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/yearDeficiencies per year
16
12
8
4
0
Census
Latest occupancy rate
90% occupied
Based on a January 2026 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy over time
Inspection Report
Complaint Investigation
Census: 112
Capacity: 124
Deficiencies: 0
Date: Jan 7, 2026
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to multiple allegations received on May 28, 2024, regarding staff neglect leading to resident pressure injuries, failure to meet resident medical needs, denial of telephone access, and failure to meet diapering needs.
Complaint Details
The complaint investigation was triggered by allegations that staff neglect led to a resident sustaining pressure injuries, staff did not meet the resident's medical needs, staff denied the resident access to the telephone, and staff did not meet the resident's diapering needs. The pressure injury allegation was unsubstantiated due to conflicting information and lack of preponderance of evidence. The medical needs and telephone access allegations were unfounded. The diapering needs allegation was also unsubstantiated.
Findings
The investigation found conflicting information and insufficient evidence to substantiate the allegations of staff neglect causing pressure injuries and failure to meet diapering needs, resulting in these allegations being deemed unsubstantiated. The allegations that staff did not meet resident medical needs and denied telephone access were found to be unfounded. No citations were issued during the visit.
Report Facts
Facility capacity: 124
Census: 112
Staffing levels: 4
Staffing levels: 1
Staffing levels: 2
Staffing levels: 1
Incontinence care frequency: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alvaro Ramirez Jr. | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Jennifer Kornmann | Administrator | Facility administrator met during the investigation and exit interview |
Inspection Report
Annual Inspection
Census: 112
Capacity: 124
Deficiencies: 1
Date: Nov 26, 2025
Visit Reason
The inspection was an unannounced required annual inspection conducted to evaluate compliance with licensing requirements for the Residential Care Facility for the Elderly.
Findings
The facility was generally found to be in compliance with licensing standards, including clean and hazard-free resident apartments, proper storage of medications and chemicals, and up-to-date fire safety measures. However, a deficiency was cited for a staff member not completing the required twenty hours of annual training, having only twelve hours documented for 2024.
Deficiencies (1)
Staff #3 did not complete the required twenty hours of annual training, only twelve hours documented for 2024.
Report Facts
Annual training hours required: 20
Annual training hours documented: 12
Deficiency correction due date: Dec 26, 2025
Fire extinguisher service date: Aug 21, 2025
Fire inspection date: Oct 21, 2025
Emergency drill date: Oct 23, 2025
Hot water temperature range: 115.5-119.8
Perishable food supply duration: 2
Nonperishable food supply duration: 7
Emergency food and water supply duration: 3
Resident files reviewed: 10
Staff files reviewed: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Kornmann | Executive Director | Present during inspection and named in training deficiency finding |
| Brandon Lopez | Licensing Program Analyst | Conducted the inspection |
| Sheila Santos | Licensing Program Manager | Named in report |
Inspection Report
Complaint Investigation
Census: 114
Capacity: 124
Deficiencies: 0
Date: Sep 19, 2025
Visit Reason
The visit was an unannounced complaint investigation into allegations that staff placed restrictions on a resident's right to have visitors and did not provide privacy during visits.
Complaint Details
The complaint alleged that staff restricted Resident #1's visitors and did not provide privacy during visits on September 10 and 11, 2025. The investigation concluded the complaint was unfounded based on evidence including interviews and review of the resident's Advance Health Care Directive and physician's note.
Findings
The investigation found that the resident's Power of Attorney had authorized restrictions on visitors due to distress caused during visits, and the resident was incapable of making her own decisions. The complaint was determined to be unfounded.
Report Facts
Capacity: 124
Census: 114
Estimated Days of Completion: 90
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Brandon Lopez | Licensing Program Analyst | Conducted the complaint investigation |
| Jasmine Barajas | Health Services Director | Facility staff who assisted during the visit and exit interview |
Inspection Report
Complaint Investigation
Census: 114
Capacity: 124
Deficiencies: 0
Date: Sep 19, 2025
Visit Reason
An unannounced visit was conducted to investigate a complaint alleging that staff placed restrictions on a resident's right to have visitors and did not provide privacy during visits.
Complaint Details
The complaint alleged that staff restricted Resident #1's visitors and did not provide privacy during visits on September 10 and 11, 2025. The resident had passed away before the investigation. Interviews and document reviews confirmed that the Power of Attorney had authorized visitor restrictions due to distress caused by certain visitors. The complaint was found to be unfounded.
Findings
The investigation found that the resident's Power of Attorney had valid authority to restrict visitors due to distress caused to the resident, and the complaint was determined to be unfounded.
Report Facts
Estimated Days of Completion: 90
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Brandon Lopez | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Sheila Santos | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
| Jasmine Barajas | Health Services Director | Facility staff who assisted during the investigation visit |
Inspection Report
Annual Inspection
Census: 107
Capacity: 124
Deficiencies: 0
Date: Jan 9, 2025
Visit Reason
An unannounced visit was conducted for the purpose of a Required/Annual Inspection of the facility.
Findings
The inspection found the facility to be generally compliant with regulations, with operational safety systems and proper resident accommodations observed. A technical violation was issued for water temperature exceeding regulatory limits, but no deficiencies were cited under Title 22 Division 6.
Report Facts
Water temperature range: 123.6
Water temperature range: 105
Supply of perishables: 2
Supply of non-perishables: 7
Fire extinguisher service date: Aug 15, 2024
Resident files reviewed: 10
Staff files reviewed: 9
Residents interviewed: 10
Staff interviewed: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Kornmann | Executive Director | Met during inspection and mentioned in report |
| Linda Robbins | Sales Manager | Met during inspection and discussed purpose of inspection |
| Claudia Gutierrez | Licensing Program Analyst | Conducted inspection and signed report |
| Eboni Bentley | Licensing Program Analyst | Conducted inspection |
| Armando J Lucero | Licensing Program Manager | Named in report |
Inspection Report
Annual Inspection
Census: 107
Capacity: 124
Deficiencies: 1
Date: Jan 9, 2025
Visit Reason
The inspection was an unannounced Required/Annual Inspection conducted to evaluate the facility's compliance with regulations.
Findings
The facility was found to be in compliance with no deficiencies cited. Observations included operable safety systems, adequate food supplies, proper medication storage, and well-maintained resident rooms and common areas. A technical violation was issued for water temperature exceeding the allowed range.
Deficiencies (1)
Water temperature tested between 105.0-123.6 degrees Fahrenheit; a Technical Violation was issued on this date.
Report Facts
Food supply duration: 2
Food supply duration: 7
Fire extinguisher service date: Aug 15, 2024
Resident files reviewed: 10
Staff files reviewed: 9
Residents interviewed: 10
Staff interviewed: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Kornmann | Executive Director | Met with LPAs during inspection and named in the report |
| Linda Robbins | Sales Manager | Met with LPAs and discussed purpose of inspection |
| Claudia Gutierrez | Licensing Program Analyst | Conducted inspection and signed report |
| Eboni Bentley | Licensing Program Analyst | Conducted inspection |
| Armando J Lucero | Licensing Program Manager | Named in report |
Inspection Report
Complaint Investigation
Census: 96
Capacity: 124
Deficiencies: 0
Date: Mar 22, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 07/08/2022 alleging that a resident suffered a fall resulting in serious injuries due to lack of care and supervision.
Complaint Details
The complaint was unsubstantiated. Although the allegation may have been valid, there was not a preponderance of evidence to prove neglect or lack of supervision by staff caused the resident's fall on July 5, 2022.
Findings
The investigation found that Resident #1 had multiple falls, including one on July 5, 2022, which resulted in serious injuries. Staff took appropriate steps including calling 911. The allegation of neglect or lack of supervision was deemed unsubstantiated due to insufficient evidence to prove the violation occurred.
Report Facts
Facility capacity: 124
Resident census: 96
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Kornmann | Administrator | Met with Licensing Program Analyst to discuss complaint findings |
| Michelle Reed | Licensing Program Analyst | Conducted complaint investigation |
| Sheila Santos | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 96
Capacity: 124
Deficiencies: 0
Date: Mar 22, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 07/08/2022 alleging that a resident suffered a fall resulting in serious injuries due to lack of care and supervision.
Complaint Details
The complaint was investigated through interviews with the administrator, six staff members, witnesses, and review of facility documentation. The allegation was unsubstantiated, meaning there was not a preponderance of evidence to prove the alleged violation occurred.
Findings
The investigation found that Resident #1 had multiple falls, including one on July 5, 2022, which resulted in serious injuries. Staff took appropriate steps to assist and call 911. The allegation of neglect or lack of supervision was deemed unsubstantiated due to insufficient evidence that staff caused or contributed to the fall.
Report Facts
Facility capacity: 124
Census: 96
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Kornmann | Administrator | Met with Licensing Program Analyst and involved in complaint investigation |
| Michelle Reed | Licensing Program Analyst | Conducted the complaint investigation |
| Sheila Santos | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 95
Capacity: 124
Deficiencies: 0
Date: Mar 20, 2023
Visit Reason
The inspection was an unannounced complaint investigation triggered by a complaint received on 08/11/2022 alleging that a resident sustained multiple falls due to lack of supervision.
Complaint Details
The complaint alleged that Resident #1 sustained multiple falls due to lack of supervision. The investigation found the allegation unsubstantiated.
Findings
The investigation included interviews with staff and review of resident records. It was determined that the allegation was unsubstantiated as there was no preponderance of evidence that the falls were due to lack of supervision.
Report Facts
Complaint control number: 22
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Jennifer Kornmann | Administrator | Facility administrator met during investigation and exit interview |
Inspection Report
Complaint Investigation
Census: 95
Capacity: 124
Deficiencies: 0
Date: Mar 20, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 08/03/2022 alleging that a resident suffered a fall resulting in serious injuries due to lack of care and supervision.
Complaint Details
The complaint alleged that a resident suffered a fall resulting in serious injuries due to lack of care and supervision. The investigation found no definitive supporting evidence or witness statements to substantiate neglect or lack of supervision. The allegation was unsubstantiated.
Findings
The investigation included interviews with the administrator, staff, and witnesses, as well as a review of facility documentation. It was determined that although the resident experienced a fall resulting in injuries, there was insufficient evidence to substantiate neglect or lack of supervision by the facility staff. The allegation was deemed unsubstantiated.
Report Facts
Facility capacity: 124
Resident census: 95
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Kornmann | Administrator | Met with Licensing Program Analyst to discuss complaint findings |
| Michelle Reed | Licensing Program Analyst | Conducted the complaint investigation |
| Sheila Santos | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 95
Capacity: 124
Deficiencies: 0
Date: Mar 20, 2023
Visit Reason
An unannounced complaint investigation was conducted following a complaint received on 08/03/2022 alleging that a resident suffered a fall resulting in serious injuries due to lack of care and supervision.
Complaint Details
The complaint was investigated through interviews with the administrator, six staff members, and witnesses, as well as review of facility documentation. The allegation of neglect or lack of supervision was unsubstantiated due to lack of definitive supporting evidence.
Findings
The investigation found that Resident #1, who was a fall risk, sustained a fall resulting in a hematoma and broken clavicle. However, there was insufficient evidence to substantiate neglect or lack of supervision by facility staff. The allegation was deemed unsubstantiated.
Report Facts
Complaint received date: Aug 3, 2022
Investigation visit time: 45
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the complaint investigation and met with the administrator |
| Jennifer Kornmann | Administrator | Facility administrator interviewed during investigation |
| Sheila Santos | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 95
Capacity: 124
Deficiencies: 0
Date: Mar 20, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 08/11/2022 alleging that a resident sustained multiple falls due to lack of supervision.
Complaint Details
The complaint alleged that Resident #1 sustained multiple falls while in care due to lack of supervision. The investigation found the allegation unsubstantiated.
Findings
The investigation included interviews with staff and review of resident records. It was determined that the allegation was unsubstantiated as there was not a preponderance of evidence to prove the falls were due to lack of supervision.
Report Facts
Complaint received date: Aug 11, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Jennifer Kornmann | Administrator | Facility administrator met during investigation and recipient of report |
Inspection Report
Complaint Investigation
Census: 94
Capacity: 124
Deficiencies: 0
Date: Feb 24, 2023
Visit Reason
An unannounced complaint investigation visit was conducted to investigate an allegation that staff did not provide a resident's authorized representative with all records.
Complaint Details
The complaint alleged that staff did not provide the resident's authorized representative with all progress notes for the first two months. The complaint was investigated and found to be unfounded.
Findings
The investigation found that the facility did not have progress notes for the first two months of the resident's stay, but all available progress notes were provided to the authorized representative. The allegation was deemed unfounded and dismissed.
Report Facts
Capacity: 124
Census: 94
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jessica Cho | Licensing Program Analyst | Conducted the complaint investigation visit |
| Jennifer Kornmann | Executive Director | Interviewed during the investigation and participated in exit interview |
Inspection Report
Complaint Investigation
Census: 94
Capacity: 124
Deficiencies: 0
Date: Feb 24, 2023
Visit Reason
An unannounced complaint investigation was conducted to investigate the allegation that staff did not provide the resident's authorized representative with all records.
Complaint Details
The complaint alleged that staff did not provide Resident 1's authorized representative with all progress notes for the first two months. The allegation was investigated and found to be unfounded.
Findings
The investigation found that the facility did not have progress notes for the first two months of the resident's stay, but all available progress notes were provided to the authorized representative. The allegation was deemed unfounded and dismissed.
Report Facts
Capacity: 124
Census: 94
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jessica Cho | Licensing Program Analyst | Conducted the complaint investigation |
| Jennifer Kornmann | Executive Director | Interviewed during the investigation and named in findings |
| Sheila Santos | Licensing Program Manager | Named in report header and signature section |
Inspection Report
Complaint Investigation
Census: 89
Capacity: 124
Deficiencies: 3
Date: Nov 1, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that the facility did not have hot water, residents were not being bathed, and residents' laundry services were not being met while in care.
Complaint Details
The complaint was substantiated. The investigation was initiated based on a complaint received on 08/23/2022 alleging lack of hot water, residents not being bathed, and unmet laundry services. The findings confirmed these allegations.
Findings
The investigation found that out of 9 rooms tested, 6 did not have hot water meeting regulation guidelines. Shift reports and staff interviews confirmed that six residents did not receive showers and laundry services were not completed due to lack of hot water. The allegations were substantiated based on water temperature measurements, interviews, and record reviews.
Deficiencies (3)
Maintenance and Operation-Faucets used by residents for personal care did not deliver hot water within the required temperature range of 105 to 120 degrees F.
Basic services including personal assistance with bathing were not provided as six residents did not receive showers due to no warm or hot water.
Facilities with washing machines did not have adequate supplies available and equipment maintained in good repair, resulting in laundry services not being completed due to no hot water.
Report Facts
Rooms without hot water meeting regulation: 6
Residents not showered: 6
Facility capacity: 124
Facility census: 89
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the complaint investigation and inspection |
| Jennifer Kornmann | Administrator | Facility administrator met during inspection and involved in investigation |
| Sheila Santos | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 89
Capacity: 124
Deficiencies: 0
Date: Nov 1, 2022
Visit Reason
An unannounced complaint investigation was conducted following a complaint alleging that a resident wandered away from the facility twice due to lack of supervision.
Complaint Details
Complaint alleging that a resident wandered away from the facility twice due to lack of supervision was investigated and found to be unfounded.
Findings
The investigation found the complaint to be unfounded, meaning the allegation was false, could not have happened, or was without a reasonable basis. No evidence supported the claim that a resident wandered away due to lack of supervision.
Report Facts
Capacity: 124
Census: 89
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the complaint investigation |
| Jennifer Kornmann | Administrator | Facility administrator met during investigation |
Inspection Report
Complaint Investigation
Census: 89
Capacity: 124
Deficiencies: 0
Date: Nov 1, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation of lack of supervision resulting in a resident suffering a fall and sustaining an injury.
Complaint Details
The complaint alleged lack of supervision resulting in a resident suffering a fall and injury. The investigation included interviews and record reviews and concluded the allegation was unsubstantiated.
Findings
The investigation found no supporting evidence of neglect or lack of supervision by facility staff that caused or contributed to the resident's fall. The allegation was determined to be unsubstantiated.
Report Facts
Complaint Control Number: 22
Complaint Control Number: 20220711174604
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Kornmann | Administrator | Met with Licensing Program Analyst to discuss complaint findings |
| Michelle Reed | Licensing Program Analyst | Conducted the complaint investigation |
Inspection Report
Complaint Investigation
Census: 89
Capacity: 124
Deficiencies: 3
Date: Nov 1, 2022
Visit Reason
An unannounced complaint investigation visit was conducted following allegations that the facility did not have hot water, residents were not being bathed, and residents' laundry services were not being met while in care.
Complaint Details
The complaint was substantiated based on water temperature measurements, interviews, and record reviews. The complaint control number is 22-AS-20220823133542. The complaint was received on 08/23/2022 and investigated with an unannounced visit on 11/01/2022.
Findings
The investigation found that out of 9 rooms, 6 did not have hot water meeting regulation guidelines. End of shift reports and staff interviews confirmed that six residents did not receive showers and laundry services were not completed due to lack of hot water. The allegations were substantiated and posed immediate health and safety risks.
Deficiencies (3)
Maintenance and Operation-Faucets used by residents for personal care did not deliver hot water within the required temperature range of 105 to 120 degrees F.
Basic services including personal assistance with bathing were not provided as six residents did not receive showers due to no warm or hot water.
Facilities with washing machines did not have adequate supplies available and equipment maintained in good repair, resulting in laundry services not being completed due to no hot water.
Report Facts
Rooms without compliant hot water: 6
Residents not bathed: 6
Facility capacity: 124
Facility census: 89
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the complaint investigation and made the unannounced visit. |
| Sheila Santos | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation. |
| Jennifer Kornmann | Administrator | Facility Administrator met during the investigation and named in findings. |
Inspection Report
Complaint Investigation
Census: 89
Capacity: 124
Deficiencies: 0
Date: Nov 1, 2022
Visit Reason
The visit was an unannounced complaint investigation triggered by an allegation that a resident wandered away from the facility twice due to lack of supervision.
Complaint Details
The complaint alleged that a resident wandered away from the facility twice due to lack of supervision. No dates or times were provided, and it was unknown if these incidents were related to prior citations for elopements. The complaint was found to be unfounded.
Findings
The complaint was investigated through interviews with staff, the administrator, and witnesses. The investigation found the complaint to be unfounded, meaning the allegation was false, could not have happened, or was without reasonable basis.
Report Facts
Capacity: 124
Census: 89
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the complaint investigation and unannounced visit |
| Jennifer Kornmann | Administrator | Facility administrator met during the investigation |
Inspection Report
Complaint Investigation
Census: 89
Capacity: 124
Deficiencies: 0
Date: Nov 1, 2022
Visit Reason
The inspection visit was conducted as an unannounced complaint investigation following a complaint received on 07/11/2022 regarding lack of supervision resulting in a resident suffering a fall and injury.
Complaint Details
The complaint alleged lack of supervision resulting in a resident falling and sustaining injury. The investigation included interviews and record reviews. The allegation was unsubstantiated due to insufficient evidence to prove the violation occurred.
Findings
The investigation found no supporting evidence of neglect or lack of supervision by facility staff that caused or contributed to the resident's fall. The allegation was determined to be unsubstantiated.
Report Facts
Complaint Control Number: 22-AS-20220711174604
Capacity: 124
Census: 89
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the complaint investigation and met with the Administrator |
| Jennifer Kornmann | Administrator | Facility Administrator met during investigation and exit interview |
Inspection Report
Annual Inspection
Census: 84
Capacity: 124
Deficiencies: 0
Date: Oct 24, 2022
Visit Reason
Licensing Program Analyst Edward Tapia conducted an unannounced required annual inspection at the facility to evaluate compliance with licensing requirements and review facility conditions.
Findings
The facility was found to be in good repair with no deficiencies noted. Resident rooms and common areas were clean and safe, infection control measures were in place, and emergency and safety equipment were operational. The facility met food supply requirements and COVID-19 mitigation plans were reviewed.
Report Facts
Licensed capacity: 124
Resident census: 84
Hospice waiver beds: 10
Bedridden residents allowed: 6
Hot water temperature range: 105.0-119.8
Food supply minimum: 2
Food supply minimum: 7
Fire alarm and carbon monoxide alarm test date: Sep 23, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Edward Tapia | Licensing Program Analyst | Conducted the annual inspection and reviewed facility compliance |
| Leo Serna | Business Office Director | Met with Licensing Program Analyst during inspection |
| Jennifer Kornmann | Executive Director | Facility administrator; participated in exit interview |
Inspection Report
Annual Inspection
Census: 84
Capacity: 124
Deficiencies: 0
Date: Oct 24, 2022
Visit Reason
An unannounced required annual inspection was conducted to evaluate compliance with licensing requirements for the facility.
Findings
The facility was found to be in good repair with no deficiencies noted. Resident rooms and common areas were clean and safe, fire and safety equipment were operational, and COVID-19 mitigation plans were reviewed and found adequate.
Report Facts
Licensed capacity: 124
Census: 84
Hospice waiver beds: 10
Bedridden residents allowed: 6
Hot water temperature range (Fahrenheit): 105.0-119.8
Fire alarm and carbon monoxide alarm test date: Sep 23, 2022
Food supply minimum days: 2
Food supply minimum days: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Edward Tapia | Licensing Program Analyst | Conducted the inspection and authored the report |
| Leo Serna | Business Office Director | Met with Licensing Program Analyst during inspection |
| Jennifer Kornmann | Executive Director | Facility administrator; participated in exit interview |
Inspection Report
Follow-Up
Census: 82
Capacity: 124
Deficiencies: 1
Date: Aug 23, 2022
Visit Reason
The visit was conducted as a Case Management follow-up on an elopement incident that occurred at the facility involving Resident #1.
Findings
Resident #1 climbed over the outside exit gate and left the facility unassisted, which staff were unaware of at the time. The resident was found outside the building without injury. This posed an immediate health and safety risk due to inadequate supervision.
Deficiencies (1)
Failure to provide adequate care and supervision resulting in Resident #1 eloping by climbing over the side gate unassisted.
Report Facts
Capacity: 124
Census: 82
Plan of Correction Due Date: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the Case Management visit and authored the report |
| Kathleen McCarron | Vice President of Operations | Met with Licensing Program Analyst during the visit |
| Sheila Santos | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Follow-Up
Census: 82
Capacity: 124
Deficiencies: 1
Date: Aug 23, 2022
Visit Reason
The visit was conducted to follow-up on an elopement incident that occurred at the facility involving Resident #1 who left the facility unsupervised.
Findings
Resident #1 climbed over the side gate and eloped on 08/18/2022 without staff awareness, posing an immediate health and safety risk. The facility was cited for failure to provide adequate care and supervision.
Deficiencies (1)
Basic services including care and supervision were not met as Resident #1 eloped by climbing over the side gate and staff were unaware, posing an immediate health and safety risk.
Report Facts
Deficiencies cited: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Reed | Licensing Program Analyst | Conducted the case management visit and authored the report |
| Kathleen McCarron | Vice President of Operations | Met with Licensing Program Analyst during the visit and participated in exit interview |
| Sheila Santos | Licensing Program Manager | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Capacity: 124
Deficiencies: 1
Date: Aug 8, 2022
Visit Reason
The visit was conducted as a case management incident visit to discuss an unusual incident reported on 08/04/2022 involving a resident elopement from the Memory Care Unit.
Complaint Details
The visit was complaint-related due to an unusual incident involving Resident #1 eloping from the facility on 08/04/2022. The resident had two prior elopements on 03/27/22 and 07/24/22. The complaint was substantiated with a repeat deficiency cited.
Findings
The report found that Resident #1 eloped from the facility through delayed egress doors on three occasions, with staff unaware during the most recent incident. The facility had a delay in door locking and staff were reminded to secure doors. The deficiency was cited as a repeat violation related to insufficient staff supervision and elopement prevention.
Deficiencies (1)
Care of Person's With Dementia - Delayed egress devices shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents and to escort residents who leave the facility.
Report Facts
Capacity: 124
Deficiency count: 1
Elopement incidents: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Kornmann | Administrator | Named in relation to the incident and exit interview |
| Michelle Reed | Licensing Program Analyst | Conducted the case management visit and evaluation |
| Leo Serna | Business Office Manager | Met with Licensing Program Analyst upon arrival |
Inspection Report
Complaint Investigation
Capacity: 124
Deficiencies: 1
Date: Aug 8, 2022
Visit Reason
The visit was conducted as a case management visit to discuss an Unusual Incident reported on 08/04/2022 involving a resident elopement from the Memory Care Unit.
Complaint Details
The visit was complaint-related due to an Unusual Incident involving Resident #1 eloping from the Memory Care Unit on 08/04/2022. This was the third elopement incident involving the resident within the past year. Staff were unaware of the elopement until notified by the resident's responsible party. The complaint was substantiated with cited deficiencies.
Findings
Resident #1 eloped from the facility through delayed egress doors on 08/04/2022, the third such incident involving this resident within a 12-month period. Staff were unaware of the elopement until alerted by the resident's responsible party. The delayed egress doors have a delay in locking, and staff have been trained and reminded to secure doors properly.
Deficiencies (1)
Care of Person's With Dementia - Delayed egress devices shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents and to escort residents who leave the facility. This requirement was not met as evidenced by the resident elopements through delayed egress doors.
Report Facts
Deficiency Type: 1
Capacity: 124
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Kornmann | Administrator | Named in relation to the incident and exit interview. |
| Michelle Reed | Licensing Program Analyst | Conducted the case management visit and authored the report. |
| Leo Serna | Business Office Manager | Met with Licensing Program Analyst upon arrival. |
| Sheila Santos | Licensing Program Manager | Supervisor named in the report. |
Inspection Report
Census: 78
Capacity: 124
Deficiencies: 0
Date: Jul 12, 2022
Visit Reason
An unannounced Case Management visit was conducted to follow up on an Exemption Denial for Staff #1 and verify compliance with removal of the staff member from the facility.
Findings
The Administrator informed the Licensing Program Analyst that Staff #1 was still working at the facility, but the staff member was immediately sent home upon arrival. No citations were issued at this time pending further information.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Kornmann | Administrator | Informed Licensing Program Analyst about Staff #1 working at the facility and sent Staff #1 home upon arrival. |
| Michelle Reed | Licensing Program Analyst | Conducted the unannounced Case Management visit. |
| Tammy Sampedro | Executive Director | Signed and sent the Confirmation of Removal letter for Staff #1 on 3/28/22. |
Inspection Report
Census: 78
Capacity: 124
Deficiencies: 0
Date: Jul 12, 2022
Visit Reason
Licensing Program Analyst Michelle Reed conducted an unannounced Case Management visit to follow up on an Exemption Denial for Staff #1.
Findings
Staff #1, previously denied exemption and removed from the facility, was found still working at the facility. The staff member was immediately sent home and is no longer associated with the facility. No citations were issued at this time pending further information.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Kornmann | Administrator | Informed Licensing Program Analyst that Staff #1 was still working at the facility and sent Staff #1 home upon arrival. |
| Michelle Reed | Licensing Program Analyst | Conducted the unannounced Case Management visit and met with the Administrator. |
| Tammy Sampedro | Executive Director | Signed and sent the Confirmation of Removal letter for Staff #1 on 3/28/22. |
Inspection Report
Complaint Investigation
Census: 78
Capacity: 124
Deficiencies: 1
Date: Jul 7, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit conducted to investigate allegations received on 05/18/2022 regarding facility doors being a hazard and staff not providing adequate food service.
Complaint Details
The complaint investigation was unannounced and conducted by Licensing Program Analyst Patricia Velazquez. The allegation regarding facility doors was unsubstantiated. The allegation regarding inadequate food service was substantiated. The preponderance of evidence standard was met for the food service allegation. An exit interview was conducted with Business Office Director Leo Serna.
Findings
The allegation that facility doors are a hazard was deemed unsubstantiated after interviews, record reviews, and testing of doors with the Maintenance Director. The allegation that staff are not providing adequate food service was substantiated based on interviews, observations, and record reviews showing insufficient food service personnel, staff working outside their primary roles, and residents experiencing delays in meal service.
Deficiencies (1)
General Food Service Requirements. The licensee did not employ sufficient food service personnel which poses a potential risk to the health and safety of residents in care.
Report Facts
Capacity: 124
Census: 78
Deficiencies cited: 1
Plan of Correction Due Date: Jul 28, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Patricia Velazquez | Licensing Program Analyst | Conducted the complaint investigation |
| Jennifer Kornmann | Executive Director | Met with Licensing Program Analyst during investigation |
| Leo Serna | Business Office Director | Participated in exit interview |
Inspection Report
Complaint Investigation
Census: 78
Capacity: 124
Deficiencies: 1
Date: Jul 7, 2022
Visit Reason
An unannounced complaint investigation visit was conducted to investigate allegations regarding facility doors being a hazard and staff not providing adequate food service.
Complaint Details
The complaint investigation was initiated based on allegations received on 05/18/2022. The allegation regarding facility doors being a hazard was unsubstantiated. The allegation regarding inadequate food service was substantiated. The investigation included interviews with residents and staff, review of facility and staffing records, and observations.
Findings
The allegation that facility doors are a hazard was deemed unsubstantiated after testing doors and reviewing records. The allegation that staff are not providing adequate food service was substantiated based on interviews, observations, and review of staffing schedules and records, revealing insufficient food service personnel and staff working outside their primary roles.
Deficiencies (1)
General Food Service Requirements. The licensee did not employ sufficient food service personnel which poses a potential risk to the health and safety of residents in care.
Report Facts
Capacity: 124
Census: 78
Deficiency due date: Jul 28, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Patricia Velazquez | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Jennifer Kornmann | Executive Director | Met with Licensing Program Analyst during the investigation |
| Leo Serna | Business Office Director | Participated in exit interview and received report copy |
Inspection Report
Complaint Investigation
Census: 55
Capacity: 124
Deficiencies: 1
Date: Apr 4, 2022
Visit Reason
The visit was conducted to discuss two unusual incident reports sent to the Department on 3/17/22 and 3/28/22 involving residents wandering from the facility unassisted.
Complaint Details
The investigation was triggered by two unusual incident reports regarding residents wandering unassisted. The complaint was substantiated as deficiencies were cited related to inadequate supervision of residents with wandering behaviors.
Findings
Residents R1 and R2 wandered from the community without staff supervision despite care plans indicating they cannot leave unassisted and have wandering behaviors. Both residents were found and returned without injuries, but this posed an immediate health and safety risk.
Deficiencies (1)
Care of Person's With Dementia - Delayed egress devices shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents and to escort residents who leave the facility. R1 and R2 wandered from the Community without staff supervision. According to records reviewed they cannot leave the facility unassisted and have wandering behaviors. This poses an immediate health and safety risk to residents in care.
Report Facts
Capacity: 124
Census: 55
Deficiencies cited: 1
Plan of Correction Due Date: Apr 5, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Tammie Sampedro | Administrator | Met with Licensing Program Analyst during inspection and involved in exit interview |
| Michelle Reed | Licensing Program Analyst | Conducted the case management visit and inspection |
| Sheila Santos | Licensing Program Manager | Supervisor named in the report and deficiency section |
Inspection Report
Complaint Investigation
Census: 55
Capacity: 124
Deficiencies: 1
Date: Apr 4, 2022
Visit Reason
The visit was conducted to discuss two unusual incident reports sent to the Department on 3/17/22 and 3/28/22 involving residents wandering from the facility.
Complaint Details
The visit was complaint-related due to two unusual incident reports involving residents wandering. The report documents the incidents and the facility's failure to provide adequate supervision, posing immediate health and safety risks.
Findings
Two residents (R1 and R2) wandered from the facility without staff supervision, posing an immediate health and safety risk. The facility failed to meet requirements for care of persons with dementia, specifically regarding supervision and use of delayed egress devices.
Deficiencies (1)
Care of Person's With Dementia - Delayed egress devices shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents and to escort residents who leave the facility. This requirement was not met as evidenced by R1 and R2 wandering from the Community without staff supervision.
Report Facts
Capacity: 124
Census: 55
Deficiencies cited: 1
Plan of Correction Due Date: Apr 5, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Tammie Sampedro | Administrator | Met with Licensing Program Analyst during the visit and named in findings |
| Michelle Reed | Licensing Program Analyst | Conducted the case management visit and authored the report |
| Sheila Santos | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Original Licensing
Capacity: 124
Deficiencies: 0
Date: Nov 22, 2021
Visit Reason
The inspection was conducted as a pre-licensing visit following the application for licensure received on 2021-07-19 to evaluate the facility's readiness for licensure.
Findings
The facility was found to be in compliance with regulations, with no hazards or obstacles observed, operational safety equipment, and proper infection control measures. The facility is ready for licensure.
Report Facts
Facility capacity: 124
Non-ambulatory capacity: 118
Bedridden capacity: 6
Inspection start time: 9
Inspection end time: 12.83
Hot water temperature: 120
Fire clearance date: Nov 17, 2021
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Tammie Sampedro | Executive Director | Led the facility tour and was met during the inspection |
| Jerome Haley | Licensing Program Analyst | Conducted the inspection and signed the report |
| Joseph Alejandre | Licensing Program Analyst | Conducted the inspection |
| Danielle Morgan | President | Led the facility tour during the inspection |
| Ryan Aloi | Santa Ana Fire Department Inspector | Approved fire clearance on 11/17/2021 |
Inspection Report
Original Licensing
Capacity: 124
Deficiencies: 0
Date: Nov 22, 2021
Visit Reason
The visit was an announced pre-licensing inspection conducted to evaluate the facility's readiness for licensure following the application received on 2021-07-19.
Findings
The facility was found to be in compliance with regulations, including operational fire safety equipment, clean and operational resident rooms, secured medication rooms, and adequate emergency supplies. The facility meets Title 22 Division 6 of the California Code of Regulations and is ready for licensure.
Report Facts
Capacity: 124
Census: 0
Non-ambulatory beds: 118
Bedridden beds: 6
Hot water temperature: 120
Fire clearance date: Nov 17, 2021
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Tammie Sampedro | Executive Director | Led the facility tour and was met during the inspection |
| Danielle Morgan | President | Led the facility tour during the inspection |
| Jerome Haley | Licensing Program Analyst | Conducted the inspection and inspected the kitchen and medication room |
| Joseph Alejandre | Licensing Program Analyst | Participated in the announced pre-licensing inspection visit |
| Ryan Aloi | Santa Ana Fire Department Inspector | Approved fire clearance on 2021-11-17 |
Inspection Report
Original Licensing
Capacity: 124
Deficiencies: 0
Date: Nov 4, 2021
Visit Reason
Initial licensing evaluation conducted via telephone call to confirm applicant and administrator understanding of Title 22 and related facility operation requirements.
Findings
Applicant and administrator successfully completed Component II of the licensing process, demonstrating understanding of facility operation, staff qualifications, program policies, and compliance requirements. No clients were in care at the time of the evaluation.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Tammie Sampedro | Administrator | Applicant/administrator participating in licensing evaluation |
| Danielle Morgan | Applicant/administrator participating in licensing evaluation |
Inspection Report
Original Licensing
Capacity: 124
Deficiencies: 0
Date: Nov 4, 2021
Visit Reason
Initial licensing evaluation conducted via telephone call to confirm applicant and administrator understanding of licensing requirements and program policies.
Findings
The applicant and administrator successfully completed the Component II evaluation, demonstrating understanding of facility operation, staff qualifications, program policies, and COVID-19 mitigation plan. No clients were in care at the time of the evaluation.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Tammie Sampedro | Administrator | Applicant/administrator participating in licensing evaluation |
| Danielle Morgan | Applicant/administrator participating in licensing evaluation | |
| Jude De La Concepcion | Licensing Program Manager | Named in report header |
| Maria Ejaz | Licensing Program Analyst | Named in report header |
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