Inspection Report
Annual Inspection
Census: 76
Capacity: 120
Deficiencies: 0
Aug 29, 2025
Visit Reason
The inspection was an unannounced required annual inspection conducted to ensure the health and safety of residents in care at the facility.
Findings
The inspection found no health, safety, or personal rights violations. Resident and personnel records were reviewed and found to have the required documentation and training. No deficiencies were cited as a result of the visit.
Report Facts
Residents on hospice: 4
Hospice waiver capacity: 15
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Angelique Doyle | Executive Director | Met with Licensing Program Analyst during inspection and mentioned in report |
| Cassie Yang | Licensing Program Analyst | Conducted the inspection and signed the report |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Census: 85
Capacity: 120
Deficiencies: 2
May 8, 2025
Visit Reason
The inspection visit was a case management visit conducted in relation to a separate inspection on the same date, focusing on deficiencies found regarding resident records and reporting.
Findings
The facility was unable to provide the Licensing Program Analyst with resident R1's complete centrally stored medication record and unusual incident/injury reports. Additionally, the facility and department lacked written records of R1's hospitalizations on December 9 and 10, 2024, which should have been reported within seven days.
Severity Breakdown
Type B: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to maintain a complete record of centrally stored prescription medications for resident R1 for at least one year. | Type B |
| Failure to submit written reports to the licensing agency regarding resident R1's hospitalizations within seven days of occurrence. | Type B |
Report Facts
Capacity: 120
Census: 85
Plan of Correction Due Date: May 22, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Angela Hood | Licensing Program Analyst | Conducted the inspection and cited deficiencies |
| Terry Ervin | Vice President of Operations | Met with Licensing Program Analyst during inspection |
| Angelique Doyle | Administrator | Facility administrator named in report header |
| Maribeth Senty | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 85
Capacity: 120
Deficiencies: 0
May 8, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations received on 2024-12-30 regarding medication mismanagement, unmet incontinence care needs resulting in infection, and unmet hygiene care needs at the facility.
Findings
Based on medication counts, interviews with residents, staff, and witnesses, and review of documentation, there was insufficient evidence to substantiate the allegations. No deficiencies were cited and the allegations were determined to be unsubstantiated.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff mismanaging medications, failing to meet residents' incontinence care needs resulting in infection, and failing to meet hygiene care needs. Despite some challenges in providing care to resident R1, evidence did not support the allegations.
Report Facts
Capacity: 120
Census: 85
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Angela Hood | Licensing Program Analyst | Conducted the complaint investigation and medication count |
| Terry Ervin | Vice President of Operations | Met with Licensing Program Analyst during investigation |
Inspection Report
Census: 87
Capacity: 120
Deficiencies: 1
Apr 16, 2025
Visit Reason
The inspection visit was a case management visit conducted in relation to a separate inspection on the same date, focusing on deficiencies related to document availability.
Findings
The facility was unable to provide requested resident and incident report documents on two occasions because they were locked in the Executive Director's storage, who was not present. Deficiencies were cited for failure to maintain readily available resident records as required by California regulations.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to maintain a separate, complete, and current resident record readily available to facility and licensing staff, evidenced by inability to provide requested documents on 04/08/2025 and 04/16/2025. | Type B |
Report Facts
Capacity: 120
Census: 87
Plan of Correction Due Date: Apr 30, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Angela Hood | Licensing Program Analyst | Conducted the inspection and signed the report |
| Lori Gales | Senior Health Services Director | Met with Licensing Program Analyst during inspection |
| Angelique Doyle | Administrator | Facility Administrator mentioned in report |
| Maribeth Senty | Licensing Program Manager | Named as Licensing Program Manager overseeing the inspection |
Inspection Report
Capacity: 120
Deficiencies: 0
Sep 13, 2024
Visit Reason
The visit was an unannounced case management visit to confirm orders for immediate exclusion of an individual from all facilities.
Findings
The facility was informed of an immediate exclusion order effective 09/13/2024, excluding individual S1 from working, living in, or having contact with clients. The facility was ordered to remove S1 from any contact with clients and not allow this employee to be physically present.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cassie Yang | Licensing Program Analyst | Conducted the unannounced case management visit. |
| Nancy Glensor | Concierge met with the Licensing Program Analyst during the visit. | |
| James Dial | Executive Director | Spoke with the Licensing Program Analyst by phone regarding the purpose of the visit. |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Annual Inspection
Census: 83
Capacity: 120
Deficiencies: 0
Jun 20, 2024
Visit Reason
The inspection was a required unannounced annual inspection utilizing the full care tool to evaluate the facility's compliance with licensing regulations.
Findings
The facility was found to be clean, safe, and in good repair with no deficiencies observed. File reviews showed required documents were complete, and the facility was in substantial compliance.
Report Facts
Residents on hospice services: 9
Hospice waiver capacity: 15
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Parvaneh Manouchehri | Executive Director | Met with Licensing Program Analyst during inspection and discussed transition of director role |
| Cassie Yang | Licensing Program Analyst | Conducted the inspection and met with Executive Director |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 83
Capacity: 120
Deficiencies: 0
Jun 20, 2024
Visit Reason
The visit was an unannounced annual inspection conducted to clear the Post-Licensing inspection in the system.
Findings
No citations were issued during this inspection. The Licensing Program Analyst met with the Executive Director and explained the purpose of the visit.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cassie Yang | Licensing Program Analyst | Conducted the annual inspection visit. |
| Parvaneh Manouchehri | Administrator/Executive Director | Met with Licensing Program Analyst during the inspection. |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Complaint Investigation
Capacity: 120
Deficiencies: 0
Feb 29, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations received on 2024-02-08 regarding staff CPR training, pest control, timely changing of residents, and staff smoking marijuana at the facility.
Findings
The investigation found that the allegation of staff not being CPR trained was unfounded as the facility ensures at least one CPR-trained staff member per shift. The allegations of pest presence, untimely changing of residents, and staff smoking marijuana were unsubstantiated due to lack of sufficient evidence. No deficiencies were cited during the visit.
Complaint Details
The complaint investigation addressed multiple allegations: 1) Staff are not CPR trained - found unfounded. 2) Staff did not ensure facility was free from pests - unsubstantiated. 3) Staff do not change residents timely - unsubstantiated. 4) Staff smoke marijuana at the facility - unsubstantiated.
Report Facts
Facility capacity: 120
Number of staff interviewed: 7
Number of residents interviewed: 1
Number of CPR and First Aid certifications reviewed: 10
Number of staff not CPR trained: 4
Number of staff statements received: 5
Number of staff statements received: 5
Number of staff statements received: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sarena Keosavang | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Pari Manouchehri | Executive Director | Met with Licensing Program Analyst during investigation |
| Troy Ordonez | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 83
Capacity: 120
Deficiencies: 0
Jul 28, 2023
Visit Reason
The inspection was an unannounced Case Management - Annual Continuation visit conducted to review resident files, medication administration, and staff training compliance.
Findings
The Licensing Program Analyst reviewed five resident files and five staff records, found medications properly stored and administered, and confirmed staff training compliance. No deficiencies were cited during the inspection.
Report Facts
Resident files reviewed: 5
Staff records reviewed: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Lori Gales | Senior Health Service Director | Met with Licensing Program Analyst during inspection |
| Sarena Keosavang | Licensing Program Analyst | Conducted the inspection |
| Anthony Perez | Licensing Program Manager | Named in report header |
Inspection Report
Annual Inspection
Census: 83
Capacity: 120
Deficiencies: 0
Jul 27, 2023
Visit Reason
The inspection was an unannounced Required-1 Year Annual Inspection conducted to evaluate the health and safety conditions of the facility and ensure compliance with regulations.
Findings
The inspection found no deficiencies; the facility was observed to be clean, sanitary, and in good repair with proper safety measures such as operable fire detectors and locked toxic supplies.
Report Facts
Hot water temperature: 115
Fire extinguisher last serviced: Jul 24, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Lori Gales | Senior Health Service Director | Met with Licensing Program Analyst during inspection |
| Sarena Keosavang | Licensing Program Analyst | Conducted the inspection |
| Anthony Perez | Licensing Program Manager | Named in report header |
Inspection Report
Annual Inspection
Census: 81
Capacity: 120
Deficiencies: 1
Jul 19, 2022
Visit Reason
The visit was an unannounced Required-1 Year Inspection focusing on infection control protocols at the facility.
Findings
During the inspection, Licensing Program Analysts observed kitchen staff and a contracted salon worker not wearing masks, posing an immediate health risk in a COVID-19 positive facility. Deficiencies were cited related to personnel requirements and infection control.
Deficiencies (1)
| Description |
|---|
| Facility kitchen staff preparing food without wearing a mask and a contracted worker giving a manicure without wearing a mask, posing a potential health, safety, or personal rights risk to residents. |
Report Facts
Capacity: 120
Census: 81
Plan of Correction Due Date: Jul 26, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Terence Ervin | Administrator | Facility administrator named in the report |
| Angelique Doyle | Executive Director | Met with Licensing Program Analysts during inspection |
| Anthony Perez | Licensing Program Manager | Supervisor named in relation to the inspection |
| Jacob Williams | Licensing Program Analyst | Licensing evaluator conducting the inspection |
Inspection Report
Complaint Investigation
Census: 89
Capacity: 120
Deficiencies: 4
Jun 15, 2022
Visit Reason
Unannounced complaint investigation visit conducted in response to multiple allegations including staff not preventing resident wandering, untimely response to residents' alerts, improper assistance with oxygen, and inadequate bedding for residents.
Findings
The investigation substantiated several allegations including failure to prevent a resident from wandering, untimely response to call buttons with response times up to 41 minutes, lack of oxygen safety signage, and inadequate bedding maintenance. Other allegations such as inappropriate staff comments, improper feeding, facility maintenance, staffing levels, and protection of residents' personal information were found unsubstantiated.
Complaint Details
The complaint investigation was triggered by allegations received on 2021-11-23 regarding staff failing to prevent resident wandering, delayed response to call buttons, improper oxygen assistance, and inadequate bedding. The investigation included interviews, facility tour, and record reviews. The allegations related to wandering, call button response, oxygen signage, and bedding were substantiated, while allegations about inappropriate comments, feeding, facility maintenance, staffing, and personal information protection were unsubstantiated.
Severity Breakdown
Type A: 1
Type B: 3
Deficiencies (4)
| Description | Severity |
|---|---|
| Failure to ensure adequate supervision of a resident with dementia resulting in elopement (AWOL). | Type A |
| Insufficient and untimely response to residents' call buttons, with response times reaching 41 minutes. | Type B |
| Failure to post 'No Smoking-Oxygen in Use' signs on apartment doors where oxygen is used. | Type B |
| Failure to provide clean and comfortable bedding, including replacement of soiled mattresses in resident rooms. | Type B |
Report Facts
Capacity: 120
Census: 89
Call button response time: 41
Plan of Correction Due Dates: Jun 16, 2022
Plan of Correction Due Dates: Jun 30, 2022
Plan of Correction Due Dates: Jul 7, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Michael Hood | Licensing Program Analyst | Conducted the complaint investigation and signed the report |
| Anthony Perez | Licensing Program Manager | Oversaw the complaint investigation |
| Angelique Doyle | Executive Director | Facility representative interviewed during investigation and exit interview |
Inspection Report
Complaint Investigation
Census: 77
Capacity: 120
Deficiencies: 0
May 4, 2022
Visit Reason
The visit was an unannounced Case Management follow-up on two theft unusual incident/injury reports submitted on 03/24/2022 involving a missing resident's wedding ring and chain, and reported fraudulent activity on a resident's bank account.
Findings
The Licensing Program Analyst toured the facility, interviewed the Executive Director who confirmed an internal investigation and police report were filed. No deficiencies were cited at this time.
Complaint Details
The visit was triggered by two theft-related incidents reported on 03/24/2022. The facility conducted an internal investigation and reported the theft to the Roseville Police Department (Police Report Number 2022-15099).
Report Facts
Police Report Number: 202215099
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Angelique Doyle | Executive Director | Interviewed regarding the theft incident reports |
| Lori Gales | Health Service Director | Met with Licensing Program Analyst during the visit |
| Sarena Keosavang | Licensing Program Analyst | Conducted the Case Management visit |
| Anthony Perez | Licensing Program Manager | Named in report header |
Inspection Report
Original Licensing
Census: 79
Capacity: 120
Deficiencies: 0
Jul 27, 2021
Visit Reason
The visit was an announced Pre-Licensing inspection related to the facility's change of ownership and readiness for licensing approval.
Findings
The facility was toured and found to have appropriate safety features, sufficient food supplies, and organized records. Fire clearance was approved, emergency supplies were observed, and the facility was deemed ready for licensing pending final approval by the Central Applications Unit.
Report Facts
Fire Clearance Capacity: 120
Hot Water Temperature: 105
Food Supply Duration: 7
Food Supply Duration: 2
Fire Extinguisher Service Date: Jul 8, 2021
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Terence Ervin | Executive Director | Met during the Pre-Licensing inspection and mentioned in the report |
| Praveen Singh | Licensing Program Analyst | Conducted the Pre-Licensing inspection |
| Angelique Doyle | Interim Executive Director | Met during the Pre-Licensing inspection and mentioned in the report |
Loading inspection reports...



