Deficiencies (last 7 years)
Deficiencies (over 7 years)
4.6 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
15% worse than California average
California average: 4 deficiencies/yearDeficiencies per year
12
9
6
3
0
Occupancy
Latest occupancy rate
83% occupied
Based on a January 2026 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy rate over time
Inspection Report
Complaint Investigation
Census: 128
Capacity: 155
Deficiencies: 0
Date: Jan 15, 2026
Visit Reason
The visit was a follow-up on an SOC341 submitted by the facility to Community Care Licensing on 2025-12-31 regarding allegations of abuse towards a resident (R1). The facility was conducting an internal investigation and had scheduled a care conference to update the care plan for R1.
Complaint Details
The visit was triggered by allegations of abuse towards Resident (R1) as reported in an SOC341 submitted on 2025-12-31. The facility was investigating internally and had adjusted staff schedules as a precaution. No deficiencies were found.
Findings
No deficiencies were cited during this unannounced case management visit. The Licensing Program Analyst conducted interviews, observations, and gathered documents. An exit interview was conducted with the Administrator who acknowledged receipt of the report.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Candice Moses | Administrator | Met during the visit and participated in the exit interview. |
| Beatriz Cortez | Memory Care Director | Met during the visit. |
| Elias Magdaleno | Licensing Program Analyst | Conducted the inspection visit. |
| Victoria Bertozzi | Licensing Program Manager | Named in the report header. |
Inspection Report
Census: 127
Capacity: 155
Deficiencies: 0
Date: Dec 12, 2025
Visit Reason
The visit was an unannounced Case Management - Other inspection to gather further information regarding an Incident Report and subsequent Death Report received by Community Care Licensing on 6/26/2025 and 6/27/2025, and to follow up on a reported change of Administrator from Samuel Deguzman to Candice Moses.
Findings
No deficiencies were cited during this visit. The Licensing Program Analyst requested several documents to be submitted by 1/12/2025, including an active Administrator Certificate and personnel reports. An exit interview was conducted with the Executive Director.
Report Facts
Capacity: 155
Census: 127
Document submission deadline: Jan 12, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Candice Moses | Executive Director | Met with Licensing Program Analyst during the visit and involved in follow-up on administrator change |
| Samuel Deguzman | Administrator | Reported change of Administrator from Samuel Deguzman to Candice Moses |
| Elias Magdaleno | Licensing Program Analyst | Conducted the unannounced Case Management - Other visit |
| Victoria Bertozzi | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Annual Inspection
Census: 130
Capacity: 155
Deficiencies: 1
Date: Nov 18, 2025
Visit Reason
The inspection was an unannounced Required-1 Year annual inspection to evaluate the health and safety compliance of the facility and ensure regulatory adherence.
Findings
The facility was generally found to be in good condition with no immediate health, safety, or personal rights violations observed during the tour. However, 4 of 15 resident reappraisals were not conducted within the last 12 months, and documentation of physician visits or declination forms was missing in 4 of 15 files.
Deficiencies (1)
Reappraisals were not updated within the last 12 months in 4 of 15 resident records, posing a potential health, safety, or personal rights risk to persons in care.
Report Facts
Resident files reviewed: 14
Reappraisals not conducted within last 12 months: 4
Hospice waiver capacity: 25
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Christopher Arnhold | Licensing Program Analyst | Conducted the inspection and signed the report |
| Candice Moses | Administrator | Met with Licensing Program Analyst during inspection and reviewed report findings |
| Kimberley Mota | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 89
Capacity: 155
Deficiencies: 1
Date: Oct 16, 2025
Visit Reason
An unannounced complaint investigation was conducted regarding an allegation that staff did not dispose of residents' records properly.
Complaint Details
The complaint was substantiated based on evidence including photographs and observations that confidential resident documents were disposed of in unlocked dumpsters outside the facility.
Findings
The investigation substantiated that the facility did not dispose of confidential resident records in a secure manner, as waste containers and dumpsters were unlocked and accessible, posing a risk to resident confidentiality.
Deficiencies (1)
Licensee did not dispose of confidential resident records in a secure manner which poses a potential health, safety, or personal rights risk to persons in care.
Report Facts
Capacity: 155
Census: 89
Plan of Correction Due Date: Nov 14, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elias Magdaleno | Licensing Evaluator | Conducted the complaint investigation and authored the report |
| Tava Setareki | Business Office Director Specialist | Met with the Licensing Evaluator during the investigation |
| Samuel Deguzman | Administrator | Facility administrator named in the report |
| Victoria Bertozzi | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Census: 138
Capacity: 155
Deficiencies: 0
Date: Sep 22, 2025
Visit Reason
An unannounced complaint investigation was conducted based on allegations received regarding staff not assisting residents in a timely manner, facility sanitation and repair issues, and pest control concerns.
Complaint Details
The complaint was unsubstantiated as there was insufficient evidence to prove the alleged violations occurred.
Findings
The investigation found no evidence to substantiate the allegations of delayed staff assistance, unsanitary conditions, or pest issues. The facility is undergoing leadership changes and repairs to the call system, has purchased replacement laundry machines, and is actively addressing an ant problem with a pest control company.
Report Facts
Capacity: 155
Census: 138
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Christopher Arnhold | Licensing Program Analyst | Conducted the complaint investigation |
| Tamia Lindsay | Activity Director | Met with the Licensing Program Analyst during the investigation |
| Jasmine Seiffert | Administrator | Facility administrator named in the report |
| Kimberley Mota | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 138
Capacity: 155
Deficiencies: 0
Date: 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.
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.
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.
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
Date: Aug 11, 2025
Visit Reason
An unannounced complaint investigation was conducted regarding an allegation that staff were occupying residents' rooms without authorization.
Complaint Details
The allegation that staff were occupying residents' rooms without authorization was investigated and found to be unsubstantiated due to lack of preponderance of evidence.
Findings
The investigation found that a staff member was reported to have been caught sleeping in a resident room in May 2025, was reprimanded, and later quit employment. The facility does not allow staff to use resident rooms for breaks or sleeping. No evidence was found to substantiate the allegation, which was determined to be unsubstantiated.
Report Facts
Capacity: 155
Census: 96
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Christopher Arnhold | Licensing Program Analyst | Conducted the complaint investigation |
| Tamara Mason | Care Coordinator | Met with the Licensing Program Analyst during the investigation |
| Jasmine Seiffert | Administrator | Facility administrator named in the report |
Inspection Report
Complaint Investigation
Census: 96
Capacity: 155
Deficiencies: 0
Date: Aug 11, 2025
Visit Reason
An unannounced investigation was conducted in response to a complaint alleging that staff were occupying residents' rooms without authorization.
Complaint Details
The complaint was unsubstantiated due to lack of sufficient evidence to prove the alleged violation occurred.
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.
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
Date: Jul 29, 2025
Visit Reason
An unannounced complaint investigation was conducted in response to an allegation of neglect/lack of care and supervision received on 07/22/2025.
Complaint Details
The complaint allegation was neglect/lack of care and supervision. The allegation was determined to be unsubstantiated due to lack of preponderance of evidence.
Findings
The investigation found that Resident R1 was issued an eviction notice for refusing care and being aggressive. The facility has been updating R1's care plan and attempting to provide care when allowed. There was insufficient evidence to substantiate the allegation, resulting in an unsubstantiated finding.
Report Facts
Capacity: 155
Census: 141
Eviction notice date: Jun 19, 2025
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 |
Inspection Report
Complaint Investigation
Census: 141
Capacity: 155
Deficiencies: 0
Date: 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.
Complaint Details
The complaint was unsubstantiated due to lack of preponderance of evidence to prove the alleged violation occurred.
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.
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
Census: 141
Capacity: 155
Deficiencies: 0
Date: Jul 18, 2025
Visit Reason
The visit was an unannounced case management inspection conducted in response to an incident report submitted by the facility on 2025-06-02 involving a resident who contacted law enforcement and threatened harm to another resident.
Findings
The Licensing Program Analyst reviewed records and observed that the resident was able to leave the facility unassisted and had no recollection of the incident. The facility has been in constant contact with the resident's physician and responsible party, and the care plan is being updated as needed. No citations were issued during the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Beatriz Cortez | Assisted Living Care Coordinator | Met with Licensing Program Analyst during the case management visit and involved in review of incident records. |
| Jasmine Seiffert | Administrator/Director | Named as facility administrator/director. |
| Christopher Arnhold | Licensing Program Analyst | Conducted the case management visit. |
| Kimberley Mota | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Complaint Investigation
Census: 141
Capacity: 155
Deficiencies: 0
Date: 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.
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.
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.
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
Date: Jul 2, 2025
Visit Reason
An unannounced complaint investigation was conducted in response to allegations that a resident's room was not clean and sanitary.
Complaint Details
The complaint was unsubstantiated after observations, interviews, and record review. The resident was under a lawful 30-day eviction notice due to refusal to clean or allow cleaning of the room.
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.
Report Facts
Capacity: 155
Census: 141
Complaint Control Number: 21-AS-20250630103354
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Administrator | Met with Licensing Program Analyst during investigation |
| Elias Magdaleno | Licensing Evaluator | Conducted the complaint investigation |
| Victoria Bertozzi | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 141
Capacity: 155
Deficiencies: 0
Date: 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.
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.
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.
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
Date: Mar 10, 2025
Visit Reason
An unannounced complaint investigation was conducted due to an allegation that staff did not provide adequate supervision to a resident, resulting in multiple falls.
Complaint Details
The complaint alleged inadequate supervision of a resident leading to multiple falls. The allegation was found to be unsubstantiated based on the investigation, which included review of the resident's service plan, medication adjustments, and fall prevention measures.
Findings
The investigation reviewed records, observations, and statements regarding the resident's care and supervision. Despite the allegations, there was insufficient evidence to substantiate that staff failed to provide adequate supervision, and no citations were issued.
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 Evaluator | Conducted the complaint investigation |
| Kimberley Mota | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 144
Capacity: 155
Deficiencies: 0
Date: 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.
Complaint Details
Allegation that staff did not provide adequate supervision to resident in care resulting in multiple falls was investigated and found unsubstantiated.
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.
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
Date: Jan 29, 2025
Visit Reason
This was a required unannounced 1-year inspection visit to evaluate the facility's compliance with licensing regulations.
Findings
The facility was found to be in good condition with no deficiencies cited. The environment was safe and clean, with proper food supplies, emergency preparedness, and staff training documented. The fire safety features were operational and resident accommodations were appropriate.
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 | Accompanied Licensing Program Analyst during facility tour |
| Araceli Canela | Licensing Evaluator | Conducted the inspection |
| Kimberley Mota | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Annual Inspection
Census: 140
Capacity: 155
Deficiencies: 0
Date: 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
Date: Jan 17, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that staff do not respond to call bells in a timely manner and that resident hygiene needs were not being met.
Complaint Details
The complaint was unsubstantiated. Allegations included staff not responding timely to call bells and resident hygiene needs not being met. Records showed timely call responses and resident refusal of showers. No citations were issued.
Findings
The investigation found that call bell response times were generally within acceptable limits with no evidence of calls being answered up to an hour. Resident hygiene needs were not met due to resident refusal of showers. Both allegations were unsubstantiated based on interviews, observations, and record reviews.
Report Facts
Call bell response times: 14
Call bell response times: 11
Call bell response times: 14
Call bell response times: 3
Resident showers received: 10
Resident showers refused: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Executive Director | Met with Licensing Program Analyst during investigation |
| Araceli Canela | Licensing Evaluator | Conducted the complaint investigation |
| Kimberley Mota | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 142
Capacity: 155
Deficiencies: 0
Date: 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.
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.
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.
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
Date: 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.
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.
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.
Deficiencies (2)
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.
87303(a) Facility failed to keep R1's bedroom clean, safe, sanitary, and odor free, posing a potential risk to residents.
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
Date: 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 that staff training on dementia care and mandated reporting needed reinforcement. The facility terminated the involved staff member and submitted required reports. No citations were issued at this time, but additional documentation on dementia care plans was requested.
Report Facts
Residents with Dementia in Assisted Living: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Executive Director | Met with Licensing Program Analyst and involved in incident report |
| Araceli Canela | Licensing Program Analyst | Conducted the unannounced inspection and evaluation |
| Kimberley Mota | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Census: 132
Capacity: 155
Deficiencies: 0
Date: 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
Date: 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.
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.
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.
Deficiencies (2)
Facility personnel were not sufficient in numbers and competent to provide necessary supervision, resulting in residents R2 and R3 leaving the facility unassisted.
Facility was not clean and pest-free; mice were observed in a resident's room closet.
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
Date: May 10, 2024
Visit Reason
The inspection was conducted as part of a complaint investigation regarding the facility's failure to report several incidents and a death report for a resident to Community Care Licensing as 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. The reports were not submitted in November 2023 and prior to the new Executive Director's appointment.
Findings
The facility was found deficient for failing to report several incidents and a death report for resident R1 in November 2023, prior to the current Executive Director's tenure. This failure poses a potential risk to the health and safety of residents in care.
Deficiencies (1)
Failure to report several incidents and a death report for resident R1 to Community Care Licensing as required by CCR 87211(a)(1)(A).
Report Facts
Capacity: 155
Census: 130
Plan of Correction Due Date: May 17, 2024
Staff Training 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 Evaluator | Conducted the inspection and signed the report |
| Kimberley Mota | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 130
Capacity: 155
Deficiencies: 1
Date: 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.
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.
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.
Deficiencies (1)
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
Date: 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. The administrator took action, submitted required reports, conducted an internal investigation, and provided Mandated Reporter retraining for all staff.
Findings
No deficiencies were cited during the informal meeting. The administrator agreed to submit proof of training to Community Care Licensing.
Report Facts
Facility capacity: 155
Census: 127
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Administrator | Administrator of the Lodge at Glen Cove, involved in addressing the incident and actions taken |
| Kimberley Mota | Licensing Program Manager | Present at the informal meeting |
| Araceli Canela | Licensing Program Analyst | Present at the informal meeting and licensing evaluator |
Inspection Report
Census: 127
Capacity: 155
Deficiencies: 0
Date: 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
Date: 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.
Deficiencies (2)
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.
Criminal Record Clearance: Staff member was fingerprint cleared but not properly associated with the facility prior to working.
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
Census: 129
Capacity: 155
Deficiencies: 2
Date: Mar 4, 2024
Visit Reason
The visit was an unannounced case management visit to gather information and records regarding a self-reported incident involving staff and a resident, and to issue citations observed during a prior complaint investigation on 02/02/2024.
Complaint Details
The visit was partially related to a complaint investigation from 02/02/2024 where citations were observed but not issued due to time constraints. The complaint involved unsafe conditions and staff clearance issues.
Findings
Deficiencies were found related to accessible hazardous items to residents with dementia and staff fingerprint clearance issues. Items such as vitamins, a sharp knife, cleaning solution, and a hammer were found accessible to residents with dementia. Additionally, a staff member was working without being properly associated with the facility despite fingerprint clearance.
Deficiencies (2)
Care of Persons with Dementia: Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as cleaning supplies and disinfectants were accessible to residents with dementia.
Criminal Record Clearance: Staff member was working without proper association to the facility despite fingerprint clearance.
Report Facts
Deficiencies cited: 2
Plan of Correction Due Date: Mar 5, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Executive Director / Administrator | Met with Licensing Program Analyst during the visit and discussed deficiencies. |
| Araceli Canela | Licensing Program Analyst | Conducted the unannounced case management visit and complaint investigation. |
Inspection Report
Complaint Investigation
Census: 125
Capacity: 155
Deficiencies: 0
Date: Feb 2, 2024
Visit Reason
The visit was an unannounced case management inspection conducted during a complaint investigation to assess compliance and safety concerns at the facility.
Complaint Details
During the complaint investigation, staff S1 was found not associated with the facility as required, and residents R1 and R2 with dementia had unsafe items in their rooms. No citations were issued at this time.
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, and no citations were issued at this time.
Report Facts
Capacity: 155
Census: 125
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Executive Director/Administrator | Met with Licensing Program Analyst during inspection |
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation and inspection |
Inspection Report
Complaint Investigation
Census: 125
Capacity: 155
Deficiencies: 0
Date: 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.
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.
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.
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
Date: Jan 18, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that staff did not seek medical attention for a resident in a timely manner and that a resident was not adequately fed.
Complaint Details
The complaint involved 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 inadequately fed a resident. The first allegation was unsubstantiated and the second was unfounded.
Findings
The investigation found the first allegation unsubstantiated due to lack of preponderance of evidence, with documentation showing appropriate medical attention was given. The second allegation was found unfounded as the facility consistently provided adequate food and nutrition, and the complaint was dismissed.
Report Facts
Capacity: 155
Census: 131
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jasmine Seiffert | Administrator | Facility administrator met during the investigation |
| David Leibert | Licensing Program Analyst | Evaluator who conducted the complaint investigation |
Inspection Report
Complaint Investigation
Census: 131
Capacity: 155
Deficiencies: 0
Date: 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.
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.
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.
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
Date: Jan 13, 2024
Visit Reason
This was an unannounced annual inspection visit conducted to evaluate the facility's compliance with licensing requirements.
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 facility tour |
| Jasmine Seiffert | Administrator | Facility administrator named in the report |
| Kerry Hiratsuka | Licensing Evaluator | Conducted the inspection and signed the report |
| Troy Ordonez | Supervisor | Supervisor named in the report |
Inspection Report
Annual Inspection
Capacity: 155
Deficiencies: 0
Date: 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
Date: 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.
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.
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.
Deficiencies (1)
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).
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: 1
Date: Aug 3, 2023
Visit Reason
The visit was an unannounced case management inspection conducted during the course of a complaint investigation to assess changes in a resident's condition and compliance with care plan requirements.
Complaint Details
The visit was triggered by a complaint investigation concerning a resident (R1) whose condition had deteriorated without an updated care plan or appraisal as required by regulation. The deficiency was substantiated by observations and documentation.
Findings
The inspection found that a resident's condition had significantly changed since the initial placement, but the required updated appraisal and care plan reflecting this change had not been completed, resulting in a cited deficiency.
Deficiencies (1)
Failure to update the pre-admission appraisal to reflect significant changes in resident condition, specifically the need for substantial bed rest due to a pressure injury.
Report Facts
Capacity: 155
Census: 106
Deficiency count: 1
Plan of Correction Due Date: Aug 17, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Leibert | Licensing Program Analyst | Conducted the inspection and cited the deficiency |
| Grace Sandoval | Administrator | Facility administrator met during inspection |
Inspection Report
Complaint Investigation
Census: 106
Capacity: 155
Deficiencies: 0
Date: Aug 3, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that staff were not allowing a resident to have a visitor take the resident out of the facility.
Complaint Details
The complaint alleged staff were not allowing a resident to have a visitor take the resident out of the facility. The allegation was found to be unfounded after investigation and dismissed.
Findings
The investigation found that the allegation was due to a miscommunication regarding visitor access and was unfounded. Statements confirmed the complaint was a misunderstanding and not accurate, resulting in the complaint being dismissed.
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 | Met with Licensing Program Analyst during investigation |
Inspection Report
Complaint Investigation
Census: 106
Capacity: 155
Deficiencies: 0
Date: Aug 3, 2023
Visit Reason
An unannounced complaint investigation was conducted in response to an allegation that facility staff were not meeting residents' needs.
Complaint Details
The complaint alleged that staff left a resident in a wheelchair all day causing leg swelling. Statements from staff, witnesses, Home Health personnel, and the resident's Power of Attorney indicated appropriate care was provided. The allegation was unsubstantiated.
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 the facility was meeting the resident's needs. The complaint was determined to be unsubstantiated.
Report Facts
Capacity: 155
Census: 106
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Leibert | Licensing Program Analyst | Conducted the complaint investigation |
| Grace Sandoval | Administrator | Facility administrator met during investigation |
Inspection Report
Complaint Investigation
Census: 106
Capacity: 155
Deficiencies: 0
Date: 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.
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.
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.
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
Date: Aug 3, 2023
Visit Reason
The inspection was an unannounced complaint investigation triggered by an allegation that facility staff were not meeting residents' needs.
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.
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.
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
Date: Jul 6, 2023
Visit Reason
This was an unannounced complaint investigation visit triggered by a complaint received on 2023-05-18 regarding allegations of inadequate hygiene service, food service, call bell response, and facility disrepair.
Complaint Details
The complaint was unsubstantiated after investigation through multiple site visits, witness statements, and document reviews. Allegations included inadequate hygiene, food service, call bell response, and facility disrepair, but evidence did not prove these occurred.
Findings
The investigation found that while some allegations may be true, there was insufficient evidence to substantiate them. Food service was found to be adequate, call bell response was mostly timely, and the facility was clean and in good repair. No citations were issued.
Report Facts
Capacity: 155
Census: 105
Call response times: 1
Call response times: 1
Shower refusals: 4
Investigation visit time: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Grace Sandoval | Administrator | Met with during the investigation |
| David Leibert | Licensing Program Analyst | Conducted the complaint investigation |
Inspection Report
Complaint Investigation
Census: 105
Capacity: 155
Deficiencies: 0
Date: 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.
Complaint Details
The complaint was unsubstantiated after investigation through multiple site visits, witness statements, and document reviews. No citations were issued.
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.
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
Complaint Investigation
Census: 109
Capacity: 155
Deficiencies: 2
Date: Jun 5, 2023
Visit Reason
Unannounced Case Management - Incident visit conducted to review several incident reports involving resident safety and medication errors.
Complaint Details
Visit was complaint-related involving incidents of resident falls, medication errors, and resident leaving premises without staff knowledge. Substantiation status is not explicitly stated.
Findings
The facility failed to ensure resident R2's medication was administered correctly, resulting in two Fentanyl patches being applied simultaneously, and resident R1 left the facility without staff knowledge on multiple occasions, posing immediate health and safety risks. A civil penalty was assessed for repeated citation.
Deficiencies (2)
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.
Facility personnel were insufficient and not competent to meet resident needs; resident R1 left the facility without staff knowledge, posing immediate risk.
Report Facts
Civil penalty amount: 250
Deficiency citation count: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Grace Sandoval | Administrator | Met with Licensing Program Analyst during inspection and involved in incident interviews |
| Araceli Canela | Licensing Program Analyst | Conducted the unannounced Case Management - Incident visit and evaluation |
Inspection Report
Census: 109
Capacity: 155
Deficiencies: 2
Date: 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.
Deficiencies (2)
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.
Resident R1 left the facility on two occasions without staff knowledge or signing out, posing immediate risk to health and safety.
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
Date: Feb 7, 2023
Visit Reason
The inspection was an unannounced complaint investigation triggered by allegations that the facility did not provide assistance with resident care needs and failed to notify the resident's responsible party or properly address a resident's injury.
Complaint Details
The complaint investigation was substantiated. Allegations included failure to provide assistance with resident care needs and failure to notify the resident's responsible party or properly address the resident's injury.
Findings
The investigation substantiated that the facility failed to provide adequate assistance with oral care to a dementia resident and did not notify the resident's family or properly address the resident's arm injury, including failure to change bandages and lack of medical assessment documentation.
Deficiencies (2)
Facility failed to ensure resident R1 was assisted with their oral, self care needs and plan to ensure injuries are assessed.
Facility failed to report R1's arm injuries to family and Community Care Licensing within 7 days.
Report Facts
Capacity: 155
Census: 87
Plan of Correction Due Date: Feb 8, 2023
Plan of Correction Due Date: Feb 16, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Grace Sandoval | Administrator | Facility administrator involved in the investigation |
| Kimberley Mota | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Complaint Investigation
Census: 87
Capacity: 155
Deficiencies: 2
Date: 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.
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.
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.
Deficiencies (2)
Facility failed to ensure resident R1 was assisted with their oral, self care needs and plan to ensure injuries are assessed.
Facility failed to report R1's arm injuries to family and Community Care Licensing within 7 days.
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
Annual Inspection
Census: 83
Capacity: 155
Deficiencies: 0
Date: Dec 15, 2022
Visit Reason
The inspection was an unannounced Required - 1 Year annual inspection focused on Infection Control procedures and practices at the Residential Care Facility for the Elderly.
Findings
No deficiencies were cited during this inspection. Infection control practices were observed including COVID-19 precautions, PPE usage, and daily disinfection. A concern was noted regarding the delayed egress door alarm system not adequately alerting staff, and a plan was requested to address this by 12/16/2022. No fire safety hazards were observed and fire safety equipment was properly serviced.
Report Facts
Capacity: 155
Census: 83
Fire extinguisher service date: Dec 13, 2022
Deadline for updated records submission: Jan 10, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the inspection and made findings |
| Grace Sandoval | Administrator | Facility administrator mentioned as not available during visit |
| Cathy Villarreal | Marketing Director | Met with Licensing Program Analyst during inspection and exit interview |
Inspection Report
Complaint Investigation
Capacity: 155
Deficiencies: 2
Date: Dec 15, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations of untrained staff assisting residents and the facility not following COVID-19 procedures.
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.
Findings
Both allegations were substantiated based on corroborating statements and observations. The facility failed to ensure staff received required medication training and did not consistently enforce COVID-19 visitor screening protocols, posing health and safety risks to residents. An allegation of insufficient staffing was unsubstantiated.
Deficiencies (2)
Failure to comply with Department of Public Health and Department of Social Services COVID-19 guidelines, including inadequate visitor screening and hand sanitizing, posing immediate health and safety risks.
Personnel did not receive required on-the-job training or have related experience, specifically staff S2 lacked all required medication training prior to assisting residents.
Report Facts
Facility capacity: 155
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Evaluator conducting the complaint investigation |
| Nichole Kindred | Administrator | Facility administrator mentioned in report |
| Cathy Villareal | Marketing Director | Facility representative met during inspection |
Inspection Report
Complaint Investigation
Capacity: 155
Deficiencies: 2
Date: 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.
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.
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.
Deficiencies (2)
Failure to ensure COVID-19 procedures were followed, including visitor screening and hand sanitizing, posing an immediate health and safety risk to residents.
Personnel did not receive required on-the-job training or related experience, evidenced by staff assisting residents without completing medication training.
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
Date: 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
Follow-Up
Census: 98
Capacity: 155
Deficiencies: 0
Date: 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.
Complaint Details
The visit was triggered by a self-reported incident involving resident R2 who alleged inappropriate behavior by a male staff member during the night shift. The allegation was not substantiated as the resident later mentioned nothing regarding the matter and no other complaints were received.
Findings
No additional information was received regarding the incident, no complaints from other residents, 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 |
Inspection Report
Complaint Investigation
Census: 98
Capacity: 155
Deficiencies: 1
Date: Aug 9, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2022-04-18 alleging inadequate medication management at the facility.
Complaint Details
The complaint investigation was substantiated regarding inadequate medication management. Other allegations about unmet resident needs and call button response times were unsubstantiated.
Findings
The investigation substantiated the allegation that medication management was inadequate, specifically that staff initially failed to provide prescribed medication to a resident, posing an immediate health and safety risk. Other allegations regarding unmet resident needs and delayed call button responses were unsubstantiated.
Deficiencies (1)
Failure to ensure resident's medication was provided as prescribed, with staff initially reporting medication was unavailable when it was in fact present, posing an immediate health and safety risk.
Report Facts
Capacity: 155
Census: 98
Plan of Correction Due Date: Aug 10, 2022
Plan of Correction Training Proof Due Date: Aug 19, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Nichole Kindred | Administrator | Facility administrator responsible for submitting plan of correction |
| Grace Sandoval | Met with during inspection |
Inspection Report
Complaint Investigation
Census: 98
Capacity: 155
Deficiencies: 1
Date: 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.
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.
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.
Deficiencies (1)
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.
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
Date: 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
Complaint Investigation
Census: 90
Capacity: 155
Deficiencies: 0
Date: Jul 29, 2022
Visit Reason
The inspection visit was conducted unannounced to ensure the health and safety of residents following a self-reported fire incident on 07/28/2022 involving an air conditioning unit outside the building.
Complaint Details
The visit was triggered by a self-reported incident involving smoke and fire from an air conditioning unit. The complaint was investigated and found to have no deficiencies.
Findings
The fire was contained by staff using a fire extinguisher and confirmed by the Fire Department. No residents were harmed, and there was no structural damage to the affected resident apartment. The facility ventilated the apartment and offered relocation to residents during repairs. No deficiencies were cited during the inspection.
Report Facts
Capacity: 155
Census: 90
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Manuel Ferrer | Maintenance Director | Met with Licensing Program Analyst during inspection regarding the fire incident |
Inspection Report
Census: 90
Capacity: 155
Deficiencies: 0
Date: 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
Date: Jul 19, 2022
Visit Reason
The Licensing Program Analyst arrived unannounced to 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 a resident received medication as prescribed, resulting in a medication error involving two residents with the same first name. The facility took corrective actions including creating resident photo cards and staff training on medication administration.
Deficiencies (1)
Facility failed to ensure resident'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.
Report Facts
Deficiency Type: 1
Plan of Correction Due Date: Jul 20, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the follow-up visit and evaluation. |
| Grace Sandoval | Administrator | Met with Licensing Program Analyst during the visit. |
| Kimberley Mota | Supervisor | Supervisor overseeing the licensing evaluation. |
Inspection Report
Follow-Up
Census: 96
Capacity: 155
Deficiencies: 1
Date: 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.
Deficiencies (1)
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.
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
Date: Jun 21, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2022-01-10 regarding allegations that medication was accessible to residents and that staff were not adequately trained.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included medication being accessible to residents and inadequate staff training. No evidence or corroborating statements were found to support these allegations.
Findings
The Licensing Program Analyst conducted inspections and interviews, finding no evidence that medication was left accessible to residents or that untrained staff administered medication. Staff training records were current, and no corroborating statements supported the allegations. The complaints were determined to be unsubstantiated with no citations issued.
Report Facts
Capacity: 155
Census: 93
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Evaluator | Conducted the complaint investigation and authored the report |
| Kimberley Mota | Supervisor | Supervisor overseeing the complaint investigation |
| Grace Sandoval | Administrator | Facility administrator met during the inspection |
| Nichole Kindred | Administrator | Facility administrator listed in report header |
Inspection Report
Complaint Investigation
Census: 93
Capacity: 155
Deficiencies: 0
Date: 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.
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.
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.
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
Date: Jan 20, 2022
Visit Reason
The inspection was an unannounced Required - 1 Year annual inspection focused on Infection Control procedures and practices of this Residential Care Facility for the Elderly.
Findings
The inspection found that COVID-19 precaution signs and infection control practices were in place, including screening, PPE use, and cleaning protocols. Fire safety measures were also compliant with no hazards observed. No deficiencies were cited during this inspection.
Report Facts
PPE supply duration: 30
Fire extinguisher service date: Dec 27, 2021
Number of floors used: 3
Delayed egress time: 30
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Araceli Canela | Licensing Program Analyst | Conducted the inspection |
| Grace Sandoval | Administrator | Met with Licensing Program Analyst during inspection |
Inspection Report
Annual Inspection
Census: 90
Capacity: 155
Deficiencies: 0
Date: 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
Date: Oct 14, 2021
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by 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.
Complaint Details
The complaint investigation was substantiated for the allegation that staff did not safeguard resident's personal items. Other allegations about unexplained weight loss, hygiene assistance, and meal provision were unsubstantiated due to insufficient evidence.
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 unexplained weight loss, hygiene, and meal provision were unsubstantiated due to lack of sufficient evidence.
Deficiencies (1)
Failure to safeguard resident's personal items, specifically an electric shaver that was missing and reimbursed by the facility.
Report Facts
Reimbursement amount: 70
Capacity: 155
Census: 83
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Nichole Kindred | Administrator | Met with Licensing Program Analyst during investigation and provided explanations regarding the missing electric shaver |
| Araceli Canela | Licensing Program Analyst | Conducted the complaint investigation visit |
| Kimberley Mota | Supervisor | Supervisor overseeing the complaint investigation |
Inspection Report
Complaint Investigation
Census: 83
Capacity: 155
Deficiencies: 1
Date: 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.
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.
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.
Deficiencies (1)
Failure to safeguard resident's personal items, specifically an electric shaver that was missing and reimbursed by the facility.
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
Date: Aug 18, 2021
Visit Reason
The inspection was a Post Licensing unannounced 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 screening, infection control practices, PPE availability, and safety measures including fire extinguisher maintenance and water temperature regulation.
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 the Licensing Program Analyst during the inspection and provided information on infection control. |
Inspection Report
Census: 63
Capacity: 155
Deficiencies: 0
Date: 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
Date: 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
Date: 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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