Inspection Reports for
Brookdale Santa Monica Gardens

CA, 90403

Back to Facility Profile

Deficiencies (last 5 years)

Deficiencies (over 5 years) 3.2 deficiencies/year

Deficiencies are regulatory violations found during state inspections.

20% better than California average
California average: 4 deficiencies/year

Deficiencies per year

8 6 4 2 0
2021
2022
2023
2024
2025

Census

Latest occupancy rate 44% occupied

Based on a May 2025 inspection.

This facility has shown a decline in demand based on occupancy rates.

Occupancy over time

30 60 90 120 150 Feb 2021 Mar 2022 Jul 2023 Jan 2024 Jun 2024 Mar 2025 May 2025

Inspection Report

Annual Inspection
Census: 56 Capacity: 128 Deficiencies: 1 Date: May 1, 2025

Visit Reason
An unannounced annual required inspection visit was conducted to evaluate compliance with licensing requirements at the facility.

Findings
The facility was generally found to be clean, sanitary, and appropriately furnished with no major physical plant issues. However, a Technical Advisory was issued due to three of six staff members not having up-to-date first aid/CPR certifications.

Deficiencies (1)
Three of six staff members did not have the required first aid/CPR certifications up to date.
Report Facts
Staff files reviewed: 7 Resident files reviewed: 6 Medication administration records audited: 6 Staff without up-to-date first aid/CPR certifications: 3 Fire/Disaster Drills last conducted: Apr 30, 2025 Perishable food supply: 5 Non-perishable food supply: 7

Employees mentioned
NameTitleContext
Bernadette AllenLicensing Program AnalystConducted the inspection visit.
Richard PachecoMaintenance DirectorMet with Licensing Program Analyst during inspection and assisted with physical plant tour.
Amanda MonroyAdministratorMet with Licensing Program Analyst and assisted with inspection; received exit interview.

Inspection Report

Annual Inspection
Census: 56 Capacity: 128 Deficiencies: 1 Date: May 1, 2025

Visit Reason
An unannounced annual required inspection visit was conducted to evaluate compliance with licensing requirements at the facility.

Findings
The facility was found to be generally clean, sanitary, and appropriately furnished with no major physical plant issues. However, a Technical Advisory was issued for three of six staff members not having up-to-date first aid/CPR certifications.

Deficiencies (1)
Three of six staff members did not have the required first aid/CPR certifications up to date.
Report Facts
Staff files reviewed: 7 Staff without up-to-date First Aid/CPR certification: 3 Resident files reviewed: 6 Resident medication administration records audited: 6 Perishable food supply: 5 Non-perishable food supply: 7 Resident rooms inspected: 7 Bathrooms inspected: 7 Resident rooms total: 92

Employees mentioned
NameTitleContext
Amanda MonroyAdministratorMet with during inspection and exit interview
Richard PachecoMaintenance DirectorMet with during physical plant tour
Bernadette AllenLicensing Program AnalystConducted the inspection visit
Stephanie CifuentesLicensing Program ManagerNamed as Licensing Program Manager on report

Inspection Report

Complaint Investigation
Census: 62 Capacity: 128 Deficiencies: 0 Date: Mar 5, 2025

Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations that staff do not respond timely to residents' calls for assistance, do not ensure residents are provided with planned daily activities, and do not maintain a facility activities calendar.

Complaint Details
The complaint alleged that staff do not respond timely to residents' calls for assistance, residents must wait up to one hour for help, planned daily activities are not provided due to lack of an activities director, and the facility does not maintain an activities calendar. Interviews with staff (S1-S4) and residents (R1-R8) mostly denied these allegations, with the majority confirming timely assistance and presence of planned activities and calendar. The investigation concluded the allegations were unsubstantiated.
Findings
Based on interviews with staff and residents, review of records including staff rosters, activity calendars, and in-service trainings, and direct observations, there was insufficient evidence to substantiate any of the allegations. The staff were found to respond timely to calls, planned daily activities were provided, and the facility maintained an activities calendar. No citations were issued.

Report Facts
Capacity: 128 Census: 62 Resident interviews: 8 Staff interviews: 4 Resident denials of allegation #1: 5 Resident denials of allegation #2: 7 Resident denials of allegation #3: 7

Employees mentioned
NameTitleContext
Paloma KeitelmanBusiness Office ManagerMet with during investigation and participated in exit interview
Perry ScottLicensing Program AnalystConducted the complaint investigation
Janae HammondLicensing Program ManagerOversaw the complaint investigation

Inspection Report

Complaint Investigation
Census: 62 Capacity: 128 Deficiencies: 0 Date: Mar 5, 2025

Visit Reason
The inspection was conducted as an unannounced complaint investigation visit triggered by allegations that staff do not respond timely to residents' calls for assistance, do not ensure residents are provided with planned daily activities, and do not maintain a facility activities calendar.

Complaint Details
The complaint alleged that staff do not respond timely to residents' calls for assistance, residents are not provided with planned daily activities, and the facility does not maintain an activities calendar. Interviews with staff (S1-S4) and residents (R1-R8), review of records, and observations showed that the majority of residents and all staff denied these allegations. The investigation concluded the allegations were unsubstantiated due to insufficient evidence.
Findings
Based on interviews with staff and residents, review of records including staff rosters, activity calendars, and in-service trainings, and observations, there was insufficient evidence to substantiate any of the allegations. The staff were found to respond timely to calls, planned activities were provided daily, and an activities calendar was maintained. Therefore, all allegations were unsubstantiated and no citations were issued.

Report Facts
Capacity: 128 Census: 62 Resident interviews: 8 Staff interviews: 4 Average wait time for assistance: 15

Employees mentioned
NameTitleContext
Paloma KeitelmanBusiness Office ManagerMet with during the investigation and participated in exit interview
Perry ScottLicensing EvaluatorConducted the complaint investigation
Janae HammondSupervisorSupervisor overseeing the investigation
Ralph BalbinAdministratorFacility administrator named in the report

Inspection Report

Complaint Investigation
Census: 66 Capacity: 128 Deficiencies: 0 Date: Sep 11, 2024

Visit Reason
The inspection was conducted as a complaint investigation following allegations that the facility did not provide comfortable accommodations, quality food, and the correct refund amount.

Complaint Details
The complaint investigation was unsubstantiated. Allegations included uncomfortable accommodations due to noise from pipe repairs, poor food quality linked to use of Styrofoam containers causing gout and hospitalization, and incorrect refund amounts. After interviews and document reviews, no violations were found.
Findings
The investigation found no evidence to support the allegations. Resident and staff interviews, as well as record reviews, indicated that noise complaints were addressed appropriately, food quality was maintained despite temporary use of Styrofoam containers, and refund amounts were correctly applied as credits to resident accounts. All allegations were unsubstantiated.

Report Facts
Refund amount allegedly not reimbursed: 810 Refund amounts paid: 3853 Refund amounts paid: 3043 Resident hospitalization duration: 11 Rehabilitation duration: 28 Residents interviewed: 8 Residents living at facility Aug-Sept 2023: 4

Employees mentioned
NameTitleContext
Regina CloydLicensing Program AnalystConducted complaint investigation and interviews
Mia NakanatzuExecutive Director IIMet with Licensing Program Analyst during investigation and exit interview
Ralph BalbinAdministratorFacility administrator named in report header
Ulysses CoronelLicensing Program ManagerNamed as Licensing Program Manager on report
Paloma KeitelmanAdministratorMet with Licensing Program Analysts during initial complaint investigation

Inspection Report

Complaint Investigation
Census: 66 Capacity: 128 Deficiencies: 0 Date: Sep 11, 2024

Visit Reason
The inspection was an unannounced complaint investigation conducted in response to allegations that the facility did not provide comfortable accommodations, quality food, and the correct refund amount to residents.

Complaint Details
The complaint investigation addressed three allegations: 1) the facility did not provide comfortable accommodations due to noise from repairs, 2) the facility did not provide quality food related to use of Styrofoam containers during repairs, and 3) the facility did not provide the correct refund amount for August services. All allegations were found unsubstantiated based on interviews and record reviews.
Findings
The investigation found no preponderance of evidence to support the allegations. Resident and staff interviews, record reviews, and observations indicated that noise complaints were addressed, food quality was maintained despite temporary use of Styrofoam dishware, and refund amounts were correctly applied as credits. All allegations were unsubstantiated and no deficiencies were cited.

Report Facts
Refund amount disputed: 810 Refund amounts paid: 3853 Refund amounts paid: 3043 Resident interviews: 8 Residents living at facility Aug-Sep 2023: 4

Employees mentioned
NameTitleContext
Regina CloydLicensing Program AnalystConducted complaint investigation and interviews
Mia NakanatzuExecutive Director IIFacility representative met during investigation and exit interview
Ulysses CoronelSupervisorSupervisor overseeing the complaint investigation

Inspection Report

Annual Inspection
Census: 57 Capacity: 128 Deficiencies: 0 Date: Jun 26, 2024

Visit Reason
An unannounced annual required visit was conducted to assess compliance with licensing regulations and infection control practices.

Findings
The facility was found to be sanitary, appropriately furnished, and compliant with Title 22 regulations. No deficiencies were cited during this inspection visit.

Report Facts
Licensed capacity: 128 Current census: 57

Employees mentioned
NameTitleContext
David EspañaLicensing Program AnalystConducted the inspection and risk assessment
Mia NakamatzuFacility staff member who accompanied the Licensing Program Analyst during the visit
Stephanie CifuentesLicensing Program ManagerNamed in report as Licensing Program Manager

Inspection Report

Annual Inspection
Census: 57 Capacity: 128 Deficiencies: 0 Date: Jun 26, 2024

Visit Reason
An unannounced annual required visit was conducted to assess compliance with licensing regulations and infection control measures.

Findings
The facility was found to be sanitary, appropriately furnished, and compliant with Title 22 regulations. No deficiencies were cited during the inspection, and infection control practices were observed to be adequate.

Report Facts
Residents present: 57 Licensed capacity: 128 Hospice waiver beds: 10

Employees mentioned
NameTitleContext
David EspañaLicensing Program AnalystConducted the inspection and risk assessment
Mia NakamatzuFacility RepresentativeMet with the Licensing Program Analyst during the inspection and received the report

Inspection Report

Complaint Investigation
Census: 56 Capacity: 128 Deficiencies: 0 Date: Jun 6, 2024

Visit Reason
An unannounced complaint investigation visit was conducted in response to multiple allegations received on 05/17/2024 regarding staff record-keeping, monitoring of resident condition changes, resident care related to incontinence, and restrictions on resident removal by responsible parties.

Complaint Details
The complaint investigation addressed four main allegations: 1) staff not maintaining accurate records, 2) staff not monitoring a resident's change in condition, 3) resident left in soiled diapers for extended periods, and 4) staff not allowing resident's responsible party to remove the resident from the facility. Each allegation was investigated through interviews and document review, and all were found unsubstantiated due to lack of sufficient evidence.
Findings
The investigation found insufficient evidence to substantiate any of the allegations. Staff and resident interviews, document reviews, and observations indicated that while some concerns were raised, there was no preponderance of evidence to prove violations occurred. All allegations were determined to be unsubstantiated.

Report Facts
Facility capacity: 128 Resident census: 56 Staff interviewed: 6 Residents interviewed: 6

Employees mentioned
NameTitleContext
Felisa ShirleyLicensing Program AnalystConducted the complaint investigation visit and interviews
Stephanie CifuentesLicensing Program ManagerOversaw the complaint investigation
Mia NakamatzuExecutive DirectorFacility representative met during the investigation
Ralph BalbinAdministratorFacility administrator named in the report

Inspection Report

Complaint Investigation
Census: 56 Capacity: 128 Deficiencies: 0 Date: Jun 6, 2024

Visit Reason
An unannounced complaint investigation was conducted in response to allegations received on 2024-05-17 regarding staff record accuracy, monitoring of resident condition changes, resident care related to soiled diapers, and restrictions on resident removal by responsible parties.

Complaint Details
The complaint investigation was unsubstantiated. Allegations included inaccurate staff records, failure to monitor resident condition changes, residents left in soiled diapers, and staff not allowing responsible parties to remove residents. Interviews with staff and residents showed mixed knowledge but no preponderance of evidence to prove violations.
Findings
The investigation found insufficient evidence to substantiate any of the allegations. Staff generally maintained records and monitored residents, residents were not left in soiled diapers for extended periods, and staff allowed responsible parties to remove residents from the facility without resistance.

Report Facts
Census: 56 Total Capacity: 128 Staff interviewed: 6 Residents interviewed: 6

Employees mentioned
NameTitleContext
Felisa ShirleyLicensing Program AnalystConducted the complaint investigation
Mia NakamatzuExecutive DirectorFacility representative met during investigation
Stephanie CifuentesSupervisorSupervisor overseeing the investigation
Ralph BalbinAdministratorFacility administrator

Inspection Report

Complaint Investigation
Census: 57 Capacity: 128 Deficiencies: 2 Date: May 16, 2024

Visit Reason
An unannounced complaint investigation was conducted in response to allegations that the facility's signal system did not produce an auditory signal loud enough to summon staff and that there was a lack of supervision of residents.

Complaint Details
The complaint investigation was substantiated. The facility failed to provide an auditory signal loud enough to summon staff when residents pressed their medical alert pendants, and failed to adequately supervise a resident who fell during the night and waited several hours for assistance.
Findings
The investigation substantiated both allegations. It was found that the facility's alert pendant system and phone system were not reliably summoning staff, causing delays in resident assistance. Additionally, a fall risk resident was not adequately monitored overnight, resulting in the resident waiting several hours for help after a fall.

Deficiencies (2)
Facilities shall have signal systems which shall transmit a visual and/or auditory signal to a central staffed location or produce an auditory signal at the living unit loud enough to summon staff. This regulation was not met as staff did not ensure resident’s alert pendant signaled to staff to summon them to provide assistance.
Every facility shall provide basic services including monitoring the activities of residents to ensure their health, safety, and well-being. This regulation was not met as a fall risk resident was not monitored through the night.
Report Facts
Capacity: 128 Census: 57 Deficiency count: 2 Plan of Correction Due Date: May 30, 2024 Resident wait time: 3 Resident wait time: 4 Resident wait time: 8.5

Employees mentioned
NameTitleContext
Wendy GibbsLicensing Program AnalystConducted the complaint investigation and authored the report
Milca OsorioHealth and Wellness DirectorMet with Licensing Program Analyst during exit interview
Ralph BalbinAdministratorNamed in relation to facility operations and plan of correction

Inspection Report

Complaint Investigation
Census: 57 Capacity: 128 Deficiencies: 2 Date: May 16, 2024

Visit Reason
An unannounced complaint investigation was conducted following allegations that the facility's signal system did not produce an auditory signal loud enough to summon staff and that there was a lack of supervision.

Complaint Details
The complaint investigation was substantiated. The facility failed to provide an auditory signal loud enough to summon staff when a resident pressed the medical alert button, and a fall risk resident was not supervised overnight after a fall, resulting in delayed assistance until breakfast time.
Findings
The investigation substantiated both allegations: the facility's signal system failed to ensure resident alert pendants summoned staff, and a fall risk resident was not properly monitored overnight, resulting in delayed assistance. Deficiencies were cited related to maintenance of signal systems and supervision of residents.

Deficiencies (2)
Facilities shall have signal systems which shall transmit a visual and/or auditory signal to a central staffed location or produce an auditory signal at the living unit loud enough to summon staff. This regulation was not met, based on interviews, staff did not ensure resident’s alert pendant signaled to staff to summon them to provide assistance.
Monitoring the activities of the residents while they are under the supervision of the facility to ensure their general health, safety, and well-being. This regulation was not met, based on record review and interviews the Administrator did not comply with this regulation and a fall risk resident was not monitored through the night.
Report Facts
Capacity: 128 Census: 57 Plan of Correction Due Date: May 30, 2024 Resident wait time: 3 Resident wait time: 4.5

Employees mentioned
NameTitleContext
Wendy GibbsLicensing Program AnalystConducted the complaint investigation and authored the report
Milca OsorioHealth and Wellness DirectorFacility representative met during investigation and exit interview
Eva M AlvarezSupervisorSupervisor named in the report
Ralph BalbinAdministratorFacility administrator responsible for implementing plan of correction

Inspection Report

Complaint Investigation
Census: 60 Capacity: 128 Deficiencies: 0 Date: Feb 2, 2024

Visit Reason
The visit was an unannounced complaint investigation to determine whether facility staff failed to provide a resident's representative with a statement itemizing all separate charges incurred.

Complaint Details
The complaint alleged that resident #1's representative was not provided with an itemized statement for a $2,000 rate increase beyond the contracted basic service rate of $6,094. The investigation reviewed the Residency Agreement, assessments, account reports, and interviewed staff. It was found that itemized charges were included in the contract and acknowledged by the resident's representative. Staff interviews and documentation did not support the allegation. The complaint was unsubstantiated.
Findings
The investigation found no evidence to support the allegation that the facility failed to provide the resident's representative with an itemized statement of charges. The allegation was determined to be unsubstantiated after interviews, record reviews, and facility inspection.

Report Facts
Capacity: 128 Census: 60 Basic Service Rate: 6505 Basic Service Rate Discount: 1626 Personal Service Rate: 1211 Personal Service Plan Maximum Rate: 7965 Community Fee before Move-In: 5000 Total Personal Service Charges: 8402 Medication Management Charge: 1101 Chronic Condition Management Charge: 1982 Nutrition Charge: 330 Service Coordinator Charge: 110

Inspection Report

Complaint Investigation
Census: 60 Capacity: 128 Deficiencies: 0 Date: Feb 2, 2024

Visit Reason
The inspection was an unannounced complaint investigation conducted to address allegations that staff did not issue a refund.

Complaint Details
The complaint alleged that staff did not issue a refund. The investigation found that residents R1 and R2 were refunded their community fee as per the admission agreement, and accounting mailed the remaining credit balance. Interviews with staff and residents mostly disagreed with the allegation. The complaint was determined to be unsubstantiated.
Findings
The investigation revealed that refunds were issued according to the terms of the signed admission agreement, and interviews with residents and staff did not support the allegation. Therefore, the complaint was unsubstantiated and no deficiencies were cited.

Report Facts
Residents interviewed: 6 Staff interviewed: 5 Refund amount: 500 Refund percentage: 60

Employees mentioned
NameTitleContext
Regina CloydLicensing Program AnalystConducted the complaint investigation
Ashley FernandezBusiness ManagerMet with Licensing Program Analyst during investigation and named in report
Mia NakamatzuExecutive DirectorInterviewed via Zoom during investigation
Ulysses CoronelLicensing Program ManagerNamed in report as Licensing Program Manager

Inspection Report

Complaint Investigation
Census: 60 Capacity: 128 Deficiencies: 0 Date: Feb 2, 2024

Visit Reason
The visit was an unannounced complaint investigation conducted to investigate an allegation that facility staff did not provide a resident's representative with a statement itemizing all separate charges incurred.

Complaint Details
The complaint alleged that resident #1's representative was not provided with an itemized statement of charges, including a disputed $2,000 rate increase. The investigation reviewed the Residency Agreement, assessments, account reports, and interviewed staff. The allegation was found unsubstantiated.
Findings
The investigation included interviews, record reviews, and a facility tour. The Department found no evidence to support the allegation, concluding the complaint was unsubstantiated due to lack of preponderance of evidence.

Report Facts
Capacity: 128 Census: 60 Rate increase: 2000 Basic Service Rate: 6505 Basic Service Rate Discount: 1626 Personal Service Rate: 1211 Personal Service Plan Service Rate Maximum: 7965 Itemized Personal Service Charges: 8402 Medication management charge: 1101 Chronic condition management charge: 1982 Nutrition charge: 330 Service coordinator charge: 110

Employees mentioned
NameTitleContext
Ernand DabuetLicensing Program AnalystConducted the complaint investigation visit
Ashley FernandezBusiness ManagerMet with investigator upon arrival
Mia NakamatzuExecutive DirectorInterviewed during investigation via virtual communication
Milca OsorioMet with investigator and participated in exit interview
Janae HammondSupervisorSupervisor overseeing the investigation

Inspection Report

Complaint Investigation
Census: 60 Capacity: 128 Deficiencies: 0 Date: Feb 2, 2024

Visit Reason
An unannounced complaint investigation was conducted in response to an allegation that staff did not issue a refund to residents.

Complaint Details
The complaint alleged that staff did not issue a refund. The investigation included interviews with residents and staff, and review of records. The allegation was found unsubstantiated due to evidence showing refunds were properly issued.
Findings
The investigation found that refunds were issued according to the terms of the signed admission agreement, and interviews with residents and staff did not support the allegation. Therefore, the complaint was unsubstantiated and no deficiencies were cited.

Report Facts
Residents interviewed: 6 Staff interviewed: 5 Refund amount non-refundable: 500 Refund percentage: 60

Employees mentioned
NameTitleContext
Regina CloydLicensing Program AnalystConducted the complaint investigation
Ashley FernandezBusiness ManagerInterviewed during investigation and received report
Mia NakamatzuExecutive DirectorInterviewed via Zoom during investigation
Ulysses CoronelSupervisorSupervisor overseeing the investigation

Inspection Report

Complaint Investigation
Census: 65 Capacity: 128 Deficiencies: 1 Date: Jan 25, 2024

Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations received on 07/26/2023 regarding inadequate activities for residents and prevention of residents having visitors during reasonable hours.

Complaint Details
The complaint investigation was substantiated for the allegation that staff do not provide adequate activities for residents, citing staffing shortages and lack of adherence to the activity calendar. The allegation that staff prevent residents from having visitors during reasonable hours was unsubstantiated.
Findings
The investigation substantiated that staff did not provide adequate activities for residents due to staffing issues and failure to follow the community activities calendar. However, the allegation that staff prevent residents from having visitors during reasonable hours was found to be unsubstantiated.

Deficiencies (1)
Failure to ensure that the facility has an active activity planner that all residents attend, posing a potential health and safety risk.
Report Facts
Capacity: 128 Census: 65 Deficiencies cited: 1 Plan of Correction Due Date: Feb 2, 2024

Employees mentioned
NameTitleContext
Jose CalderonLicensing Program AnalystConducted the complaint investigation and authored the report
Eva M AlvarezLicensing Program ManagerOversaw the complaint investigation
Ralph BalbinAdministratorFacility administrator involved in the investigation
Dimple KamdarOperations DirectorFacility operations director interviewed during investigation
S1Facility driver and activities director interviewed regarding staffing and activities

Inspection Report

Complaint Investigation
Census: 65 Capacity: 128 Deficiencies: 1 Date: Jan 25, 2024

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 07/26/2023 regarding inadequate activities for residents and prevention of residents having visitors during reasonable hours.

Complaint Details
The complaint investigation was substantiated for inadequate activities provided to residents, with evidence including interviews with staff and residents, review of the monthly activities calendar, and observations. The allegation regarding prevention of visitors was unsubstantiated based on interviews and review of the residency agreement.
Findings
The investigation substantiated the allegation that staff do not provide adequate activities for residents due to staffing issues affecting the activity program. The allegation that staff prevent residents from having visitors during reasonable hours was found to be unsubstantiated.

Deficiencies (1)
Failure to ensure the facility has an active activity planner that all residents attend, posing a potential health and safety risk to residents.
Report Facts
Capacity: 128 Census: 65 Plan of Correction Due Date: Feb 2, 2024

Employees mentioned
NameTitleContext
Jose CalderonLicensing Program AnalystConducted the complaint investigation and interviews
Ralph BalbinAdministratorFacility administrator involved in interviews and findings
Dimple KamdarOperations DirectorInterviewed during investigation and received exit report
Eva M AlvarezSupervisorSupervisor overseeing the licensing evaluation

Inspection Report

Complaint Investigation
Census: 60 Capacity: 128 Deficiencies: 0 Date: Jan 24, 2024

Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations received on 2023-10-05 regarding staff failing to safeguard resident's personal property and financial abuse of a resident at the facility.

Complaint Details
The complaint involved two allegations: 1) staff failed to safeguard resident's personal property, including theft of items, and 2) resident was being financially abused through overcharging for services. Interviews and document reviews did not find sufficient evidence to support these allegations, resulting in an unsubstantiated status.
Findings
The investigation included interviews with residents and staff, review of relevant documents, and facility tours. No evidence was found to substantiate the allegations of theft or financial abuse. The allegations were determined to be unsubstantiated, and no deficiencies were cited during the visit.

Report Facts
Capacity: 128 Census: 60 Number of allegations: 2 Number of residents interviewed: 6 Number of staff interviewed: 6

Employees mentioned
NameTitleContext
Wendy GibbsLicensing Program AnalystConducted the complaint investigation visit
Mia NakamatzuExecutive DirectorMet with Licensing Program Analyst during investigation and exit interview
Ralph BalbinAdministratorFacility administrator named in report header

Inspection Report

Complaint Investigation
Census: 60 Capacity: 128 Deficiencies: 0 Date: Jan 24, 2024

Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations received on 2023-10-05 regarding staff failing to safeguard resident's personal property and financial abuse of a resident at the facility.

Complaint Details
The complaint involved two allegations: 1) staff failed to safeguard resident's personal property, including theft of items, and 2) resident was being financially abused through overcharging for services. Interviews and document reviews did not find sufficient evidence to support these allegations, resulting in an unsubstantiated status.
Findings
The investigation included interviews with residents and staff, review of relevant documents, and facility tours. No evidence was found to substantiate the allegations of theft or financial abuse. The allegations were determined to be unsubstantiated, and no deficiencies were observed or cited during the visit.

Report Facts
Capacity: 128 Census: 60

Employees mentioned
NameTitleContext
Wendy GibbsLicensing Program AnalystConducted the complaint investigation visit
Mia NakamatzuExecutive DirectorMet with Licensing Program Analyst during the visit and participated in exit interview
Ralph BalbinAdministratorNamed as facility administrator
Eva M AlvarezSupervisorSupervisor overseeing the investigation

Inspection Report

Complaint Investigation
Census: 65 Capacity: 128 Deficiencies: 1 Date: Aug 2, 2023

Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations received on 07/26/2023 regarding inadequate activities for residents and prevention of residents having visitors during reasonable hours.

Complaint Details
The complaint investigation was substantiated for the allegation that staff do not provide adequate activities for residents. The allegation that staff prevent residents from having visitors during reasonable hours was unsubstantiated based on interviews and review of residency agreements.
Findings
The investigation substantiated that the facility failed to provide adequate planned activities for residents, posing a potential health and safety risk. The allegation that staff prevent residents from having visitors during reasonable hours was found to be unsubstantiated.

Deficiencies (1)
Failure to ensure that the facility has an active activity planner that all residents attend, which poses a potential health and safety risk to residents in care.
Report Facts
Capacity: 128 Census: 65 Deficiency due date: Aug 11, 2023

Employees mentioned
NameTitleContext
Jose CalderonLicensing Program AnalystConducted the complaint investigation and authored the report
Dimple KamdarOperations DirectorInterviewed during the investigation and recipient of the exit interview
Ralph BalbinAdministratorFacility administrator named in the report

Inspection Report

Complaint Investigation
Census: 65 Capacity: 128 Deficiencies: 1 Date: Aug 2, 2023

Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations received on 2023-07-26 regarding inadequate activities for residents and prevention of residents having visitors during reasonable hours.

Complaint Details
The complaint investigation was substantiated for the allegation that staff do not provide adequate activities for residents. The allegation that staff prevent residents from having visitors during reasonable hours was unsubstantiated.
Findings
The investigation substantiated that the facility failed to ensure an active activity planner that all residents attend, posing a potential health and safety risk. The allegation that staff prevent residents from having visitors during reasonable hours was unsubstantiated due to insufficient evidence.

Deficiencies (1)
Failed to ensure that the facility has an active activity planner that all residents attend, posing a potential health and safety risk.
Report Facts
Capacity: 128 Census: 65 Plan of Correction Due Date: Aug 11, 2023

Employees mentioned
NameTitleContext
Jose CalderonLicensing Program AnalystConducted the complaint investigation and unannounced visit
Dimple KamdarOperations DirectorMet with the evaluator during the investigation and provided information
Eva M AlvarezSupervisorSupervisor overseeing the investigation
Ralph BalbinAdministratorFacility administrator mentioned in the report

Inspection Report

Complaint Investigation
Census: 62 Capacity: 128 Deficiencies: 2 Date: Jul 25, 2023

Visit Reason
The visit was an unannounced complaint investigation conducted to investigate allegations including insufficient staff to meet residents' needs, inadequate communication with residents, failure to follow resident care plans, and delayed response to resident calls for assistance.

Complaint Details
The complaint investigation was substantiated for insufficient staffing and inadequate communication with residents. Allegations regarding failure to follow care plans and delayed response to calls were unsubstantiated based on resident and staff interviews and observations.
Findings
The investigation substantiated that the facility lacked sufficient staff and did not adequately communicate updated information to residents. However, allegations that staff were not following care plans and not responding timely to calls for assistance were unsubstantiated. The facility had staffing instability with vacancies in key positions and plans for correction were developed.

Deficiencies (2)
Facility does not have sufficient staff to meet the needs of the residents.
Staff are not adequately communicating with residents regarding updated information.
Report Facts
Estimated Days of Completion: 90 Capacity: 128 Census: 62

Employees mentioned
NameTitleContext
Mario LeonLicensing Program AnalystConducted the complaint investigation and authored the report
Ulysses CoronelLicensing Program ManagerOversaw the complaint investigation
Mia NakamatzuExecutive DirectorFacility representative met during exit interview and report delivery
Dimple KamdarOperations SpecialistMet during complaint visit and involved in plan of correction development
Callie MichaelDistrict Director of Clinical ServicesMet during complaint visit
Ralph BalbinAdministratorNamed as facility administrator

Inspection Report

Complaint Investigation
Census: 62 Capacity: 128 Deficiencies: 2 Date: Jul 25, 2023

Visit Reason
The inspection was an unannounced complaint investigation visit conducted to investigate multiple allegations including insufficient staffing to meet resident needs and inadequate communication with residents regarding updated information.

Complaint Details
The complaint investigation was substantiated for allegations of insufficient staffing and inadequate communication with residents. Other allegations about staff not following care plans and delayed response to resident calls were unsubstantiated.
Findings
The investigation substantiated that the facility lacked sufficient staff to meet resident needs and that staff were not adequately communicating updated information to residents. Other allegations regarding staff following care plans and timely response to resident calls were found to be unsubstantiated.

Deficiencies (2)
Facility does not have sufficient staff to meet the needs of the residents.
Staff are not adequately communicating with residents regarding updated information.
Report Facts
Estimated Days of Completion: 90 Resident interviews agreeing insufficient staff allegation: 7 Staff interviews agreeing insufficient staff allegation: 3 Resident interviews agreeing inadequate communication allegation: 5 Staff interviews agreeing inadequate communication allegation: 2 Vacant positions noted: 4 Caregiving hours added: 8

Employees mentioned
NameTitleContext
Mario LeonLicensing Program AnalystConducted the complaint investigation visit and authored the report
Mia NakamatzuExecutive DirectorMet with Licensing Program Analyst during visits and exit interviews
Dimple KamdarOperations SpecialistMet with Licensing Program Analyst during complaint visit and exit interview
Callie MichaelDistrict Director of Clinical ServicesMet with Licensing Program Analyst during complaint visit
Ralph BalbinAdministratorNamed as facility administrator

Inspection Report

Annual Inspection
Census: 67 Capacity: 128 Deficiencies: 1 Date: Jun 19, 2023

Visit Reason
An unannounced annual required visit was conducted using the CARE Inspection Tool to evaluate compliance with licensing requirements and facility conditions.

Findings
The facility was found to be sanitary, appropriately furnished, and compliant with infection control practices. However, a deficiency was noted due to the absence of an administrator meeting certification or recertification requirements during the visit.

Deficiencies (1)
No administrator available at the facility meeting Administrator Certification or Recertification Requirements as specified in CCR 87412(d).
Report Facts
Capacity: 128 Census: 67 Plan of Correction Due Date: Jul 3, 2023 Hot water temperature: 117.9 Hospice waiver capacity: 10

Employees mentioned
NameTitleContext
Antonine RichardLicensing Program AnalystConducted the inspection and cited deficiency
Julie ManzanaresBusiness manager met during inspection and received report
Matan BurstynExecutive DirectorJoined the inspection visit

Inspection Report

Annual Inspection
Census: 67 Capacity: 128 Deficiencies: 1 Date: Jun 19, 2023

Visit Reason
An unannounced annual required visit was conducted using the CARE Inspection Tool to evaluate compliance with licensing requirements.

Findings
The facility was found to be sanitary, appropriately furnished, and compliant with infection control practices. However, a deficiency was noted due to the absence of an administrator on site, violating Administrator Certification or Recertification Requirements.

Deficiencies (1)
No administrator available at the facility, failing to meet Administrator Certification or Recertification Requirements as per CCR 87412(d).
Report Facts
Capacity: 128 Census: 67 Hot water temperature: 117.9 PPE supply: 30 Plan of Correction Due Date: Jul 3, 2023

Employees mentioned
NameTitleContext
Antonine RichardLicensing Program AnalystConducted the inspection and authored the report
Julie ManzanaresBusiness ManagerMet with LPA during inspection and received report
Matan BurstynExecutive DirectorJoined the visit during inspection

Inspection Report

Annual Inspection
Census: 65 Capacity: 128 Deficiencies: 0 Date: Jul 8, 2022

Visit Reason
An unannounced annual required visit was conducted with a primary focus on Infection Control measures using the CARE Inspection Tool.

Findings
The facility was found to be sanitary, appropriately furnished, and in compliance with infection control protocols. No deficiencies were cited during this inspection visit.

Report Facts
Licensed capacity: 128 Current census: 65 PPE supply: 30

Employees mentioned
NameTitleContext
Amanda MonroyNurseMet with Licensing Program Analyst during inspection and named in exit interview
Stephanie CifuentesLicensing Program AnalystConducted the inspection visit
Eva M AlvarezLicensing Program ManagerNamed in report as Licensing Program Manager

Inspection Report

Annual Inspection
Census: 65 Capacity: 128 Deficiencies: 0 Date: Jul 8, 2022

Visit Reason
An unannounced annual required visit was conducted with a primary focus on Infection Control measures using the CARE Inspection Tool.

Findings
The facility was found to be sanitary, appropriately furnished, and compliant with infection control protocols. No deficiencies were cited during the inspection.

Report Facts
Licensed capacity: 128 Current census: 65 Hospice waiver beds: 10 Resident rooms: 92 PPE supply: 30

Employees mentioned
NameTitleContext
Amanda MonroyNurseFacility nurse present during inspection and exit interview
Stephanie CifuentesLicensing Program AnalystConducted the inspection visit

Inspection Report

Complaint Investigation
Census: 67 Capacity: 128 Deficiencies: 0 Date: Mar 21, 2022

Visit Reason
An unannounced complaint investigation was conducted regarding allegations that the facility did not provide adequate supervision to residents, specifically concerning Resident 1 isolating Resident 2 and soliciting funds.

Complaint Details
The complaint alleged inadequate supervision, isolation of Resident 2 by Resident 1, and solicitation of funds. The investigation found the allegation unsubstantiated due to lack of evidence.
Findings
Interviews with staff and residents, record reviews, and observations found no preponderance of evidence to substantiate the allegation. Residents and staff stated that Resident 1 is not isolating Resident 2 or soliciting money, and Resident 2 is engaged in other activities and aware of their rights.

Report Facts
Capacity: 128 Census: 67

Employees mentioned
NameTitleContext
Jade JordanLicensing Program AnalystConducted the complaint investigation
Michael CavaLicensing Program ManagerNamed in report as Licensing Program Manager
Ralph BalbinAdministratorFacility Administrator met during investigation

Inspection Report

Complaint Investigation
Census: 67 Capacity: 128 Deficiencies: 0 Date: Mar 21, 2022

Visit Reason
An unannounced complaint investigation was conducted regarding allegations that the facility did not provide adequate supervision to residents, specifically concerning Resident 1 isolating Resident 2 and soliciting funds.

Complaint Details
The complaint alleged inadequate supervision and isolation of Resident 2 by Resident 1, including solicitation of funds. The allegation was found unsubstantiated after investigation.
Findings
The investigation included interviews, record reviews, and observations. It was found that Resident 1 is controlling but not isolating Resident 2, and there was no evidence of solicitation of funds. Both residents and staff denied the allegations. The complaint was unsubstantiated due to lack of preponderance of evidence.

Report Facts
Capacity: 128 Census: 67

Employees mentioned
NameTitleContext
Jade JordanLicensing Program AnalystConducted the complaint investigation
Ralph BalbinFacility AdministratorMet with Licensing Program Analyst during investigation
Michael CavaSupervisorSupervisor overseeing the investigation

Inspection Report

Complaint Investigation
Census: 67 Capacity: 128 Deficiencies: 0 Date: Oct 13, 2021

Visit Reason
The visit was an unannounced complaint investigation conducted in response to a complaint received on 07/24/2020 regarding allegations of overcharging residents for unneeded services, improper resident assessments, retention of residents with unstageable pressure injuries, and retaining residents requiring a higher level of care.

Complaint Details
The complaint involved four main allegations: charging residents for unneeded services, improper assessment of residents, retaining residents with unstageable pressure injuries, and retaining residents requiring a higher level of care. The investigation found no evidence to substantiate these allegations.
Findings
The investigation included interviews with residents, staff, family members, and review of service records and facility documents. No evidence was found to support the allegations, and the complaints were determined to be unsubstantiated. No deficiencies were cited during this visit.

Report Facts
Capacity: 128 Census: 67

Employees mentioned
NameTitleContext
Ralph BalbinExecutive DirectorMet with Licensing Program Analyst during the investigation and participated in interviews
Ernand DabuetLicensing Program AnalystConducted the complaint investigation visit and authored the report
Eva M AlvarezLicensing Program ManagerNamed as Licensing Program Manager on the report

Inspection Report

Complaint Investigation
Census: 67 Capacity: 128 Deficiencies: 0 Date: Oct 13, 2021

Visit Reason
The visit was an unannounced complaint investigation conducted to gather additional information and deliver findings regarding allegations including charging residents for unneeded services, improper resident assessments, retaining residents with unstageable pressure injuries, and retaining residents requiring a higher level of care.

Complaint Details
The complaint investigation was unsubstantiated. Allegations included facility charging residents for unneeded services, staff not properly assessing residents, retaining residents with unstageable pressure injuries, and retaining residents requiring a higher level of care. The investigation included interviews with residents, staff, witnesses, and review of service records and facility documents.
Findings
The investigation found no evidence to support the allegations. Interviews, record reviews, and observations indicated that residents were properly assessed, charges were transparent, pressure injuries were managed appropriately, and residents requiring higher levels of care were not improperly retained. The allegations were unsubstantiated and no deficiencies were cited.

Report Facts
Capacity: 128 Census: 67 Hospice waiver capacity: 10

Employees mentioned
NameTitleContext
Ralph BalbinExecutive DirectorMet with Licensing Program Analyst during the investigation and participated in interviews
Ernand DabuetLicensing Program AnalystConducted the complaint investigation visit
Eva M AlvarezSupervisorSupervisor overseeing the complaint investigation

Inspection Report

Annual Inspection
Census: 59 Capacity: 128 Deficiencies: 0 Date: Jun 15, 2021

Visit Reason
An unannounced annual required visit was conducted with a primary focus on Infection Control measures using the new CARE Inspection Tool.

Findings
The facility was found to be sanitary, appropriately furnished, and compliant with infection control protocols. No deficiencies were cited during this inspection visit.

Report Facts
PPE supply duration: 30 Resident rooms: 92 Hospice waiver capacity: 10

Employees mentioned
NameTitleContext
Ralph BalbinExecutive DirectorMet with Licensing Program Analyst during inspection and received the report.
Stephanie CifuentesLicensing Program AnalystConducted the inspection and authored the report.
Eva M AlvarezLicensing Program ManagerNamed in the report as Licensing Program Manager.

Inspection Report

Annual Inspection
Census: 59 Capacity: 128 Deficiencies: 0 Date: Jun 15, 2021

Visit Reason
An unannounced annual required visit was conducted with a primary focus on Infection Control measures using the new CARE Inspection Tool.

Findings
The facility was observed to be sanitary, appropriately furnished, and compliant with infection control practices. No deficiencies were cited during this inspection visit.

Report Facts
Licensed capacity: 128 Current census: 59 PPE supply duration: 30

Employees mentioned
NameTitleContext
Ralph BalbinExecutive DirectorFacility administrator met during inspection and exit interview
Stephanie CifuentesLicensing Program AnalystConducted the inspection visit
Eva M AlvarezSupervisorSupervisor overseeing the inspection

Inspection Report

Complaint Investigation
Census: 62 Capacity: 128 Deficiencies: 0 Date: Feb 22, 2021

Visit Reason
The inspection was an unannounced complaint investigation initiated due to allegations that a resident sustained multiple fractures, multiple pressure injuries, and multiple falls due to lack of supervision while in care.

Complaint Details
The complaint investigation was triggered by allegations that a resident sustained multiple fractures, multiple pressure injuries, and multiple falls due to lack of supervision. After review of hospital and facility records and interviews with staff and family, the allegations were found to be unsubstantiated.
Findings
The investigation found no evidence to substantiate the allegations. Record reviews and interviews indicated that the resident did not sustain multiple fractures, pressure injuries, or falls while at the facility. All allegations were determined to be unsubstantiated.

Report Facts
Capacity: 128 Census: 62

Employees mentioned
NameTitleContext
Ulysses CoronelLicensing Program AnalystConducted the complaint investigation and delivered findings
Ralph BalbinAdministratorFacility administrator interviewed during the investigation

Viewing

Loading inspection reports...