Most inspections found deficiencies related primarily to staff training, medical assessments, criminal record clearances, and reporting requirements, with some issues posing potential health or safety risks. The facility was fined $900 on March 7, 2025, for failing to submit a required Plan of Correction on time following the January 29, 2025 annual inspection, which cited several deficiencies including missing criminal record clearance and expired certifications. Several complaint investigations were unsubstantiated, including allegations about resident care and refund disputes, while one complaint about failure to report incidents was substantiated in November 2024. The most recent report from March 7, 2025, showed no new deficiencies during a complaint investigation of resident altercations. While some issues persist, the facility has addressed certain deficiencies over time, but there is no clear pattern of consistent improvement or decline.
An unannounced Case Management visit was conducted regarding incidents reported to the Community Care Licensing Division on 2025-03-02 involving resident altercations.
Findings
The investigation involved interviews with staff witnesses and review of video evidence showing resident altercations. Emergency services were called, and responsible parties notified. No deficiencies were cited during the visit.
Complaint Details
The visit was triggered by two incidents reported on 2025-03-02: one involving resident R1 slapping resident R2 with a plastic hanger, and another where R1 punched resident R3 in the shoulder. Both incidents involved emergency response and notification of responsible parties. R3's responsible party declined emergency room transport. The complaint was investigated through staff interviews and video review.
Report Facts
Facility capacity: 75Resident census: 55
Employees Mentioned
Name
Title
Context
Erica Diala
Executive Director
Met with Licensing Program Analyst during visit
Lori Alexander-Washington
Licensing Program Analyst
Conducted the unannounced Case Management visit
Bennett Fong
Licensing Program Manager
Named in report header
Inspection Report Plan of CorrectionCensus: 55Capacity: 75Deficiencies: 1Mar 7, 2025
Visit Reason
The visit was an unannounced Plan of Correction (POC) inspection conducted because the facility administrator failed to submit the POC by the due date following an Annual Inspection visit where deficiencies were cited.
Findings
The facility had deficiencies cited during the Annual Inspection on 2025-01-29, and the administrator failed to submit the required Plan of Correction by the due date. During this POC visit, some deficiencies were cleared, but civil penalties totaling $900.00 were assessed for failure to meet the POC deadline.
Deficiencies (1)
Description
Failure to submit Plan of Correction by due date resulting in civil penalties of $900.00
Report Facts
Civil Penalties: 900Days late: 9
Employees Mentioned
Name
Title
Context
Erica Diala
Executive Director
Met during inspection and named as facility administrator
Laura-Anne Leake-Mosley
Executive Assistant
Met during inspection and provided First Aid/CPR certificates
Unannounced 1-Year Annual Required inspection conducted to evaluate compliance with licensing regulations and facility safety standards.
Findings
The inspection found several deficiencies related to criminal record clearance, annual medical assessments, staff training certifications, and food handler certifications. All deficiencies were cited with plans of correction and due dates provided. Some deficiencies were cleared during the visit.
Severity Breakdown
Type A: 1Type B: 3
Deficiencies (4)
Description
Severity
Licensee did not have S1 associated through Guardian for criminal record clearance, posing immediate health, safety or personal rights risk.
Type A
Licensee did not have updated annual medical assessments for residents R1-R4, posing potential health, safety or personal rights risk.
Type B
Licensee did not have updated First Aid/CPR certifications for staff S2 and S3, posing potential health, safety or personal rights risk.
Type B
Licensee did not have current Food Handler Certifications for staff S4 and S5, posing potential health, safety or personal rights risk.
Type B
Report Facts
Residents records reviewed: 13Staff records reviewed: 16Staff with current first aid training: 14Hospice waiver residents: 19Facility capacity: 75Facility census: 58
Employees Mentioned
Name
Title
Context
Erica Diala
Executive Director
Met with Licensing Program Analyst during inspection and named in plan of correction
The visit was an unannounced case management visit conducted to investigate a complaint (#15-AS-20241120095158) regarding the facility's failure to submit incident reports to Licensing for incidents including residents' hospitalizations.
Findings
The facility was found deficient for not submitting required incident reports to Licensing, including those related to residents' hospitalizations, which poses a potential health, safety, or personal rights risk to persons in care.
Complaint Details
Complaint investigation #15-AS-20241120095158 was conducted and substantiated based on the facility's failure to submit incident reports to Licensing.
Severity Breakdown
Type B: 1
Deficiencies (1)
Description
Severity
Failure to comply with reporting requirements by not submitting incident reports including hospitalizations to Licensing for residents in care.
Type B
Report Facts
Deficiencies cited: 1Plan of Correction Due Date: Dec 5, 2024
Employees Mentioned
Name
Title
Context
Erica Diala
Administrator
Met with Licensing Program Analyst during the visit
Lori Alexander-Washington
Licensing Program Analyst
Conducted the complaint investigation and inspection
An unannounced Case Management visit was conducted regarding an incident reported to the Community Care Licensing Division on 2024-04-26 involving two residents.
Findings
The investigation found that two residents were involved in a physical altercation resulting in one resident being sent to the Emergency Room but returning the same day with negative exam results. Both residents were reported to be okay with no further issues. No deficiencies were issued during the visit.
Complaint Details
The visit was triggered by a complaint incident reported on 2024-04-26 involving two residents who had a physical altercation. The complaint was investigated and found to be unsubstantiated as no deficiencies were issued and both residents were reported to be okay.
The inspection was an unannounced 1-Year Annual Required inspection conducted to evaluate compliance with licensing requirements and facility safety.
Findings
The inspection identified deficiencies related to staff training in First Aid/CPR, health screenings including TB tests for certain staff, and the lack of an updated medical assessment for a resident with dementia. Plans of correction were agreed upon with due dates.
Deficiencies (3)
Description
Staff did not have current First Aid/CPR training, posing a potential health, safety or personal rights risk to persons in care.
Personnel did not have required health screening and TB tests, posing a potential health, safety or personal rights risk to persons in care.
Resident with dementia did not have an updated medical assessment, posing a potential health, safety or personal rights risk to persons in care.
Report Facts
Deficiencies cited: 3Hospice waiver residents: 19Staff records reviewed: 8Resident records reviewed: 6
Employees Mentioned
Name
Title
Context
Evelyn Jensen
Executive Director
Met with Licensing Program Analyst during inspection
An unannounced complaint investigation was conducted in response to a complaint received on 2022-01-10 regarding the facility not issuing a refund.
Findings
The investigation included interviews with staff and the complainant, and review of relevant documents. The allegation was found to be unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged that the facility did not issue a refund. The allegation was investigated and found to be unsubstantiated.
Report Facts
Complaint received date: Jan 10, 2022Check issue date: Feb 10, 2022Check clearance date: Feb 16, 2022
Employees Mentioned
Name
Title
Context
Grace Luk
Licensing Program Analyst
Conducted the complaint investigation and delivered findings
Laura Leake-Mosley
Executive Assistant
Met with Licensing Program Analyst during the investigation
The visit was an unannounced Infection Control Inspection conducted as a required one-year routine inspection.
Findings
The inspection found no deficiencies. The facility was toured including multiple areas, and all observed conditions such as lighting, temperature, and safety features were adequate. Several updated documents were requested for submission.
Report Facts
Hot water temperature: 111.9Fire extinguisher last serviced: Jul 13, 2022
Employees Mentioned
Name
Title
Context
Evelyn Jensen
Executive Director
Met with Licensing Program Analyst during inspection
Unannounced visit to investigate a complaint received on 2021-11-02 regarding allegations of staff leaving residents unattended, inadequate nutrition, interference with visitation, and lack of resident activities.
Findings
The investigation included interviews, observations, and records review. The allegations were found to be unsubstantiated due to insufficient evidence to prove the violations occurred. Staff were observed checking residents regularly, providing adequate nutrition and activities, and accommodating visitation schedules.
Complaint Details
Complaint was unsubstantiated after investigation. Allegations included staff leaving residents unattended, inadequate nutrition, interference with visitation, and lack of activities. Evidence did not support these claims.
Report Facts
Capacity: 75Census: 42
Employees Mentioned
Name
Title
Context
Leslie Ibo
Licensing Program Analyst
Conducted the complaint investigation
Harpreet Humpal
Licensing Program Manager
Oversaw the complaint investigation
Evelyn Valladares
Executive Director
Met with Licensing Program Analyst during investigation
Myrene Gaeta
Resident Care Director
Met with Licensing Program Analyst during investigation
Unannounced case management visit conducted by Licensing Program Analyst L. Ibo to evaluate compliance with regulations.
Findings
The licensee failed to comply with criminal record clearance requirements by not associating S1 and S3 to the facility, posing a potential safety risk to persons in care. A deficiency was cited per Title 22 California Code of Regulations.
Deficiencies (1)
Description
Failure to comply with criminal record clearance requirements by not associating S1 and S3 to the facility, posing potential safety risk to persons in care.
Report Facts
Capacity: 75Census: 42Plan of Correction Due Date: Jun 22, 2022
Employees Mentioned
Name
Title
Context
Leslie Ibo
Licensing Program Analyst
Conducted the unannounced case management visit and authored the report
The inspection was an unannounced infection control inspection conducted as a required one-year visit to evaluate compliance with health and safety standards.
Findings
The Licensing Program Analyst toured the facility and found adequate lighting, maintained hallway temperature, grab bars in bathrooms, sufficient food supply, and secure storage of medications and hazardous materials. No deficiencies were cited during the visit.
Employees Mentioned
Name
Title
Context
Myrene Gaeta
DRS
Met with Licensing Program Analyst during inspection and assisted with facility tour.
Carol Fowler
Licensing Program Analyst
Conducted the infection control inspection.
Bennett Fong
Licensing Program Manager
Named in the report as Licensing Program Manager.
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