Inspection Reports for
Desert Cottages I
83617 Himalaya Drive, Indio, CA 92203, Indio, CA, 92203
Back to Facility ProfileDeficiencies (last 5 years)
Deficiencies (over 5 years)
1.8 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
55% better than California average
California average: 4 deficiencies/yearDeficiencies per year
4
3
2
1
0
Occupancy
Latest occupancy rate
0% occupied
Based on a March 2026 inspection.
Occupancy rate over time
Inspection Report
Capacity: 6
Deficiencies: 0
Date: Mar 3, 2026
Visit Reason
The visit was an unannounced case management meeting held to serve as the first level of enforcement addressing citations issued over the past four years.
Findings
The meeting discussed Personal Rights violations, presence of uncleared staff, reporting requirements, and the appeals process. The licensee agreed to submit proof of training on dementia care and reporting requirements within 30 days.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee / Administrator | Met with during the enforcement meeting and agreed to submit proof of training. |
| Anthony Perez | Licensing Program Manager | Attended the enforcement meeting. |
| Abdoulaye Zerbo | Licensing Program Analyst | Attended the enforcement meeting. |
Inspection Report
Capacity: 6
Deficiencies: 0
Date: Mar 3, 2026
Visit Reason
The visit was an unannounced case management meeting held to serve as the first level of enforcement addressing citations issued over the past four years.
Findings
The meeting discussed Personal Rights violations, presence of uncleared staff, reporting requirements, and the appeals process. The licensee agreed to submit proof of training on dementia care and reporting requirements within 30 days.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Administrator/Director | Licensee present during the enforcement meeting |
| Anthony Perez | Licensing Program Manager | Attended the enforcement meeting |
| Abdoulaye Zerbo | Licensing Program Analyst | Attended the enforcement meeting |
| Peter Nolan | Attorney | Represented Desert Cottages during the meeting |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 0
Date: Feb 20, 2026
Visit Reason
The visit was an unannounced complaint investigation to examine the allegation that staff was isolating a resident in care.
Complaint Details
The complaint alleged that staff was isolating a resident in care. After investigation including interviews with residents R1-R7, staff, and the resident's Power of Attorney, and review of medical and care documents, the allegation was found unsubstantiated due to lack of preponderance of evidence.
Findings
Based on interviews with residents, staff, and the resident's Power of Attorney, as well as review of records and observations, there was no evidence to substantiate the allegation of isolation. The allegation was determined to be unsubstantiated.
Report Facts
Capacity: 6
Census: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Administrator | Met with during investigation and named in report |
| Glenn Trueman | Licensing Evaluator | Conducted the complaint investigation |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 0
Date: Feb 20, 2026
Visit Reason
The visit was an unannounced complaint investigation to examine the allegation that staff was isolating a resident in care at Desert Cottage facility.
Complaint Details
The complaint alleged that staff was isolating a resident in care. The investigation included interviews with residents R1 through R7, staff members, and the resident's Power of Attorney, as well as a tour and record review. The allegation was found unsubstantiated.
Findings
After interviews with residents, staff, and the resident's Power of Attorney, and review of relevant records, there was no preponderance of evidence to prove the allegation of isolation. The allegation was determined to be unsubstantiated.
Report Facts
Capacity: 6
Census: 6
Years Staff Employed: 5
Years Staff Employed: 7
Dates of Physician's Reports: Reports dated 08/26/2025 and 09/13/2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Administrator | Met during investigation and named in report |
| Glenn Trueman | Licensing Evaluator | Conducted the complaint investigation |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 1
Date: Feb 18, 2026
Visit Reason
An unannounced complaint investigation was conducted following allegations that staff caused injuries to a resident and mishandled a resident.
Complaint Details
The complaint investigation was substantiated. Staff #1 was observed by another staff member to have hit Resident #1 in the face and mishandled the resident by lifting and throwing them onto the bed and wheelchair. Law enforcement observed bruises on the resident's face. Staff #1 was arrested. The licensee did not comply with regulations, resulting in injuries to the resident.
Findings
The investigation substantiated the allegations that Staff #1 caused injuries to Resident #1 by physically mishandling them, including lifting and throwing the resident onto the bed and punching them in the face. Staff #1 was arrested and a civil penalty of $500 was assessed.
Deficiencies (1)
Personnel – Operations: Care and supervision of residents shall be provided without physical or verbal abuse, exploitation or prejudice.
Report Facts
Civil penalty assessed: 500
Capacity: 6
Census: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Administrator | Facility administrator met during investigation and received report. |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the complaint investigation. |
| Anthony Perez | Supervisor | Supervisor overseeing the investigation. |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Date: Feb 18, 2026
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility to perform a health and safety check.
Findings
During the visit, no immediate health or safety concerns were observed at the time of the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee | Met with Licensing Program Analyst during the visit |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Date: Feb 18, 2026
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility to perform a health and safety check.
Findings
During the visit, no immediate health or safety concerns were observed at the time of the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee | Met with Licensing Program Analyst during the inspection visit. |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and health and safety check. |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 1
Date: Feb 18, 2026
Visit Reason
An unannounced complaint investigation visit was conducted following allegations that staff caused injuries to a resident and mishandled a resident.
Complaint Details
The complaint was substantiated based on interviews, record reviews, and physical evidence of injuries to Resident #1. Staff #1 was observed and reported to have physically abused the resident, leading to their arrest.
Findings
The investigation substantiated that Staff #1 caused injuries to Resident #1 by physically mishandling them, including lifting and throwing the resident onto the bed and wheelchair and punching the resident in the face. Staff #1 was arrested and a civil penalty of $500 was assessed.
Deficiencies (1)
Personnel – Operations: Care and supervision of residents shall be provided without physical or verbal abuse, exploitation or prejudice.
Report Facts
Civil penalty amount: 500
Capacity: 6
Census: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Administrator | Facility administrator met during investigation and named in report |
| Abdoulaye Zerbo | Licensing Program Analyst | Investigator who conducted the complaint investigation |
| Anthony Perez | Supervisor | Supervisor named in the report |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Jan 14, 2026
Visit Reason
Licensing Program Analysts conducted an unannounced visit to perform a health and safety check at the facility.
Findings
During the visit, no immediate health or safety concerns were observed at the time of the inspection.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Claudia Martinez | Caregiver | Met with during the inspection and provided a copy of the report. |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 0
Date: Jan 14, 2026
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2025-09-12 alleging that staff refused to tell an authorized representative who the resident(s) responsible parties were, impeding an investigation.
Complaint Details
The complaint alleged staff refused to give an authorized party the resident’s responsible party information, impeding an investigation. The allegation was found to be unfounded.
Findings
The investigation determined that the resident in question never resided at this facility but at a different facility. Based on record reviews and interviews, the allegation was found to be unfounded, meaning the allegation could not have happened, was false, or without reasonable basis.
Report Facts
Capacity: 6
Census: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the complaint investigation and exit interview |
| Claudia Martinez | Caregiver | Met with during the investigation and provided report copy |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Jan 14, 2026
Visit Reason
Licensing Program Analysts conducted an unannounced visit to perform a health and safety check at the facility.
Findings
During the visit, no immediate health or safety concerns were observed at the time of the inspection.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Claudia Martinez | Caregiver | Met with Licensing Program Analysts during the inspection. |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 0
Date: Dec 17, 2025
Visit Reason
Licensing Program Analyst Seo Jeon conducted an unannounced visit to the facility to conduct a health and safety check and to deliver an amended complaint investigation report dated 2025-12-03.
Complaint Details
The visit was related to an amended complaint investigation report dated 2025-12-03. No deficiencies or violations were found during this investigation.
Findings
The facility was toured and all utilities were observed to be operating without issues. The food supply met regulatory requirements and no health or safety concerns were observed. No deficiencies or civil penalties were cited.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Administrator | Met with Licensing Program Analyst during the inspection visit. |
| Seo Jeon | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Rikesha Stamps | Licensing Program Manager | Named in the report header. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Dec 17, 2025
Visit Reason
Licensing Program Analyst Seo Jeon conducted an unannounced visit to the facility to conduct a health and safety check and to deliver an amended complaint investigation report dated 2025-12-03.
Findings
The facility was observed to have all utilities operating without issues, and the food supply met regulatory requirements. No health or safety concerns were observed, and no deficiencies or civil penalties were cited.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Administrator | Met with Licensing Program Analyst during inspection visit. |
| Seo Jeon | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Rikesha Stamps | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 1
Date: Dec 3, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to multiple allegations received on 2024-12-03 regarding resident restraint, unauthorized provision of THC/protein drinks, charging for services not rendered, unauthorized resident moves, residents left unattended, unauthorized bed rails, and restricting visiting hours.
Complaint Details
The complaint investigation was triggered by allegations including staff restraining residents with weighted vests, providing THC/protein drinks without physician orders, charging residents for services not rendered, moving residents without consent, leaving residents unattended, putting up bed rails without physician orders, and restricting visiting hours. All allegations except the restriction of visiting hours were unsubstantiated. The visiting hours restriction was substantiated.
Findings
All allegations except one were found to be unsubstantiated after interviews, observations, and record reviews. The only substantiated allegation was that staff were restricting visiting hours by posting visiting hour signs and requiring approval for visits outside those hours, which was found to be a potential violation of residents' personal rights.
Deficiencies (1)
Posting visiting hours at the entrance of the facility which poses potential personal rights violation to residents in care.
Report Facts
Capacity: 6
Census: 6
Deficiencies cited: 1
Plan of Correction Due Date: Dec 31, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee/Administrator | Met with during investigation and named in findings |
| Seo Jeon | Licensing Program Analyst (Evaluator) | Conducted the complaint investigation and authored the report |
| Janira Arreola | Licensing Program Analyst | Assisted in conducting the complaint investigation |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 1
Date: Dec 3, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by multiple allegations received on 2024-12-03 regarding resident restraint, unauthorized provision of THC/protein drinks, charging for services not rendered, unauthorized resident moves, residents left unattended, unauthorized bed rails, and restricting visiting hours.
Complaint Details
The complaint investigation was triggered by allegations including staff restraining residents with weighted vests, providing THC/protein drinks without physician orders, charging residents for services not rendered, moving residents without consent, leaving residents unattended, putting up bed rails without physician orders, and restricting visiting hours. All allegations except the restriction of visiting hours were unsubstantiated. The visiting hours restriction was substantiated.
Findings
All allegations except one were found to be unsubstantiated after interviews, observations, and record reviews. The only substantiated allegation was that staff were restricting visiting hours by posting visiting hour signs and requiring approval for visits outside those hours, which was found to be a potential violation of residents' personal rights.
Deficiencies (1)
Personal Rights of Residents in All Facilities: Residents have visitors permitted during reasonable hours without prior notice; Licensee posted visiting hours sign restricting this right.
Report Facts
Capacity: 6
Census: 6
Deficiency count: 1
Plan of Correction Due Date: Dec 31, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee/Administrator | Met with during investigation and mentioned in findings |
| Seo Jeon | Licensing Program Analyst (Evaluator) | Conducted the complaint investigation and authored the report |
| Janira Arreola | Licensing Program Analyst | Assisted in conducting the complaint investigation |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Nov 26, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility to perform a health and safety check.
Findings
During the visit, no immediate health or safety concerns were observed at the time of the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee | Met with Licensing Program Analyst during the visit |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Oct 30, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility to perform a health and safety check.
Findings
During the visit, no immediate health or safety concerns were observed at the time of the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee | Met with Licensing Program Analyst during the visit. |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Oct 30, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility to perform a health and safety check.
Findings
During the visit, no immediate health or safety concerns were observed. An exit interview was conducted and a copy of the report was provided to the licensee.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee | Met with Licensing Program Analyst during the inspection visit. |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Oct 24, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility to perform a health and safety check.
Findings
During the visit, no immediate health or safety concerns were observed at the time of the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee / Administrator | Met with Licensing Program Analyst during the visit. |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Oct 24, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility to perform a health and safety check.
Findings
During the visit, no immediate health or safety concerns were observed at the time of the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee | Met with during the inspection and provided a copy of the report. |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Anthony Perez | Licensing Program Manager | Named on the report as Licensing Program Manager. |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Date: Oct 16, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility to perform a health and safety check.
Findings
During the visit, no immediate health or safety concerns were observed. An exit interview was conducted and a copy of the report was provided to Caregiver Rhonda Wilts.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Rhonda Wilts | Caregiver | Met with the Licensing Program Analyst during the visit. |
| Elizabeth Hengstler | Administrator/Director | Named as facility administrator/director. |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Date: Oct 16, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility to perform a health and safety check.
Findings
During the visit, no immediate health or safety concerns were observed. An exit interview was conducted and a copy of the report was provided to Caregiver Rhonda Wilts.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Rhonda Wilts | Caregiver | Met with Licensing Program Analyst during the visit. |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 1
Date: Oct 10, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility to perform a health and safety check.
Findings
No immediate health or safety concerns were observed at the time of the visit. However, the toilet tank in the master bedroom was noted to be in disrepair, with maintenance planned to address the issue by the end of the weekend.
Deficiencies (1)
Toilet tank in the master bedroom was in disrepair.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee | Met with Licensing Program Analyst during the visit and named in relation to the toilet tank deficiency. |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Oct 3, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility for a health and safety check.
Findings
During the visit, the facility was toured and no immediate health and safety concerns were observed. An exit interview was conducted and a copy of the report was provided to the licensee.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee / Administrator | Met with Licensing Program Analyst during the inspection and named in the report. |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and signed the report. |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Sep 26, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility for a health and safety check.
Findings
During the visit, the facility was toured and no immediate health and safety concerns were observed. An exit interview was conducted and a copy of the report was provided to the licensee.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Elizabeth Hengstler | Administrator/Director | Licensee who joined the visit and received the report. |
| Claudia Martinez | Caregiver | Met with the Licensing Program Analyst during the visit. |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 0
Date: Sep 19, 2025
Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations received on 09/22/2023 regarding staff denying resident visitors, neglect causing unexplained bruises, overmedication, failure to notify authorized representatives, and unauthorized medication increases.
Complaint Details
The complaint was unsubstantiated and deemed unfounded after investigation. The alleged victim was identified as Resident 1 (R1), who never resided at this facility according to the licensee and responsible person.
Findings
The investigation found the allegations to be unfounded as the alleged victim was confirmed to have never resided at the facility. The Department opened a complaint at the facility where the alleged victim actually resided to investigate the allegations.
Report Facts
Capacity: 6
Census: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Janette Romero | Licensing Program Analyst | Conducted the complaint investigation visit |
| Elizabeth Hengstler | Licensee | Facility licensee met during investigation and provided information |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Sep 16, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility for a health and safety check.
Findings
During the visit, the facility was toured and no immediate health and safety concerns were observed. An exit interview was conducted and a copy of the report was provided to the licensee Elizabeth Hengstler.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee / Administrator | Met with during the inspection and named in the report. |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit. |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Sep 8, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility for a health and safety check.
Findings
During the visit, the analyst toured the facility, conducted interviews and records review, and found no immediate health and safety concerns.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Rhonda Wilts | Caregiver | Met with the Licensing Program Analyst during the visit. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Sep 4, 2025
Visit Reason
Licensing Program Analyst Abdoulaye Zerbo conducted an unannounced visit to the facility for a health and safety check.
Findings
During the visit, the facility was toured and no immediate health and safety concerns were observed. An exit interview was conducted and a copy of the report was provided to the licensee.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee / Administrator | Met with Licensing Program Analyst during the inspection visit. |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Date: Aug 30, 2025
Visit Reason
The visit was an unannounced case management visit conducted to perform a health and safety check of the facility.
Findings
No health and safety concerns were observed during the visit, and no citations were issued.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee/Administrator | Met with during the inspection and informed of the purpose of the visit. |
| Armando Perez | Licensing Program Analyst | Conducted the case management visit. |
| Claudia Martinez | Caregiver | Greeted and granted entry to the Licensing Program Analyst. |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Date: Aug 27, 2025
Visit Reason
The visit was an unannounced case management visit to deliver an Immediate Exclusion order for staff member Destiny Villalta.
Findings
During the visit, Licensing Program Analysts toured the facility with the Licensee/Administrator and delivered the Immediate Exclusion order. No citations or deficiencies were issued during the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee/Administrator | Informed of the purpose of the visit and received the Immediate Exclusion order. |
| Rhonda Wilts | Caregiver | Greeted Licensing Program Analysts and was informed of the purpose of the visit. |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the case management visit. |
| Armando Perez | Licensing Program Analyst | Conducted the case management visit. |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 0
Date: Aug 21, 2025
Visit Reason
The Licensing Program Analyst conducted an unannounced case management visit to check on the health, safety, and welfare of residents in care regarding a complaint report received on 2024-12-03.
Complaint Details
The visit was triggered by a complaint report received on 2024-12-03. No deficiencies or violations were found during the investigation.
Findings
No deficiencies were cited and no civil penalties were issued. The food supply met regulatory requirements and no immediate health or safety concerns were observed for residents in care.
Report Facts
Staff on duty: 3
Food supply requirement: 7
Food supply requirement: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Destiny Villalta | Administrator | Met with Licensing Program Analyst during the visit |
| Seo Jeon | Licensing Program Analyst | Conducted the inspection visit |
| Rikesha Stamps | Licensing Program Manager | Named in the report |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 0
Date: Aug 21, 2025
Visit Reason
The Licensing Program Analyst conducted an unannounced case management visit to check on the health, safety, and welfare of residents in care regarding a complaint report received on 2024-12-03.
Complaint Details
The visit was triggered by a complaint report received on 2024-12-03. No deficiencies or violations were found during the investigation.
Findings
No deficiencies were cited and no civil penalties were issued. The food supply met regulatory requirements and no immediate health or safety concerns were observed for residents in care.
Report Facts
Staff on duty: 3
Food supply regulatory requirements: 7
Food supply regulatory requirements: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Destiny Villalta | Administrator | Met with Licensing Program Analyst during the visit |
| Seo Jeon | Licensing Program Analyst | Conducted the inspection visit |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Date: Aug 4, 2025
Visit Reason
An unannounced required annual inspection was conducted to evaluate the facility's compliance with licensing requirements.
Findings
The facility was found to be clean, well-maintained, and in compliance with infection control, physical plant, medication management, and disaster preparedness requirements. No deficiencies were cited during the visit.
Report Facts
Fire extinguisher expiration date: 2026
Water temperature: 111.2
Administrator certificate expiration date: 2026
CPR certification expiration date: 2027
Emergency drill date: 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Destiny Villata | Administrator | Greeted Licensing Program Analyst and participated in exit interview |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the inspection visit |
| Rikesha Stamps | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 4
Capacity: 6
Deficiencies: 0
Date: Jul 8, 2025
Visit Reason
Licensing Program Analysts conducted an unannounced Case Management visit regarding a complaint report #18-AS-20241203155436.
Complaint Details
The visit was conducted in response to a complaint report #18-AS-20241203155436. No deficiencies were found and no health or safety concerns were observed.
Findings
No health and safety concerns were observed during the visit, and no deficiencies were cited according to California Health & Safety Code and Code of Regulations, Title 22.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Destiny Villalta | Administrator | Met with Licensing Program Analysts during the inspection. |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 0
Date: May 21, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to multiple allegations received on 2024-12-03 regarding resident restraint, unauthorized provision of THC drinks/protein powder, restricted visiting hours, improper charges, unauthorized resident transfers, unattended residents, and unauthorized use of bed rails.
Complaint Details
The complaint investigation was unsubstantiated, meaning the allegations may have occurred but there was insufficient evidence to prove violations. Allegations included staff restraining residents, providing THC drinks/protein powder without physician orders, restricting visiting hours, charging for services not rendered, moving residents without consent, leaving residents unattended, and putting up bed rails without physician orders.
Findings
After resident and staff interviews, file reviews, and facility observations, all allegations were found to be unsubstantiated. No evidence was found of physical restraints, unauthorized THC drinks, restricted visiting hours, improper charges beyond incontinence supplies, unauthorized resident transfers, unattended residents, or bed rails without physician orders.
Report Facts
Residents consuming protein drinks with physician orders: 3
Residents with full bed rails with physician orders: 1
Residents with half bed rails with physician orders: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Seo Jeon | Licensing Program Analyst | Conducted the complaint investigation visit and interviews. |
| Destiny Villalta | Administrator | Met with Licensing Program Analyst during investigation and provided information. |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 1
Date: Jan 9, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2022-03-30 regarding a resident who sustained an unwitnessed fall resulting in a fracture.
Complaint Details
The complaint was substantiated. The investigation included record reviews and interviews with residents, family members, staff, and the facility administrator. The resident sustained a fall with a fracture due to insufficient staffing and lack of supervision. An immediate $500 civil penalty was assessed, with additional penalties pending.
Findings
The investigation found that the facility did not ensure sufficient staffing levels as specified by the Program Plan and Admission Agreement, posing an immediate risk to residents' health and safety. The allegation of neglect/lack of care and supervision was substantiated, with a lack of care resulting in a resident's serious injury.
Deficiencies (1)
The Licensee did not ensure sufficient staffing levels as specified by the Program Plan and Admission Agreement, posing an immediate risk to the health, safety, and personal rights of residents in care.
Report Facts
Capacity: 6
Census: 6
Civil penalty: 500
Plan of Correction Due Date: Jan 10, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee | Named in investigation and findings related to staffing and supervision |
| Janira Arreola | Licensing Program Analyst | Conducted the complaint investigation |
| Tricia Danielson | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 0
Date: Oct 7, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to an allegation that staff did not provide comfortable accommodations to a resident in care.
Complaint Details
The complaint alleged that staff did not provide comfortable accommodations to a resident in care. The investigation was unsubstantiated.
Findings
The investigation found that although one resident reported their room was always hot and staff provided a fan, other residents denied discomfort and the facility temperature was observed at 83 degrees Fahrenheit. Staff interviews confirmed accommodations were provided when residents reported being hot or cold. The allegation was unsubstantiated due to lack of preponderance of evidence.
Report Facts
Capacity: 6
Census: 6
Thermostat setting: 83
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Sara Martinez | Licensing Program Analyst | Conducted the complaint investigation |
| Tricia Danielson | Licensing Program Manager | Named as Licensing Program Manager on the report |
| Elizabeth Hengstler | Administrator | Facility Administrator |
| Destiny Villalta | Administrator | Met with during the investigation |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Date: Aug 21, 2024
Visit Reason
An unannounced one (1) year required visit was conducted to evaluate the facility's compliance with licensing requirements.
Findings
No immediate violations or concerns were observed during the visit. The facility met all required standards including safety, staffing, and physical plant conditions.
Report Facts
Staff present: 2
Resident bedrooms: 4
Staff bedroom: 1
Bathrooms: 4
Perishable food supply: 2
Non-perishable food supply: 7
Water temperature: 111.3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Administrator | Facility Administrator present during the inspection |
| Valerie Flores | Licensing Program Analyst | Conducted the inspection |
| Rikesha Stamps | Licensing Program Manager | Supervising Licensing Program Manager |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 1
Date: Aug 7, 2023
Visit Reason
The Licensing Program Analyst conducted an unannounced annual inspection to evaluate the facility's compliance with regulatory requirements.
Findings
The facility was found to be clean, well-maintained, and in compliance with regulations. No deficiencies were observed, but a technical violation was issued due to one staff member lacking current CPR certification.
Deficiencies (1)
Staff member does not have a current CPR certification card.
Report Facts
Fire alarms observed: 7
Carbon monoxide detectors observed: 1
Fire extinguishers on site: 1
Food supply nonperishable: 1
Food supply perishable: 2
Water temperature: 105
Facility temperature: 75
Staff reviewed: 4
Client records reviewed: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Administrator | Administrator conducted the facility tour and was involved in the exit interview; named in relation to staff CPR certification issue |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Date: Aug 30, 2022
Visit Reason
The inspection was an unannounced annual inspection limited to infection control conducted by Licensing Program Analyst Crystal Colvin.
Findings
The facility was found to be successfully incorporating several aspects of its COVID-19 Mitigation Plan, including availability of hand sanitizer and PPE supplies. However, paper towels were missing in bathrooms and staff other than administrators had not been fit tested for N95 masks. Technical Assistance Advisory Notes were issued for these issues, but no deficiencies were cited due to the absence of COVID-19 positive residents.
Report Facts
Capacity: 6
Census: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Administrator | Met with Licensing Program Analyst and involved in infection control discussion |
| Crystal Colvin | Licensing Program Analyst | Conducted the inspection and issued Technical Assistance Advisory Notes |
| Joel Esquivel | Licensing Program Manager | Named as Licensing Program Manager on the report |
| Liberty Almazon | Mentioned in relation to staff training on COVID-19 infection control |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 1
Date: Apr 6, 2022
Visit Reason
An unannounced visit was made to investigate a complaint (#18-AS-20220330113756) regarding staff clearance and exemption transfer compliance at the facility.
Complaint Details
Complaint #18-AS-20220330113756 triggered the investigation. The deficiency was substantiated as the staff member did not have the required exemption transfer.
Findings
The inspection found that a staff member (S1) was working at the facility without an approved criminal record exemption transfer, which is a violation of licensing requirements. The facility was cited for this deficiency and fined $500 for civil penalties.
Deficiencies (1)
Staff member (S1) working without an approved criminal record exemption transfer as required by CCR 87355(e)(3).
Report Facts
Civil penalty amount: 500
Staff employment start date: May 8, 2020
Plan of Correction due date: Apr 7, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee/Administrator | Named in relation to the deficiency and exit interview. |
| Crystal Colvin | Licensing Program Analyst | Conducted the inspection and identified the deficiency. |
| Joel Esquivel | Supervisor | Supervisor overseeing the inspection. |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 1
Date: Apr 6, 2022
Visit Reason
An unannounced visit was made to the facility to investigate a complaint #18-AS-20220330113756 regarding staff clearance and exemption transfer compliance.
Complaint Details
Complaint #18-AS-20220330113756 triggered the investigation. The deficiency was substantiated as the staff member lacked proper exemption transfer clearance.
Findings
The inspection found that a staff member (S1) was present and working at the facility without the required criminal record exemption transfer, which is a violation of licensing regulations and poses an immediate safety risk to residents.
Deficiencies (1)
Staff member (S1) working at the facility without an approved criminal record exemption transfer, with incorrect ID number on the form.
Report Facts
Civil penalty amount: 500
Staff employment start date: 2020
Census: 5
Total capacity: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Hengstler | Licensee/Administrator | Facility administrator involved in the exit interview and review of deficiencies. |
| Crystal Colvin | Licensing Program Analyst | Conducted the inspection and identified the deficiency. |
| Joel Esquivel | Licensing Program Manager | Supervisor overseeing the inspection. |
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