Inspection Reports for Ivy Park at Cerritos
11000 New Falcon Way Cerritos, CA 90703, CA, 90703
Back to Facility ProfileInspection Report Summary
Most inspections found no deficiencies, and several complaint investigations were unsubstantiated, indicating generally consistent compliance with regulations. However, the facility has had some deficiencies over time, primarily related to resident care documentation, medication management, staffing levels, and staff training records. The most recent report from July 31, 2025, identified several deficiencies including retaining a bedridden resident without proper fire clearance, missing staff first aid training and TB test results, and an outdated medical assessment for a resident with dementia; this resulted in a $500 civil penalty. Earlier substantiated complaints involved failure to follow care plans leading to pressure wounds, unmet diapering and dietary needs, and insufficient staffing causing delays in food service. While some issues have recurred, the facility has also shown improvement in areas such as infection control and physical plant safety, but recent findings suggest ongoing attention is needed in staff training and resident care documentation.
Deficiencies (last 6 years)
Deficiencies (over 6 years)
3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
25% better than California average
California average: 4 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
84% occupied
Based on a July 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Census over time
Inspection Report
Annual Inspection
Census: 137
Capacity: 163
Deficiencies: 4
Jul 31, 2025
Visit Reason
The inspection was an unannounced required annual inspection conducted to evaluate compliance with licensing requirements and regulatory standards for the facility.
Findings
The facility was found to have several deficiencies including retaining one bedridden resident without appropriate fire clearance, staff lacking valid first aid training and missing TB test results, and a resident with dementia lacking an updated medical assessment. An immediate civil penalty of $500 was issued due to the bedridden resident issue.
Severity Breakdown
Type A: 1
Type B: 3
Deficiencies (4)
| Description | Severity |
|---|---|
| Facility retained one bedridden resident without a bedridden fire clearance, posing an immediate health, safety, or personal rights risk. | Type A |
| Staff #3, Staff #4, Staff #5, and Staff #6 did not have valid first aid training in file. | Type B |
| Staff #1's file did not have a TB test result. | Type B |
| Resident #6 with dementia did not have an updated medical assessment. | Type B |
Report Facts
Immediate civil penalty amount: 500
Licensed capacity: 163
Current census: 137
Hospice waiver residents: 6
Home health residents: 7
Hospice waiver approval: 25
Staff files reviewed: 10
Resident files reviewed: 14
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Konishi | Licensing Program Analyst | Conducted the inspection and authored the report. |
| David Sicairos | Licensing Program Manager | Supervisor overseeing the inspection. |
| Carmen Hernandez | Business Office Manager | Facility representative met during the inspection. |
Inspection Report
Annual Inspection
Census: 137
Capacity: 163
Deficiencies: 0
Jul 29, 2025
Visit Reason
The visit was an unannounced required annual inspection conducted to evaluate compliance with licensing requirements for the facility.
Findings
The inspection found no deficiencies during the visit. The facility demonstrated compliance with infection control, physical plant safety, resident rights, food service, medical and dental care, and disaster preparedness requirements.
Report Facts
Hospice waiver residents: 6
Home health residents: 7
Residents' rooms inspected: 14
Residents on modified diet: 3
Days of perishable food supply: 2
Days of non-perishable food supply: 7
Days since last fire/disaster drill: 6
CARE Tool domains to complete later: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Konishi | Licensing Program Analyst | Conducted the unannounced required annual inspection |
| Carmen Hernandez | Business Office Manager | Met with Licensing Program Analyst during inspection and received the report |
| David Sicairos | Supervisor | Supervisor overseeing the licensing evaluation |
| Laura Rodriguez | Administrator/Director | Facility Administrator/Director |
Inspection Report
Complaint Investigation
Census: 135
Capacity: 163
Deficiencies: 0
Jul 24, 2025
Visit Reason
An unannounced complaint investigation visit was conducted to address allegations including staff not responding to resident call buttons in a timely manner and the facility not issuing a refund to a resident's responsible party.
Findings
The investigation found insufficient evidence to substantiate the allegations. Interviews with residents and staff, record reviews, and facility tours did not corroborate the complaints, resulting in an unsubstantiated determination.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included delayed staff response to resident call pendants and failure to issue a refund to a resident's responsible party. Interviews with residents and staff, as well as record reviews, did not support the allegations. Specific delays in call pendant response were noted on two dates but were explained by staff. The refund issue was clarified with staff stating the family would receive a refund of $628.10 and that a 30-day termination notice was required for refunds.
Report Facts
Delay in pendant response: 18
Delay in pendant response: 24
Refund amount: 628.1
Capacity: 163
Census: 135
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Erik Zaragoza | Evaluator / Licensing Program Analyst | Conducted the complaint investigation |
| Gabriela Castro | Licensing Program Analyst | Assisted in conducting the complaint investigation |
| Martha Altimeda | Resident Care Director | Met with investigators during the visit |
| Dina Davis | Administrator | Arrived during the investigation visit |
Inspection Report
Complaint Investigation
Census: 136
Capacity: 163
Deficiencies: 0
Jul 3, 2025
Visit Reason
The visit was an unannounced complaint investigation regarding an allegation that staff retaliated against a resident by issuing a 30-day eviction notice after the resident expressed safety concerns to the city council.
Findings
The investigation included interviews, record reviews, and a physical tour. Findings showed that the eviction notice was issued due to the resident's aggressive behavior and violation of house rules. There was insufficient evidence to substantiate the retaliation allegation, and the complaint was determined to be unsubstantiated.
Complaint Details
Allegation: Staff retaliates against resident by issuing a 30-day eviction notice after the resident raised safety concerns. Investigation found multiple incidents of aggressive behavior by the resident and no evidence of retaliation. The allegation was unsubstantiated.
Report Facts
Capacity: 163
Census: 136
Incidents of aggressive behavior: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Noemi Galarza | Licensing Program Analyst | Conducted the complaint investigation |
| Dina Davis | Interim Executive Director | Met with investigator during the visit |
| Lisa Hicks | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 140
Capacity: 163
Deficiencies: 0
Jan 16, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations received on 2025-01-08 regarding staff not observing residents for changes in condition, not assisting with grooming, delayed response to call buttons, lack of housekeeping services, and failure to safeguard residents' personal belongings.
Findings
The investigation included interviews with staff and residents, file reviews, and physical plant tours. All allegations were found to be unsubstantiated due to lack of preponderance of evidence, with staff and residents denying the claims and documentation supporting appropriate care and services.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included failure to observe residents for changes in condition, grooming assistance, timely response to call buttons, housekeeping services, and safeguarding personal belongings. Interviews with 7 staff and 10 residents, file reviews, and observations did not corroborate the allegations.
Report Facts
Capacity: 163
Census: 140
Call button response time: 11
Staff interviewed: 7
Residents interviewed: 10
Allegations: 5
Missing money amount: 70
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jose Villalobos | Licensing Program Analyst | Conducted the complaint investigation |
| Laura Rodriguez | Administrator | Facility administrator met during investigation and exit interview |
| Fernando Fierros | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Follow-Up
Census: 135
Capacity: 163
Deficiencies: 0
Sep 24, 2024
Visit Reason
Unannounced case management visit to follow up on the incident report submitted by the licensee dated 09/16/2024 regarding a staff and a resident.
Findings
No deficiencies were cited during the visit. Staff #1 was terminated due to actions not following company protocols, and the facility plans to conduct in-service training for current staff.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Rodriguez | Executive Director | Met during the visit and advised regarding the findings; named in relation to the incident and follow-up. |
| Jewel Baptiste | Licensing Program Analyst | Conducted the unannounced case management visit. |
Inspection Report
Complaint Investigation
Census: 135
Capacity: 163
Deficiencies: 0
Sep 16, 2024
Visit Reason
The inspection was an unannounced complaint investigation conducted in response to allegations received on 2024-08-01 regarding sexual abuse of a resident and staff not ensuring resident privacy.
Findings
The investigation found insufficient evidence to substantiate the allegations of sexual abuse and lack of privacy. Interviews, observations, and file reviews indicated conflicting statements and no preponderance of evidence to prove the alleged violations occurred.
Complaint Details
The complaint involved allegations that a resident (R1) was sexually abused by another resident (R2) and that staff did not ensure resident privacy. The investigation included interviews with residents, staff, and review of police and medical records. The allegations were determined to be unsubstantiated.
Report Facts
Residents interviewed: 9
Staff interviewed: 2
Residents total: 11
Staff total: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Rodriguez | Executive Director | Met with during investigation and named in findings |
| Jewel Baptiste | Licensing Program Analyst | Conducted the complaint investigation |
| Dennis Douglas | IB Investigator | Also investigated the complaint and interviewed residents |
| Lisa Hicks | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Follow-Up
Capacity: 163
Deficiencies: 0
Aug 12, 2024
Visit Reason
An unannounced case management visit was conducted to follow up on an incident report and SOC 341 submitted by the Executive Director regarding a resident altercation.
Findings
The visit confirmed that on 08/02/2024, a resident exhibited aggressive behavior towards two other residents, resulting in a scratch. Staff intervened and no ambulance or police were contacted. The resident involved was scheduled to move to a higher level of care facility, and no current issues were reported by the facility.
Report Facts
Facility capacity: 163
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Rodriguez | Executive Director | Interviewed during the visit and named in the incident report |
| Jewel Baptiste | Licensing Program Analyst | Conducted the unannounced case management visit |
Inspection Report
Annual Inspection
Census: 135
Capacity: 163
Deficiencies: 1
Jul 26, 2024
Visit Reason
The inspection was an unannounced required annual inspection to evaluate compliance with licensing regulations for the facility.
Findings
The facility was found to have appropriate infection control practices, sufficient staffing, proper physical plant and environmental safety, and compliance with personnel record and training requirements. However, deficiencies were cited related to personnel health screenings and TB test results missing from staff files.
Deficiencies (1)
| Description |
|---|
| One staff member does not have a health screening and TB test result, and one staff member does not have a TB test result, posing a potential health, safety, or personal rights risk to persons in care. |
Report Facts
Hospice waiver residents: 9
Home health residents: 8
Modified diet residents: 5
Resident rooms inspected: 10
Resident files inspected: 10
Deficiencies cited: 1
Plan of Correction due date: Aug 2, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Rodriguez | Administrator | Met during inspection and named in relation to plan of correction and facility operations |
| David Sicairos | Supervisor | Named as supervisor overseeing the inspection |
| Christine Wong | Licensing Evaluator | Conducted the inspection and signed the report |
Inspection Report
Complaint Investigation
Census: 133
Capacity: 163
Deficiencies: 0
May 16, 2024
Visit Reason
An unannounced complaint investigation was conducted regarding an allegation that staff did not ensure residents were served food free from contamination, which reportedly caused illness among residents and staff.
Findings
The investigation found that a norovirus outbreak occurred affecting 32 residents and 18 staff, but there was no evidence that the facility's food caused the outbreak. The allegation was unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged that staff did not ensure residents were served food free from contamination, resulting in over twenty residents and three staff becoming sick. The investigation concluded the outbreak was norovirus-related, but the source was undetermined and not linked to the facility's food. The allegation was unsubstantiated.
Report Facts
Residents sick: 32
Staff sick: 18
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Luis Mora | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Laura Rodriguez | Administrator | Facility administrator interviewed during investigation |
| Wei Siew Ho | Licensing Program Manager | Named as Licensing Program Manager on the report |
| Martha Altamira | Resident Care Director | Interviewed during the investigation |
Inspection Report
Complaint Investigation
Census: 133
Capacity: 163
Deficiencies: 1
Apr 19, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to multiple allegations including failure to follow a resident's care plan resulting in a prohibited health condition, resident falls resulting in injury, and inadequate assistance with oral hygiene and dressing.
Findings
The investigation substantiated that staff did not follow Resident #1's care plan, leading to a Stage III pressure wound. Other allegations regarding multiple falls resulting in a hip fracture, leaving a resident unattended on the floor, failure to transfer the resident routinely, and inadequate assistance with oral hygiene and dressing were found to be unsubstantiated due to insufficient evidence.
Complaint Details
The complaint investigation was triggered by allegations that staff did not follow Resident #1's care plan, resulting in a prohibited health condition (pressure wound). Additional allegations included multiple falls resulting in a hip fracture, resident left unattended on the floor, failure to transfer resident routinely, and inadequate assistance with oral hygiene and dressing. The allegation regarding failure to follow the care plan was substantiated, while the others were unsubstantiated due to lack of evidence.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to update Resident #1's appraisal to document repositioning self after staff repositioning, leading to a Stage III pressure ulcer. | Type A |
Report Facts
Immediate Civil Penalty: 500
Capacity: 163
Census: 133
Plan of Correction Due Date: Due date was 04/20/2024 as stated for the plan of correction.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Valeria Maldonado | Licensing Program Analyst | Conducted the complaint investigation and authored the report. |
| Fernando Fierros | Licensing Program Manager | Oversaw the complaint investigation. |
| Laura Rodriguez | Executive Director | Facility representative met during the investigation and exit interviews. |
| Kris Schero | Staff member met during the investigation visit. | |
| Lilit Chaparyan | Administrator | Facility administrator named in the report. |
Inspection Report
Complaint Investigation
Census: 133
Capacity: 163
Deficiencies: 1
Apr 19, 2024
Visit Reason
The visit was an unannounced case management inspection conducted to investigate a complaint dated 2023-01-30 regarding resident falls and care deficiencies.
Findings
The facility failed to update the care plan for Resident #1 to reflect the resident's increased fall risk after multiple falls, resulting in continued falls and inadequate supervision. The deficiency was related to failure to update the physician's report and care plan to address the resident's changed condition.
Complaint Details
The investigation was triggered by a complaint dated 2023-01-30 concerning Resident #1 who sustained multiple falls after a hip fracture and surgery. Staff acknowledged knowledge of the resident's increased agitation and fall risk, but the facility failed to update the care plan accordingly.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to update Resident #1's Physician's Report and Appraisal to indicate that the resident was a fall risk, posing a potential health, safety, or personal rights risk. | Type B |
Report Facts
Resident falls: 3
Staff interviewed: 7
Plan of Correction due date: Apr 26, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Valeria Maldonado | Licensing Program Analyst | Conducted the unannounced visit and investigation. |
| Fernando Fierros | Supervisor | Supervisor overseeing the inspection. |
| Laura Rodriguez | Administrator | Facility administrator named in the report header. |
Inspection Report
Complaint Investigation
Census: 135
Capacity: 163
Deficiencies: 0
Feb 1, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2022-06-23 regarding allegations that the licensee did not ensure pre-admission appraisal was done correctly and that the facility did not issue the correct refund amount.
Findings
The investigation found insufficient evidence to substantiate the allegations. Interviews with residents and staff, as well as document reviews, indicated that the facility completed the required pre-admission appraisal and provided an appropriate refund amount to the resident's family. Therefore, the allegations were determined to be unsubstantiated.
Complaint Details
The complaint involved two allegations: 1) The licensee did not ensure pre-admission appraisal was done correctly, and 2) The facility did not issue the correct refund amount. After investigation, including interviews and document review, the allegations were found unsubstantiated due to lack of sufficient evidence.
Report Facts
Capacity: 163
Census: 135
Community fee: 3500
Community fee waiver: 2000
Prorated monthly charge: 2762
Refund amount: 4265
Total amount paid: 6707
Refund percentage: 80
Refund amount per agreement: 1193
Miscellaneous fee: 310
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christine Wong | Licensing Program Analyst | Conducted the complaint investigation |
| David Sicairos | Licensing Program Manager | Oversaw the complaint investigation |
| Laura Rodriguez | Administrator | Facility administrator who assisted with the visit and received the exit interview |
| Randyl Lowe | Receptionist | Staff member who allowed entry into the facility during the investigation |
Inspection Report
Complaint Investigation
Census: 134
Capacity: 163
Deficiencies: 0
Jan 18, 2024
Visit Reason
An unannounced complaint investigation was conducted regarding an allegation that staff do not maintain the facility at a comfortable temperature for residents.
Findings
The investigation found no evidence to substantiate the allegation. Temperature measurements throughout the facility were within regulatory range, staff and residents denied the allegation, and the thermostat in the concerned resident's room was functioning properly.
Complaint Details
The allegation was that a resident did not have heat for over a week and that the temperature in the resident's room was 69 degrees F. The investigation included interviews with staff and residents, temperature measurements, review of work orders and physician reports, and observation. The allegation was determined to be unsubstantiated due to lack of evidence.
Report Facts
Capacity: 163
Census: 134
Temperature: 82
Temperature: 72.8
Temperature: 75.3
Temperature Range: 73.9 to 78.0
Number of staff interviewed: 5
Number of residents interviewed: 13
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Alberto Lopez | Licensing Program Analyst | Conducted the complaint investigation |
| Laura Rodriguez | Executive Director | Facility representative interviewed and involved in investigation |
| Lisa Hicks | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 113
Capacity: 163
Deficiencies: 0
Dec 4, 2023
Visit Reason
The inspection was an unannounced complaint investigation conducted in response to an allegation that staff were not maintaining a comfortable room temperature for residents.
Findings
The investigation found that although some residents reported issues with their A/C units, the Executive Director and staff denied the allegations, and documentation showed the A/C units were operational. There was insufficient evidence to substantiate the complaint, resulting in an unsubstantiated finding.
Complaint Details
The complaint alleged that staff were not maintaining a comfortable room temperature for residents. The investigation included interviews with residents and staff, review of maintenance records and A/C service reports, and observations. The allegation was unsubstantiated due to lack of preponderance of evidence.
Report Facts
Residents interviewed: 5
Residents reporting A/C issues: 2
Staff denying allegation: 2
Residents stating A/C units work: 10
Total residents surveyed: 13
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Rodriguez | Executive Director | Met with Licensing Program Analysts and involved in investigation regarding thermostat and room temperature |
| Jewel Baptiste | Licensing Program Analyst | Conducted complaint investigation and interviews |
| Lisa Hicks | Licensing Program Manager | Named as Licensing Program Manager overseeing investigation |
Inspection Report
Complaint Investigation
Census: 130
Capacity: 163
Deficiencies: 0
Oct 10, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that staff did not assist residents with activities of daily living (ADLs) and did not meet residents' needs.
Findings
The investigation found that the allegations were unsubstantiated. Interviews with facility staff and residents indicated that most residents reported receiving assistance with ADLs and that their needs were met. There was insufficient evidence to prove the alleged violations occurred.
Complaint Details
The complaint alleged that staff did not assist residents with ADLs and did not meet residents' needs. The investigation included interviews with the Executive Director, Resident Care Director, staff, residents, a former resident, family members, and hospice agency representatives. The allegations were found to be unsubstantiated due to lack of preponderance of evidence.
Report Facts
Residents interviewed: 10
Residents denying ADL allegation: 8
Residents supporting ADL allegation: 1
Residents denying needs allegation: 8
Residents supporting needs allegation: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Rodriguez | Executive Director | Interviewed and involved in investigation findings |
| Martha Altamira | Resident Care Director | Interviewed and involved in investigation findings |
| Jewel Baptiste | Licensing Program Analyst | Conducted the complaint investigation |
Inspection Report
Complaint Investigation
Census: 130
Capacity: 163
Deficiencies: 1
Oct 10, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by complaints received on 03/07/2023 regarding allegations that the facility failed to provide a safe environment for residents, failed to provide a comfortable temperature, and had insufficient staffing to meet residents' needs.
Findings
The investigation substantiated the allegation of insufficient staffing, finding that 8 out of 10 residents reported waiting an hour or more for food due to lack of staff. The allegations regarding unsafe environment and uncomfortable temperature were unsubstantiated based on interviews, observations, and file review.
Complaint Details
The complaint investigation was unannounced and conducted by Licensing Program Analyst Jewel Baptiste. Allegations included failure to provide a safe environment, comfortable temperature, and sufficient staffing. The insufficient staffing allegation was substantiated; others were unsubstantiated.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. Evidence showed residents waited an hour or more for food due to lack of staff. | Type B |
Report Facts
Resident census: 130
Total capacity: 163
Residents reporting wait time: 8
Residents interviewed: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jewel Baptiste | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Laura Rodriguez | Executive Director | Interviewed during investigation; denied allegations regarding safety and temperature |
| Lilit Chaparyan | Former Executive Director | Interviewed during investigation; denied allegations regarding safety and temperature |
| Chelsea Vandueck | Receptionist and Activities Director | Greeted Licensing Program Analyst upon arrival |
| Lisa Hicks | Licensing Program Manager | Oversaw licensing program; named on report |
Inspection Report
Annual Inspection
Census: 130
Capacity: 163
Deficiencies: 1
Sep 14, 2023
Visit Reason
An unannounced Annual Continuation visit was conducted to evaluate compliance with licensing requirements at Ivy Park Cerritos.
Findings
The inspection found that PRN medications for residents R1 through R5 were missing without discontinued orders, posing an immediate health, safety, or personal rights risk to persons in care. The administrator certificate was expired but processing and pending.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Incidental Medical and Dental Care Services. Once ordered by the physician, nonprescription PRN medications shall be given in accordance with the physician’s directions. PRN medications were missing without a discontinued order, posing an immediate health, safety, or personal rights risk to persons in care. | Type A |
Report Facts
Capacity: 163
Census: 130
Plan of Correction Due Date: Sep 15, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Rodriguez | Executive Director | Met during inspection and participated in exit interview |
| Jewel Baptiste | Licensing Program Analyst | Conducted the inspection |
| Lisa Hicks | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Annual Inspection
Census: 130
Capacity: 163
Deficiencies: 0
Aug 15, 2023
Visit Reason
An unannounced annual/required inspection was conducted at Ivy Park Cerritos to evaluate compliance with licensing regulations and assess the facility's physical plant, food supply, safety equipment, and resident accommodations.
Findings
The inspection found the facility to be well-maintained with functioning smoke and carbon monoxide detectors, fully charged fire extinguishers, a well-stocked kitchen and pantry meeting Title 22 guidelines, and clean and sanitary conditions throughout. Resident rooms were properly furnished and bathrooms equipped with necessary safety features.
Report Facts
Residents interviewed: 10
Staff interviewed: 5
Studio apartments: 90
One-bedroom apartments: 42
Two-bedroom apartments: 12
Approved hospice waiver: 10
Inspection start time: 930
Inspection end time: 1500
Water temperature range: 105
Water temperature range: 120
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Rodriguez | Executive Director | Met with Licensing Program Analyst and participated in facility tour and exit interview |
| Adriana Ruiz | Regional Health Services Specialist | Participated in facility tour and exit interview |
| Jewel Baptiste | Licensing Program Analyst | Conducted the inspection |
| Lisa Hicks | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 130
Capacity: 163
Deficiencies: 0
Mar 2, 2023
Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations received on 06/22/2021 regarding failure to provide resident medical records, charging for unneeded services, refusal to accept resident after hospitalization, and illegal eviction.
Findings
The investigation found insufficient evidence to substantiate the allegations. Staff and administrators interviewed were unable to provide information or recall the resident involved due to management changes and missing records. Therefore, the allegations were determined to be unsubstantiated.
Complaint Details
The complaint investigation was unsubstantiated as there was no preponderance of evidence to prove the alleged violations occurred. The allegations included failure to provide medical records, charging for unnecessary services, refusal to readmit a resident after hospitalization, and illegal eviction. Interviews with current and former staff and administrators were inconclusive due to staff turnover and missing resident files.
Report Facts
Facility capacity: 163
Census: 130
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Irra | Licensing Program Analyst | Conducted the complaint investigation visit |
| Tony Vasallo | Licensing Program Manager | Named as Licensing Program Manager on report |
| Lilit Chaparyan | Executive Director | Interviewed during investigation; began employment September 2022 |
| Krystal Jenkins | Former Administrator | Attempted interview; no longer employed at facility |
| Brittney Buchannan | Administrator | Interviewed during initial complaint visit on 06/30/21 |
Inspection Report
Complaint Investigation
Census: 130
Capacity: 163
Deficiencies: 0
Feb 21, 2023
Visit Reason
An unannounced complaint investigation visit was conducted following a complaint received on 2022-02-11 regarding multiple allegations including disrepair of air conditioner, untimely food service, chemicals in water, and toaster disrepair.
Findings
The investigation included interviews with staff and residents, inspection of physical plant and documents, and observation of facility operations. All allegations were denied by staff and most residents, and observations and documentation supported that the facility was functioning properly. The allegations were determined to be unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included residents' air conditioner in disrepair, staff not serving food timely, staff putting chemicals in water used by residents, and facility toaster in disrepair. Interviews and observations did not support these allegations.
Report Facts
Capacity: 163
Census: 130
Staff interviewed: 6
Residents interviewed: 6
Time of visit: 555
Temperature observed: 72
Temperature set: 65
Bread slices toasted: 3
Time to serve breakfast: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Ramirez | Licensing Program Analyst | Conducted the complaint investigation visit |
| Tony Vasallo | Licensing Program Manager | Named as Licensing Program Manager on report |
| Brittney Buchannan | Administrator | Facility administrator named in report |
| Carmen Hernandez | Person met with during investigation |
Inspection Report
Complaint Investigation
Census: 124
Capacity: 163
Deficiencies: 4
Dec 30, 2022
Visit Reason
This was an unannounced complaint investigation visit triggered by multiple allegations received on 01/14/2021 regarding resident care issues including lack of resident rotation resulting in pressure injuries, medication administration failures, unmet diapering needs, and dietary noncompliance.
Findings
The investigation substantiated all allegations: Resident #1 was not rotated regularly causing worsening pressure injuries; medication (insulin injections) was not consistently administered as ordered; diapering needs were not met with soiled diapers observed; and dietary instructions were not followed, with the resident given orange juice despite dietary restrictions. A $500 civil penalty was issued.
Complaint Details
The complaint investigation was substantiated. Allegations included failure to rotate resident causing pressure injuries, failure to administer medication properly, unmet diapering needs, and failure to follow dietary restrictions. Evidence included interviews, medical and hospice records, and observations. A civil penalty of $500 was issued.
Severity Breakdown
Type B: 4
Deficiencies (4)
| Description | Severity |
|---|---|
| Failure to ensure residents with injection medications are taking them as prescribed, including lack of a plan for when health declines or refusal occurs. | Type B |
| Failure to ensure Resident #1 was rotated frequently to prevent wound worsening. | Type B |
| Failure to ensure Resident #1's diapering needs were met, including frequent changing to keep area dry. | Type B |
| Failure to follow dietary plan by providing Resident #1 orange juice despite hospice instructions. | Type B |
Report Facts
Civil Penalty: 500
Capacity: 163
Census: 124
Plan of Correction Due Date: Jan 13, 2023
Plan of Correction Due Date: Dec 30, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cynthia D Chan | Licensing Program Analyst | Conducted the complaint investigation and authored the report. |
| Tony Vasallo | Licensing Program Manager | Oversaw the complaint investigation and signed the report. |
| Lilit Chaparyan | Executive Director | Facility representative met during the investigation. |
| Peter Zertuche | Investigation Branch Investigator | Conducted interviews and obtained medical records related to pressure injury allegation. |
Inspection Report
Complaint Investigation
Census: 126
Capacity: 163
Deficiencies: 0
Dec 20, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that facility staff did not dispense correct medications to residents and did not provide care to residents.
Findings
The investigation included interviews with residents, staff, and review of records. Residents denied the allegations regarding medication and care, and staff reported no complaints. Medication management was found to be proper. There was insufficient evidence to substantiate the allegations, resulting in an unsubstantiated finding.
Complaint Details
The complaint investigation was unsubstantiated based on interviews with 13 residents and staff, and review of medication management for 6 residents. No evidence supported the allegations that staff failed to dispense correct medications or provide care.
Report Facts
Capacity: 163
Census: 126
Residents interviewed: 13
Residents' medication reviewed: 6
Staff interviewed: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christine Wong | Licensing Program Analyst | Conducted the complaint investigation visit |
| David Sicairos | Licensing Program Manager | Named as Licensing Program Manager on report |
| Brittney Buchannan | Administrator | Facility administrator during investigation |
| Lilit Chaparyan | Executive Director | Met with Licensing Program Analyst during investigation |
| Carment Hernandez | Business Office Manager | Assisted with the visit |
| Teresa Picos | Receptionist | Met with Licensing Program Analyst and was informed of visit reason |
Inspection Report
Complaint Investigation
Census: 132
Capacity: 163
Deficiencies: 0
Oct 17, 2022
Visit Reason
The visit was an unannounced complaint investigation regarding allegations that staff were not maintaining a comfortable room temperature for residents.
Findings
The investigation found that 12 out of 13 residents reported comfortable temperatures and functioning air/heating units. Staff addressed complaints from one resident (R1) and maintenance records showed the unit was working correctly. Temperature readings were within regulatory limits. The allegation was unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged that staff were not maintaining a comfortable room temperature for residents. The allegation was unsubstantiated after interviews, observations, and record reviews showed compliance with temperature regulations and proper maintenance.
Report Facts
Residents interviewed: 13
Staff interviewed: 5
Temperature range: 78
Temperature range: 80
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Bennette Pena | Licensing Program Analyst | Conducted the complaint investigation and authored the report. |
| David Sicairos | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation. |
| Nicole Reyes | Business Office Director | Met with the Licensing Program Analyst during the investigation and received the report. |
Inspection Report
Complaint Investigation
Census: 122
Capacity: 163
Deficiencies: 0
Sep 29, 2022
Visit Reason
An unannounced complaint investigation was conducted in response to allegations that staff mismanaged a resident's medication and did not prevent inappropriate interactions between residents.
Findings
The investigation found that the medication mismanagement allegation was unsubstantiated as the resident only received one medication as prescribed, with two others discontinued. The allegation regarding inappropriate interactions between residents was also unsubstantiated due to lack of evidence and conflicting statements.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff mismanaging resident medication and failure to prevent inappropriate resident interactions. Interviews and document reviews did not provide sufficient evidence to substantiate the allegations.
Report Facts
Capacity: 163
Census: 122
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jewel Baptiste | Licensing Program Analyst | Conducted the complaint investigation |
| Lisa Hicks | Licensing Program Manager | Named in report as Licensing Program Manager |
| Lililit Chaparyan | Executive Director | Met with Licensing Program Analyst during investigation and provided information |
Inspection Report
Annual Inspection
Census: 122
Capacity: 163
Deficiencies: 0
Jul 27, 2022
Visit Reason
An unannounced annual visit was conducted using the Infection Control Evaluation Tool to evaluate the facility's compliance with regulations.
Findings
The facility was toured including common areas and resident rooms. No deficiencies were observed. Safety features, medication storage, food supply, and infection control measures were all found to be in compliance.
Report Facts
Resident medications reviewed: 10
Water temperature range (Fahrenheit): 107.9
Water temperature range (Fahrenheit): 111.2
Food supply duration (days): 2
Food supply duration (days): 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Julius Osorio | Executive Director | Met with Licensing Program Analyst during inspection and involved in facility tour |
| David Sicairos | Licensing Program Analyst | Conducted the unannounced annual visit and inspection |
Inspection Report
Complaint Investigation
Census: 122
Capacity: 163
Deficiencies: 0
Jul 13, 2022
Visit Reason
An unannounced complaint investigation visit was conducted regarding an allegation that a resident was being intimidated while in care.
Findings
The investigation included interviews with staff and residents, review of records, and a facility tour. No evidence was found to substantiate the allegation, with staff and most residents denying any intimidation. The allegation was determined to be unsubstantiated due to insufficient evidence.
Complaint Details
The complaint alleged that a male staff member intimidated residents by staring at them intensely during dinner. Interviews with 5 staff members and 11 residents found no corroboration. The allegation was unsubstantiated.
Report Facts
Staff interviewed: 5
Residents interviewed: 11
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Sicairos | Licensing Program Analyst | Conducted the complaint investigation visit. |
| Sahar Mosalla | Administrator | Met with Licensing Program Analyst during the investigation. |
| Stefanie Coronel | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Complaint Investigation
Census: 133
Capacity: 163
Deficiencies: 3
Jun 7, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2021-01-14 regarding resident care issues including pressure injuries due to lack of rotation, unmet diapering needs, and dietary noncompliance.
Findings
The investigation substantiated that Resident #1 was not rotated regularly resulting in worsening pressure injuries, diapering needs were not consistently met leading to soiled diapers and wound contamination, and dietary instructions were not followed as orange juice was given despite contraindications. However, the allegation that Resident #1's medication was not administered was unsubstantiated as the resident self-administered insulin until unable, after which hospice staff administered it.
Complaint Details
The complaint investigation was substantiated for allegations related to resident rotation, diapering, and dietary needs. The medication administration allegation was unsubstantiated. A $500 civil penalty was issued related to the substantiated findings.
Severity Breakdown
Type B: 3
Deficiencies (3)
| Description | Severity |
|---|---|
| Resident #1 was not rotated frequently enough to prevent wound worsening. | Type B |
| Resident #1's diapering needs were not met, resulting in soiled diapers and wound contamination. | Type B |
| Facility staff did not follow Resident #1's dietary plan and gave orange juice despite contraindications. | Type B |
Report Facts
Civil Penalty Amount: 500
Plan of Correction Due Date: Jun 21, 2022
Capacity: 163
Census: 133
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cynthia D Chan | Licensing Program Analyst | Conducted the complaint investigation and authored the report. |
| Kianny Soto | Director of Assisted Living | Met with Licensing Program Analyst during investigation and exit interview. |
| Sahar Mosalla | Executive Director | Met with Licensing Program Analyst during investigation. |
| Peter Zertuche | Investigation Branch Investigator | Conducted interviews and obtained medical records related to pressure injury allegation. |
| Camille Crenshaw | Administrator | Named as facility administrator in report. |
Inspection Report
Complaint Investigation
Census: 128
Capacity: 163
Deficiencies: 0
Apr 19, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2021-11-04 alleging that staff did not seek medical attention for a resident in a timely manner.
Findings
The investigation found that Resident #1 had a change of condition on 2021-10-24 and staff did not call 911 immediately because the resident regularly refused medication and care. The allegation was determined to be unsubstantiated due to insufficient evidence to prove a violation.
Complaint Details
The complaint alleged that staff failed to seek timely medical attention for Resident #1 after a change of condition on 2021-10-24. The investigation included interviews with staff and residents, review of resident records, and found that the resident refused insulin and meals regularly. Staff did not call 911 immediately on 10/24/21 because it was not unusual for the resident to refuse care. The allegation was unsubstantiated.
Report Facts
Blood sugar level: 345
Complaint received date: Nov 4, 2021
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tony Vasallo | Licensing Program Analyst | Conducted the complaint investigation visit |
| Wei Siew Ho | Licensing Program Manager | Named as Licensing Program Manager on the report |
| Brittney Buchannan | Administrator | Facility administrator named in the report |
| Carmen Galicia | Business Manager | Met with Licensing Program Analyst during the investigation |
| La'Keisha Phillips | Director of Assisted Living | Interviewed during the initial complaint visit |
Inspection Report
Complaint Investigation
Census: 128
Capacity: 163
Deficiencies: 0
Apr 18, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2022-02-03 regarding inadequate food service and lack of resident privacy at the facility.
Findings
The investigation found that the allegations of inadequate food service and lack of resident privacy were unsubstantiated. Interviews with residents, staff, and the Business Manager indicated that food service was adequate and residents were provided privacy with staff knocking before entering rooms.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included inadequate food service and residents not being provided privacy. Interviews and evidence did not corroborate these allegations.
Report Facts
Facility capacity: 163
Resident census: 128
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nune Margaryan | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Wei Siew Ho | Licensing Program Manager | Oversaw the complaint investigation |
| Carmen Galicia | Business Manager | Interviewed during the investigation regarding allegations |
| Brittney Buchannan | Administrator | Facility administrator named in the report |
Inspection Report
Complaint Investigation
Census: 117
Capacity: 163
Deficiencies: 0
Aug 19, 2021
Visit Reason
An unannounced complaint investigation visit was conducted in response to an allegation received on 2020-11-20 that food services at the facility were inadequate.
Findings
The investigation included interviews with staff and residents, and a tour of the kitchen and food supply. Residents and staff consistently stated that food service was adequate, with sufficient portions and options, and extra food available if requested. The food supply was sufficient for the residents. The allegation was determined to be unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged that food services were inadequate. After investigation, including interviews with staff and residents and inspection of food supply, the allegation was found to be unsubstantiated.
Report Facts
Capacity: 163
Census: 117
Number of residents interviewed: 11
Number of staff interviewed: 3
Food supply sufficiency: 2
Food supply sufficiency: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nina Galarza | Licensing Program Analyst | Conducted the complaint investigation |
| Nune Margaryan | Licensing Program Analyst | Conducted the complaint investigation |
| Brittney Buchannan | Facility administrator met during the investigation | |
| Wei Siew Ho | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 116
Capacity: 163
Deficiencies: 2
Aug 11, 2021
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by complaints received on 2021-07-08 regarding the facility not sharing CCLD information with residents and staff not ensuring resident safety.
Findings
The investigation substantiated that the facility did not provide Provider Information Notices (PINs) to residents and that staff did not respond timely to emergency pendants, with 31 instances of response times of 20 minutes or more. Another allegation regarding facility disrepair and fire alarm functionality was unsubstantiated.
Complaint Details
The complaint investigation was substantiated for allegations that the facility did not share CCLD information with residents and that staff did not ensure the safety of residents, specifically regarding emergency pendant response times. The allegation of facility disrepair was unsubstantiated.
Severity Breakdown
Type A: 1
Type B: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to respond timely to resident emergency pendants, posing an immediate health and safety risk. | Type A |
| Failure to provide and post Provider Information Notices (PINs) to residents, posing a potential health and safety risk. | Type B |
Report Facts
Resident census: 116
Total capacity: 163
Instances of delayed pendant response: 31
Residents interviewed: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nina Galarza | Licensing Program Analyst | Conducted the complaint investigation |
| Glenn Trueman | Licensing Program Analyst | Conducted the complaint investigation |
| Brittney Buchannan | Administrator met with during investigation and interviewed | |
| Wei Siew Ho | Licensing Program Manager | Oversaw the complaint investigation |
| Camille Crenshaw | Administrator | Facility administrator named in report header |
| Carlos Monnarez | Building Manager | Interviewed regarding fire and smoke alarms |
Inspection Report
Annual Inspection
Census: 112
Capacity: 163
Deficiencies: 0
Jul 28, 2021
Visit Reason
The inspection was an unannounced visit conducted for the purpose of the required annual inspection of the facility.
Findings
The inspection found no deficiencies. The facility was in compliance with California Code of Regulations, Title 22, and California Health and Safety Code. The facility was well maintained with required furniture, clean bathrooms with grab bars, unobstructed exits, and proper infection control practices.
Report Facts
Hot water temperature: 109.4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| La'Keisha Phillips | Director of Assisted Living | Assisted with the inspection visit and discussed infection control practices |
| Angelica Rea | Licensing Program Analyst | Conducted the unannounced annual inspection visit |
Inspection Report
Complaint Investigation
Census: 132
Capacity: 163
Deficiencies: 0
Nov 10, 2020
Visit Reason
The inspection was conducted to investigate a complaint alleging that staff denied resident visitation at the facility.
Findings
The investigation found that the facility had a Coronavirus Visitation Policy allowing essential visitors while restricting non-essential visits. Interviews with staff and residents indicated no denial of visitation to essential workers. The allegation was unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged that on 01/27/2020, an individual was denied visitation by a staff member. The investigation included interviews with staff and residents, review of visitation policies, and concluded the allegation was unsubstantiated.
Report Facts
Residents interviewed: 10
Staff interviewed: 6
Capacity: 163
Census: 132
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Renee Arterberry | Licensing Program Analyst | Conducted the complaint investigation |
| Wei Siew Ho | Licensing Program Manager | Oversaw the complaint investigation |
| Krystal Jenkins | Administrator | Facility administrator interviewed during the investigation |
| Camille Crenshaw | Administrator | Named as facility administrator in report header |
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