Deficiencies (last 5 years)
Deficiencies (over 5 years)
3.6 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
10% better than California average
California average: 4 deficiencies/yearDeficiencies per year
8
6
4
2
0
Census
Latest occupancy rate
51% occupied
Based on a February 2026 inspection.
This facility has shown a decline in demand based on occupancy rates.
Occupancy over time
Inspection Report
Complaint Investigation
Census: 111
Capacity: 219
Deficiencies: 2
Date: Feb 23, 2026
Visit Reason
An unannounced complaint investigation visit was conducted in response to an allegation of neglect and lack of supervision resulting in serious bodily injury to a resident.
Complaint Details
The complaint was substantiated. Resident 1 sustained multiple falls due to inadequate supervision and care, resulting in a serious injury (acute left femoral neck fracture). The facility was aware of the resident's increased care needs but failed to update the care plan or relocate the resident to a more appropriate setting.
Findings
The investigation substantiated that the facility failed to provide adequate care and supervision to Resident 1, who experienced multiple falls resulting in a serious injury. The facility did not update the care plan to reflect the resident's need for two-person assistance and failed to relocate the resident to a higher level of care despite awareness of his increased needs.
Deficiencies (2)
Basic services shall at a minimum include care and supervision as defined in regulations; the facility failed to meet this requirement.
The facility did not provide Resident 1 sufficient care and supervision, which led to falls resulting in fracture/injury, posing an immediate health, safety, or personal rights risk.
Report Facts
Resident falls: 9
Facility capacity: 219
Resident census: 111
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Sarah Hurt | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Adrian Guillen | Administrator | Facility administrator involved in the investigation and exit interview |
| See Moua | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 104
Capacity: 219
Deficiencies: 1
Date: Feb 18, 2026
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint alleging that facility staff were not following proper eviction procedures.
Complaint Details
The complaint alleged that facility staff were not following proper eviction procedures. The investigation found that the facility did not inform the department of the 30-day eviction notice given to Resident 1, the notice lacked reasons for eviction and appeal rights, and no discharge plan or assistance was provided. The complaint was substantiated.
Findings
The investigation substantiated that the facility failed to follow proper eviction procedures by not providing the required 30-day written notice with specific facts for eviction, including reasons and appeal rights. There was also no evidence of discharge planning or assistance for the affected resident.
Deficiencies (1)
Failure to include specific facts in the eviction notice to permit determination of the date, place, witnesses, and circumstances concerning the reasons for eviction, violating CCR 87224(d).
Report Facts
Residents present during inspection: 104
Total licensed capacity: 219
Deficiencies cited: 1
Plan of Correction due date: Mar 6, 2026
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Amy Domingo | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Adrian Guillen | Administrator | Facility administrator involved in the investigation and exit interview |
Inspection Report
Annual Inspection
Census: 103
Capacity: 219
Deficiencies: 0
Date: Dec 5, 2025
Visit Reason
An unannounced required annual inspection was conducted to evaluate compliance with licensing requirements for Monte Vista Village Senior Living Facility.
Findings
The facility was found to be clean, sanitary, and in good repair with no deficiencies observed or cited. Resident rooms and common areas met all regulatory standards, and staff and client interviews revealed no significant concerns.
Report Facts
Facility capacity: 219
Census: 103
Refrigerator temperature: 30
Freezer temperature: 0
Hot water temperature: 112
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Administrator | Facility Administrator met during inspection and participated in exit interview |
| Amy Domingo | Licensing Program Analyst | Conducted the inspection |
| Simon Jacob | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 102
Capacity: 219
Deficiencies: 0
Date: Nov 26, 2025
Visit Reason
An unannounced complaint investigation was conducted in response to allegations that the facility is in disrepair and that staff do not ensure residents are served food of good quality.
Complaint Details
The complaint was unsubstantiated based on interviews with staff, residents, and outside sources, review of maintenance logs, food service observations, and documentation. No violations were found regarding facility disrepair or food quality.
Findings
The investigation found no evidence to substantiate the allegations. The facility was observed to be clean, well maintained, and free of hazards. Food quality was confirmed to be good based on interviews, observations, and documentation.
Report Facts
Capacity: 219
Census: 102
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Amy Domingo | Licensing Program Analyst | Conducted the complaint investigation |
| Adrian Guillen | Administrator/Executive Director | Facility administrator interviewed during investigation |
Inspection Report
Complaint Investigation
Capacity: 219
Deficiencies: 0
Date: Oct 2, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 06/29/2023 regarding failure to protect a resident, unlawful eviction, and neglect resulting in resident-on-resident abuse at Monte Vista Village Senior Living Facility.
Complaint Details
The complaint involved allegations that the licensee did not protect Resident #1 from another resident despite a restraining order, neglected Resident #1 resulting in resident-on-resident abuse by Resident #2, and issued an unlawful eviction notice to Resident #1. The investigation found no supporting evidence for these claims and concluded the allegations were unsubstantiated.
Findings
The investigation found no evidence to substantiate the allegations. Staff interviews, records review, and facility visits confirmed that the facility was aware of resident conflicts and took appropriate actions. The eviction was found to be procedurally proper and not retaliatory. Therefore, the allegations were unsubstantiated.
Report Facts
Facility capacity: 219
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Amy Rodgers | Licensing Program Analyst | Conducted the complaint investigation visit and delivered findings |
| Adrian Guillen | Executive Director | Facility representative met during the investigation and exit interview |
| Simon Jacob | Supervisor | Supervisor overseeing the complaint investigation |
Inspection Report
Complaint Investigation
Census: 102
Capacity: 219
Deficiencies: 0
Date: Aug 19, 2025
Visit Reason
An unannounced Case Management visit was conducted to address an existing complaint and a records request.
Complaint Details
The visit was triggered by an existing complaint involving Resident 1 (R1).
Findings
The Licensing Program Analyst conducted an interview with a resident regarding the complaint and discussed the visit purpose with the Executive Director. An exit interview was conducted and a copy of the report and License Rights were provided to the Executive Director.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met with during the visit and involved in the exit interview. |
| Debbie Correia | Licensing Program Analyst | Conducted the unannounced Case Management visit and interview. |
Inspection Report
Census: 102
Capacity: 219
Deficiencies: 0
Date: Aug 19, 2025
Visit Reason
An unannounced Case Management visit was conducted by the Licensing Program Analyst to address an existing complaint and a records request.
Complaint Details
The visit was related to an existing complaint involving Resident 1, which was discussed during the interview.
Findings
The Licensing Program Analyst conducted an interview with a resident regarding the complaint and records request. An exit interview was held with the Executive Director, and a copy of the report and License Rights was provided.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met with during the visit and exit interview. |
| Debbie Correia | Licensing Program Analyst | Conducted the unannounced Case Management visit and resident interview. |
Inspection Report
Census: 104
Capacity: 219
Deficiencies: 0
Date: Jul 23, 2025
Visit Reason
The visit was an unannounced Case Management visit conducted to obtain signatures on amended complaints and discuss the purpose of the visit with the Executive Director.
Findings
The Licensing Program Analyst conducted the visit, met with the Executive Director, and obtained signatures on amended complaints. An exit interview was conducted and a copy of the report and Licensee/Appeal Rights were provided.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met during the visit and involved in exit interview and discussion of visit purpose. |
| Debbie Correia | Licensing Program Analyst | Conducted the unannounced Case Management visit. |
Inspection Report
Census: 104
Capacity: 219
Deficiencies: 0
Date: Jul 23, 2025
Visit Reason
An unannounced Case Management visit was conducted to obtain signatures on amended complaints and discuss the purpose of the visit with the Executive Director.
Findings
The Licensing Program Analyst conducted the visit, met with facility staff, and obtained necessary signatures on amended complaints. An exit interview was conducted and a copy of the report and appeal rights were provided to the Executive Director.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met during the visit and involved in discussion and exit interview. |
| Debbie Correia | Licensing Program Analyst | Conducted the unannounced Case Management visit. |
| Michael Stickler | Marketing Regional | Welcomed the Licensing Program Analyst upon arrival. |
| Robyn Clark | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jul 15, 2025
Visit Reason
An unannounced complaint investigation was conducted regarding allegations that the facility was not following proper COVID-19 infection control protocols.
Complaint Details
The complaint alleged failure to follow proper COVID-19 infection control protocols. Interviews revealed conflicting information about COVID-19 testing and infection control measures. Resident R1 had COVID-19 like symptoms and self-administered a test with inconclusive results. Staff disclosed isolation and PCR testing with negative results. The complaint was unsubstantiated.
Findings
The investigation included staff and resident interviews, records review, and a facility tour. The allegation was determined to be unsubstantiated based on evidence including interviews and records, as the evidence did not meet the preponderance of the evidence standard.
Report Facts
Capacity: 219
Census: 103
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation visit |
| Adrian Guillen | Executive Director | Met with Licensing Program Analyst during investigation and exit interview |
| Paul Markovich | Administrator | Facility administrator listed in report |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jul 15, 2025
Visit Reason
The inspection visit was conducted as an unannounced complaint investigation following a complaint received on 2025-04-23 alleging that facility staff changed a resident's level of care without a physician's reassessment.
Complaint Details
The complaint alleged that staff changed Resident 1's level of care without a physician's reassessment. The investigation found that Resident 1 was reassessed by a physician on 2025-04-01, which supported the increased level of care. Subsequent reassessments and interviews showed conflicting information about the resident's ability to self-medicate, but overall the allegation was unsubstantiated.
Findings
The investigation included staff and outside source interviews and a resident record review. The allegation was determined to be unsubstantiated as evidence did not support that the violation occurred.
Report Facts
Complaint Control Number: 08-AS-20250423125647
Capacity: 219
Census: 103
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation |
| Adrian Guillen | Executive Director | Facility representative met during investigation |
| Robyn Clark | Licensing Program Manager | Named in report signature section |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jul 15, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that the facility was not following proper COVID-19 infection control protocols.
Complaint Details
The complaint alleged failure to follow proper COVID-19 infection control protocols. Interviews revealed conflicting statements about COVID-19 testing and infection control measures, but overall evidence did not support the allegation, resulting in an unsubstantiated finding.
Findings
The investigation included staff and resident interviews, records review, and a facility tour. The allegation was found to be unsubstantiated based on evidence including interviews and records, indicating the facility did follow appropriate COVID-19 protocols.
Report Facts
Complaint Control Number: 8
Capacity: 219
Census: 103
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Evaluator | Conducted the complaint investigation and unannounced visit |
| Adrian Guillen | Executive Director | Met with Licensing Evaluator during the investigation and exit interview |
| Paul Markovich | Administrator | Facility administrator named in the report |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jul 15, 2025
Visit Reason
An unannounced complaint investigation was conducted following a complaint received on 2025-04-23 alleging that facility staff changed a resident's level of care without a physician's assessment.
Complaint Details
The complaint alleged that staff changed Resident 1's level of care without a physician's assessment. The investigation found the allegation unsubstantiated based on record reviews and interviews, indicating insufficient evidence to prove the violation.
Findings
The investigation included interviews and record reviews and found that the allegation was unsubstantiated as evidence did not support that the violation occurred. The resident was reassessed by a physician and changes in care level were documented, but conflicting reports about the resident's ability to self medicate were noted.
Report Facts
Complaint Control Number: 8
Capacity: 219
Census: 103
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation |
| Adrian Guillen | Executive Director | Met with investigator and named in report |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jul 14, 2025
Visit Reason
The inspection was an unannounced complaint investigation triggered by an allegation that the facility did not prevent financial abuse of a resident by their roommate.
Complaint Details
The complaint alleged that Resident1 (R1) was financially abused by Resident2 (R2), who was allegedly R1's roommate, by feeding R1 sweets that were harmful due to R1's Diabetes. The investigation found that R1 had severe mental health issues, never had a roommate, and had a private room. The allegation was unsubstantiated.
Findings
The investigation included staff interviews, facility and resident records reviews, and a facility tour. The allegation was determined to be unsubstantiated as there was no preponderance of evidence to prove the violation occurred.
Report Facts
Complaint Control Number: 08-AS-20250210162803
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the unannounced complaint investigation visit. |
| Adrian Guillen | Executive Director | Met with the Licensing Program Analyst during the investigation. |
| Robyn Clark | Licensing Program Manager | Named in the report as Licensing Program Manager. |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jul 14, 2025
Visit Reason
The inspection visit was conducted to investigate a complaint alleging that staff did not prevent financial abuse of a resident by their roommate.
Complaint Details
The complaint alleged that Resident 1 was financially abused by Resident 2, their alleged roommate, who was feeding them sweets against medical advice for financial gain. The investigation found no evidence to support this claim and determined the allegation to be unsubstantiated.
Findings
The investigation included staff interviews, facility and resident records reviews, and a facility tour. The allegation was determined to be unsubstantiated due to lack of evidence, with findings confirming the resident had a private room and no roommate as alleged.
Report Facts
Complaint Control Number: 8
Complaint Control Number Full: 20250210162803
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report. |
| Adrian Guillen | Executive Director | Met with the Licensing Program Analyst during the investigation and was involved in the exit interview. |
| Robyn Clark | Supervisor | Supervisor overseeing the complaint investigation. |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jul 11, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that the licensee changed a resident's room without their consent and did not allow the resident to use their own transportation provider.
Complaint Details
The complaint alleged that the licensee changed a resident's room without consent and required the resident to use the facility's transportation service. The investigation found no preponderance of evidence to prove the violations occurred, resulting in an unsubstantiated finding.
Findings
The investigation included staff and resident interviews and record reviews. It was found that the resident had given verbal agreement to the room change while in a Skilled Nursing Facility, and the facility's contract allowed room substitution under certain conditions. The allegation regarding transportation was found to be false. The complaint was determined to be unsubstantiated due to lack of evidence.
Report Facts
Capacity: 219
Census: 103
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation visit |
| Adrian Guillen | Executive Director | Met with Licensing Program Analyst during investigation and provided information |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jul 11, 2025
Visit Reason
The inspection was an unannounced complaint investigation triggered by allegations that the facility changed a resident's room without their consent and did not allow the resident to use their own transportation provider.
Complaint Details
The complaint was unsubstantiated. Allegations included unauthorized room change and forced use of facility transportation. Investigation included interviews, record reviews, and emails. The resident had agreed verbally to the room change, and transportation was not mandated by staff.
Findings
The investigation found that the resident had given verbal agreement to the room change while in a Skilled Nursing Facility, supported by facility records and emails. The allegation regarding transportation was found to be false as residents were not required to use the facility's transportation services. The complaint was determined to be unsubstantiated due to lack of preponderance of evidence.
Report Facts
Capacity: 219
Census: 103
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation |
| Adrian Guillen | Executive Director | Facility representative interviewed during investigation |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jul 2, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that staff were not assisting a resident with obtaining necessary medical care.
Complaint Details
The complaint alleged that staff were not assisting Resident 1 with obtaining medical care. After investigation including interviews, observations, and records review, the allegation was found unsubstantiated due to insufficient evidence.
Findings
The investigation found that the allegation was unsubstantiated. The facility had a longstanding 10-mile transportation policy, which was reinstated without exception due to increased demand. Observations, interviews, and records confirmed staff continued to assist the resident within policy guidelines.
Report Facts
Capacity: 219
Census: 103
Complaint Control Number: 08-AS-20250225144112
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Renita Hall | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Adrian Guillen | Administrator | Facility administrator interviewed during investigation |
| Sabel Martinez | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jul 2, 2025
Visit Reason
An unannounced complaint investigation was conducted regarding an allegation that staff were not assisting a resident with obtaining necessary medical care.
Complaint Details
The complaint alleged that staff were not assisting Resident 1 with obtaining medical care. After interviews, observations, and records review, the allegation was found unsubstantiated.
Findings
The investigation found that staff continued to assist the resident within policy guidelines, and the allegation was unsubstantiated due to insufficient evidence. The facility had a transportation policy limiting services to a 10-mile radius, which was reinstated without exception.
Report Facts
Capacity: 219
Census: 103
Complaint Control Number: 08-AS-20250225144112
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Renita Hall | Licensing Program Analyst | Conducted the complaint investigation and unannounced visit |
| Adrian Guillen | Administrator | Facility administrator interviewed during investigation |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jun 19, 2025
Visit Reason
An unannounced complaint investigation was conducted due to an allegation that the facility did not provide a higher level of care for a resident.
Complaint Details
The complaint alleged the facility did not provide a higher level of care for Resident1. The investigation found that Resident1 had a fall resulting in a traumatic subdural hematoma and was receiving outside agency services. Facility management was actively working with the resident's responsible parties and primary care physician to ensure proper care. The allegation was unsubstantiated.
Findings
The investigation included staff and outside source interviews and record reviews. The allegation was determined to be unsubstantiated as evidence did not support that the facility failed to provide the appropriate level of care for the resident.
Report Facts
Complaint Control Number: 08-AS-20250612162956
Capacity: 219
Census: 103
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation |
| Adrian Guillen | Executive Director | Met with Licensing Program Analyst during investigation |
| Monica Maldonado | Resident Service Director | Met with Licensing Program Analyst during investigation |
| Jennifer Lott | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 103
Capacity: 219
Deficiencies: 0
Date: Jun 19, 2025
Visit Reason
An unannounced complaint investigation was conducted in response to an allegation that the facility did not provide a higher level of care for a resident.
Complaint Details
The complaint alleged the facility did not provide a higher level of care for Resident1. The allegation was found to be unsubstantiated based on evidence from interviews and record reviews.
Findings
The investigation included staff and outside source interviews and record reviews. It was found that the resident had a fall resulting in a traumatic subdural hematoma and was receiving outside agency services. Facility management was actively working with the resident's responsible parties and primary care physician to ensure proper care. The allegation was determined to be unsubstantiated.
Report Facts
Facility capacity: 219
Census: 103
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation |
| Adrian Guillen | Executive Director | Met with investigator and involved in exit interview |
| Monica Maldonado | Resident Service Director | Interviewed during investigation |
Inspection Report
Complaint Investigation
Census: 111
Capacity: 219
Deficiencies: 1
Date: Mar 12, 2025
Visit Reason
The inspection was conducted in response to a complaint received on 09/06/2024 alleging that the faucets in the women's restroom sinks in the facility's auditorium were not supplying hot water, among other allegations including contaminated food, unrepaired bathroom toilet, and unsanitary conditions.
Complaint Details
The complaint investigation was substantiated for the allegation that the facility did not ensure delivery of hot water to the women's restroom faucets in the auditorium. The issue was due to the hot water valve being turned off, likely by construction workers, and was fixed during the visit. Other allegations about contaminated food, unrepaired bathroom toilet, and unsanitary conditions were unsubstantiated.
Findings
The complaint regarding the lack of hot water in the women's restroom faucets was substantiated and corrected during the visit. Other allegations about contaminated food, unrepaired bathroom toilet, and unsanitary conditions were found to be unsubstantiated based on interviews, observations, and facility tour.
Deficiencies (1)
The facilities faucet used for hand washing were not providing hot water, posing a potential health risk to residents in care.
Report Facts
Capacity: 219
Census: 111
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met with Licensing Program Analyst during the investigation and involved in findings |
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation visit |
| Jennifer Lott | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 111
Capacity: 219
Deficiencies: 1
Date: Mar 12, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2024-09-06 alleging that the facility was not delivering hot water, served contaminated food, did not repair a bathroom toilet, and was unsanitary.
Complaint Details
The complaint investigation was substantiated for the allegation that staff did not ensure the facility was delivering hot water. The other allegations regarding contaminated food, unrepaired bathroom toilet, and unsanitary conditions were unsubstantiated.
Findings
The allegation that the women's restroom faucets in the auditorium were not producing hot water was substantiated and corrected during the visit. Allegations regarding contaminated food, unrepaired bathroom toilet, and unsanitary conditions were unsubstantiated based on staff and resident interviews and facility observations.
Deficiencies (1)
Facility faucets used for hand washing were not providing hot water, posing a potential health risk to residents.
Report Facts
Capacity: 219
Census: 111
Deficiencies cited: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Named in relation to the hot water deficiency and investigation |
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation visit |
| Jennifer Lott | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 111
Capacity: 219
Deficiencies: 3
Date: Mar 10, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that the facility was not maintained in good repair, not maintained at a comfortable temperature for residents, and not maintained sanitary.
Complaint Details
The complaint investigation was substantiated for allegations that the facility was not maintained in good repair, not maintained at a comfortable temperature, and not maintained sanitary. One allegation regarding malodorous conditions was unsubstantiated.
Findings
The investigation substantiated that the facility had multiple maintenance issues including non-working toilets, malfunctioning electric sliding doors, leaks in the ceiling, lack of hot water, and uncomfortable cold temperatures in common areas. Sanitary conditions were poor with brown water, dirt, and food crumbs observed. One allegation regarding malodorous conditions was unsubstantiated.
Deficiencies (3)
Facility ceiling, bathrooms, and sliding doors were not maintained in good repair, posing a potential risk to residents.
Facility common areas were not heated to a minimum of 68 degrees F, posing a potential health risk to residents.
Facility floors in bath, laundry, kitchen, dining, and auditorium areas were not maintained in a clean, sanitary, and odorless condition, posing a potential safety risk to residents.
Report Facts
Residents in care: 111
Total capacity: 219
Estimated Days of Completion: 30
Plan of Correction Due Date: Mar 31, 2025
Temperature observed: 60
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Administrator / Director | Met with Licensing Program Analyst during inspection and discussed findings |
| Kathryn Hubbard | Concierge | Participated in exit interviews and signed documents |
| Juliana Barfield | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report |
| Lizzette Tellez | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Complaint Investigation
Census: 111
Capacity: 219
Deficiencies: 3
Date: Mar 10, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that the facility was not maintained in good repair, not maintained at a comfortable temperature for residents, and not maintained sanitary.
Complaint Details
The complaint investigation was substantiated for allegations of poor maintenance, uncomfortable temperatures, and unsanitary conditions. One allegation of malodorous conditions was unsubstantiated.
Findings
The investigation substantiated that the facility had maintenance issues including non-working toilets, malfunctioning electric sliding doors, ceiling leaks, lack of hot water, and inadequate heating with temperatures as low as 60 degrees. Sanitary conditions were poor with brown water, dirt, and food crumbs observed. One allegation regarding malodorous conditions was unsubstantiated.
Deficiencies (3)
Facility ceiling, bathrooms, and sliding doors not maintained in good repair, posing potential risk to residents.
Facility did not maintain a comfortable temperature; common areas observed at 60 degrees F, posing potential health risk.
Facility floors in bath, laundry, and kitchen areas not maintained in a clean, sanitary, and odorless condition, posing potential safety risk.
Report Facts
Residents in care: 111
Total licensed capacity: 219
Estimated Days of Completion: 30
Plan of Correction Due Date: 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Director | Met with Licensing Program Analyst during investigation |
| Kathryn Hubbard | Concierge | Participated in exit interviews and signed documents |
| Juliana Barfield | Licensing Program Analyst | Conducted the complaint investigation visit |
| Lizzette Tellez | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Annual Inspection
Census: 114
Capacity: 219
Deficiencies: 0
Date: Feb 18, 2025
Visit Reason
The visit was an unannounced case management annual continuation inspection to continue the annual inspection commenced on January 25, 2025.
Findings
No deficiencies were cited during this continuation of the inspection. An exit interview was conducted and the report was discussed with the Executive Director.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met with during the inspection and discussed the report findings. |
| Debbie Correia | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Jennifer Lott | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Annual Inspection
Census: 114
Capacity: 219
Deficiencies: 0
Date: Feb 18, 2025
Visit Reason
The visit was an unannounced case management - annual continuation inspection to continue the annual inspection commenced on January 25, 2025.
Findings
During the visit, a continuation of resident and facility records reviews was conducted. No deficiencies were cited at this time.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met with during the inspection and discussed the report and licensing appeal rights. |
| Debbie Correia | Licensing Program Analyst | Conducted the unannounced visit and inspection. |
| Jennifer Lott | Supervisor | Supervisor named in the report. |
Inspection Report
Complaint Investigation
Census: 113
Capacity: 219
Deficiencies: 0
Date: Feb 13, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that the facility wrongfully evicted a resident, did not provide a refund, and staff did not report an injury to a resident's responsible party.
Complaint Details
The complaint investigation was unsubstantiated for all allegations: wrongful eviction, failure to provide a refund, and failure to report an injury to the resident's responsible party.
Findings
The investigation found insufficient evidence to substantiate the allegations. The resident was moved due to increased care needs and fee changes, not wrongful eviction. A refund was provided but the amount was disputed and unsubstantiated. Staff followed protocol regarding injury reporting, and there was no evidence the responsible party was not notified of a bruise.
Report Facts
Capacity: 219
Census: 113
Refund amount: 1687
Monthly fee: 4500
Late fee: 250
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Sabel Martinez | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Adrian Guillen | Executive Director | Facility Executive Director interviewed during investigation |
Inspection Report
Complaint Investigation
Census: 113
Capacity: 219
Deficiencies: 0
Date: Feb 13, 2025
Visit Reason
An unannounced complaint investigation was conducted following allegations that the facility wrongfully evicted a resident, did not provide a refund, and staff did not report an injury to a resident's responsible party.
Complaint Details
The complaint involved three allegations: wrongful eviction of a resident, failure to provide a refund, and failure to report an injury to the resident's responsible party. All allegations were investigated and found unsubstantiated due to lack of evidence.
Findings
The investigation found insufficient evidence to substantiate the allegations. The resident was re-assessed with increased level of care and fees, and the responsible party agreed to move the resident voluntarily. Refunds were provided as documented, and staff protocols for injury reporting were followed. All allegations were unsubstantiated.
Report Facts
Capacity: 219
Census: 113
Refund amount: 1687
Late fee: 250
Payment for May: 4500
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Sabel Martinez | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Adrian Guillen | Executive Director | Facility Executive Director interviewed during investigation |
| Lizzette Tellez | Supervisor | Supervisor overseeing the complaint investigation |
Inspection Report
Annual Inspection
Census: 117
Capacity: 219
Deficiencies: 0
Date: Jan 31, 2025
Visit Reason
An unannounced required One-Year Inspection was conducted to ensure substantial compliance with Title 22 regulations.
Findings
The Licensing Program Analyst conducted a review of resident, staff, and facility records and found all records to be complete and compliant. The Executive Director Certification and facility liability policy were current. Due to time constraints, the annual inspection will be completed at a later date.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met during inspection and involved in exit interview. |
| Debbie Correia | Licensing Program Analyst | Conducted the unannounced inspection visit. |
Inspection Report
Annual Inspection
Census: 117
Capacity: 219
Deficiencies: 0
Date: Jan 31, 2025
Visit Reason
Licensing Program Analyst Debbie Correia made an unannounced visit to conduct the required One-Year Inspection to ensure substantial compliance with Title 22 regulations.
Findings
Staff and resident records were reviewed and found to be complete and compliant. The Executive Director certification and facility liability policy were up to date. Due to time constraints, the annual inspection will be completed at a later date.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met during inspection and participated in exit interview |
| Debbie Correia | Licensing Program Analyst | Conducted the inspection visit |
Inspection Report
Follow-Up
Census: 114
Capacity: 219
Deficiencies: 1
Date: Oct 10, 2024
Visit Reason
An unannounced Case Management Visit was conducted to cite a deficiency identified during a separate complaint investigation regarding the facility's admissions agreement.
Complaint Details
The visit was a follow-up to a complaint investigation where the admissions agreement was found to contain problematic language. The deficiency was substantiated and cited.
Findings
The admissions agreement contained language waiving facility responsibility for safety and healthful equipment and accommodations, which posed a Personal Rights risk to residents. One deficiency was cited related to this issue.
Deficiencies (1)
Admission Agreements - The admission agreement shall not contain written agreements to waive facility responsibility or liability for the health, safety, or personal property of residents, or the provision of safe and healthful facilities, equipment and accommodations.
Report Facts
Residents in care: 115
Deficiencies cited: 1
Plan of Correction Due Date: Nov 7, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Iby Strong | Licensing Program Analyst | Conducted the inspection and cited the deficiency |
| Adrian Guillen | Executive Director | Met with Licensing Program Analyst during the visit |
| Simon Jacob | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 114
Capacity: 219
Deficiencies: 1
Date: Oct 10, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by complaints received on 2024-09-12 alleging that the licensee did not ensure the facility grounds were free of pests and that staff spoke to a resident in an inappropriate manner, as well as a complaint that the licensee did not keep appliances in good repair.
Complaint Details
The complaint investigation was conducted following allegations received on 2024-09-12. The allegations included pest infestation and inappropriate staff conduct, both of which were unsubstantiated. The complaint regarding appliances not being kept in good repair was substantiated. The investigation included interviews with residents, staff, and facility management, as well as review of records and observations.
Findings
The pest control and staff conduct allegations were unsubstantiated due to lack of evidence and inconsistent statements. However, the allegation regarding failure to keep appliances in good repair was substantiated, with evidence that 12 resident units had malfunctioning appliances posing a potential safety and personal rights risk.
Deficiencies (1)
Maintenance and Operation (a) the facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provisions of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
Report Facts
Resident units with malfunctioning appliances: 12
Residents served: 115
Total licensed capacity: 219
Current census: 114
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met with during the investigation and exit interview; involved in discussions regarding findings. |
| Iby Strong | Licensing Program Analyst | Conducted the complaint investigation and authored the report. |
| Simon Jacob | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation. |
Inspection Report
Follow-Up
Census: 114
Capacity: 219
Deficiencies: 1
Date: Oct 10, 2024
Visit Reason
An unannounced Case Management Visit was conducted to cite a deficiency identified during a separate complaint investigation regarding the facility's admissions agreement.
Findings
The admissions agreement contained language waiving facility responsibility for safety and healthful equipment and accommodations, which posed a Personal Rights risk to residents. A deficiency was cited per California Code of Regulations, Title 22.
Deficiencies (1)
Admission Agreements - The admission agreement shall not contain written agreements to waive facility responsibility or liability for the health, safety or the personal property of residents, or the provision of safe and healthful facilities, equipment and accommodations.
Report Facts
Residents in care: 115
Plan of Correction Due Date: Nov 7, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met with Licensing Program Analyst during the visit and named in findings |
| Iby Strong | Licensing Program Analyst | Conducted the unannounced Case Management Visit and cited the deficiency |
| Simon Jacob | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Census: 115
Capacity: 219
Deficiencies: 1
Date: May 6, 2024
Visit Reason
An unannounced complaint investigation was conducted due to an allegation that the licensee did not comply with the admission agreement, specifically regarding laundry services.
Complaint Details
The complaint was substantiated. The allegation was that the licensee did not comply with the admission agreement regarding laundry services. The investigation included interviews, records review, and a facility tour. The evidence supported the allegation.
Findings
The investigation found that the facility changed its admission agreement between 2021 and 2022 to include charges for personal laundry services, but did not have a monetary charge listed in the 2023 rate list. A written notice was sent to residents about charging for personal laundry starting March 1, 2024, but the notice lacked a resident signature section or language amending the admission agreement. The allegation was substantiated based on interviews and records review.
Deficiencies (1)
Licensee did not ensure that residents were provided with personal clothing laundry as part of the basic services, posing a potential personal rights risk to all 115 residents in care.
Report Facts
Census: 115
Total Capacity: 219
Deficiency Count: 1
Plan of Correction Due Date: May 17, 2024
Laundry Charge: 100
Laundry Charge: 200
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Met during the investigation and named in findings regarding laundry service deficiency |
| Rebecca A Ruiz | Licensing Program Analyst | Conducted the complaint investigation |
| Jennifer Lott | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 115
Capacity: 219
Deficiencies: 1
Date: May 6, 2024
Visit Reason
An unannounced complaint investigation was conducted due to an allegation that the licensee did not comply with the admission agreement, specifically regarding laundry services.
Complaint Details
The complaint was substantiated based on interviews, records review, and evidence that the licensee did not comply with the admission agreement regarding laundry services. The allegation was deemed substantiated.
Findings
The investigation found that the facility changed its admission agreement between 2021 and 2022 to include charges for personal laundry services, but did not have a monetary charge listed in the 2023 rate list. A written notice was sent to residents about charging for personal laundry starting March 1, 2024, without a resident signature or amendment to the admission agreement. The allegation was substantiated.
Deficiencies (1)
Licensee did not ensure residents were provided with personal clothing laundry as part of the basic services, violating CCR 87307(a)(3)(F).
Report Facts
Residents in care: 115
Facility capacity: 219
Plan of Correction due date: May 17, 2024
Charge for 1 load of laundry per week: 100
Charge for 2 loads of laundry per week: 200
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rebecca A Ruiz | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Adrian Guillen | Executive Director | Facility representative involved in the investigation and exit interview |
| Jennifer Lott | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 117
Capacity: 219
Deficiencies: 0
Date: Mar 15, 2024
Visit Reason
An unannounced complaint investigation was conducted in response to allegations including unlawful eviction, failure to provide medical attention, and failure to treat a resident with dignity.
Complaint Details
The complaint was investigated and determined to be unfounded, meaning the allegations were false, could not have happened, or lacked reasonable basis. The complaint was dismissed.
Findings
The investigation found that the allegations were unfounded based on facility records and interviews. The resident had sustained a fall and staff called 911 and transferred the resident to the hospital. The resident was resistant to medical care and prior attempts to assist were documented. The unlawful eviction allegation was previously investigated and dismissed.
Report Facts
Complaint Control Number: 08-AS-20240308160149
Facility Capacity: 219
Census: 117
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation |
| Adrian Guillen | Executive Director | Facility representative met during investigation |
Inspection Report
Complaint Investigation
Census: 117
Capacity: 219
Deficiencies: 0
Date: Mar 15, 2024
Visit Reason
An unannounced complaint investigation was conducted regarding allegations of unlawful eviction, failure to provide medical attention, and failure to treat a resident with dignity at Monte Vista Village Senior Living Facility.
Complaint Details
The complaint included allegations of unlawful eviction, failure to provide medical attention, and failure to treat a resident with dignity. The allegations were determined to be unfounded and the complaint was dismissed.
Findings
The investigation found the allegations to be unfounded based on facility records, staff and outside source interviews, and a prior investigation. The resident sustained a fall and received medical attention, and staff attempted to assist the resident despite resistance. The unlawful eviction allegation was previously investigated and dismissed.
Report Facts
Capacity: 219
Census: 117
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation |
| Adrian Guillen | Executive Director | Facility representative met during investigation |
| Simon Jacob | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 119
Capacity: 219
Deficiencies: 0
Date: Feb 9, 2024
Visit Reason
An unannounced complaint investigation was conducted following allegations of unlawful eviction and staff not providing assistance resulting in multiple falls at Monte Vista Village Senior Living Facility.
Complaint Details
The complaint investigation was triggered by allegations of unlawful eviction and staff not providing assistance resulting in multiple falls. The allegations were found unsubstantiated as the preponderance of evidence standard was not met.
Findings
The investigation found that the allegations of unlawful eviction and failure to provide assistance were unsubstantiated based on interviews, record reviews, and observations. Resident 1 was verbally informed of eviction but no 30-day notice was given; however, evidence showed non-compliance with facility policies and a change in condition. Staff and residents confirmed assistance was provided when needed.
Report Facts
Capacity: 219
Census: 119
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mark Mandel | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Monica Maldonado | Resident Services Director | Met with Licensing Program Analyst during investigation and received report |
| Adrian Guillen | Administrator | Facility administrator named in report header |
Inspection Report
Complaint Investigation
Census: 119
Capacity: 219
Deficiencies: 0
Date: Feb 9, 2024
Visit Reason
The visit was an unannounced complaint investigation triggered by allegations received on 2024-01-05 regarding unlawful eviction and staff not providing assistance resulting in multiple falls at Monte Vista Village Senior Living Facility.
Complaint Details
The complaint alleged unlawful eviction and failure of staff to provide assistance resulting in multiple falls. The investigation included interviews with residents and staff, record reviews, and observations. The allegations were found unsubstantiated as the preponderance of evidence standard was not met.
Findings
The investigation found the allegations unsubstantiated. Resident 1 was not given a formal 30-day eviction notice but was verbally informed of eviction due to non-compliance with facility policies. Interviews and record reviews did not support claims that staff failed to assist residents resulting in multiple falls.
Report Facts
Capacity: 219
Census: 119
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mark Mandel | Licensing Program Analyst | Conducted the complaint investigation visit |
| Monica Maldonado | Resident Services Director | Met with the evaluator during the investigation and received investigative findings |
| Adrian Guillen | Administrator | Facility administrator named in the report |
Inspection Report
Annual Inspection
Census: 121
Capacity: 219
Deficiencies: 0
Date: Jan 12, 2024
Visit Reason
The inspection was an unannounced required one-year inspection conducted by Licensing Program Analyst Amy Rodgers to evaluate compliance with licensing requirements at Monte Vista Village Senior Living Facility.
Findings
The facility was found to be in compliance with no deficiencies issued, though advisory notes were given. The inspection included a tour of the facility, review of resident and staff records, and verification of safety and sanitation measures. Residents were observed to be treated with dignity and there were sufficient staff on duty.
Report Facts
Hospice Waiver residents: 8
Non-ambulatory residents: 33
Bedridden residents: 8
Food supply duration (perishable): 2
Food supply duration (nonperishable): 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Facility representative who accompanied the Licensing Program Analyst during the inspection and acknowledged receipt of the report |
| Amy Rodgers | Licensing Program Analyst | Conducted the unannounced one-year inspection and authored the report |
| Denise Powell | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Annual Inspection
Census: 121
Capacity: 219
Deficiencies: 0
Date: Jan 12, 2024
Visit Reason
Licensing Program Analyst Amy Rodgers conducted an unannounced required one-year inspection of Monte Vista Village Senior Living to assess compliance with licensing regulations.
Findings
The facility was found to be in compliance with no deficiencies issued, though advisory notes were given. The environment was safe and sanitary, food and medication storage were proper, and residents were treated with dignity with sufficient staffing.
Report Facts
Hospice Waiver residents: 8
Non-ambulatory residents: 33
Bedridden residents: 8
Food supply duration (days): 2
Food supply duration (days): 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Guillen | Executive Director | Facility representative who accompanied the Licensing Program Analyst during the inspection and acknowledged receipt of the report |
| Amy Rodgers | Licensing Program Analyst | Conducted the unannounced one-year inspection |
| Denise Powell | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Census: 120
Capacity: 219
Deficiencies: 0
Date: Dec 26, 2023
Visit Reason
An unannounced complaint investigation visit was conducted in response to multiple allegations received on 03/09/2023 regarding medication administration, supervision, resident care, and staff behavior at Monte Vista Village Senior Living Facility.
Complaint Details
The complaint included allegations of unqualified staff dispensing medication, staff pre-pouring medications, failure to assist with medication as prescribed, lack of supervision resulting in resident AWOL, unmet incontinence and basic needs, and staff not treating residents with dignity. The investigation concluded these allegations were unsubstantiated.
Findings
The investigation found no substantiated evidence to support the allegations. Interviews, record reviews, and observations indicated that medication administration, resident supervision, incontinence care, basic needs assistance, and staff treatment of residents were appropriate and met regulatory standards.
Report Facts
Capacity: 219
Census: 120
Allegations: 7
Estimated Days of Completion: 0
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Nacole Patterson | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Monica Maldonado | Resident Services Director | Facility representative met during the investigation and exit interview |
Inspection Report
Complaint Investigation
Census: 120
Capacity: 219
Deficiencies: 0
Date: Dec 26, 2023
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations received on 2023-03-09 regarding unqualified staff dispensing medication, staff pre-pouring medications, lack of assistance with medication as prescribed, lack of supervision resulting in resident AWOL, unmet incontinence and basic needs, and staff not treating residents with dignity.
Complaint Details
The complaint investigation was unsubstantiated based on interviews, direct observations, and records review. Allegations included unqualified medication staff, improper medication handling, lack of supervision, unmet resident needs, and staff mistreatment. No evidence was found to prove the allegations.
Findings
The investigation, including interviews with staff, residents, and review of records, found no corroborating evidence to support the allegations. Staff were properly trained, medications were administered correctly, supervision and care needs were met, and no substantiated evidence of staff mistreatment was found. The allegations were determined to be unsubstantiated.
Report Facts
Facility capacity: 219
Resident census: 120
Complaint receipt date: Mar 9, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Nacole Patterson | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report |
| Monica Maldonado | Resident Services Director | Facility representative met during the investigation and exit interview |
| Lizzette Tellez | Supervisor | Supervisor overseeing the investigation |
| Paul Markovich | Administrator | Facility administrator named in the report |
Inspection Report
Complaint Investigation
Census: 124
Capacity: 219
Deficiencies: 1
Date: Sep 8, 2023
Visit Reason
The visit was conducted in response to an LIC624 Incident Report regarding a medication error where a resident received medications not prescribed to them.
Complaint Details
The visit was complaint-related, triggered by a medication error incident reported by the licensee. The incident was substantiated with evidence showing the staff did not administer medications as prescribed. No injury or serious illness resulted.
Findings
The investigation found that a staff member did not use the required labeled medication containers, resulting in a resident receiving another resident's medications. The affected resident did not suffer injury or serious illness. One deficiency was cited, and two technical violations were issued related to reporting requirements.
Deficiencies (1)
The licensee did not assist 1 of 124 residents with self-administered medications as needed, posing a potential health risk.
Report Facts
Residents present: 124
Total licensed capacity: 219
Deficiencies cited: 1
Technical Violations issued: 2
Plan of Correction due date: Oct 8, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Adrian Gullien | Executive Director | Met during the visit and involved in exit interview |
| Monica Maldonado | Resident Services Director | Met during the visit |
| Dang Nguyen | Licensing Program Analyst | Conducted the inspection and authored the report |
| Lizzette Tellez | Licensing Program Manager | Supervisor of the Licensing Program Analyst |
Inspection Report
Complaint Investigation
Census: 124
Capacity: 219
Deficiencies: 1
Date: Sep 8, 2023
Visit Reason
The visit was an unannounced Case Management – Incident inspection conducted in response to an LIC624 Incident Report regarding a medication error where a resident received medications prescribed to another resident.
Complaint Details
The visit was complaint-related, triggered by a medication error incident reported by the licensee. The incident was substantiated with evidence showing the medication error occurred but did not result in injury or serious illness.
Findings
The investigation found that a staff member did not use the required labeled medication containers, resulting in a resident receiving incorrect medications. The resident did not suffer injury or serious illness. One deficiency was cited, and a plan of correction was developed. Two technical violations related to reporting were also issued.
Deficiencies (1)
Licensee did not assist 1 of 124 residents with self-administered medications as needed/prescribed, posing a potential health risk.
Report Facts
Deficiencies cited: 1
Technical Violations issued: 2
Resident census: 124
Facility capacity: 219
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dang Nguyen | Licensing Program Analyst | Conducted the unannounced Case Management – Incident visit |
| Adrian Gullien | Executive Director | Met with Licensing Program Analyst during visit and exit interview |
| Monica Maldonado | Resident Services Director | Met with Licensing Program Analyst during visit |
| Lizzette Tellez | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Census: 128
Capacity: 219
Deficiencies: 0
Date: Jun 20, 2023
Visit Reason
An unannounced complaint investigation visit was conducted regarding allegations that the facility violated eviction procedures and a resident's personal rights related to notification of rate increases.
Complaint Details
The complaint was unsubstantiated based on evidence obtained, including interviews and record reviews. The allegations did not meet the preponderance of the evidence standard.
Findings
The investigation found sufficient evidence that the facility served the resident with a 30-day eviction notice and level of care increase notice, both appropriate and in accordance with Title 22 Regulations and the resident's Admission Agreement. The allegations were determined to be unsubstantiated.
Report Facts
Capacity: 219
Census: 128
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Pena | Licensing Program Analyst | Conducted the complaint investigation visit |
| Adrian Guillen | Executive Director | Met with Licensing Program Analyst during the investigation |
| Paul Markovich | Administrator | Facility administrator named in the report header |
| Simon Jacob | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 128
Capacity: 219
Deficiencies: 0
Date: Jun 20, 2023
Visit Reason
An unannounced complaint investigation visit was conducted regarding allegations that the facility violated eviction procedures and Resident 1's personal rights related to notification of rate increases.
Complaint Details
The complaint investigation was unsubstantiated based on interviews and record reviews, concluding that the allegations did not meet the preponderance of evidence standard.
Findings
The investigation found sufficient evidence that the facility served Resident 1 with a 30-day eviction notice and level of care increase notice in accordance with Title 22 Regulations and the resident's Admission Agreement. The allegations were determined to be unsubstantiated.
Report Facts
Capacity: 219
Census: 128
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Pena | Licensing Program Analyst | Conducted the complaint investigation visit |
| Adrian Guillen | Executive Director | Met with Licensing Program Analyst during the investigation |
| Paul Markovich | Administrator | Facility administrator named in the report |
| Simon Jacob | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Census: 117
Capacity: 219
Deficiencies: 0
Date: Feb 7, 2023
Visit Reason
An unannounced Case Management visit was conducted to provide technical assistance and education on updating the facility administrator's name on record with the Community Care Licensing Division.
Findings
No deficiencies were cited during the visit. The Licensing Program Analyst conducted a brief tour and observed staff and residents in care, providing technical assistance.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dang Nguyen | Licensing Program Analyst | Conducted the unannounced Case Management visit. |
| Jackie Comardo | Sales Director | Met with the Licensing Program Analyst to discuss the purpose of the visit and participated in the exit interview. |
Inspection Report
Census: 117
Capacity: 219
Deficiencies: 0
Date: Feb 7, 2023
Visit Reason
An unannounced Case Management visit was conducted by Licensing Program Analyst Dang Nguyen to provide technical assistance and education regarding updating the facility administrator's name on record with CCLD.
Findings
No deficiencies were cited during the visit. The Licensing Program Analyst conducted a brief tour, observed staff and residents, and provided technical assistance.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dang Nguyen | Licensing Program Analyst | Conducted the unannounced Case Management visit. |
| Jackie Comardo | Sales Director | Met with the Licensing Program Analyst to discuss the purpose of the visit and participated in the exit interview. |
Inspection Report
Original Licensing
Capacity: 219
Deficiencies: 0
Date: Aug 11, 2022
Visit Reason
The visit was conducted as part of a change of ownership application process and involved a telephone interview to verify the applicant/administrator's identification and understanding of California Code Title 22 Regulations.
Findings
The applicant and administrator demonstrated understanding of facility operation, admission policies, staffing requirements, restricted health conditions, general provisions, emergency preparedness, complaints and reporting, and pre-licensing readiness during the COMP II telephone interview.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Susan Zanca-Brown | Administrator | Named as facility administrator in relation to the licensing evaluation |
| Paul Markovich | Participant in COMP II telephone interview | |
| Jude De La Concepcion | Licensing Program Manager | Named as Licensing Program Manager |
| Bethany Hunter | Licensing Program Analyst | Named as Licensing Program Analyst who conducted the evaluation |
Inspection Report
Capacity: 219
Deficiencies: 0
Date: Aug 11, 2022
Visit Reason
The visit was an office evaluation related to a change of ownership application for the Residential Care Facility for the Elderly.
Findings
The applicant/administrator participated in a COMP II telephone interview to verify identification and confirm understanding of California Code Title 22 regulations, including facility operation, admission policies, staffing, health conditions, emergency preparedness, complaints, and pre-licensing readiness.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Susan Zanca-Brown | Administrator | Named as facility administrator in relation to the change of ownership application. |
| Paul Markovich | Participated in COMP II interview as applicant/administrator. | |
| Bethany Hunter | Licensing Evaluator | Conducted licensing evaluation and signed report. |
| Jude De La Concepcion | Supervisor | Named as supervisor on the report. |
Inspection Report
Original Licensing
Census: 110
Capacity: 219
Deficiencies: 0
Date: Jan 13, 2022
Visit Reason
An announced pre-licensing visit was conducted to observe the facility's compliance with Title 22, Division 6 regulations and the California health and safety code.
Findings
The facility was found to have proper furnishings, adequate linens, operational fire safety equipment, secured hazardous materials, and sufficient space for activities. The Resident Services Director's certificate had expired and was awaiting renewal.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Maricor Laus | Resident Services Director | Met with Licensing Program Analyst during the pre-licensing visit; certificate expired and awaiting renewal. |
Inspection Report
Original Licensing
Census: 110
Capacity: 219
Deficiencies: 0
Date: Jan 13, 2022
Visit Reason
An announced Pre-Licensing visit was conducted to observe the facility's compliance with Title 22, Division 6 regulations and the California health and safety code.
Findings
The facility was found to have proper furnishings, adequate linens, operational fire safety equipment, and sufficient space for activities. Some administrative details such as an expired administrator certificate were noted, but overall the facility met regulatory requirements.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Maricor Laus | Resident Services Director | Met with Licensing Program Analyst during the Pre-Licensing visit and participated in the exit interview. |
| Tiffany Holmes | Licensing Program Analyst | Conducted the announced Pre-Licensing visit and evaluation. |
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