Inspection Report Summary
Most inspections in recent years found no deficiencies, with several complaint investigations unsubstantiated. The most recent report from September 22, 2025, was clean, showing ongoing efforts to address minor maintenance and pest control issues without citations. Earlier reports included some substantiated deficiencies related to resident care, supervision, medication errors, and failure to report incidents, with the most serious events occurring between 2022 and 2024, including immediate health and safety risks and a civil penalty. The facility has shown improvement over time, with no deficiencies cited in the last two annual inspections and recent complaint investigations. Several complaints were unsubstantiated, and enforcement actions such as fines and staff terminations were limited and addressed promptly.
Deficiencies per Year
4
3
2
1
0
High
Moderate
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Complaint Investigation
Census: 138
Capacity: 155
Deficiencies: 0
Sep 22, 2025
Visit Reason
An unannounced investigation was conducted in response to a complaint alleging that staff did not assist residents in a timely manner, the facility was not sanitary and in good repair, and staff did not keep the facility free from pests.
Findings
The investigation found no evidence to substantiate the allegations. The call system was not fully operational but staff managed responses appropriately. The facility was addressing laundry machine repairs and pest control issues, including an ant problem with ongoing extermination efforts.
Complaint Details
The complaint was unsubstantiated based on interviews, observations, and record reviews. There was no preponderance of evidence to prove the alleged violations occurred.
Report Facts
Capacity: 155
Census: 138
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christopher Arnhold | Licensing Program Analyst | Conducted the complaint investigation |
| Kimberley Mota | Licensing Program Manager | Named in report as Licensing Program Manager |
| Tamia Lindsay | Activity Director | Met with Licensing Program Analyst during investigation |
| Jasmine Seiffert | Administrator | Facility Administrator named in report |
Inspection Report
Complaint Investigation
Census: 96
Capacity: 155
Deficiencies: 0
Aug 11, 2025
Visit Reason
An unannounced investigation was conducted in response to a complaint alleging that staff were occupying residents' rooms without authorization.
Findings
The investigation found no preponderance of evidence to support the allegation. A staff member was reported to have been caught sleeping in a resident room in May 2025, was reprimanded, and later quit. The facility does not allow staff to use resident rooms for breaks or sleep, and no evidence was found to substantiate the complaint.
Complaint Details
The complaint was unsubstantiated due to lack of sufficient evidence to prove the alleged violation occurred.
Report Facts
Complaint Control Number: 21
Complaint Control Number Full: 21-AS-20250729095017
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christopher Arnhold | Licensing Program Analyst | Conducted the complaint investigation |
| Tamara Mason | Care Coordinator | Met with Licensing Program Analyst during investigation |
| Jasmine Seiffert | Administrator | Facility administrator |
Inspection Report
Complaint Investigation
Census: 141
Capacity: 155
Deficiencies: 0
Jul 29, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to an allegation of neglect/lack of care and supervision received on 07/22/2025.
Findings
The investigation found that Resident 1 was issued an eviction notice for refusing care and being aggressive. The facility has been updating the care plan as needed and attempting to provide care when allowed. There was insufficient evidence to substantiate the allegation, resulting in an unsubstantiated finding.
Complaint Details
The complaint was unsubstantiated due to lack of preponderance of evidence to prove the alleged violation occurred.
Report Facts
Capacity: 155
Census: 141
Complaint Control Number: 21-AS-20250722102044
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christopher Arnhold | Licensing Program Analyst | Conducted the complaint investigation |
| Jasmine Seiffert | Executive Director | Met with Licensing Program Analyst during investigation |
| Kimberley Mota | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 141
Capacity: 155
Deficiencies: 0
Jul 18, 2025
Visit Reason
The inspection visit was an unannounced case management visit conducted in response to an incident report submitted by the facility on 2025-06-02 regarding a resident who contacted law enforcement and threatened harm to another resident.
Findings
The Licensing Program Analyst reviewed records and interviewed staff, confirming the resident was able to leave unassisted and had left the building during the incident. The facility has been in constant contact with the resident's physician and responsible party, updating the care plan as needed. No citations were issued during the visit.
Complaint Details
The visit was triggered by a complaint/incident report involving a resident who threatened physical harm to another resident and left the facility unassisted. The complaint was investigated and no citations were issued.
Report Facts
Incident report date: Jun 2, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Beatriz Cortez | Assisted Living Care Coordinator | Met with Licensing Program Analyst during the inspection and involved in reviewing records related to the incident |
| Christopher Arnhold | Licensing Program Analyst | Conducted the unannounced case management visit |
| Jasmine Seiffert | Administrator | Named as facility administrator |
Inspection Report
Complaint Investigation
Census: 141
Capacity: 155
Deficiencies: 0
Jul 2, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint alleging that a resident's room was not clean and sanitary.
Findings
The investigation found that the resident's room was observed to be unclean with a strong smell of urine and trash present, but the resident had continuously refused housekeeping services. Due to lack of preponderance of evidence, the complaint was determined to be unsubstantiated and no deficiencies were cited.
Complaint Details
The complaint alleged that a resident's room was not clean and sanitary, with a strong smell of urine, trash on the floor, unmade beds, and dirty dishes. The resident was under a lawful 30-day eviction notice due to refusal to allow cleaning. The complaint was found unsubstantiated.
Report Facts
Capacity: 155
Census: 141
Complaint Control Number: 21-AS-20250630103354
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elias Magdaleno | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Jasmine Seiffert | Administrator | Met with Licensing Program Analyst during the investigation |
| Victoria Bertozzi | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 144
Capacity: 155
Deficiencies: 0
Mar 10, 2025
Visit Reason
Unannounced complaint investigation visit conducted to investigate allegations that staff did not provide adequate supervision to a resident resulting in multiple falls.
Findings
The investigation found that although the resident had multiple falls and exhibited aggressive behavior, the facility followed medical and hospice orders, developed a fall prevention plan, and staff supervision was adequate according to service plans and interviews. The allegation was unsubstantiated due to lack of preponderance of evidence.
Complaint Details
Allegation that staff did not provide adequate supervision to resident in care resulting in multiple falls was investigated and found unsubstantiated.
Report Facts
Capacity: 155
Census: 144
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Executive Director/Administrator | Met with Licensing Program Analyst during investigation |
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation |
| Kimberley Mota | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Annual Inspection
Census: 140
Capacity: 155
Deficiencies: 0
Jan 29, 2025
Visit Reason
This was a required unannounced 1-year inspection conducted by the Licensing Program Analyst to evaluate the facility's compliance with regulations.
Findings
The facility was found to be in compliance with no deficiencies cited. The environment was safe and well-maintained, with proper food supplies, emergency preparedness, and staff training documented.
Report Facts
Apartments: 141
Fire extinguisher last charged date: Dec 10, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Executive Director/Administrator | Met with Licensing Program Analyst during inspection |
| Beatriz Cortez | Assisted Living Care Coordinator | Toured the facility with Licensing Program Analyst |
| Araceli Canela | Licensing Program Analyst | Conducted the inspection |
Inspection Report
Complaint Investigation
Census: 142
Capacity: 155
Deficiencies: 0
Jan 17, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2024-10-03 regarding staff response times to call bells and resident hygiene needs not being met.
Findings
The investigation found that most call bells were answered within 10 minutes, with no documentation supporting calls being answered up to an hour. Resident hygiene concerns were related to a resident refusing showers. Interviews and records did not substantiate the allegations, resulting in an unsubstantiated finding with no citations issued.
Complaint Details
The complaint involved allegations that staff do not respond to call bells in a timely manner and that resident hygiene needs were not being met. The investigation was unsubstantiated based on records, observations, and interviews.
Report Facts
Call response times: 14
Call response times: 11
Call response times: 14
Call response times: 3
Showers received: 10
Showers refused: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Kimberley Mota | Licensing Program Manager | Named in report as Licensing Program Manager |
| Jasmine Seiffert | Executive Director | Facility representative met during investigation |
Inspection Report
Complaint Investigation
Census: 139
Capacity: 155
Deficiencies: 2
Sep 27, 2024
Visit Reason
Unannounced visit/investigation of a complaint received on 2024-05-02 regarding neglect/lack of supervision resulting in resident's care needs not being met and the facility not being kept clean and sanitary.
Findings
The investigation substantiated the allegations that resident R1 was found with feces on their body and clothing soaked in urine, and the facility failed to keep R1 clean and dry and maintain a clean and sanitary environment. The facility did not meet R1's care needs and the room was found to have a strong urine odor and feces stains.
Complaint Details
Complaint investigation was substantiated based on observations and statements that resident R1 was neglected and the facility was not kept clean and sanitary. The resident was found with feces on their body and soaked in urine, and the room had strong urine odor and feces stains. The resident's family reported moving the resident out due to lack of care. Statements from the resident were not obtained due to dementia diagnosis.
Severity Breakdown
Type A: 1
Type B: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| 87464(d) Basic Services: Facility failed to ensure resident R1 was clean and dry and did not meet their needs, posing an immediate health, safety, or personal rights risk. | Type A |
| 87303(a) Facility failed to keep R1's bedroom clean, safe, sanitary, and odor free, posing a potential risk to residents. | Type B |
Report Facts
Capacity: 155
Census: 139
Plan of Correction Due Date: Oct 4, 2024
Plan of Correction Due Date: Oct 11, 2024
Plan of Correction Due Date: Sep 30, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Kimberley Mota | Licensing Program Manager | Oversaw the complaint investigation report |
| Jasmine Seiffert | Executive Director/Administrator | Facility representative met during investigation |
Inspection Report
Census: 132
Capacity: 155
Deficiencies: 0
Jul 23, 2024
Visit Reason
The visit was an unannounced case management inspection to review a recent incident involving inappropriate staff actions towards a Memory Care resident and to assess compliance with dementia care regulations.
Findings
The Licensing Program Analyst reviewed the incident report, interviewed involved staff and residents, and found the facility had terminated the staff member involved. The facility was reminded of dementia care regulations and requested to submit updated medical assessments and service plans for residents with dementia. No citations were issued at this time.
Report Facts
Residents with dementia in assisted living: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Executive Director | Met with Licensing Program Analyst regarding incident and facility operations |
| Araceli Canela | Licensing Program Analyst | Conducted the unannounced visit and reviewed incident and facility compliance |
| Kimberley Mota | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 132
Capacity: 155
Deficiencies: 2
Jul 23, 2024
Visit Reason
Unannounced complaint investigation visit conducted due to allegations of lack of care/supervision resulting in residents going AWOL and staff not keeping the facility free of pests.
Findings
The investigation substantiated that residents with dementia were placed in Assisted Living bedrooms without proper supervision, resulting in residents R2 and R3 leaving the facility unsupervised. Additionally, a pest issue involving mice was confirmed in a resident's bedroom. Another allegation regarding neglect resulting in a resident's severe injury was unsubstantiated.
Complaint Details
The complaint investigation was substantiated for allegations of lack of care/supervision resulting in residents going AWOL and failure to keep the facility free of pests. The allegation of neglect resulting in a resident sustaining falls with severe injury was unsubstantiated.
Severity Breakdown
Type A: 1
Type B: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility personnel were not sufficient in numbers and competent to provide necessary supervision, resulting in residents R2 and R3 leaving the facility unassisted. | Type A |
| Facility was not clean and pest-free; mice were observed in a resident's room closet. | Type B |
Report Facts
Civil Penalty: 500
Plan of Correction Due Date: Jul 31, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Executive Director | Met with Licensing Program Analyst during investigation and named in findings regarding supervision |
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation |
| Kimberley Mota | Licensing Program Manager | Oversaw complaint investigation |
Inspection Report
Complaint Investigation
Census: 130
Capacity: 155
Deficiencies: 1
May 10, 2024
Visit Reason
The inspection was conducted as a complaint investigation due to failure by the facility's Assisted Living Care Coordinator to report several incidents and a death report for resident R1 to Community Care Licensing as required.
Findings
The facility was found deficient for failing to report several incidents and a death report in November 2023, which is a potential risk to the health and safety of residents. A plan of correction and staff training were required.
Complaint Details
During the complaint investigation, it was discovered that the Assisted Living Care Coordinator failed to report incidents and a death report for resident R1 in November 2023. The deficiency was prior to the current Executive Director's tenure.
Deficiencies (1)
| Description |
|---|
| Failure to report several incidents and a death report for resident R1 to Community Care Licensing as required. |
Report Facts
Capacity: 155
Census: 130
Plan of Correction Due Date: May 17, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Executive Director/Administrator | Met with Licensing Program Analyst during inspection |
| Araceli Canela | Licensing Program Analyst | Conducted the inspection and signed the report |
| Kimberley Mota | Licensing Program Manager | Named as Licensing Program Manager and Supervisor |
Inspection Report
Census: 127
Capacity: 155
Deficiencies: 0
Apr 24, 2024
Visit Reason
The visit was an informal meeting conducted to address concerns regarding a self-reported incident by the facility on 2024-02-09 involving staff and a resident.
Findings
The administrator took action by submitting required reports, conducting an internal investigation, and providing Mandated Reporter retraining for all staff. No deficiencies were cited during the informal meeting.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Administrator | Administrator involved in addressing the self-reported incident and actions taken. |
| Kimberley Mota | Licensing Program Manager | Present at the informal meeting. |
| Araceli Canela | Licensing Program Analyst | Present at the informal meeting. |
Inspection Report
Census: 129
Capacity: 155
Deficiencies: 2
Mar 4, 2024
Visit Reason
The visit was an unannounced case management visit to gather information and records regarding a self-reported incident on 2024-02-09 involving staff and a resident, and to issue citations observed during a prior complaint investigation on 2024-02-02.
Findings
Deficiencies were found related to accessible hazardous items to residents with dementia and improper staff fingerprint clearance association to the facility. Items such as vitamins, a sharp knife, cleaning solution, and a hammer were accessible to residents with dementia, posing immediate risk. Staff fingerprint clearance was not properly associated with the facility as required.
Severity Breakdown
Type A: 1
Type B: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Care of Persons with Dementia: Over-the-counter medication, nutritional supplements, vitamins, toxic substances, and cleaning supplies were accessible to residents with dementia, posing immediate risk. | Type A |
| Criminal Record Clearance: Staff member was fingerprint cleared but not properly associated with the facility prior to working. | Type B |
Report Facts
Deficiencies cited: 2
Plan of Correction Due Date: 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Executive Director / Administrator | Met with Licensing Program Analyst during visit and involved in incident statement |
| Araceli Canela | Licensing Program Analyst | Conducted the case management visit and inspection |
| Kimberley Mota | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 125
Capacity: 155
Deficiencies: 0
Feb 2, 2024
Visit Reason
The visit was an unannounced complaint investigation conducted by the Licensing Program Analyst to address concerns regarding unauthorized staff and potentially unsafe items in residents' rooms.
Findings
The Licensing Program Analyst found a staff member not associated with the facility as required and discovered residents with dementia possessing potentially hazardous items such as vitamins, a sharp knife, and a hammer. Items were removed and made inaccessible, but no citations were issued at this time.
Complaint Details
The complaint investigation revealed unauthorized staff presence and unsafe items in residents' rooms. No citations were issued during this visit, but a return visit was planned to issue warranted citations.
Report Facts
Capacity: 155
Census: 125
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Executive Director/Administrator | Met with Licensing Program Analyst during the complaint investigation |
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation and found deficiencies |
Inspection Report
Complaint Investigation
Census: 131
Capacity: 155
Deficiencies: 0
Jan 18, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to complaints alleging that staff did not seek medical attention for a resident in a timely manner and that the facility ran out of food and served a resident a salad for dinner.
Findings
The investigation found the first complaint unsubstantiated due to lack of preponderance of evidence, with staff and documents indicating appropriate medical attention was given. The second complaint was found unfounded as the facility consistently provided adequate food and met nutritional standards.
Complaint Details
The complaint investigation addressed allegations that staff failed to seek timely medical attention for a resident exhibiting unusual behavior and high blood pressure, and that the facility ran out of food and served a salad for dinner. Both complaints were determined to be unsubstantiated or unfounded based on staff statements, document reviews, and site visits.
Report Facts
Capacity: 155
Census: 131
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Leibert | Evaluator / Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Jasmine Seiffert | Administrator | Facility administrator met during the investigation |
Inspection Report
Annual Inspection
Capacity: 155
Deficiencies: 0
Jan 13, 2024
Visit Reason
This was an unannounced annual inspection visit conducted to evaluate compliance with licensing requirements for the assisted living and memory care facility.
Findings
The inspection included a tour of the facility and review of staff and resident records. No deficiencies were cited, but several documents were required to be updated and submitted by 02/10/2024.
Report Facts
Capacity: 155
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Beatriz Cortez | Assisted Living Care Coordinator | Accompanied the Licensing Program Analyst during the inspection tour |
| Jasmine Seiffert | Administrator | Facility administrator named in the report |
| Troy Ordonez | Licensing Program Manager | Named as Licensing Program Manager |
| Kerry Hiratsuka | Licensing Program Analyst | Conducted the unannounced annual inspection |
Inspection Report
Complaint Investigation
Census: 106
Capacity: 155
Deficiencies: 1
Aug 3, 2023
Visit Reason
The inspection visit was an unannounced complaint investigation triggered by concerns about a resident's significant change in condition since initial placement.
Findings
The Licensing Program Analyst observed that Resident 1's condition had significantly deteriorated, requiring substantial bed rest due to a pressure injury, but the resident's care plan and appraisal had not been updated as required by regulation, resulting in a cited deficiency.
Complaint Details
The visit was complaint-related, investigating a significant change in Resident 1's condition that was not reflected in the care plan or appraisal. The deficiency was substantiated as the appraisal had not been updated.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to update Resident 1's pre-admission appraisal to reflect significant changes in condition, including the need for substantial bed rest due to a pressure injury, as required by regulation 87463(a). | Type B |
Report Facts
Capacity: 155
Census: 106
Deficiency count: 1
Plan of Correction Due Date: Due date for correction is 08/17/2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Leibert | Licensing Program Analyst | Conducted the complaint investigation and cited the deficiency |
| Carla Martinez | Licensing Program Manager | Supervisor overseeing the inspection |
| Grace Sandoval | Administrator | Facility administrator met during the inspection |
Inspection Report
Complaint Investigation
Census: 106
Capacity: 155
Deficiencies: 0
Aug 3, 2023
Visit Reason
An unannounced complaint investigation was conducted in response to a complaint alleging that staff did not allow a resident to have a visitor take the resident out of the facility.
Findings
The investigation found that the complaint was the result of a miscommunication regarding a visitor seeking to take a resident outside while remaining on facility premises. The allegation was determined to be unfounded and the complaint was dismissed.
Complaint Details
The complaint alleged that staff did not allow a resident to have a visitor take the resident out of the facility. The investigation found this allegation to be unfounded due to a miscommunication and confirmed by statements from the complainant.
Report Facts
Capacity: 155
Census: 106
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Leibert | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Grace Sandoval | Administrator | Facility administrator met with Licensing Program Analyst to discuss the complaint disposition |
Inspection Report
Complaint Investigation
Census: 106
Capacity: 155
Deficiencies: 0
Aug 3, 2023
Visit Reason
The inspection was an unannounced complaint investigation triggered by an allegation that facility staff were not meeting residents' needs.
Findings
The investigation found that although the allegation may be true or valid, there was not a preponderance of evidence to prove it. Staff complied with Home Health recommendations, and both Home Health personnel and the resident's Power of Attorney believe appropriate care is being provided. Therefore, the allegation was unsubstantiated.
Complaint Details
The complaint alleged that staff left a resident in a wheelchair all day causing leg swelling. The investigation included statements from staff, witnesses, and review of documents and multiple site visits. The allegation was determined to be unsubstantiated.
Report Facts
Complaint Control Number: 21
Complaint Control Number Suffix: 20230531082558
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Leibert | Evaluator / Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Grace Sandoval | Administrator | Facility administrator met with the evaluator to discuss the disposition |
Inspection Report
Complaint Investigation
Census: 105
Capacity: 155
Deficiencies: 0
Jul 6, 2023
Visit Reason
An unannounced complaint investigation visit was conducted following a complaint received on 2023-05-18 regarding allegations of inadequate hygiene service, food service, call bell response, and facility disrepair.
Findings
The investigation found that while some allegations may be true, there was insufficient evidence to substantiate them. Observations included refusal of showers by one resident on certain dates, generally timely call bell responses, fresh and nourishing food, and the facility being clean and in good repair.
Complaint Details
The complaint was unsubstantiated after investigation through multiple site visits, witness statements, and document reviews. No citations were issued.
Report Facts
Capacity: 155
Census: 105
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Leibert | Licensing Program Analyst | Conducted the complaint investigation and met with the Administrator |
| Grace Sandoval | Administrator | Facility Administrator met during the investigation |
Inspection Report
Census: 109
Capacity: 155
Deficiencies: 2
Jun 5, 2023
Visit Reason
An unannounced Case Management - Incident visit was conducted to review several incident reports submitted by the facility, including falls and medication errors involving residents.
Findings
The facility failed to ensure resident R2's medication was administered correctly, resulting in a medication error with two Fentanyl patches applied simultaneously. Resident R1 left the facility unsupervised on multiple occasions, posing an immediate health and safety risk. A civil penalty was assessed for repeated citation.
Severity Breakdown
Type A: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility failed to ensure R2's medication was given as prescribed; staff found 2 Fentanyl patches on resident at one time, posing immediate health and safety risk. | Type A |
| Resident R1 left the facility on two occasions without staff knowledge or signing out, posing immediate risk to health and safety. | Type A |
Report Facts
Civil penalty amount: 250
Deficiencies cited: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grace Sandoval | Administrator | Met with Licensing Program Analyst during visit and interviewed regarding incidents |
| Araceli Canela | Licensing Program Analyst | Conducted the unannounced Case Management - Incident visit and authored the report |
| Kimberley Mota | Licensing Program Manager | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Census: 87
Capacity: 155
Deficiencies: 2
Feb 7, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that the facility did not provide assistance with resident care needs and did not notify the resident's responsible party or properly address a resident's injury.
Findings
The investigation substantiated that the facility failed to provide adequate assistance with oral care and self-care needs to resident R1 and failed to notify the resident's family of an injury, with bandages left unchanged for several days without medical assessment. Deficiencies were cited related to resident care and reporting requirements.
Complaint Details
The complaint investigation was substantiated based on evidence that the facility did not provide assistance with resident care needs for Dementia resident R1 and failed to notify the resident's responsible party of an injury. The bandages on R1 were not changed for several days and there was no documentation of medical assessment.
Severity Breakdown
Type A: 1
Type B: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility failed to ensure resident R1 was assisted with their oral, self care needs and plan to ensure injuries are assessed. | Type A |
| Facility failed to report R1's arm injuries to family and Community Care Licensing within 7 days. | Type B |
Report Facts
Census: 87
Total Capacity: 155
Deficiency Type A Plan of Correction Due Date: Feb 8, 2023
Deficiency Type B Plan of Correction Due Date: Feb 16, 2023
Staff Training Due Date: Feb 14, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Kimberley Mota | Licensing Program Manager | Oversaw complaint investigation and signed report |
| Grace Sandoval | Administrator | Facility administrator met during investigation |
Inspection Report
Complaint Investigation
Capacity: 155
Deficiencies: 2
Dec 15, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 07/06/2022 regarding untrained staff assisting residents and the facility not following COVID-19 procedures.
Findings
The investigation substantiated that untrained staff assisted residents without completing required medication training and that the facility failed to follow COVID-19 procedures, including inadequate visitor screening and hand sanitizing, especially on weekends. An allegation of insufficient staffing was found unsubstantiated.
Complaint Details
The complaint investigation was substantiated for allegations of untrained staff assisting residents and failure to follow COVID-19 procedures. The allegation of insufficient staffing was unsubstantiated.
Severity Breakdown
Type B: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to ensure COVID-19 procedures were followed, including visitor screening and hand sanitizing, posing an immediate health and safety risk to residents. | Type B |
| Personnel did not receive required on-the-job training or related experience, evidenced by staff assisting residents without completing medication training. | Type B |
Report Facts
Capacity: 155
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Kimberley Mota | Licensing Program Manager | Oversaw the complaint investigation |
| Nichole Kindred | Administrator | Facility administrator involved in staffing statements |
| Cathy Villareal | Marketing Director | Met with Licensing Program Analyst during the visit |
Inspection Report
Annual Inspection
Census: 83
Capacity: 155
Deficiencies: 0
Dec 15, 2022
Visit Reason
The inspection was an unannounced Required - 1 Year annual inspection focused on Infection Control procedures and practices at this Residential Care Facility for the Elderly.
Findings
The facility demonstrated infection control practices including COVID-19 symptom screening, PPE supply, and cleaning protocols. However, the alarm on the 30 second delayed egress door in the memory care area was not loud enough to alert staff and did not send a signal to staff, requiring a plan to ensure staff are alerted. No deficiencies were cited during this inspection.
Report Facts
Capacity: 155
Census: 83
Fire Extinguisher Service Date: Dec 13, 2022
Records Submission Deadline: Jan 10, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grace Sandoval | Administrator | Named as facility administrator; not present during inspection |
| Cathy Villarreal | Marketing Director | Met with Licensing Program Analyst during inspection and exit interview |
| Araceli Canela | Licensing Program Analyst | Conducted the inspection |
| Kimberley Mota | Licensing Program Manager | Named in report header and footer |
Inspection Report
Complaint Investigation
Census: 98
Capacity: 155
Deficiencies: 1
Aug 9, 2022
Visit Reason
Unannounced complaint investigation visit conducted due to allegations of inadequate medication management, unmet resident needs, and untimely response to call buttons.
Findings
The allegation of inadequate medication management was substantiated, with evidence showing a medication was initially not provided due to staff error, posing an immediate health and safety risk. Allegations regarding unmet resident dietary needs and untimely call button responses were unsubstantiated due to lack of corroborating evidence.
Complaint Details
The complaint investigation was substantiated for inadequate medication management based on statements and record review. Allegations regarding unmet resident needs and delayed call button response were unsubstantiated.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure resident's medication was provided as prescribed, with staff initially reporting medication was unavailable when it was present, posing an immediate health and safety risk. | Type A |
Report Facts
Capacity: 155
Census: 98
Deficiencies cited: 1
Plan of Correction due date: Aug 10, 2022
Plan of Correction training due date: Aug 19, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Kimberley Mota | Licensing Program Manager | Named in report as Licensing Program Manager |
| Nichole Kindred | Administrator | Facility administrator involved in findings and plan of correction |
Inspection Report
Follow-Up
Census: 98
Capacity: 155
Deficiencies: 0
Aug 9, 2022
Visit Reason
The visit was an unannounced Case Management - Incident inspection to follow up on a self-reported incident involving a resident in memory care who made a comment about inappropriate behavior by a male staff member during the night shift.
Findings
The facility attempted to gather more information from the resident, who later did not mention the matter further. The facility notified the resident's family and Community Care Licensing. No other complaints were received and no citations were issued during this visit.
Report Facts
Staff during night shifts: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grace Sandoval | Administrator | Met with Licensing Program Analyst during the inspection |
| Beatrice Cortez | Care Coordinator | Spoke with Licensing Program Analyst regarding resident (R2) |
| Araceli Canela | Licensing Program Analyst | Conducted the unannounced Case Management - Incident inspection |
| Kimberley Mota | Licensing Program Manager | Named in report header |
Inspection Report
Census: 90
Capacity: 155
Deficiencies: 0
Jul 29, 2022
Visit Reason
The inspection visit was an unannounced case management incident inspection to ensure the health and safety of residents following a self-reported fire incident on 07/28/2022.
Findings
The facility staff observed and contained a fire involving an air conditioning unit outside the dining room window. The fire was extinguished without resident injury or structural damage. Smoke entered one resident apartment, which was ventilated and offered relocation for repairs. No deficiencies were cited during the inspection.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Manuel Ferrer | Maintenance Director | Met with Licensing Program Analyst during inspection and provided information about the incident and HVAC replacement. |
Inspection Report
Follow-Up
Census: 96
Capacity: 155
Deficiencies: 1
Jul 19, 2022
Visit Reason
The visit was an unannounced follow-up on a self-reported incident involving a medication error that occurred on 2022-03-10, where a staff member accidentally gave the wrong medication to a resident.
Findings
The facility failed to ensure that resident R1 received medication as prescribed when staff member S1 gave R1 medication intended for another resident with the same first name, posing an immediate health and safety risk. The facility implemented corrective actions including resident photo cards and staff training.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure R1's medication was given as prescribed when staff accidentally gave medication intended for another resident with the same name, posing an immediate health and safety risk. | Type A |
Report Facts
Capacity: 155
Census: 96
Deficiencies cited: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the follow-up inspection and authored the report |
| Grace Sandoval | Administrator | Met with Licensing Program Analyst during inspection and involved in incident report |
| Kimberley Mota | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 93
Capacity: 155
Deficiencies: 0
Jun 21, 2022
Visit Reason
The visit was an unannounced complaint investigation triggered by allegations received on 2022-01-10 regarding medication accessibility to residents and staff training adequacy.
Findings
The Licensing Program Analyst conducted inspections, observations, and interviews but found no evidence supporting the allegations. Medication was not left accessible to residents, and staff training records were current. The allegations were determined to be unsubstantiated.
Complaint Details
The complaint alleged medication was accessible to residents due to unlocked medication rooms or cabinets and that staff were not adequately trained, including medication techs handing out medication to untrained staff. The investigation found no corroborating evidence or statements to substantiate these claims. The allegations were unsubstantiated.
Report Facts
Capacity: 155
Census: 93
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Kimberley Mota | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
| Grace Sandoval | Administrator | Facility administrator met during the inspection |
| Nichole Kindred | Administrator | Facility administrator named in the report header |
Inspection Report
Annual Inspection
Census: 90
Capacity: 155
Deficiencies: 0
Jan 20, 2022
Visit Reason
The inspection was an unannounced Required - 1 Year annual inspection focused on Infection Control procedures and practices at this Residential Care Facility for the Elderly.
Findings
The inspection found that infection control practices were in place, including COVID-19 symptom screening, PPE usage, visitor vaccination verification, and daily cleaning and disinfection. Fire safety measures were also observed to be compliant with no hazards noted. No deficiencies were cited during this inspection.
Report Facts
Facility capacity: 155
Resident census: 90
Fire extinguisher service date: Dec 27, 2021
Inspection start time: 1353
Inspection end time: 1545
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grace Sandoval | Administrator | Met with Licensing Program Analyst during inspection |
| Araceli Canela | Licensing Program Analyst | Conducted the inspection |
| Kimberley Mota | Licensing Program Manager | Named in report header |
Inspection Report
Complaint Investigation
Census: 83
Capacity: 155
Deficiencies: 1
Oct 14, 2021
Visit Reason
An unannounced complaint investigation was conducted based on allegations that staff did not safeguard a resident's personal items, specifically an electric shaver, and other complaints regarding resident care including unexplained weight loss, hygiene assistance, and meal provision.
Findings
The allegation that staff did not safeguard the resident's personal items was substantiated, with evidence showing the resident's electric shaver was missing and the facility reimbursed the family $70. Other allegations regarding weight loss, hygiene, and meal provision were unsubstantiated due to lack of sufficient evidence.
Complaint Details
The complaint investigation was substantiated for the allegation that staff did not safeguard resident's personal items. Other allegations related to unexplained weight loss, hygiene care, and meal provision were unsubstantiated due to insufficient evidence.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to safeguard resident's personal items, specifically an electric shaver that was missing and reimbursed by the facility. | Type B |
Report Facts
Reimbursement amount: 70
Deficiency count: 1
Plan of Correction due date: Oct 30, 2021
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Nichole Kindred | Administrator | Met with Licensing Program Analyst during investigation |
| Kimberley Mota | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Census: 63
Capacity: 155
Deficiencies: 0
Aug 18, 2021
Visit Reason
The inspection was an unannounced Post Licensing visit focused on Infection Control procedures and practices at this Residential Care Facility for the Elderly.
Findings
No deficiencies were cited during this inspection. The facility demonstrated compliance with COVID-19 mitigation measures, infection control practices, and safety regulations including fire extinguisher maintenance and water temperature checks.
Report Facts
Residents in Memory Care: 37
Staff and resident surveillance testing: 25
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jill Nakagawa | Licensing Program Analyst | Conducted the Post Licensing Inspection. |
| Maggie Perri | Care Coordinator | Met with Licensing Program Analyst during inspection and participated in exit interview. |
| Kimberley Mota | Licensing Program Manager | Named in report header and signature section. |
Inspection Report
Original Licensing
Capacity: 155
Deficiencies: 0
Jan 12, 2021
Visit Reason
This was a prelicensing inspection conducted to evaluate the facility prior to licensing and to ensure compliance with regulations including fire clearance, safety, and COVID-19 protocols.
Findings
The facility was found to have no apparent safety hazards or concerns. All required safety equipment, emergency supplies, and COVID-19 precautions were in place and functioning. The facility met requirements for fire safety, medication security, and emergency preparedness.
Report Facts
Total apartments: 141
Nonambulatory residents capacity: 130
Bedridden residents capacity: 25
Hospice residents capacity: 25
Water temperature: 116
Emergency generator run time: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nichole Kindred | Administrator | Administrator present during inspection and waived Component III orientation |
| Jason Reyes | Licensee | Licensee met during inspection |
| Cathy Villareal | Marketing Director | Marketing Director met during inspection |
| Jason Simon | Maintenance Director | Maintenance Director met during inspection |
| Araceli Canela | Licensing Program Analyst | Conducted the prelicensing inspection |
| Bethany Moellers | Licensing Program Manager | Named as Licensing Program Manager |
Inspection Report
Original Licensing
Capacity: 155
Deficiencies: 0
Dec 17, 2020
Visit Reason
This was an initial licensing evaluation conducted via telephone call with the Community Care Licensing analyst to verify applicant and administrator understanding of Title 22 and facility operation requirements.
Findings
The applicant and administrator successfully completed the COMP II component, confirming understanding of licensing requirements including facility operation, staff qualifications, training, grievances, food service, and medication management. No deficiencies were noted.
Report Facts
Capacity: 155
Census: 0
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nichole Kindred | Administrator | Participant in COMP II and applicant/administrator for licensing |
| Jason Reyes | Managing Member | Participant in COMP II |
| Shannon Betker | Analyst | Community Care Licensing analyst conducting COMP II |
| Jude De La Concepcion | Licensing Program Manager | Named as Licensing Program Manager on report |
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