Deficiencies (last 5 years)
Deficiencies (over 5 years)
3.4 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
15% better than California average
California average: 4 deficiencies/yearDeficiencies per year
12
9
6
3
0
Census
Latest occupancy rate
39% occupied
Based on a December 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy over time
Inspection Report
Follow-Up
Census: 63
Capacity: 160
Deficiencies: 1
Date: Dec 17, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on a death report submitted to the department on 12/16/2025.
Findings
The visit revealed a violation for failure to notify the department of a change in Administrator, which poses a potential health and safety risk to residents in care. The death report detailed a resident's passing after EMS intervention.
Deficiencies (1)
Licensee failed to notify the Department, in writing, within thirty (30) days of the hiring of a new administrator.
Report Facts
Capacity: 160
Census: 63
Plan of Correction Due Date: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit and authored the report |
| Alisa Ortiz | Licensing Program Manager | Named in relation to the licensing program management |
Inspection Report
Complaint Investigation
Census: 58
Capacity: 160
Deficiencies: 0
Date: Sep 9, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on an SOC 341 received by the department regarding a reported incident involving a resident sustaining a skin tear caused by a caregiver while assisting the resident.
Complaint Details
The complaint involved Resident 1 reporting a skin tear caused by a caregiver during assistance. The resident initially was unaware of which caregiver was involved and later reported different names. The injury was unintentional and occurred during an attempt to assist the resident.
Findings
The investigation found that the caregiver caused a skin tear on the resident's arm unintentionally while attempting to prevent a fall. The resident was diagnosed with Parkinson's Disease and was declining, with a care plan meeting scheduled. No health or safety concerns were observed during the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit and investigation. |
| Christine Perez | Administrator/Director | Facility administrator met with the Licensing Program Analyst during the visit. |
| Alisa Ortiz | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Complaint Investigation
Census: 58
Capacity: 160
Deficiencies: 0
Date: Sep 9, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on an SOC 341 received by the department regarding a reported incident involving a caregiver causing a skin tear on a resident's arm.
Complaint Details
The visit was triggered by a complaint (SOC 341) received on 08/29/2025 regarding a caregiver causing a skin tear on Resident 1's arm. The resident initially was unaware of the caregiver involved and later reported different names. The injury was not intentional.
Findings
The Licensing Program Analyst observed no health or safety concerns during the visit. The resident reported the injury was unintentional and caregivers were attempting to assist. The facility has scheduled a care plan meeting and conducted an in-service on transfers in response to the resident's decline.
Report Facts
Capacity: 160
Census: 58
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit |
| Christine Perez | Administrator/Director | Met with Licensing Program Analyst during the visit |
Inspection Report
Complaint Investigation
Census: 68
Capacity: 160
Deficiencies: 1
Date: Jul 11, 2025
Visit Reason
An unannounced visit was conducted to investigate a complaint alleging that the facility was mismanaging residents' medication.
Complaint Details
The complaint alleging mismanagement of residents' medication was substantiated based on interviews, record reviews, and observations. The preponderance of evidence standard was met.
Findings
The investigation found that following a resident's admission, initial prescription filling difficulties resulted in missed self-administered medication doses, which were later resolved. Another resident missed medication for four days due to pharmacy refill errors. The allegation was substantiated and a Type A deficiency was cited.
Deficiencies (1)
Failure to assist residents with self-administered medications as needed, resulting in missed doses due to supply issues.
Report Facts
Census: 68
Total Capacity: 160
Missed medication days: 4
Deficiency Type: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kevin Saborit-Guasch | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Christine Perez | Executive Director | Facility representative who assisted with the visit |
Inspection Report
Complaint Investigation
Census: 68
Capacity: 160
Deficiencies: 1
Date: Jul 11, 2025
Visit Reason
An unannounced visit was conducted to investigate a complaint alleging that the facility was mismanaging residents' medication.
Complaint Details
The complaint alleged that the facility was mismanaging residents' medication. The investigation substantiated the allegation based on interviews, record reviews, and observations.
Findings
The investigation found that initial medication management issues occurred for resident R1 after admission, and a prescription for resident R2 was not administered for four days due to pharmacy refill errors. The allegation was substantiated and a Type A deficiency was cited.
Deficiencies (1)
Failure to assist residents with self-administered medications as required by California Code of Regulations Section 87465(a)(4), resulting in at least two residents missing multiple doses of prescription medication due to supply issues.
Report Facts
Days medication not administered: 4
Facility capacity: 160
Facility census: 68
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kevin Saborit-Guasch | Licensing Program Analyst | Conducted the complaint investigation and authored the report. |
| Sheila Santos | Licensing Program Manager | Oversaw the complaint investigation. |
| Christine Perez | Executive Director | Facility representative who assisted during the visit. |
| John Goodwin | Administrator | Facility administrator named in the report header. |
Inspection Report
Complaint Investigation
Census: 65
Capacity: 160
Deficiencies: 0
Date: Jul 10, 2025
Visit Reason
An unannounced complaint investigation was conducted in response to an allegation that facility staff were not keeping resident rooms at a comfortable temperature.
Complaint Details
The complaint alleged that facility staff were not maintaining comfortable temperatures in resident rooms. The allegation was investigated and found to be unfounded based on observations and documentation.
Findings
The investigation found that temperatures in the resident's room and common areas were within regulatory guidelines, and the allegation was deemed unfounded.
Report Facts
Facility capacity: 160
Resident census: 65
Room temperature: 76
Common area temperature: 75
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation |
Inspection Report
Complaint Investigation
Census: 65
Capacity: 160
Deficiencies: 0
Date: Jul 10, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on incident reports received by the department on 06/23/2025 and 07/07/2025 involving allegations of caregiver misconduct and a resident fall.
Complaint Details
The visit was triggered by two incident reports: one alleging caregiver abuse (yelling and pushing) with police involvement and another concerning a resident's fall causing a fractured hip. The facility investigated the abuse allegation and closed it based on interviews. The fall incident was documented with medical and service plan details.
Findings
The facility conducted an internal investigation into the allegation of a caregiver yelling and pushing a resident, which was closed based on interviews. Another incident involved a resident's un-witnessed fall resulting in a fractured hip, with the resident currently hospitalized post-surgery.
Report Facts
Incident report dates: Incident reports received on 06/23/2025 and 07/07/2025
Police report number: 25032623
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit |
| John Goodwin | Administrator/Director | Facility administrator named in the report header |
Inspection Report
Complaint Investigation
Census: 65
Capacity: 160
Deficiencies: 0
Date: Jul 10, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on incident reports received by the department on 06/23/2025 and 07/07/2025 involving allegations of caregiver misconduct and a resident fall.
Complaint Details
The visit was triggered by complaints including a report that a caregiver yelled and pushed Resident 1, with police involvement and an internal investigation. Another complaint involved Resident 2's unwitnessed fall leading to a fractured hip. The facility's internal investigation was closed based on interviews.
Findings
The facility conducted an internal investigation into the allegation of a caregiver yelling and pushing a resident, which was closed based on interviews. Another incident involved a resident's unwitnessed fall resulting in a fractured hip, with the resident currently hospitalized post-surgery.
Report Facts
Incident report dates: 06/23/2025 and 07/07/2025
Police report number: 25032623
Resident capacity: 160
Resident census: 65
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit |
| John Goodwin | Administrator/Director | Facility administrator named in report header |
| Christine Perez | Met with during inspection | |
| Alisa Ortiz | Licensing Program Manager | Named as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 65
Capacity: 160
Deficiencies: 0
Date: Jul 10, 2025
Visit Reason
An unannounced complaint investigation was conducted in response to an allegation that facility staff were not keeping resident rooms at a comfortable temperature.
Complaint Details
The complaint alleged that facility staff were not keeping resident rooms at a comfortable temperature. The allegation was investigated and found to be unfounded, meaning it was false or without reasonable basis.
Findings
The investigation found that temperatures in the resident's room and common areas were within regulatory guidelines, and the allegation was deemed unfounded. Documentation showed multiple maintenance visits and provision of additional cooling measures.
Report Facts
Facility capacity: 160
Census: 65
Room temperature: 76
Common area temperature: 75
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation visit |
| John Goodwin | Facility Administrator | |
| Alisa Ortiz | Licensing Program Manager | Oversaw the complaint investigation |
| Christine Perez | Met with the Licensing Program Analyst during the visit |
Inspection Report
Annual Inspection
Census: 67
Capacity: 160
Deficiencies: 0
Date: Jun 18, 2025
Visit Reason
The visit was an unannounced annual required inspection conducted to evaluate compliance with licensing requirements for the facility.
Findings
The inspection found no deficiencies in the areas inspected, including resident care, physical plant, fire safety, medication storage, and food service. All required documentation was present and residents were observed participating in activities and receiving proper care.
Report Facts
Residents on hospice: 6
Hospice waiver capacity: 12
Resident files reviewed: 8
Staff files reviewed: 5
Fire drill date: May 7, 2025
Water temperature range Fahrenheit: 105.9-107.0
Employees mentioned
| Name | Title | Context |
|---|---|---|
| John Goodwin | Executive Director | Named as Executive Director assisting with the visit |
| Christine Perez | Executive Director | Named as Executive Director assisting with the visit and participated in exit interview |
| Michael Tea | Licensing Program Analyst | Conducted the inspection visit |
| Jose Contreras-Silva | Maintenance Director | Assisted with facility tour during inspection |
| Alisa Ortiz | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 67
Capacity: 160
Deficiencies: 0
Date: Jun 18, 2025
Visit Reason
The visit was an unannounced annual required inspection conducted to evaluate compliance with licensing requirements for the facility.
Findings
The inspection found no deficiencies in the areas inspected, including resident care, physical plant, food service, medication storage and administration, and safety systems. Residents were observed participating in activities and staff responded promptly to emergency pendants.
Report Facts
Hospice residents: 6
Hospice waiver capacity: 12
Bedridden residents capacity: 21
Inspection start time: 8
Inspection end time: 17
Water temperature range Fahrenheit: 105.9-107.0
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michael Tea | Licensing Program Analyst | Conducted the inspection visit |
| John Goodwin | Executive Director | Facility Executive Director assisting with the visit |
| Christine Perez | Executive Director | Facility Executive Director assisting with the visit and participated in exit interview |
| Jose Contreras-Silva | Maintenance Director | Assisted with facility tour during inspection |
Inspection Report
Complaint Investigation
Census: 69
Capacity: 160
Deficiencies: 0
Date: May 29, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on an SOC 341 report regarding a resident's allegation that a staff member had propositioned them.
Complaint Details
The complaint involved Resident 1 reporting that Staff 1 had propositioned them. The facility suspended Staff 1 pending investigation. Resident denied injuries and relations. Staff 1 returned to work on the inspection date.
Findings
The investigation found that the resident denied any injuries and reported no relations had occurred. The staff member was suspended pending investigation but was cleared to return to work on the day of the visit. The resident appeared clean, well cared for, and verbalized feeling safe at the facility. The incident requires further investigation.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit and investigation. |
| John Goodwin | Administrator/Director | Facility administrator named in the report header. |
Inspection Report
Complaint Investigation
Census: 69
Capacity: 160
Deficiencies: 0
Date: May 29, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on an SOC 341 report regarding an incident where a staff member was alleged to have propositioned a resident.
Complaint Details
The complaint involved Resident 1 reporting that Staff 1 had propositioned the resident. The resident denied any injuries and no relations occurred. Staff 1 was suspended pending investigation and returned to work on May 29, 2025.
Findings
The investigation found that the resident denied any injuries and no relations had occurred. The staff member was suspended pending investigation but was allowed to return to work on the day of the visit. The resident appeared clean, well cared for, and verbalized feeling safe at the facility. The incident requires further investigation.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit and investigation. |
| John Goodwin | Administrator | Named as facility administrator. |
| Christine Perez | Met with Licensing Program Analyst during the visit. | |
| Alisa Ortiz | Licensing Program Manager | Named as Licensing Program Manager. |
Inspection Report
Complaint Investigation
Census: 56
Capacity: 160
Deficiencies: 0
Date: Feb 24, 2025
Visit Reason
The visit was an unannounced case management follow-up on an incident report received by the department regarding a resident's elevated heart rate, lethargy, and increased respirations.
Complaint Details
The visit was triggered by an incident report dated 02/12/2025 concerning Resident 1's medical condition and fall history. The report was reviewed and clarified during the visit.
Findings
The incident report indicated a resident was sent out for medical evaluation due to elevated heart rate and other symptoms. The report mistakenly referenced a prior fracture from December 2024. The resident had an unwitnessed fall in December 2024 but was able to leave the facility unassisted at that time. Fall precautions were in place and observed during the visit. The resident had no prior falls.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit and follow-up on the incident report. |
| Patricia Perez | Administrator/Director | Facility administrator named in the report header. |
| Alisa Ortiz | Supervisor | Supervisor overseeing the licensing evaluation. |
| Chiquita Morris | Met with during the inspection visit. |
Inspection Report
Complaint Investigation
Census: 56
Capacity: 160
Deficiencies: 0
Date: Feb 24, 2025
Visit Reason
Unannounced case management visit conducted to follow up on an incident report received by the department regarding a resident's elevated heart rate, lethargy, increased respirations, and a displaced fracture.
Complaint Details
Visit was triggered by an incident report dated 02/12/2025 concerning Resident 1's elevated heart rate and fracture. The report was found to reference a prior fracture from December 2024. The resident's primary diagnosis is difficulty walking. Fall precautions were in place and observed.
Findings
The incident report referred to a previous fracture from December 2024. The resident had an unwitnessed fall in December 2024 but was able to leave the facility unassisted at that time. Fall precautions such as a low bed and scoop mattress were observed during the visit. The resident had no prior falls.
Report Facts
Incident report date: Feb 12, 2025
Incident report received date: Feb 19, 2025
Care plan date: Oct 8, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit |
| Patricia Perez | Administrator | Facility administrator named in the report |
| Chiquita Morris | Met with Licensing Program Analyst during the visit | |
| Alisa Ortiz | Licensing Program Manager | Named as Licensing Program Manager in the report |
Inspection Report
Complaint Investigation
Census: 60
Capacity: 160
Deficiencies: 0
Date: Jan 15, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff did not respond to a resident's call in a timely manner and that staff utilized an inappropriate lock on a resident's door.
Complaint Details
The complaint was investigated and found to be unfounded, meaning the allegations were false, could not have happened, or were without reasonable basis.
Findings
The investigation found that the resident requested staff to call 911 for knee pain and that staff locked the resident's door with an exterior lock per resident request while the staff in charge was on break. The lock allowed residents to exit from inside. Based on interviews and observations, the allegations were deemed unfounded.
Report Facts
Elapsed time staff was on break: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation visit |
| Melissa Weibel | Administrator | Facility administrator involved in the investigation |
| Chiquita Morris | Met with during the investigation | |
| Alisa Ortiz | Supervisor | Supervisor named in the report |
Inspection Report
Plan of Correction
Census: 60
Capacity: 160
Deficiencies: 2
Date: Jan 15, 2025
Visit Reason
An unannounced plan of correction visit was conducted to follow up on citations issued on 2025-01-08.
Findings
The deficiencies cited under Title 22 Regulation 87464(f)(4) pertaining to Basic Services and Title 22 Regulation 87628(a) pertaining to Diabetes have been cleared. The licensee provided proof of correction and complied with the terms of the plan of correction.
Deficiencies (2)
Deficiency cited under Title 22 Regulation 87464(f)(4) pertaining to Basic Services
Deficiency cited under Title 22 Regulation 87628(a) pertaining to Diabetes
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced plan of correction visit |
| Patricia Perez | Administrator/Director | Facility Administrator/Director |
Inspection Report
Complaint Investigation
Census: 60
Capacity: 160
Deficiencies: 0
Date: Jan 15, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff did not respond to a resident's call in a timely manner and that staff utilized an inappropriate lock on a resident's door.
Complaint Details
The complaint was investigated and found to be unfounded, meaning the allegations were false, could not have happened, or were without a reasonable basis.
Findings
The investigation found that on 02/13/2024, a resident requested staff to call 911 for knee pain, EMS arrived and transported the resident downstairs. The resident's door was locked with an exterior lock per resident request while staff was on break for approximately 10-15 minutes. The lock allowed residents to exit from inside. Based on interviews and observations, the allegations were deemed unfounded.
Report Facts
Elapsed time staff was on break: 10
Elapsed time staff was on break: 15
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation visit |
| Melissa Weibel | Administrator | Facility administrator involved in the incident |
Inspection Report
Plan of Correction
Census: 60
Capacity: 160
Deficiencies: 2
Date: Jan 15, 2025
Visit Reason
Unannounced plan of correction visit to follow up on citations issued on 2025-01-08.
Findings
Deficiencies cited under Title 22 Regulation 87464(f)(4) pertaining to Basic Services and Title 22 Regulation 87628(a) pertaining to Diabetes have been cleared. Licensee provided proof of correction and complied with the terms of the plan of correction.
Deficiencies (2)
Deficiency cited under Title 22 Regulation 87464(f)(4) pertaining to Basic Services
Deficiency cited under Title 22 Regulation 87628(a) pertaining to Diabetes
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Made the unannounced plan of correction visit |
| Patricia Perez | Administrator | Facility Administrator named in report header |
Inspection Report
Complaint Investigation
Census: 61
Capacity: 160
Deficiencies: 1
Date: Jan 8, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations of lack of care and supervision and improper medication administration at the facility.
Complaint Details
The complaint investigation was initiated due to allegations of lack of care and supervision and improper medication administration. The lack of care allegation was unsubstantiated, while the medication administration allegation was substantiated.
Findings
The allegation of lack of care and supervision was found to be unsubstantiated based on staff and resident interviews and observations. However, the allegation that the facility was not administering medications properly was substantiated due to missed diabetes-related injections and 13 missed medications in December 2023 with no documented reasons.
Deficiencies (1)
Basic services shall at a minimum include personal assistance and care as needed by the resident, including assistance with taking prescribed medications. This requirement was not met as evidenced by missed multiple medications and injections posing an immediate health and safety risk.
Report Facts
Missed medications: 13
Resident census: 61
Total capacity: 160
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Melissa Weibel | Administrator | Facility administrator named in the report |
Inspection Report
Complaint Investigation
Census: 61
Capacity: 160
Deficiencies: 1
Date: Jan 8, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to complaints alleging lack of care and supervision, and improper medication administration at the facility.
Complaint Details
The complaint investigation was triggered by allegations of lack of care and supervision and improper medication administration. The lack of care allegation was unsubstantiated, while the medication administration allegation was substantiated.
Findings
The allegation of lack of care and supervision was found to be unsubstantiated after interviews and observations. However, the allegation that the facility was not administering medications properly was substantiated, with evidence of missed diabetes-related injections and 13 missed medications in December 2023 due to lack of glucose test strips.
Deficiencies (1)
Failure to ensure medication assistance was provided to resident, resulting in missed multiple medications and injections.
Report Facts
Missed medications: 13
Facility capacity: 160
Census: 61
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Alisa Ortiz | Licensing Program Manager | Oversaw the complaint investigation |
| Melissa Weibel | Administrator | Facility administrator named in the report |
Inspection Report
Complaint Investigation
Census: 61
Capacity: 160
Deficiencies: 1
Date: Jan 8, 2025
Visit Reason
An unannounced case management visit was conducted in conjunction with a complaint investigation (22-AS-20240205143436) to assess compliance with regulations regarding glucose testing by appropriately skilled professionals.
Complaint Details
The visit was triggered by complaint 22-AS-20240205143436. The deficiency was substantiated based on staff interviews and observations.
Findings
The investigation found that two staff members performed glucose checks on a resident without being appropriately skilled professionals, violating California Code of Regulations, Title 22, Division 6, Chapter 8. This posed an immediate health and safety risk to residents.
Deficiencies (1)
Licensee failed to ensure glucose testing was performed by an appropriately skilled professional, posing an immediate health and safety risk to residents.
Report Facts
Capacity: 160
Census: 61
Plan of Correction Due Date: Jan 9, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit and complaint investigation |
| Alisa Ortiz | Licensing Program Manager / Supervisor | Named as Licensing Program Manager and Supervisor in the report |
| Patricia Perez | Administrator | Facility Administrator named in the report |
| Chiquita Morris | Met with during the inspection |
Inspection Report
Follow-Up
Census: 62
Capacity: 160
Deficiencies: 0
Date: Dec 27, 2024
Visit Reason
The visit was an unannounced case management follow-up on an incident report regarding a resident who was hospitalized after sustaining a fall with a fracture to the medial right tibia.
Findings
The Licensing Program Analyst confirmed the resident was ambulatory prior to the incident and had attended a facility event. The resident remains hospitalized and had surgery. No deficiencies were cited during this visit.
Report Facts
Service calls placed by resident: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Samer Haddadin | Licensing Program Analyst | Conducted the unannounced case management visit |
| Jeri Miles | Executive Director | Met with Licensing Program Analyst during the visit |
| Patricia Perez | Administrator/Director | Named as facility administrator/director |
Inspection Report
Follow-Up
Census: 62
Capacity: 160
Deficiencies: 0
Date: Dec 27, 2024
Visit Reason
The visit was an unannounced case management follow-up on an incident report regarding a resident who was hospitalized due to a fracture after a fall in their room.
Findings
The Licensing Program Analyst confirmed the resident was ambulatory prior to the incident and had attended a facility event. No deficiencies were cited during this visit.
Report Facts
Service calls placed by resident: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Samer Haddadin | Licensing Program Analyst | Conducted the unannounced case management visit |
| Jeri Miles | Executive Director | Met with Licensing Program Analyst during the visit |
| Patricia Perez | Administrator | Named as facility administrator |
Inspection Report
Follow-Up
Census: 55
Capacity: 160
Deficiencies: 0
Date: Aug 16, 2024
Visit Reason
The visit was conducted as a follow-up on an eviction letter received on May 6, 2024, concerning Resident #1 (R1).
Findings
The Licensing Program Analyst confirmed that Resident #1 had passed away on May 30, 2024, and obtained a copy of the death report. An exit interview was conducted with the Executive Director and a copy of the report and files were provided.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Patricia Perez | Executive Director | Met with Licensing Program Analyst during the visit and participated in the exit interview. |
| RoseMarie Ruppert | Licensing Program Analyst | Conducted the unannounced case management visit. |
| Alisa Ortiz | Supervisor | Named as supervisor in the report. |
Inspection Report
Census: 55
Capacity: 160
Deficiencies: 0
Date: Aug 16, 2024
Visit Reason
The visit was conducted as a follow-up on an eviction letter received on May 6, 2024, concerning Resident #1 (R1).
Findings
The Licensing Program Analyst was informed that Resident #1 had passed away on May 30, 2024, and obtained a copy of the death report. An exit interview was conducted with the Executive Director and a copy of the report and files were provided.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Patricia Perez | Executive Director | Met with Licensing Program Analyst during the visit and participated in exit interview. |
| RoseMarie Ruppert | Licensing Program Analyst | Conducted the unannounced case management visit. |
| Alisa Ortiz | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Annual Inspection
Census: 50
Capacity: 160
Deficiencies: 0
Date: Jun 17, 2024
Visit Reason
Licensing Program Analyst Joseph Alejandre made an unannounced visit to conduct the required annual inspection of the facility.
Findings
The facility was found to be well maintained with no deficiencies observed. Resident rooms, common areas, and safety equipment were inspected and found compliant. Staff files and resident medications showed no discrepancies.
Report Facts
Resident rooms inspected: 6
Resident files reviewed: 5
Resident medications reviewed: 5
Staff files reviewed: 5
Emergency drill date: May 6, 2024
Signal system response time: 3
Facility rooms: 81
Hot water temperature: 105
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Patricia Perez | Executive Director | Met with Licensing Program Analyst during inspection and involved in facility tour. |
| Joseph Alejandre | Licensing Program Analyst | Conducted the unannounced annual inspection. |
| Sheila Santos | Supervisor | Named as supervisor on the report. |
Inspection Report
Annual Inspection
Census: 50
Capacity: 160
Deficiencies: 0
Date: Jun 17, 2024
Visit Reason
The Licensing Program Analyst conducted an unannounced visit to perform the required annual inspection of the facility.
Findings
The facility was found to be well maintained with no deficiencies observed. Resident rooms and bathrooms were clean and operational, fire extinguishers were fully charged, and safety systems were functional. Staff files and resident medications reviewed showed no discrepancies.
Report Facts
Resident rooms inspected: 6
Resident files reviewed: 5
Resident medications reviewed: 5
Staff files reviewed: 5
Emergency drill date: May 6, 2024
Signal system response time: 3
Hot water temperature: 105
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Patricia Perez | Executive Director | Met with Licensing Program Analyst during inspection and involved in facility tour. |
| Joseph Alejandre | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Sheila Santos | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Complaint Investigation
Census: 46
Capacity: 160
Deficiencies: 0
Date: May 7, 2024
Visit Reason
An unannounced case management visit was conducted to follow up on incident reports submitted regarding thefts of residents' checks and cash.
Complaint Details
The visit was triggered by complaints of missing checks and cash from residents' rooms. The thefts were substantiated through investigation and interviews with victims.
Findings
The investigation confirmed multiple thefts by a staff member who admitted to the thefts and was terminated. Police responded and charges are pending. All residents with missing checks were reimbursed through their banks.
Report Facts
Amount of missing checks: 900
Amount of missing cash: 140
Amount of missing checks: 1000
Amount of missing cash: 1000
Attempted cashing amount: 6260
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Patricia Perez | Administrator/Director | Facility administrator met during the visit |
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit |
| Alisa Ortiz | Supervisor | Supervisor named in the report |
Inspection Report
Complaint Investigation
Census: 46
Capacity: 160
Deficiencies: 0
Date: May 7, 2024
Visit Reason
An unannounced case management visit was conducted to follow up on incident reports submitted to the department regarding thefts reported by residents.
Complaint Details
The visit was triggered by incident reports of thefts involving missing checks and cash from residents. The staff member responsible admitted to the thefts and was terminated. Police involvement and pending charges were noted.
Findings
The investigation confirmed multiple thefts of checks and cash from residents' rooms by a staff member who admitted to the thefts and was terminated. Police responded and charges are pending. All residents with missing checks were reimbursed.
Report Facts
Amount of missing checks: 900
Amount of missing cash: 140
Amount of missing checks: 1000
Amount of missing cash: 1000
Attempted cash amount: 6260
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit |
| Patricia Perez | Administrator | Met with during the inspection visit |
| Staff 1 | Staff member who admitted to thefts and was terminated |
Inspection Report
Complaint Investigation
Census: 49
Capacity: 160
Deficiencies: 2
Date: Mar 4, 2024
Visit Reason
An unannounced complaint investigation was conducted following allegations that facility staff were not properly trained, the facility was unsanitary, and the facility failed to safeguard resident belongings.
Complaint Details
The complaint investigation was substantiated for allegations that staff were not properly trained and that the facility was unsanitary. The allegation that the facility failed to safeguard resident belongings was found to be unfounded.
Findings
The investigation substantiated that staff were not properly trained to administer suppositories and that the facility was unsanitary due to failure to clean a resident's soiled floor and wheelchair. The Health and Wellness Director was terminated and corrective actions were taken. The allegation regarding failure to safeguard resident belongings was found to be unfounded.
Deficiencies (2)
Licensee failed to ensure an appropriately skilled professional administered a suppository. S1 administered a suppository to R1 and is not a skilled professional, posing an immediate health and safety risk.
Licensee failed to ensure facility is clean and sanitary. S2 failed to clean up resident's soiled floor and wheelchair, posing a potential health and safety risk.
Report Facts
Capacity: 160
Census: 49
Deficiencies cited: 2
Plan of Correction Due Dates: Type A deficiency due date 2024-03-06, Type B deficiency due date 2024-03-18
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation |
| Melissa Weibel | Administrator | Facility administrator named in the report |
| Patricia Perez | Person met with during the investigation | |
| Alisa Ortiz | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 49
Capacity: 160
Deficiencies: 2
Date: Mar 4, 2024
Visit Reason
An unannounced complaint investigation was conducted in response to allegations that facility staff were not properly trained, the facility was unsanitary, and the facility failed to safeguard resident belongings.
Complaint Details
The complaint investigation was substantiated for allegations that facility staff were not properly trained and that the facility was unsanitary. The allegation that the facility failed to safeguard resident belongings was found to be unfounded.
Findings
The investigation substantiated that staff were not properly trained as a non-skilled professional administered a vaginal suppository, and the facility was unsanitary due to failure to clean a resident's soiled floor and wheelchair. The allegation that the facility failed to safeguard resident belongings was found to be unfounded.
Deficiencies (2)
Licensee failed to ensure an appropriately skilled professional administered a suppository. S1 administered a suppository to R1 and is not a skilled professional, posing an immediate health and safety risk.
Licensee failed to ensure facility is clean and sanitary. S2 failed to clean up resident's soiled floor and wheelchair, posing a potential health and safety risk.
Report Facts
Capacity: 160
Census: 49
Deficiencies cited: 2
Plan of Correction Due Date: Mar 6, 2024
Plan of Correction Due Date: Mar 18, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation |
| Melissa Weibel | Administrator | Facility administrator named in report |
Inspection Report
Complaint Investigation
Census: 64
Capacity: 160
Deficiencies: 0
Date: Oct 3, 2023
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff did not ensure special dietary restrictions were followed for a resident and that staff did not ensure the resident received medical treatment in a timely manner.
Complaint Details
The complaint was received on 2023-09-01 and investigated on 2023-10-03. Allegations included failure to follow dietary restrictions and failure to provide timely medical treatment. The allegations were found to be unfounded based on interviews, document review, and observations.
Findings
The investigation found that the resident was not on a special diet at the time of the complaint and dietary restrictions were followed as evidenced by observations and interviews. Regarding medical treatment, paramedics were called and the resident was transported to the hospital at the request of a family member. Both allegations were deemed unfounded.
Report Facts
Capacity: 160
Census: 64
Witnesses interviewed: 8
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jerome Haley | Licensing Program Analyst | Conducted the complaint investigation and unannounced visit |
| Melissa Weibel | Executive Director | Met with Licensing Program Analyst during the investigation |
Inspection Report
Complaint Investigation
Census: 64
Capacity: 160
Deficiencies: 0
Date: Oct 3, 2023
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations received on 2023-09-01 regarding dietary restrictions not being followed and delayed medical treatment for a resident.
Complaint Details
The complaint was deemed unfounded after investigation, meaning the allegations were false or without reasonable basis.
Findings
The investigation found that the resident was not on a special diet at the time of the complaint and dietary restrictions were followed as evidenced by observations and staff interviews. The allegation of delayed medical treatment was also unfounded as the resident was assessed promptly, paramedics were called, and the resident was transported to the hospital and returned the same day with no new orders.
Report Facts
Capacity: 160
Census: 64
Witnesses interviewed: 8
Witnesses confirming dietary restrictions followed: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jerome Haley | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Melissa Weibel | Executive Director | Facility representative met during the investigation |
| Luz Adams | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 55
Capacity: 160
Deficiencies: 1
Date: Feb 27, 2023
Visit Reason
An unannounced complaint investigation visit was conducted in response to an allegation that lack of staffing resulted in the facility not meeting residents' needs.
Complaint Details
The complaint was substantiated based on interviews and evidence. The allegation was that lack of staffing resulted in the facility not meeting residents' needs. The preponderance of evidence standard was met.
Findings
The investigation found that four out of four staff and six out of six residents confirmed staffing issues during the alleged time frame. Staff indicated that Resident 1 required two-person assistance but sometimes only one caregiver was working. Staffing issues were reported to have improved by the time of complaint filing. The allegation was substantiated.
Deficiencies (1)
Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. Licensee failed to ensure facility staff is sufficient to meet the resident's needs, posing an immediate health and safety risk.
Report Facts
Capacity: 160
Census: 55
Deficiencies cited: 1
Plan of Correction Due Date: Mar 2, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation visit |
| Melissa Weibel | Executive Director | Met with Licensing Program Analyst during investigation |
| Michelle Drinkard | Wellness Director | Arrived during the investigation visit |
| Daniel Lines | Administrator | Facility administrator named in report header |
| Alisa Ortiz | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 55
Capacity: 160
Deficiencies: 1
Date: Feb 27, 2023
Visit Reason
An unannounced complaint investigation visit was conducted in response to a complaint alleging that lack of staffing resulted in the facility not meeting residents' needs.
Complaint Details
The complaint alleging lack of staffing resulting in unmet resident needs was substantiated based on interviews with staff and residents and review of documentation. The facility failed to provide the pendant response log to the department. The preponderance of evidence standard was met.
Findings
The investigation found that staffing issues were confirmed by all interviewed staff and residents during the alleged time frame, with evidence that Resident 1 required two-person assistance but sometimes only one caregiver was working. Staffing issues were reported to have improved by the time of complaint filing. The allegation was substantiated.
Deficiencies (1)
Facility personnel were not sufficient in numbers and competent to meet resident needs, posing an immediate health and safety risk.
Report Facts
Capacity: 160
Census: 55
Deficiencies cited: 1
Plan of Correction Due Date: Due date was 03/02/2023 (date only, no numeric value to extract)
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report |
| Melissa Weibel | Executive Director | Met with Licensing Program Analyst during the investigation |
| Michelle Drinkard | Wellness Director | Present during the investigation visit |
| Daniel Lines | Administrator | Facility administrator named in the report |
| Alisa Ortiz | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 52
Capacity: 160
Deficiencies: 0
Date: Jan 12, 2023
Visit Reason
The inspection visit was conducted as an unannounced complaint investigation regarding an allegation that the facility was increasing residents' rent without proper notice.
Complaint Details
The complaint alleged that the facility was increasing residents' rent without proper notice. The investigation included interviews with the administrator, former Health and Wellness Director, and the alleged victim, as well as review of documentation. The allegation was found unsubstantiated.
Findings
The investigation found that although there was some confusion due to billing practices and rescheduling of care conferences, adequate notice was given prior to adjustments in the Personal Service Rate and cost-of-living adjustments. The allegation was deemed unsubstantiated due to lack of preponderance of evidence.
Report Facts
Capacity: 160
Census: 52
Date complaint received: Complaint received on 11/15/2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kevin Saborit-Guasch | Licensing Program Analyst | Conducted the complaint investigation visit |
| Melissa Weibel | Executive Director | Facility representative who granted entry and participated in the investigation |
| Daniel Lines | Administrator | Interviewed during the investigation |
| Sheila Santos | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 52
Capacity: 160
Deficiencies: 0
Date: Jan 12, 2023
Visit Reason
The inspection visit was conducted to investigate a complaint alleging that the facility was increasing residents' rent without proper notice.
Complaint Details
The complaint alleged that the facility was increasing residents' rent without proper notice. The investigation included interviews with the administrator, former Health and Wellness Director, and the alleged victim, as well as review of documentation. The allegation was found unsubstantiated.
Findings
The investigation found that although there was some confusion regarding billing due to rescheduling of care conferences, adequate notice was given for both personal service rate adjustments and cost-of-living rate changes. The allegation was deemed unsubstantiated due to lack of preponderance of evidence.
Report Facts
Capacity: 160
Census: 52
Date complaint received: Complaint received on 11/15/2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kevin Saborit-Guasch | Licensing Program Analyst | Conducted the complaint investigation |
| Sheila Santos | Licensing Program Manager | Named in report as Licensing Program Manager |
| Daniel Lines | Administrator | Facility administrator interviewed during investigation |
| Melissa Weibel | Executive Director | Met with Licensing Program Analyst during inspection |
Inspection Report
Census: 49
Capacity: 160
Deficiencies: 0
Date: Nov 22, 2022
Visit Reason
The visit was a Case Management visit conducted by Licensing Program Analysts and the Executive Director to discuss regulatory requirements and reporting obligations related to changes in facility administration.
Findings
The Administrator was reminded of the regulation and reporting requirements when hiring a new Administrator. A Technical Assistance was issued, and an exit interview was conducted with a copy of the report and Technical Advisory provided.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kevin Saborit-Guash | Licensing Program Analyst | Conducted the Case Management visit and issued Technical Assistance. |
| Alvaro Ramirez | Licensing Program Analyst | Conducted the Case Management visit. |
| Melissa Weibel | Executive Director | Met with Licensing Program Analysts during the Case Management visit. |
| Daniel Lines | Administrator | Facility Administrator reminded of regulations and reporting requirements. |
Inspection Report
Census: 49
Capacity: 160
Deficiencies: 0
Date: Nov 22, 2022
Visit Reason
The visit was a Case Management visit conducted by Licensing Program Analysts and the Executive Director to inform the facility about the requirement to notify the Community Care Licensing division within 30 days of a change in Administrator.
Findings
The Administrator was reminded of the regulation and reporting requirements when hiring a new Administrator. A Technical Assistance was issued. An exit interview was conducted and a copy of the report and Technical Advisory was provided.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Melissa Weibel | Executive Director | Met with during the Case Management visit and informed about reporting requirements. |
| Kevin Saborit-Guash | Licensing Program Analyst | Conducted the Case Management visit. |
| Alvaro Ramirez | Licensing Program Analyst | Conducted the Case Management visit. |
Inspection Report
Annual Inspection
Census: 54
Capacity: 160
Deficiencies: 0
Date: May 5, 2022
Visit Reason
Licensing Program Analyst Michelle Reed made an unannounced visit to conduct an annual inspection focusing on infection control at the facility.
Findings
The facility was found to be in compliance with infection control protocols, including adequate PPE supply, posted COVID signs, social distancing, mask wearing, and proper sanitation supplies. No deficiencies were noted during the visit.
Report Facts
PPE supply duration: 30
Census: 54
Total capacity: 160
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Esmiralda Behonsky | Health and Wellness Director | Met with the Licensing Program Analyst during the inspection. |
| Daniel Lines | Administrator | Facility administrator contacted and present during part of the inspection. |
Inspection Report
Annual Inspection
Census: 54
Capacity: 160
Deficiencies: 0
Date: May 5, 2022
Visit Reason
The visit was an unannounced annual inspection focused on infection control at the facility.
Findings
The inspection found that infection control measures were in place including posted Covid signs, temperature checks, vaccination verification, hand sanitizing stations, sufficient PPE supply, and social distancing. No deficiencies were noted during the visit.
Report Facts
PPE supply duration: 30
Covid testing frequency: 7
Resident temperature checks: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the inspection visit |
| Esmiralda Behonsky | Health and Wellness Director | Met with Licensing Program Analyst during inspection |
| Daniel Lines | Administrator | Facility administrator contacted and present during inspection |
Inspection Report
Follow-Up
Census: 56
Capacity: 160
Deficiencies: 0
Date: Dec 1, 2021
Visit Reason
An unannounced case management visit was conducted to follow up on an incident report submitted regarding a resident found outside the facility.
Findings
The visit confirmed that Resident 1 was found outside the facility with their dog, was redirected back, and placed on hourly checks and caregiver supervision overnight. Resident 1 was later moved to a memory care unit with no adverse effects.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Lines | Executive Director | Met with Licensing Program Analysts during the visit and provided information about Resident 1. |
| Kimberly Lyman | Licensing Evaluator | Conducted the unannounced case management visit. |
| Kevin Saborit-Guasch | Licensing Program Analyst | Conducted the unannounced case management visit. |
Inspection Report
Complaint Investigation
Census: 56
Capacity: 160
Deficiencies: 1
Date: Dec 1, 2021
Visit Reason
An unannounced complaint investigation visit was conducted in response to an allegation that the facility was charging fees and rent for services not provided.
Complaint Details
The complaint was substantiated. The allegation was that the facility charged fees and rent for services not provided. The investigation revealed a billing discrepancy for Resident 1, who was overcharged. The facility provided a credit during the visit.
Findings
The investigation substantiated the allegation, finding a billing discrepancy where Resident 1 was overcharged. The facility provided a credit during the visit, but the billing records did not accurately reflect this credit, indicating financial exploitation.
Deficiencies (1)
Licensee failed to ensure Resident 1 was free from financial exploitation, resulting in overcharging and posing a potential health and safety risk to residents.
Report Facts
Resident census: 56
Total capacity: 160
Amount owed discrepancy: 76
Amount Resident 1 allegedly owed: 1594
Plan of Correction due date: Dec 15, 2021
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Lines | Executive Director | Met with during investigation and provided information regarding billing |
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation |
| Kevin Saborit-Guasch | Licensing Program Analyst | Conducted the complaint investigation |
| Alisa Ortiz | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Follow-Up
Census: 56
Capacity: 160
Deficiencies: 0
Date: Dec 1, 2021
Visit Reason
Unannounced case management visit to follow up on an incident report submitted to Community Care Licensing on 11/22/2021 regarding a resident found outside the facility.
Findings
The visit confirmed that Resident 1, diagnosed with Mild Cognitive Impairment, was found outside the facility but was redirected back and placed on hourly checks. The resident was moved to a memory care unit with no adverse effects, and the Executive Director reported a gradual decline in behavior.
Report Facts
Incident report date: Nov 22, 2021
Resident diagnosis date: Oct 12, 2021
Resident moved date: Nov 24, 2021
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Lines | Executive Director | Facility representative who greeted LPAs and provided information about the resident |
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit |
| Kevin Saborit-Guasch | Licensing Program Analyst | Conducted the unannounced case management visit |
| Alisa Ortiz | Licensing Program Manager | Named in the report header |
Inspection Report
Annual Inspection
Census: 57
Capacity: 160
Deficiencies: 0
Date: Oct 5, 2021
Visit Reason
Licensing Program Analyst Kimberly Lyman conducted an unannounced visit for the purpose of conducting a required annual inspection of the facility.
Findings
The facility was observed to be clean, sanitary, and well maintained with residents appearing happy and well cared for. No deficiencies were noted during the visit. The facility has COVID-19 precautions in place including screening, vaccination, and mitigation plans.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Lines | Executive Director | Met with Licensing Program Analyst during the inspection and holds a current administrator certificate. |
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced annual inspection visit. |
Inspection Report
Complaint Investigation
Census: 57
Capacity: 160
Deficiencies: 0
Date: Oct 5, 2021
Visit Reason
The visit was an unannounced case management follow-up on an incident report received by Community Care Licensing regarding a resident eloping from the facility.
Complaint Details
The visit was triggered by an incident report dated 09/12/2021 about Resident 1 eloping to McDonald's. The resident's son reported the absence, and the facility retrieved the resident. The resident's physician indicated the resident should not leave unassisted. The investigation confirmed the resident left through a delayed egress door before the alarm activation time.
Findings
The investigation confirmed that Resident 1 left the facility unassisted through a delayed egress door before the alarm was active. The resident was found safe and unharmed, and verbalized being happy and safe at the facility during the visit.
Report Facts
Incident report date: Sep 12, 2021
Incident report received date: Sep 20, 2021
Delayed egress door alarm time: 19
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Lines | Executive Director | Facility representative who greeted Licensing Program Analyst and was involved in the visit |
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit |
| Alisa Ortiz | Supervisor | Supervisor named in the report |
Inspection Report
Annual Inspection
Census: 57
Capacity: 160
Deficiencies: 0
Date: Oct 5, 2021
Visit Reason
Licensing Program Analyst Kimberly Lyman conducted an unannounced visit for the purpose of conducting a required annual visit.
Findings
The facility appeared clean, sanitary, and well maintained with residents appearing happy and well cared for. No deficiencies were noted during the visit. COVID-19 precautions and mitigation plans were reviewed and approved.
Report Facts
Facility capacity: 160
Resident census: 57
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Lines | Executive Director | Met with Licensing Program Analyst during the inspection and holds a current administrator certificate |
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced annual inspection visit |
| Alisa Ortiz | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 57
Capacity: 160
Deficiencies: 0
Date: Oct 5, 2021
Visit Reason
The visit was an unannounced case management follow-up on an incident report received regarding a resident eloping from the facility.
Complaint Details
The complaint involved Resident 1 eloping from the facility to McDonald's. The incident was substantiated by the facility's investigation showing the resident left through a delayed egress door at approximately 6:30 PM, before the alarm activation time.
Findings
The investigation confirmed that Resident 1 left the facility through a delayed egress door before the alarm was active, was found safe with no injuries, and appeared happy and well cared for during the visit.
Report Facts
Facility capacity: 160
Resident census: 57
Incident report date: Sep 12, 2021
Incident report received date: Sep 20, 2021
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Lines | Executive Director | Facility representative who greeted Licensing Program Analyst and was involved in the incident follow-up |
| Kimberly Lyman | Licensing Program Analyst | Conducted the unannounced case management visit and investigation |
| Alisa Ortiz | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 58
Capacity: 160
Deficiencies: 0
Date: Aug 12, 2021
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff were not responding to resident needs, resident dishes were left in the hallway, and staff were sleeping in common areas.
Complaint Details
The complaint investigation was initiated based on allegations received on 08/04/2021. The allegations were found to be unfounded after interviews with staff and residents, facility tour, and document review.
Findings
The investigation found no evidence to support the allegations. No dishes were observed in the hallway during the visit, staff were reported to respond promptly to resident needs, and no staff were seen sleeping. The allegations were deemed unfounded.
Report Facts
Census: 58
Total Capacity: 160
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation |
| Daniel Lines | Executive Director | Facility administrator interviewed during investigation |
Inspection Report
Complaint Investigation
Census: 58
Capacity: 160
Deficiencies: 0
Date: Aug 12, 2021
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff were not responding to resident needs, resident dishes were left in the hallway, and staff were sleeping in common areas.
Complaint Details
The complaint investigation was initiated based on allegations of staff not responding to resident needs, resident dishes left in hallways, and staff sleeping in common areas. The allegations were found to be unfounded after interviews, observations, and documentation review.
Findings
The investigation found no evidence to support the allegations. No dishes were observed in the hallway, staff were reported to pick up dishes promptly, residents with diet modifications were being properly cared for, and no staff were observed sleeping during the visit. The allegations were deemed unfounded.
Report Facts
Capacity: 160
Census: 58
Witnesses interviewed: 8
Witnesses interviewed: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation visit |
| Daniel Lines | Executive Director | Facility administrator interviewed during investigation |
| Alisa Ortiz | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Complaint Investigation
Census: 61
Capacity: 160
Deficiencies: 0
Date: Jun 23, 2021
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations of staff neglect resulting in a resident's hospitalization and neglect of resident's calls for help multiple times.
Complaint Details
The complaint was investigated and found to be unfounded, meaning the allegations were false, could not have happened, and/or were without a reasonable basis.
Findings
The investigation revealed that the resident involved was no longer living at the facility and had not been there since May 15, 2020. Therefore, the allegations were deemed unfounded.
Report Facts
Capacity: 160
Census: 61
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation visit |
| Daniel Lines | Executive Director | Interviewed during the investigation |
Inspection Report
Complaint Investigation
Census: 61
Capacity: 160
Deficiencies: 0
Date: Jun 23, 2021
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations of staff neglect resulting in a resident's hospitalization and neglect of resident's calls for help multiple times.
Complaint Details
The complaint was investigated and deemed unfounded, meaning the allegations were false, could not have happened, and/or were without a reasonable basis.
Findings
The investigation found that the resident involved was not currently living at the facility and had only been there for respite care in May 2020. The allegations were determined to be unfounded as the resident had moved out and had not returned, and there was no evidence to support the claims.
Report Facts
Capacity: 160
Census: 61
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Lines | Executive Director | Met with during the investigation and discussed the purpose of the visit |
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation visit |
Inspection Report
Complaint Investigation
Census: 57
Capacity: 160
Deficiencies: 0
Date: Feb 25, 2021
Visit Reason
The inspection was an unannounced complaint investigation triggered by allegations of inadequate staffing and personal rights violations at the facility.
Complaint Details
The complaint investigation was initiated based on allegations of inadequate staffing and personal rights violations. The allegations were found to be unfounded after interviews, documentation review, and observation.
Findings
The investigation found that all interviewed staff denied the allegations of residents being covered in ants or urine, and staffing levels were consistent with the facility's schedule. The allegations were deemed unfounded as there was no evidence to support them.
Report Facts
Facility capacity: 160
Census: 57
Dates of ant treatment: 2
Staffing levels: 3
Staffing levels: 1
Staffing levels: 1
Staffing levels: 2
Staffing levels: 1
Staffing levels: 1
Staffing levels: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Lyman | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Daniel Lines | Administrator | Facility administrator interviewed during investigation |
| Alisa Ortiz | Licensing Program Manager | Named as Licensing Program Manager on the report |
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