiencies were cited.
Report Facts
Capacity: 220
Census: 151
Staff interviewed: 5
Residents interviewed: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Ramirez | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator who assisted with the tour and investigation |
| Ruth Villa | Wellness Director | Greeted the Licensing Program Analyst and explained the purpose of the visit |
Inspection Report
Complaint Investigation
Census: 151
Capacity: 220
Deficiencies: 0
Date: Aug 8, 2025
Visit Reason
An unannounced complaint investigation visit was conducted regarding the allegation that staff prohibit a resident from leaving the facility.
Complaint Details
The allegation was that staff prohibit resident #1 from leaving the facility. The allegation was unsubstantiated due to lack of preponderance of evidence.
Findings
The investigation found that resident #1 may not leave the facility unassisted according to a physician's report. Interviews with staff and residents mostly denied the allegation, and the facility offers community outings residents can sign up for. There was insufficient evidence to substantiate the allegation, so it was deemed unsubstantiated. No deficiencies were cited.
Report Facts
Capacity: 220
Census: 151
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Ramirez | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator who assisted during the investigation |
| Fernando Fierros | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 0
Date: Jul 24, 2025
Visit Reason
This was an unannounced complaint investigation visit conducted in response to multiple allegations received on 2025-06-16 concerning resident care and staff conduct at Astoria Park Senior Living Facility.
Complaint Details
The complaint investigation was triggered by allegations including staff retaining a resident requiring a higher level of care, failure to provide transportation to medical appointments, neglecting residents' hygiene needs, lack of dignity in staff-resident interactions, and rough handling of residents. After interviews and record reviews, the allegations were found unsubstantiated.
Findings
Based on interviews with staff, residents, and review of records, there was insufficient evidence to substantiate the allegations regarding inadequate care, transportation denial, hygiene neglect, lack of dignity, and rough handling of residents. The allegations were determined to be unsubstantiated.
Report Facts
Capacity: 220
Census: 147
Staff interviewed: 6
Residents interviewed: 9
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Christian Gutierrez | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Stephanie Funderburg | Administrator | Facility administrator interviewed during investigation |
| David Sicairos | Licensing Program Manager | Oversaw the licensing program related to this investigation |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 0
Date: Jul 24, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2025-06-16 regarding staff retaining a resident requiring a higher level of care, failure to transport residents to medical appointments, unmet hygiene needs, lack of dignity in staff-resident relationships, and rough handling of residents.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff retaining a resident needing higher care, failure to transport residents, unmet hygiene needs, lack of dignity, and rough handling. Interviews with six staff and nine residents generally refuted these claims, and no disciplinary actions were noted.
Findings
Based on interviews with staff, residents, and review of records, there was insufficient evidence to substantiate the allegations. Most staff and residents reported that care needs, transportation, hygiene, dignity, and handling were appropriately managed. The allegations were therefore unsubstantiated.
Report Facts
Staff interviewed: 6
Residents interviewed: 9
Complaint allegations: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Christian Gutierrez | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Stephanie Funderburg | Administrator | Facility administrator interviewed during investigation |
| David Sicairos | Licensing Program Manager | Oversaw complaint investigation |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 0
Date: May 20, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation received on 2025-04-14 regarding physical and mental abuse of a resident while in care.
Complaint Details
The complaint alleged that Resident #1 was physically and mentally abused by two employees on 2025-03-20 at approximately 7 pm. Interviews and investigation did not find sufficient evidence to substantiate the allegation. Staff denied rough handling and reported no prior signs of abuse before police involvement on 2025-04-15.
Findings
The investigation included interviews with the administrator, staff, and residents, and a review of relevant documents. The allegation of abuse was not substantiated due to lack of preponderance of evidence, despite bruises observed on the resident during a shower transfer in March 2025.
Report Facts
Capacity: 220
Census: 147
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during the investigation and provided information related to the complaint |
| Cynthia D Chan | Licensing Program Analyst | Conducted the complaint investigation and interviews |
| Fernando Fierros | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 147
Capacity: 220
Deficiencies: 0
Date: May 13, 2025
Visit Reason
An unannounced complaint investigation visit was conducted regarding an allegation that facility staff do not ensure a resident eats an adequate amount of food.
Complaint Details
The complaint alleged that facility staff did not ensure a resident ate an adequate amount of food, resulting in malnourishment and muscle wasting. The allegation was found to be unsubstantiated due to lack of preponderance of evidence.
Findings
The investigation found that although one resident had decreased food intake and required nutritional shakes, staff assisted the resident with meals and physician follow-ups. Interviews with residents and staff supported that meals were provided adequately. Therefore, the allegation was unsubstantiated.
Report Facts
Residents interviewed: 10
Staff interviewed: 8
Refused meals: 3
Physician visits: 4
Nutrition shakes increase: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator met during investigation and exit interview |
| Tony Vasallo | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Follow-Up
Census: 147
Capacity: 220
Deficiencies: 1
Date: Apr 29, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on deficiencies observed on 2025-04-03 during a complaint investigation visit related to missing routine medications for three residents.
Complaint Details
The visit was a follow-up to a complaint investigation conducted on 2025-04-03, which found missing routine medications for three residents. The deficiency was substantiated and cited.
Findings
The facility was found to have deficiencies related to missing routine medications for residents R1, R2, and R3, which posed a potential risk to their health, safety, and personal rights. The deficiency was cited under LIC 809D per Title 22 Regulations.
Deficiencies (1)
Routine medications were missing for residents R1, R2, and R3, with R1 missing one medication, R2 missing four medications, and R3 missing one medication, not refilled for at least 4 days.
Report Facts
Residents with missing medications: 3
Missing routine medications: 6
Plan of Correction due date: Apr 29, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with during the inspection and named in relation to the medication deficiency finding. |
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation and follow-up visit. |
| Gabriela Castro | Licensing Program Analyst | Conducted the follow-up case management visit. |
| Tony Vasallo | Licensing Program Manager | Named in the report as Licensing Program Manager. |
Inspection Report
Follow-Up
Census: 147
Capacity: 220
Deficiencies: 1
Date: Apr 29, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on deficiencies observed during a complaint investigation visit on 2025-04-03 related to missing routine medications for three residents.
Complaint Details
The follow-up visit was related to a complaint investigation conducted on 2025-04-03, which substantiated that three residents were missing routine medications for at least four days.
Findings
The facility was found to have failed to ensure availability of routine medications for three residents, with one resident missing one medication, another missing four, and a third missing one. The deficiency was noted as a Type B violation under Title 22 regulations.
Deficiencies (1)
Failure to ensure that routine medications were available for residents #1-#3, posing a potential risk to health, safety, and personal rights.
Report Facts
Residents missing medications: 3
Medications missing: 6
Plan of Correction due date: May 2, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with during inspection and named in relation to medication deficiency findings. |
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation and follow-up visit. |
| Tony Vasallo | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Complaint Investigation
Census: 146
Capacity: 220
Deficiencies: 1
Date: Apr 3, 2025
Visit Reason
Unannounced complaint investigation visit conducted due to an allegation that staff administered another resident’s medication to a resident, resulting in the resident being admitted to the hospital.
Complaint Details
The complaint was substantiated. Staff administered another resident’s medication to resident R1, resulting in R1 being admitted to the hospital on 03/27/2025. Staff member S1 made the error and received corrective action and training. Medication errors were confirmed through interviews and documentation.
Findings
The investigation substantiated the allegation that staff member S1 administered the wrong medication to resident R1, who was subsequently hospitalized. Interviews and record reviews confirmed medication errors, with corrective actions and in-service training provided to staff. Medication review also revealed that 3 out of 5 residents were missing at least one routine medication.
Deficiencies (1)
Facility personnel were not sufficient in numbers and competent to provide necessary services, resulting in a medication error where resident R1 received incorrect medication posing immediate risk to health and safety.
Report Facts
Residents interviewed: 7
Staff interviewed: 6
Residents reviewed for medication: 5
Residents missing routine medication: 3
Medication training dates: 3
Plan of Correction due date: Apr 4, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator involved in investigation and exit interview |
| Tony Vasallo | Licensing Program Manager | Named in report as Licensing Program Manager |
| S1 | Staff member | Staff who administered wrong medication to resident R1 |
Inspection Report
Complaint Investigation
Census: 131
Capacity: 220
Deficiencies: 0
Date: Feb 15, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to multiple allegations received on 2025-01-06 regarding staff response to resident calls, notification of falls and room changes, facility odors, safeguarding belongings, resident privacy, and staff negligence related to a resident fall.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included failure to respond to resident calls, failure to notify responsible parties of falls and room changes, presence of bad odors, failure to safeguard belongings, lack of resident privacy, and staff negligence leading to a fall. Interviews, observations, and document reviews did not support these allegations.
Findings
The investigation found no preponderance of evidence to substantiate any of the allegations. Staff were observed and interviewed, and documentation reviewed showed appropriate responses to resident calls, notifications to responsible parties, maintenance of facility cleanliness, safeguarding of belongings, respect for resident privacy, and proper safety precautions related to wheelchair use. All allegations were determined to be unsubstantiated.
Report Facts
Capacity: 220
Census: 131
Incident report dates: 3
Pendant call presses: 8
Incident report date: 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator involved in providing documentation and information |
| Michelle Castillo | Community Liaison | Met with Licensing Program Analyst during investigation |
| Tony Vasallo | Licensing Program Manager | Oversaw the complaint investigation report |
Inspection Report
Census: 130
Capacity: 220
Deficiencies: 0
Date: Jan 16, 2025
Visit Reason
An unannounced case management - health and safety check visit was conducted regarding the relocation of 2 residents from Foothill Heights Care Center due to mandatory evacuation orders from the Fire Advisory.
Findings
No immediate health and safety concerns were observed during the visit. The facility is fully staffed, medications for the relocated residents are centrally stored and inaccessible, and food and hygiene supplies are adequate. The administrator is working on proper placement for a resident with a prohibited health condition.
Report Facts
Number of relocated residents: 2
Date of last fire drill: Dec 17, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary Flores | Licensing Program Analyst | Conducted the unannounced case management - health and safety check visit |
| Michelle Castillo | Community Liaison Director | Met with Licensing Program Analyst during the visit |
| Stephanie Funderburg | Administrator | Facility administrator involved in the visit and exit interview |
Inspection Report
Complaint Investigation
Census: 129
Capacity: 220
Deficiencies: 0
Date: Jan 7, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff were not properly storing a resident's personal belongings and that staff did not ensure residents' hygiene needs were being met.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included improper storage of resident belongings and failure to meet residents' hygiene needs. Interviews with residents and staff, facility tour, and review of service plans showed compliance with care standards.
Findings
The investigation found no preponderance of evidence to substantiate the allegations. Residents' belongings were observed to be properly stored, and residents were assisted with showers at least twice a week with clean bedding observed. Both allegations were determined to be unsubstantiated.
Report Facts
Capacity: 220
Census: 129
Number of residents interviewed: 10
Number of staff interviewed: 9
Shower assistance frequency: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator involved in investigation and exit interview |
| Michelle Castillo | Community Liaison Director | Met with Licensing Program Analyst during investigation |
| Tony Vasallo | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 130
Capacity: 220
Deficiencies: 2
Date: Dec 12, 2024
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff were not preventing the spread of a communicable disease and were not following infection control requirements.
Complaint Details
The complaint investigation was substantiated for failure to prevent the spread of communicable disease and failure to follow infection control requirements. The allegation that staff did not report the outbreak to required agencies was unsubstantiated.
Findings
The investigation found that staff did not consistently follow infection control procedures such as hand hygiene and proper use of PPE, substantiating the allegations. However, the allegation that staff did not report an outbreak to required agencies was found to be unsubstantiated.
Deficiencies (2)
Staff provided care and meals to residents in isolation without performing hand hygiene or changing gloves between residents.
Facility staff entered a resident's room with infectious disease symptoms without using proper Personal Protective Equipment (PPE).
Report Facts
Residents interviewed: 6
Staff interviewed: 6
Residents stating staff wore gloves and mask: 3
Residents stating staff sometimes did not wear proper PPE: 2
Residents unaware of outbreak: 1
Date staff informed of symptomatic residents: Nov 18, 2024
Date of staff training on infection control: Nov 17, 2024
Date of staff training on disinfecting, PPE use, and hand hygiene: Nov 22, 2024
Date facility reported outbreak to CCLD: Nov 17, 2024
Date facility reported outbreak to PDPH: Nov 18, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report |
| Stephanie Funderburg | Administrator | Facility administrator met with Licensing Program Analyst during investigation and exit interview |
| Tony Vasallo | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 128
Capacity: 220
Deficiencies: 0
Date: Dec 12, 2024
Visit Reason
The visit was an unannounced complaint investigation triggered by an allegation that staff did not prevent inappropriate interactions between residents, including assault and stalking.
Complaint Details
The complaint alleged that staff failed to prevent inappropriate interactions between residents, including assault and stalking. The investigation included interviews with staff, residents, and family representatives, and review of medical and care documents. The allegation was unsubstantiated.
Findings
The investigation found no evidence of physical abuse or stalking. Staff were aware of the residents' interactions and took steps to supervise and separate them as needed. The allegation was determined to be unsubstantiated due to lack of evidence.
Report Facts
Capacity: 220
Census: 128
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with during investigation and exit interview |
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation |
| Tony Vasallo | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 130
Capacity: 220
Deficiencies: 2
Date: Nov 26, 2024
Visit Reason
An unannounced complaint investigation was conducted regarding allegations that staff were not preventing the spread of a communicable disease, not following infection control requirements, and did not report an outbreak to required agencies.
Complaint Details
The complaint investigation was substantiated for allegations related to failure to prevent the spread of communicable disease and failure to follow infection control requirements. The allegation that staff did not report the outbreak to required agencies was unsubstantiated.
Findings
The investigation substantiated that staff failed to follow proper infection control procedures including hand hygiene and PPE use, posing risks to residents. However, the allegation that staff did not report the outbreak to required agencies was unsubstantiated as the facility reported the outbreak to Community Care Licensing and the Department of Public Health within required timeframes.
Deficiencies (2)
Failure to ensure staff wear appropriate Personal Protective Equipment (PPE) when providing direct care to residents with contagious diseases.
Failure to ensure all staff and volunteers perform hand hygiene as required.
Report Facts
Residents interviewed: 6
Staff interviewed: 6
Deficiency due date: 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator met during investigation and named in findings |
| Tony Vasallo | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 129
Capacity: 220
Deficiencies: 1
Date: Oct 25, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit regarding allegations that staff did not seek medical attention for a resident in a timely manner and that the facility van was not accessible for residents to get in.
Complaint Details
The complaint alleged that staff did not seek medical attention for resident #1 in a timely manner after the resident injured their knee while entering the facility van on 8/1/2024. The investigation found a delay of about an hour in obtaining emergency services, substantiating the allegation.
Findings
The investigation substantiated that staff delayed obtaining emergency medical attention for resident #1 by about an hour after an injury sustained while entering the facility van, posing an immediate personal right, health, or safety risk. The allegation that the facility van was not accessible for residents to get in was unsubstantiated, as the van and its equipment were found to be in good repair and appropriate steps were used.
Deficiencies (1)
Failure to provide timely medical care to resident #1 during an incident, delaying care by an hour which posed an immediate personal right, health, or safety risk.
Report Facts
Facility capacity: 220
Resident census: 129
Delay in medical attention: 60
Date complaint received: Aug 27, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Stephanie Funderburg | Administrator | Facility administrator met with Licensing Program Analyst during the investigation and exit interview |
| Tony Vasallo | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 131
Capacity: 220
Deficiencies: 0
Date: Oct 3, 2024
Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations including questionable deaths, inadequate food service, and staff not meeting residents' needs at Astoria Park Senior Living Facility.
Complaint Details
The complaint investigation addressed allegations of questionable deaths, inadequate food service, and staff not meeting residents' needs. The investigation included interviews with residents, staff, and family members, review of incident and physician reports, and facility observations. All allegations were found to be unsubstantiated.
Findings
The investigation found no preponderance of evidence to substantiate the allegations. Two resident deaths were reviewed and determined to be sudden but not preventable by staff care. The facility was found to provide meals according to residents' dietary needs, including vegan meals, and residents reported satisfaction with care and assistance, including wheelchair and dining support.
Report Facts
Facility capacity: 220
Resident census: 131
Complaint receipt date: Aug 27, 2024
Dates of incidents: Apr 18, 2024
Date of death: Apr 25, 2024
Date resident #3 found unresponsive: Jul 9, 2024
Date resident #3 passed away: Jul 10, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator met with investigator and provided information |
| Tony Vasallo | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 131
Capacity: 220
Deficiencies: 1
Date: Sep 26, 2024
Visit Reason
The visit was an unannounced case management inspection regarding an incident report submitted on 2024-09-11 about a resident who eloped from the memory care unit on 2024-08-31.
Complaint Details
The visit was triggered by a complaint/incident report regarding resident #1 eloping from the memory care unit on 2024-08-31. The complaint was substantiated as deficiencies were cited.
Findings
The licensee failed to ensure that resident #1 did not elope from the facility, posing an immediate risk to the health, safety, and personal rights of the persons in care. Staff were unaware that the resident had left the memory care unit, and corrective actions including staff training and warnings were implemented.
Deficiencies (1)
Based on documents reviewed and interviews conducted the licensee did not ensure R1 did not elope from the facility which poses an immediate risk to the health, safety, and personal rights of the persons in care.
Report Facts
Deficiencies cited: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during the visit and involved in the exit interview |
| Mary G Flores | Licensing Program Analyst | Conducted the unannounced case management visit and authored the report |
| Tony Vasallo | Supervisor | Named as supervisor in the deficiency report |
Inspection Report
Complaint Investigation
Census: 131
Capacity: 220
Deficiencies: 0
Date: Sep 26, 2024
Visit Reason
An unannounced complaint investigation visit was conducted in response to multiple allegations including failure to prevent a resident's fracture, hazardous conditions causing injuries, facility disrepair, failure to follow physician's orders, and interference with resident's sleep.
Complaint Details
The complaint investigation was unsubstantiated for all allegations including failure to prevent resident injury, hazardous conditions, facility disrepair, failure to follow physician's orders, and interference with resident's sleep.
Findings
The investigation found no preponderance of evidence to substantiate any of the allegations. The facility was found to be safe with no hazardous conditions, the showers and A/C were in working condition, physician's orders were followed appropriately, and staff responded to resident concerns about sleep disturbances.
Report Facts
Facility capacity: 220
Resident census: 131
Number of residents interviewed: 10
Number of staff interviewed: 6
Number of resident rooms toured: 12
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephanie Funderburg | Administrator | Facility administrator met during investigation and exit interview |
| Mario Henriquez | Maintenance Director | Accompanied Licensing Program Analyst during facility tour |
| Tony Vasallo | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 131
Capacity: 220
Deficiencies: 1
Date: Sep 26, 2024
Visit Reason
An unannounced annual continuation inspection visit was conducted to evaluate compliance with various regulatory domains including infection control, staffing, medical care, and resident rights.
Findings
The inspection found a deficiency related to medication labeling where prescribed medication for resident #3 did not have labels, posing a potential health and safety risk. Other domains such as infection control, staffing, and disaster preparedness were reviewed without noted deficiencies.
Deficiencies (1)
Prescribed medication for resident #3 was observed without labels, violating medication labeling requirements.
Report Facts
Staff files reviewed: 8
Residents medication reviewed: 7
Deficiency POC due date: Oct 3, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met during inspection and involved in exit interview |
| Mary G Flores | Licensing Evaluator | Conducted the inspection and signed the report |
| Tony Vasallo | Supervisor | Supervisor overseeing the inspection process |
Inspection Report
Complaint Investigation
Census: 131
Capacity: 220
Deficiencies: 1
Date: Sep 26, 2024
Visit Reason
An unannounced case management visit was conducted regarding an incident report submitted on 2024-09-11 about a resident who left the memory care unit unattended on 2024-08-31.
Complaint Details
The visit was triggered by a complaint incident report about a resident who left the memory care unit unattended. The complaint was substantiated as the licensee failed to prevent the resident from eloping.
Findings
The licensee failed to ensure that the resident did not elope from the facility, posing an immediate risk to the health, safety, and personal rights of the resident. Staff were not aware the resident had exited the memory care unit, and corrective actions including staff training and warnings were implemented.
Deficiencies (1)
Facility personnel were not sufficient in numbers and competent to meet resident needs, resulting in a resident eloping from the facility.
Report Facts
Deficiencies cited: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during the visit and involved in the incident report |
| Mary G Flores | Licensing Program Analyst | Conducted the unannounced case management visit and evaluation |
| Tony Vasallo | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Census: 128
Capacity: 220
Deficiencies: 0
Date: Sep 6, 2024
Visit Reason
An unannounced complaint investigation visit was conducted regarding allegations that staff were not preventing the spread of COVID-19.
Complaint Details
The complaint alleged that staff were not preventing the spread of COVID-19. The allegation was unsubstantiated after investigation, with 10 of 12 residents and 5 of 5 staff denying the allegation. The COVID outbreak was not reported per the 24-hour reporting requirement, which will be addressed in a separate case management report.
Findings
The investigation included interviews with staff and residents, review of documents, and a facility tour. Although some staff and residents were observed without masks, the recent rescission of the mask order in Pasadena was noted. The allegation was found to be unsubstantiated due to insufficient evidence.
Report Facts
Residents interviewed: 12
Staff interviewed: 5
Residents denying allegation: 10
Staff denying allegation: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Executive Director | Met with Licensing Program Analyst during investigation and involved in facility tour |
| Tena Herrera | Licensing Program Analyst | Conducted the complaint investigation visit |
| David Sicairos | Licensing Program Manager | Named as Licensing Program Manager on report |
| Ann-Marie Boersma | Wellness Director | Accompanied Licensing Program Analyst during facility tour |
Inspection Report
Complaint Investigation
Census: 128
Capacity: 220
Deficiencies: 1
Date: Sep 6, 2024
Visit Reason
The visit was conducted as a case management investigation related to complaint control #28-AS-20240905092935 concerning the facility's failure to report a Covid-19 outbreak within the required 24-hour timeframe.
Complaint Details
Complaint control #28-AS-20240905092935 was investigated and substantiated based on the facility's failure to report the Covid-19 outbreak within the required timeframe.
Findings
The facility failed to notify the Department of the Covid-19 outbreak within the 24-hour reporting requirement, as multiple residents tested positive several days before the report was sent. This deficiency was documented and cited under regulation LIC809-D.
Deficiencies (1)
Failure to report epidemic outbreak to licensing agency within 24 hours as required, despite multiple residents testing positive for Covid-19 five days prior to reporting.
Report Facts
Residents tested positive for Covid-19: 6
Deficiency count: 1
Plan of Correction Due Date: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during the complaint investigation |
| Tena Herrera | Licensing Program Analyst | Conducted the case management visit and complaint investigation |
| David Sicairos | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Census: 127
Capacity: 220
Deficiencies: 1
Date: Sep 4, 2024
Visit Reason
An unannounced complaint investigation visit was conducted regarding an allegation that staff handled a resident in a rough manner.
Complaint Details
The complaint was substantiated. The allegation was that staff handled a resident in a rough manner. Evidence included incident reports, staff and resident interviews, and internal investigation. Staff member S1 was suspended and terminated following the investigation. No physical injuries were found. The Pasadena Police Department conducted a visit and filed a report.
Findings
The investigation substantiated that staff member S1 assisted resident R2 aggressively, causing R2 to scream in pain due to rough handling while placing the resident's leg in the wheelchair footrest. S1 was suspended and subsequently terminated for suspected abuse. No physical injuries were caused to the resident.
Deficiencies (1)
Deficiency on personal rights due to suspected abuse occurred to residents in care at the facility.
Report Facts
Facility capacity: 220
Census: 127
Incident report date: Aug 6, 2024
Complaint received date: Aug 27, 2024
Suspension and termination date: Aug 6, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during investigation and exit interview |
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit and interviews |
| Tony Vasallo | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 127
Capacity: 220
Deficiencies: 1
Date: Aug 27, 2024
Visit Reason
An unannounced annual inspection visit was conducted using the CARE inspection tool to evaluate compliance with licensing regulations at the facility.
Findings
The facility was found to be in good repair with sufficient food supplies and proper safety measures in place. However, a deficiency was noted regarding the storage of a cleaning solution accessible to residents in a memory care unit room, posing a safety risk.
Deficiencies (1)
Cleaning solution was observed under bathroom's sink in room #150 in the memory care unit, making it accessible to residents and posing an immediate health and safety risk.
Report Facts
Food supply duration: 2
Food supply duration: 7
Residents reviewed: 7
Residents interviewed: 7
Staff interviewed: 6
Rooms observed: 12
Water temperature range: 108
Water temperature range: 117
Fire extinguisher last checked: Sep 7, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during inspection |
| Mario Henriquez | Maintenance Director | Conducted facility tour with Licensing Program Analyst |
| Mary G Flores | Licensing Evaluator | Conducted inspection and authored report |
| Tony Vasallo | Supervisor | Supervised licensing evaluation |
Inspection Report
Complaint Investigation
Census: 126
Capacity: 220
Deficiencies: 1
Date: Aug 22, 2024
Visit Reason
The visit was an unannounced case management inspection triggered by incident reports submitted on 08/06/2024 and 08/08/2024 regarding allegations of physical abuse by staff towards residents and a choking incident requiring Heimlich maneuver assistance.
Complaint Details
The complaint investigation was substantiated regarding physical abuse by staff member S1 towards two residents (R1 and R2) in the memory care unit. The facility conducted an internal investigation, suspended, and terminated the staff member. Police department conducted a visit and filed report #PA24-61517.
Findings
The investigation substantiated physical abuse by staff member S1 towards two residents in the memory care unit, resulting in a deficiency citation. No injuries were caused, but the staff member was suspended and terminated. A separate choking incident was handled promptly with no deficiencies noted.
Deficiencies (1)
Failure to ensure staff treated residents with dignity and respect, resulting in physical abuse towards two residents in the memory care unit.
Report Facts
Incident report dates: Incident reports submitted on 08/06/2024 and 08/08/2024
Incident dates: Physical abuse incidents occurred on 07/26/2024 and 07/29/2024; choking incident on 08/04/2024
Plan of Correction Due Date: 08/23/2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during inspection and exit interview |
| Mary G Flores | Licensing Program Analyst | Conducted the unannounced case management visit and authored the report |
| Tony Vasallo | Supervisor | Supervisor named on the report |
Inspection Report
Complaint Investigation
Census: 126
Capacity: 220
Deficiencies: 1
Date: Aug 22, 2024
Visit Reason
An unannounced case management visit was conducted regarding incident reports submitted on 8/6/24 and 8/8/24 involving allegations of physical abuse by a staff member towards two residents and a choking incident requiring Heimlich maneuver assistance.
Complaint Details
The complaint investigation was substantiated regarding physical abuse by staff member S1 towards two residents in the memory care unit. The facility conducted an internal investigation, suspended, and terminated the staff member. Police department conducted a visit and left report #PA24-61517.
Findings
The investigation substantiated physical abuse by staff member S1 towards two residents, resulting in a deficiency noted on LIC 809D. No injuries occurred, and the staff member was suspended and terminated. The choking incident was managed promptly with no deficiencies noted.
Deficiencies (1)
Failure to ensure staff treated residents with dignity and respect, resulting in physical abuse towards two residents.
Report Facts
Facility Capacity: 220
Census: 126
Plan of Correction Due Date: Aug 23, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during inspection and involved in incident reporting |
| Mary G Flores | Licensing Program Analyst | Conducted the unannounced case management visit and investigation |
| Tony Vasallo | Supervisor | Named as supervisor in the report |
Inspection Report
Complaint Investigation
Capacity: 220
Deficiencies: 1
Date: Mar 19, 2024
Visit Reason
The inspection was an unannounced case management visit triggered by an incident report submitted on 2024-03-07 regarding a resident who eloped from the facility on 2024-03-04.
Complaint Details
The visit was complaint-related due to an incident report about resident #1 eloping the facility on 2024-03-04. The complaint was substantiated as deficiencies were noted regarding staffing and supervision.
Findings
The facility failed to prevent resident #1 from eloping through an emergency exit door despite the delay egress system working. The resident sustained a minor head abrasion and was placed on 24/7 supervision. A deficiency was cited for insufficient staffing to meet resident needs, which was corrected by placing one-on-one staff and providing staff training.
Deficiencies (1)
Facility personnel were not sufficient in numbers and competent to meet resident needs, failing to prevent resident #1 from eloping the facility after the first incident.
Report Facts
Facility capacity: 220
Deficiency count: 1
Plan of Correction due date: Mar 20, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Named in relation to the incident and deficiency findings |
| Mary G Flores | Licensing Evaluator | Conducted the inspection and authored the report |
| Tony Vasallo | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Capacity: 220
Deficiencies: 1
Date: Mar 19, 2024
Visit Reason
The inspection was an unannounced case management visit triggered by an incident report submitted on 2024-03-07 regarding a resident who eloped the facility on 2024-03-04.
Complaint Details
The visit was complaint-related due to an incident where resident #1 eloped the facility by exiting through an emergency exit door and climbing over a parking gate. The incident was substantiated by video footage and staff interviews.
Findings
The facility failed to prevent resident #1 from eloping through an emergency exit door despite the delay egress system working. The resident sustained a minor head laceration and was hospitalized briefly. Deficiencies were cited related to insufficient staffing to meet resident needs and failure to prevent elopement, posing immediate risk to resident safety.
Deficiencies (1)
87411 Personnel Requirements - Facility personnel were not sufficient in numbers and competent to meet resident needs, failing to prevent resident elopement.
Report Facts
Facility capacity: 220
Incident date: Mar 4, 2024
Incident report submission date: Mar 7, 2024
Plan of Correction due date: Mar 20, 2024
Laceration size: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during inspection and involved in incident interviews |
| Tony Vasallo | Supervisor | Named as supervisor in report |
| Mary G Flores | Licensing Evaluator | Conducted inspection and signed report |
Inspection Report
Complaint Investigation
Census: 97
Capacity: 220
Deficiencies: 1
Date: Mar 4, 2024
Visit Reason
The visit was an unannounced case management inspection regarding an incident report submitted on 2024-02-21 about a resident elopement from the memory care unit.
Complaint Details
The visit was triggered by a complaint incident report of resident #1 eloping from the memory care unit on 2024-02-21. The incident was substantiated by video surveillance and staff interviews.
Findings
The inspection found that a resident with dementia eloped from the memory care unit by climbing over a 7-foot fenced door. The facility had inadequate supervision at the time and had obstructed passageways with wood planks, which posed a safety risk. A deficiency was cited for failure to keep all passageways free of obstruction.
Deficiencies (1)
Failure to ensure all outdoor and indoor passageways and stairways were kept free of obstruction, specifically wood planks blocking the passageway leading to the parking lot exit door from the memory care unit courtyard.
Report Facts
Residents in Memory Care Unit: 29
Staff on shift: 3
Plan of Correction Due Date: Mar 11, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during the visit and involved in incident response. |
| Mary G Flores | Licensing Program Analyst | Conducted the unannounced case management visit and authored the report. |
| Tony Vasallo | Supervisor | Supervisor overseeing the licensing evaluation. |
Inspection Report
Complaint Investigation
Census: 97
Capacity: 220
Deficiencies: 1
Date: Mar 4, 2024
Visit Reason
The visit was an unannounced case management inspection conducted in response to an incident report submitted on 2024-02-21 regarding a resident elopement from the memory care unit.
Complaint Details
The visit was triggered by a complaint incident report of a resident elopement from the memory care unit on 2024-02-21. The complaint was substantiated by observation and review of video surveillance.
Findings
The inspection found that a resident with dementia eloped from the memory care unit by climbing over a fenced door. The facility had a plan of care for the resident and was in the process of hiring additional staff. However, an obstruction was noted in the passageway leading to the exit door from the courtyard, resulting in a cited deficiency.
Deficiencies (1)
Licensee did not ensure that all passageways were free of obstruction, posing a potential risk to health, safety, or personal rights of persons in care.
Report Facts
Residents in memory care unit: 29
Staff on shift: 3
Plan of Correction due date: Mar 11, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Funderburg | Administrator | Met with Licensing Program Analyst during visit and named in relation to incident and corrective actions |
| Mary G Flores | Licensing Evaluator | Conducted the inspection and signed the report |
| Tony Vasallo | Supervisor | Named as supervisor in the report |
Inspection Report
Complaint Investigation
Census: 94
Capacity: 220
Deficiencies: 1
Date: Dec 21, 2023
Visit Reason
The inspection visit was conducted as an unannounced complaint investigation in response to an allegation that staff unlawfully evicted a resident.
Complaint Details
The complaint alleged that staff unlawfully evicted resident #1. The allegation was substantiated based on record review and interviews. Resident #1 moved in on 11/21/2023 and left on 12/4/2023 without receiving a 30-day eviction notice. The facility determined resident #1 required a higher level of care and should not return after hospital discharge.
Findings
The investigation found that resident #1 was not given the required 30 days written eviction notice before leaving the facility. It was determined that resident #1 required a higher level of care not initially identified at admission, and the facility did not feel the resident should return after hospital discharge. The allegation was substantiated and deficiencies were cited.
Deficiencies (1)
Failure to provide resident #1 with 30 days written eviction notice as required by eviction procedures.
Report Facts
Facility capacity: 220
Census: 94
Plan of Correction due date: Dec 28, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Angelica Rea | Licensing Program Analyst | Conducted the complaint investigation |
| Stephanie Funderburg | Administrator who assisted with the investigation and exit interview | |
| Lisa Hicks | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Capacity: 220
Deficiencies: 0
Date: Dec 8, 2023
Visit Reason
The visit was an unannounced case management follow-up to an incident report submitted on 2023-12-07 regarding a resident who left the facility unattended.
Findings
The Licensing Program Analyst found that the resident had left the facility unattended twice as allowed by a physician's report, but due to concerns about the resident's dementia diagnosis and decision-making capacity, the facility will obtain a reassessment and submit updated documentation by 2023-12-18. No deficiencies were noted during the visit.
Report Facts
Facility capacity: 220
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary Flores | Licensing Program Analyst | Conducted the unannounced case management visit |
| Stephanie Funderburg | Executive Director | Met with Licensing Program Analyst during the visit |
| Erin Mahoney | Administrator | Facility administrator mentioned in the report |
Inspection Report
Complaint Investigation
Census: 94
Capacity: 220
Deficiencies: 0
Date: Dec 5, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that staff did not prevent a resident from being sexually abused while in care.
Complaint Details
The complaint alleged that staff failed to prevent sexual abuse of a resident. The investigation included interviews with residents and staff, review of surveillance footage, and contact with the police department. The allegation was unsubstantiated due to insufficient evidence.
Findings
The investigation found that a male resident allegedly inappropriately touched a female resident in an elevator. Surveillance video and interviews were reviewed, but due to cognitive impairments and lack of sufficient evidence, the allegation was determined to be unsubstantiated.
Report Facts
Capacity: 220
Census: 94
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit and interviews |
| Tony Vasallo | Licensing Program Manager | Named as Licensing Program Manager on the report |
| Stephanie Funderburg | Administrator | Facility administrator met during the investigation and exit interview |
| Brianna Goodlett | Administrator | Named as facility administrator in report header |
Inspection Report
Complaint Investigation
Census: 97
Capacity: 220
Deficiencies: 2
Date: Oct 19, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 03/28/2023 regarding inadequate care and supervision, staff blocking doorways to prevent residents from leaving, and other resident care concerns at Astoria Park Senior Living Facility.
Complaint Details
The complaint investigation was substantiated for allegations that staff did not provide adequate care and supervision, including residents exiting the memory care unit unattended and blocked exit doors. Other allegations regarding staff leaving residents soiled, inappropriate language, and risky staff behavior were unsubstantiated.
Findings
The investigation substantiated that staff did not provide adequate care and supervision, including residents exiting the memory care unit unattended and a blocked exit door with a non-functioning egress system. Other allegations such as staff leaving residents soiled, use of inappropriate language, and staff behavior posing risk were found unsubstantiated based on interviews and observations.
Deficiencies (2)
Failure to ensure residents who continue to indicate a desire to leave the facility following redirection are permitted to do so with staff supervision, specifically residents exiting the memory care unit unattended.
Failure to maintain exit door by room #129 with a working egress system at all times; door was blocked with a sliding wood board and egress system was not working.
Report Facts
Capacity: 220
Census: 97
Deficiencies cited: 2
Plan of Correction Due Dates: 10
Plan of Correction Due Dates: 26
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation and subsequent visits |
| Tony Vasallo | Licensing Program Manager | Oversaw the complaint investigation report |
| Erin Mahoney | Administrator | Met during inspection and exit interview; involved in findings |
Inspection Report
Complaint Investigation
Census: 97
Capacity: 220
Deficiencies: 2
Date: Oct 19, 2023
Visit Reason
An unannounced case management visit was conducted during a complaint investigation related to a resident who left the facility unattended and the facility's failure to report the incident and update care plans accordingly.
Complaint Details
Complaint #28-AS-20230328095738 was investigated, substantiating deficiencies related to incident reporting and care of a dementia resident.
Findings
Two deficiencies were noted: failure to report an incident involving a resident leaving the facility within seven days, and failure to obtain an annual medical assessment and develop a care plan addressing wandering and elopement risks for a dementia resident.
Deficiencies (2)
Failure to report an incident involving a resident leaving the facility unattended within seven days as required by regulations.
Failure to obtain an annual medical assessment and update care plans for a resident with dementia, including addressing wandering and elopement risks.
Report Facts
Deficiencies cited: 2
Capacity: 220
Census: 97
Plan of Correction Due Date: Oct 26, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Erin Mahoney | Administrator | Met with Licensing Program Analyst during the visit and exit interview |
Inspection Report
Complaint Investigation
Census: 97
Capacity: 220
Deficiencies: 2
Date: Oct 19, 2023
Visit Reason
An unannounced case management visit was conducted during a complaint investigation related to complaint #28-AS-20230328095738.
Complaint Details
Complaint #28-AS-20230328095738 was investigated, with findings delivered on 10/19/23. The complaint involved a resident leaving the facility unattended and lack of proper reporting and care planning.
Findings
Two deficiencies were noted: failure to report an incident involving a resident leaving the facility unattended within 7 days, and failure to provide an annual medical assessment and care plan for a dementia resident who eloped.
Deficiencies (2)
Failure to report an incident on 3/24/23 involving a resident found outside the facility within 7 days as required by regulations.
Failure to obtain an annual medical assessment and develop a care plan for a dementia resident who left the facility unattended.
Report Facts
Deficiencies cited: 2
Capacity: 220
Census: 97
Plan of Correction Due Date: Oct 26, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Evaluator | Conducted the complaint investigation and delivered findings |
| Erin Mahoney | Administrator | Met with Licensing Program Analyst during the visit and participated in exit interview |
| Tony Vasallo | Supervisor | Named as supervisor in the report |
Inspection Report
Complaint Investigation
Capacity: 220
Deficiencies: 0
Date: Oct 5, 2023
Visit Reason
The visit was an unannounced case management inspection triggered by an incident report submitted on 2023-10-02 regarding a resident who reportedly jumped from a bedroom window.
Complaint Details
The visit was conducted due to an incident report alleging Resident #1 jumped from a window. The complaint was investigated through staff interviews, file review, and observation. No substantiated deficiencies or violations were found.
Findings
The investigation found that Resident #1 jumped from a window but had no documented history or recent indications of suicidal tendencies. Staff responded promptly, and the resident was hospitalized. No deficiencies were noted during the visit.
Report Facts
Facility capacity: 220
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Brianna Goodlett | Administrator | Met with Licensing Program Analyst during the visit and was informed of the incident |
| Mary Flores | Licensing Program Analyst | Conducted the unannounced case management visit and investigation |
| Erin Mahoney | Executive Director | Provided additional information over the phone regarding the incident |
Inspection Report
Annual Inspection
Census: 95
Capacity: 220
Deficiencies: 10
Date: Sep 21, 2023
Visit Reason
Licensing Program Analyst Mary Flores conducted an unannounced annual visit at the facility using the CARE tool to evaluate compliance with regulations and licensing requirements.
Findings
The inspection identified multiple deficiencies including unsecured disinfectant sprays in the dementia unit, lack of TB clearance and health screenings for some staff, expired CPR/First Aid training, maintenance issues such as a clogged toilet and water damage, obstructed passageways, and an outdated emergency disaster plan. Plans of correction were required for all deficiencies.
Deficiencies (10)
Disinfectant sprays observed in dementia unit kitchenette cabinet without a lock, posing immediate health and safety risk.
Staff member S4 does not have a TB clearance on file.
Two staff members (S4 and S5) do not have health screenings on file.
Toilet in room #149 was clogged and overflowed.
Dementia bathroom faucet sink in dining room not working; activity room refrigerator dirty; ceiling by family lounge with water damage and crack; screen door on floor in dementia courtyard.
Five out of five staff files reviewed did not have current CPR/First Aid training; administrator's CPR/First Aid expired.
Emergency disaster plan LIC 610E(10/03) outdated and does not meet current requirements.
Resident #3 does not have an updated physician's report; last dated 3/15/22.
Passageways on first floor obstructed by bench and chairs near dementia courtyard and outside room #119.
Administrator Brianna Goodlett does not have a current administrator certificate; department not notified of change to new administrator Erin Mahoney.
Report Facts
Residents medication reviewed: 9
Resident files reviewed: 5
Staff files reviewed: 5
Food supply duration: 2
Food supply duration: 7
Fire extinguisher last checked: Sep 7, 2023
Last fire emergency drill: May 24, 2023
Water temperature range: 107.2-117.8
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Brianna Goodlett | Administrator | Named in findings related to expired CPR/First Aid training, lack of renewal of administrator certificate, and staff training plans |
| Gina Lopez | Business Manager | Met with Licensing Program Analyst during inspection and involved in facility tour and exit interview |
| Erin Mahoney | Executive Director / New Administrator | To be appointed as new administrator; department not notified of change |
| Mary G Flores | Licensing Program Analyst | Conducted the inspection and authored the report |
| Tony Vasallo | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 87
Capacity: 220
Deficiencies: 0
Date: May 13, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that a resident was hit with an object by an unknown perpetrator resulting in a fracture.
Complaint Details
The complaint alleged that a resident was assaulted by another resident resulting in a fracture. The investigation included interviews with staff and review of video footage, hospital and police reports. The evidence did not substantiate the allegation.
Findings
The investigation found that although the resident did sustain a sternal fracture and initially identified a perpetrator, there was no preponderance of evidence to support that anyone inflicted the injury. The allegations were therefore unsubstantiated.
Report Facts
Facility capacity: 220
Resident census: 87
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit and delivered findings |
| Brian Slatic | Investigator | Conducted interviews with staff and resident during investigation |
| Brianna Goodlett | Administrator | Facility administrator who provided information and reviewed video footage |
Inspection Report
Follow-Up
Census: 80
Capacity: 220
Deficiencies: 0
Date: Oct 17, 2022
Visit Reason
The visit was a case management follow-up to verify corrections needed from a pre-licensing visit conducted on 2022-09-12.
Findings
The facility corrected previously noted issues including fixing a loose outlet cover plate, repairing a hole in a wall, maintaining water temperatures within required ranges, and ensuring skid strips were present in bathrooms. Medication storage issues were resolved with updated physician documentation.
Report Facts
Water temperature range: 110.3 to 117.8
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary Flores | Licensing Program Analyst | Conducted the case management visit and inspection. |
| Brianna Goodlett | Applicant's Representative | Met with Licensing Program Analyst and participated in exit interview. |
| Gina Lopez | Staff | Accompanied Licensing Program Analyst during the tour and observation. |
Inspection Report
Original Licensing
Census: 83
Capacity: 220
Deficiencies: 5
Date: Sep 12, 2022
Visit Reason
An announced pre-licensing visit was conducted to evaluate the facility for licensing purposes and ensure compliance with regulations.
Findings
The facility was generally observed to be in good repair with clean and sanitized areas, sufficient food supplies, and proper infection control protocols. However, several deficiencies were noted including loose outlet cover plates, holes in walls, water temperatures not maintained within required range, missing skid strips/mats in some bathrooms, and medication stored in resident rooms.
Deficiencies (5)
Loose outlet cover plate in room #145
Hole in the wall in room #103
Water temperature not maintained between 105 and 120 degrees F in multiple rooms (#160, 159, 156, 153, 152, 150, 149, 145, 141, 139)
Missing skid strips/mats in bathrooms of rooms #141 and #153
Medication stored in resident rooms #155 and #256
Report Facts
Capacity: 220
Census: 83
Food supply duration: 2
Food supply duration: 7
Water temperature range: 101.6
Water temperature range: 120
Fire inspection clearance date: Jul 11, 2022
Resident files reviewed: 9
Staff files reviewed: 7
PPE supply duration: 30
Correction timeframe: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Brianna Goodlet | Applicant's Contact Person | Met with LPAs during inspection and exit interview |
| Brandon Collins | Vice President | Accompanied LPAs during facility tour |
| Jennifer Siegel | Regional Wellness Director | Accompanied LPAs during facility tour |
| Mary G Flores | Licensing Evaluator | Conducted inspection and signed report |
| Stefanie Coronel | Supervisor | Oversaw inspection process |
Inspection Report
Original Licensing
Census: 75
Capacity: 220
Deficiencies: 0
Date: Jul 27, 2022
Visit Reason
The visit was conducted as part of a Change of Ownership (CHOW) application process involving a telephone call with the Community Care Licensing analyst to verify applicant and administrator identity and confirm understanding of licensing requirements.
Findings
The applicant and administrator successfully completed Component II of the licensing process, demonstrating understanding of facility operation, staff qualifications, program policies, grievance procedures, and physical plant requirements. Technical assistance was provided regarding application documents and certifications.
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February 23, 2026
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February 23, 2026
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September 6, 2024
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