Most inspections found no deficiencies, with several complaint investigations unsubstantiated, indicating generally good compliance with regulations. However, some reports cited deficiencies related primarily to staff association and training, medication management, and resident safety, including allowing a resident access to knives and admitting a resident with MRSA, which is prohibited. The most serious issues involved staff working without proper criminal background clearance, incomplete personnel records, and falsification instructions, resulting in civil penalties and immediate health risks in early 2024. The most recent report dated September 29, 2025, cited a deficiency for admitting a resident with MRSA, posing an immediate health and safety risk, but other conditions were compliant. While some serious concerns appeared earlier, recent monitoring visits showed improvement with no deficiencies, though the latest annual inspection indicates a new isolated issue.
An unannounced annual inspection was conducted to evaluate compliance with licensing requirements at the facility.
Findings
The inspection found that a resident was admitted with MRSA, a prohibited health condition, posing an immediate health and safety risk. The facility was cited for this violation under 22 CCR Section 87615(a)(4). Other facility conditions such as temperature, food supply, and safety equipment were compliant.
Severity Breakdown
Type A: 1
Deficiencies (1)
Description
Severity
Resident admitted with MRSA, a prohibited health condition posing immediate health, safety, or personal rights risk.
Type A
Report Facts
Capacity: 6Census: 6Plan of Correction Due Date: Sep 30, 2025
The visit was a quarterly monitoring inspection conducted by Licensing Program Analyst Vincent Moleski to review compliance with licensing requirements.
Findings
The facility was found to be in compliance with all applicable regulations. No deficiencies were cited. The facility environment, safety equipment, and resident needs were all satisfactory.
Report Facts
Facility capacity: 6Census: 4
Employees Mentioned
Name
Title
Context
Vincent Moleski
Licensing Program Analyst
Conducted the quarterly monitoring visit and inspection
Sangeetha Vipulananda
Administrator
Met with Licensing Program Analyst during the inspection
The visit was an unannounced quarterly monitoring visit conducted to review compliance with licensing requirements and assess the facility's operations and resident care.
Findings
The inspection found deficiencies including a resident being given the wrong medication on one occasion, medications not stored in their originally received containers, and failure to notify the licensing agency of two unusual incidents within seven days. Facility conditions such as temperature, medication storage, and safety equipment were generally compliant.
Severity Breakdown
Type A: 1Type B: 2
Deficiencies (3)
Description
Severity
A resident (R4) was given the wrong medications on one occasion, posing an immediate health, safety, and/or personal rights risk.
Type A
Medications were not stored in their originally received containers, posing an immediate health, safety, and/or personal rights risk.
Type B
Failure to submit written reports to the licensing agency within seven days regarding two unusual incidents, posing a potential health, safety, and/or personal rights risk.
Type B
Report Facts
Capacity: 6Census: 4Plan of Correction Due Date: Feb 22, 2025Plan of Correction Due Date: Feb 28, 2025
Employees Mentioned
Name
Title
Context
Vincent Moleski
Licensing Program Analyst
Conducted the inspection and authored the report
Stephen Richardson
Licensing Program Manager
Supervisor overseeing the inspection
Sangeetha Vipulananda
Facility Administrator
Met with the Licensing Program Analyst during the inspection
The visit was a required, announced annual inspection conducted by Licensing Program Analyst Vincent Moleski to evaluate the facility's compliance with licensing regulations.
Findings
The facility was inspected thoroughly including common areas, kitchen, bedrooms, bathrooms, and backyard. All environmental conditions such as temperature and safety equipment were within required ranges. No deficiencies were cited during this visit.
Employees Mentioned
Name
Title
Context
Vincent Moleski
Licensing Program Analyst
Conducted the annual inspection and authored the report.
Sangeetha Vipulananda
Executive Assistant
Met with the Licensing Program Analyst during the inspection.
The visit was a quarterly monitoring visit conducted to assess compliance and review facility conditions as part of case management for legal/noncompliance.
Findings
No deficiencies were cited during the visit. The facility was inspected for safety, cleanliness, and compliance with regulations including temperature controls, medication storage, and fire safety equipment.
The inspection was an unannounced complaint investigation triggered by allegations received on 2024-04-02 regarding staff mismanagement of resident medication, a resident fall due to lack of supervision, and failure to report incidents to a resident's responsible party.
Findings
Based on interviews, observation, and record review, the allegations were found to be unsubstantiated due to insufficient evidence to prove the violations occurred. No deficiencies were cited related to the allegations.
Complaint Details
The complaint involved three allegations: staff mismanaged resident's medication, a resident fell due to lack of supervision, and incidents were not reported to the resident's responsible party. The investigation included interviews with residents, staff, and a responsible party, as well as review of medication records. The department determined the allegations were unsubstantiated.
Report Facts
Facility capacity: 6Census: 0
Employees Mentioned
Name
Title
Context
Vincent Moleski
Licensing Program Analyst
Conducted the complaint investigation and delivered findings
Shane Stumpf
Administrator
Facility administrator met during the investigation
The inspection was an unannounced complaint investigation visit conducted in response to allegations received on 03/22/2024 regarding resident elopement, lack of daily activities, and failure to inform authorized persons of incidents.
Findings
Based on interviews, observation, and record review, the allegations were determined to be unsubstantiated due to insufficient evidence. No deficiencies were cited related to the allegations, and staff described providing sufficient activities for the resident.
Complaint Details
The complaint involved allegations that a resident eloped due to lack of care, staff did not provide daily activities, and staff failed to inform the resident's authorized person of elopement incidents. The investigation found these allegations unsubstantiated.
Report Facts
Facility capacity: 6Census: 0
Employees Mentioned
Name
Title
Context
Vincent Moleski
Licensing Program Analyst
Conducted the complaint investigation and delivered findings
Shane Stumpf
Administrator
Facility administrator met during the investigation
The visit was a Case Management - Legal/Non-compliance unannounced inspection conducted to discuss substantiated complaints and other serious deficiencies identified by the department.
Findings
No deficiencies were cited during this meeting. The report focused on operational and administrative concerns such as acquiring criminal record clearances for new employees and completing required staff training. The licensee agreed to appoint administrators and submit updated documentation to address oversight issues.
Complaint Details
The visit was related to substantiated complaints involving operational and administrative concerns, including criminal record clearances and staff training deficiencies. The licensee acknowledged insufficient oversight and agreed to corrective actions.
Report Facts
Capacity: 6Census: 4Deadline: 8
Employees Mentioned
Name
Title
Context
Shane Stumpf
Licensee/Administrator
Named in relation to oversight deficiencies and corrective actions
Vincent Moleski
Licensing Program Analyst
Attended non-compliance conference
Stephen Richardson
Licensing Program Manager
Attended non-compliance conference
Stephenie Doub
Regional Manager
Discussed operational concerns and offered technical support
The inspection was an unannounced complaint investigation triggered by allegations received on 2024-03-21 regarding insufficient staff training, resident access to knives, and staff falsifying records.
Findings
The investigation substantiated that staff were not sufficiently trained and that a resident with dementia was allowed access to knives, posing an immediate health and safety risk. The allegation that staff falsified records was unsubstantiated due to insufficient evidence.
Complaint Details
The complaint investigation was substantiated for allegations that staff were not sufficiently trained and that a resident was allowed access to knives. The allegation that staff falsified records was unsubstantiated.
Severity Breakdown
Type A: 1Type B: 1
Deficiencies (2)
Description
Severity
Resident was allowed access to knives, which poses an immediate health and safety risk.
Type A
Staff training records were not maintained for a staff member, posing a potential health, safety, and/or personal rights risk.
Type B
Report Facts
Facility capacity: 6Census: 4Deficiency count: 2Plan of Correction due date: May 31, 2024Plan of Correction due date: Jun 13, 2024
Employees Mentioned
Name
Title
Context
Vincent Moleski
Licensing Program Analyst
Conducted the complaint investigation and delivered findings
Shane Stumpf
Administrator
Facility administrator interviewed during investigation and involved in exit interviews
An unannounced complaint investigation was conducted due to allegations that staff members worked at the facility without criminal record association and that staff files were incomplete.
Findings
The investigation substantiated the allegations that staff worked without proper criminal background clearance and that staff files were incomplete. The facility allowed an excluded individual to be present and staff were instructed to provide false information to licensing personnel, posing immediate health and safety risks.
Complaint Details
The complaint was substantiated. Staff members worked without criminal record association and staff files were incomplete. An excluded individual was present and provided direct care. Staff were instructed to lie to licensing personnel. Civil penalties were assessed for repeat violations and presence of excluded individuals.
Severity Breakdown
Type A: 3Type B: 1
Deficiencies (4)
Description
Severity
Staff member (S1) worked for 15 days without being associated to the facility, violating criminal record clearance requirements.
Type A
Administrator did not have knowledge of and ability to conform to applicable laws, rules, and regulations.
Type A
Administrator lacked good character and continuing reputation of personal integrity.
Type A
Personnel records were incomplete; staff files were not maintained properly.
Type B
Report Facts
Civil penalty amount: 1000Civil penalty amount: 500Civil penalty amount: 300Civil penalty amount: 1500Number of days non-associated employee worked: 15Number of days excluded individual present: 3Facility capacity: 6Facility census: 2
Employees Mentioned
Name
Title
Context
Shane Stumpf
Administrator
Facility administrator interviewed during investigation and named in findings
Vincent Moleski
Licensing Program Analyst
Conducted the complaint investigation
Stephen Richardson
Licensing Program Manager
Named as Licensing Program Manager overseeing the investigation
Inspection Report Original LicensingCensus: 6Capacity: 6Deficiencies: 1Feb 12, 2024
Visit Reason
The inspection was a post-licensing unannounced visit conducted to evaluate the facility's compliance following licensing.
Findings
The facility was inspected for compliance with licensing requirements including staff association, environmental conditions, and safety measures. A deficiency was cited for three staff members not being associated with the facility prior to starting work.
Deficiencies (1)
Description
Three staff members were not associated to this facility prior to starting work, posing an immediate health, safety or personal rights risk to persons in care.
Report Facts
Capacity: 6Census: 6Plan of Correction Due Date: Feb 13, 2024
Employees Mentioned
Name
Title
Context
Shane Stumpf
Administrator
Facility administrator met during inspection and named in deficiency discussion
Vincent Moleski
Licensing Program Analyst
Conducted the inspection and authored the report
Stephen Richardson
Licensing Program Manager
Named as Licensing Program Manager on the report
Inspection Report Original LicensingCapacity: 6Deficiencies: 0Sep 20, 2023
Visit Reason
The inspection was conducted as a pre-licensing visit to evaluate the facility for licensing approval.
Findings
The facility was found to be clean, odor-free, in good repair, and compliant with health and safety regulations including fire safety and medication storage. No deficiencies were cited during the inspection.
Report Facts
Water temperature: 119.5Capacity: 6Census: 0
Employees Mentioned
Name
Title
Context
Shane Stumpf
Licensee / Administrator
Met with Licensing Program Analyst during inspection
Kevin Gould
Licensing Program Analyst
Conducted the pre-licensing inspection
Inspection Report Original LicensingCapacity: 6Deficiencies: 0Sep 20, 2023
Visit Reason
The visit was conducted for the purpose of a pre-licensing component 3 orientation at Jazba Glenroy, a Residential Care Facility for the Elderly (RCFE).
Findings
The Licensing Program Analyst met with the licensee and conducted an orientation covering Operating Requirements, Physical Environment, Personnel Requirements, Resident Records, and Health Related Services and Conditions. Responsibilities of the department, analyst, and administrator were discussed, including reporting requirements.
Employees Mentioned
Name
Title
Context
Kevin Gould
Licensing Program Analyst
Conducted the pre-licensing orientation and discussed regulatory requirements.
Shane Stumpf
Administrator
Licensee met with the Licensing Program Analyst during the orientation.
Czarrina A Camilon-Lee
Licensing Program Manager
Named as Licensing Program Manager on the report.
Inspection Report Original LicensingCapacity: 6Deficiencies: 0Jul 13, 2023
Visit Reason
Initial licensing evaluation conducted via virtual interview to verify applicant/administrator's understanding of community care facility licensing laws and readiness for facility operation.
Findings
Applicant/administrator demonstrated understanding of licensing laws, facility operation, admission policies, staffing, health conditions, emergency preparedness, complaints reporting, and pre-licensing readiness. No clients were in care at the time of the visit.
Employees Mentioned
Name
Title
Context
Shane Stumpf
Licensee/Administrator
Applicant/administrator who participated in the licensing evaluation and interview.
Darla Neeley
Licensing Program Manager
Named as Licensing Program Manager on the report.
Diamond Law
Licensing Program Analyst
Named as Licensing Program Analyst on the report.
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