Most inspections found no deficiencies, and several complaint investigations were unsubstantiated, indicating the facility generally meets regulatory standards. The most recent report from July 22, 2025, was clean with no deficiencies noted, showing continued compliance. Earlier investigations found some substantiated issues related to medication management and resident care, including medication errors and failure to document timely medical attention, which posed immediate health risks. There was also a substantiated personal rights violation involving staff searching a resident’s belongings without permission, resulting in staff termination. The facility appears to have improved over time, with recent annual inspections free of deficiencies and no enforcement actions or fines listed in the available reports.
The inspection was an unannounced Required-1 Year annual inspection to evaluate the health and safety compliance of the facility.
Findings
No deficiencies or citations were observed or issued during the inspection. The facility was found to be clean, well-maintained, and compliant with health, safety, and licensing requirements. Resident and staff files contained required documentation, and emergency preparedness measures were in place.
An unannounced complaint investigation was conducted in response to allegations received on 2025-05-08 regarding staff allowing residents to be soiled, lack of privacy during showering, staff behavior posing risks, and staff stealing from residents.
Findings
The investigation found no evidence to support the allegations after reviewing records and interviewing residents and staff. The allegations were determined to be unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint investigation was unsubstantiated as no evidence was found to prove the alleged violations occurred.
Report Facts
Capacity: 108Census: 69
Employees Mentioned
Name
Title
Context
Christopher Arnhold
Licensing Program Analyst
Conducted the complaint investigation
Jennifer Hall
Administrator
Met with the Licensing Program Analyst during the investigation
An unannounced investigation was conducted in response to a complaint received on 2025-04-22 regarding alleged violations of residents' personal rights at the facility.
Findings
The investigation found no evidence to support the allegation that residents' personal rights were violated. Staff response times to pendant calls averaged 5 minutes or less, and interviews did not support claims that staff removed or restricted access to residents' pendants. The allegation was determined to be unsubstantiated.
Complaint Details
The complaint alleged violations of personal rights. The investigation was unannounced and included record reviews and staff interviews. The allegation was found to be unsubstantiated due to lack of preponderance of evidence.
An unannounced investigation was conducted in response to a complaint alleging sexual abuse at the facility.
Findings
The investigation found no evidence to support the allegation of sexual abuse. Interviews and record reviews indicated the allegation was unsubstantiated, with no indication of injury or abuse found.
Complaint Details
The complaint alleged sexual abuse. The investigation was unsubstantiated as no evidence was found to support the allegation.
An unannounced complaint investigation was conducted in response to an allegation that staff mismanaged a resident's medications.
Findings
The investigation found that a medication technician gave medication from the wrong resident's package but corrected the error by transferring the correct medication and securing the package. The technician was removed from medication duties for not following facility policies. The allegation was unsubstantiated due to insufficient evidence.
Complaint Details
The complaint alleged staff mismanaged resident's medications. The allegation was found to be unsubstantiated after investigation.
Report Facts
Facility capacity: 108
Employees Mentioned
Name
Title
Context
David Uballez
Executive Director
Met with Licensing Program Analyst during investigation
An unannounced complaint investigation was conducted due to an allegation that staff mismanaged a resident's medication.
Findings
The investigation found evidence that staff gave a resident more medication than prescribed and made errors by removing more medication from bubble packs than needed, then attempting to reseal them with tape. No medication was misplaced or missing. The allegation was substantiated.
Complaint Details
The complaint was substantiated based on evidence that staff mismanaged resident medication by giving more than prescribed and mishandling medication bubble packs.
Severity Breakdown
Type A: 1
Deficiencies (1)
Description
Severity
Licensee did not ensure resident received medications as ordered, posing an immediate health risk to persons in care.
Type A
Report Facts
Capacity: 108Census: 73Deficiencies cited: 1Plan of Correction Due Date: Oct 10, 2024
Employees Mentioned
Name
Title
Context
David Uballez
Executive Director
Met with Licensing Program Analyst during investigation and discussed findings
An unannounced complaint investigation was conducted based on a complaint received on 2024-06-25 alleging the facility failed to meet residents' care needs and failed to seek timely medical attention.
Findings
The investigation found that the facility failed to document care provided to a resident with a skin tear injury and did not ensure timely medical attention, resulting in an immediate health risk. The allegation was substantiated based on the preponderance of evidence.
Complaint Details
The complaint investigation was substantiated regarding failure to meet resident's care needs and failure to seek timely medical attention. The resident (R1) suffered a skin tear on 06/17/2024, and care documentation and physician notification were lacking. On 06/22/2024, the resident's injury worsened, requiring emergency personnel and hospital admission.
Severity Breakdown
Type A: 1
Deficiencies (1)
Description
Severity
Licensee did not ensure residents' medical needs were met, posing an immediate health risk to residents in care.
Type A
Report Facts
Capacity: 108Census: 80Deficiencies cited: 1Plan of Correction Due Date: Aug 21, 2024
Employees Mentioned
Name
Title
Context
David Uballez
Administrator
Met with Licensing Program Analyst during investigation and discussed findings
The inspection was an unannounced Required-1 Year annual inspection to evaluate compliance and licensing requirements at the facility.
Findings
No deficiencies were observed during the inspection, and no citations were issued. Resident and staff files were reviewed and found to be current and compliant with required documentation and training.
The visit was an unannounced Required-1 Year inspection to evaluate the health and safety conditions of the facility and ensure compliance with regulatory standards.
Findings
No immediate health, safety, or personal rights violations were observed. The facility was clean, well-maintained, and properly equipped with required safety devices and supplies. No citations were issued during the visit.
Report Facts
Capacity: 108Census: 73
Employees Mentioned
Name
Title
Context
David Uballez
Administrator
Met with Licensing Program Analyst during inspection
The visit was conducted due to a report of medication bubble packs being tampered with, specifically involving substitution of Oxycodone 5mg with Quetiapine in medication cards for multiple residents.
Findings
The investigation found that medication cards for 10 residents were tampered with, with Oxycodone replaced by Quetiapine. Additionally, a medication cart was found unsecured and unattended with medication present, posing an immediate risk to residents.
Complaint Details
The complaint involved tampering with medication bubble packs where Oxycodone 5mg was replaced with Quetiapine. The incident is under investigation by the Humboldt County Sheriff's Department.
Severity Breakdown
Type A: 1
Deficiencies (1)
Description
Severity
Centrally stored medication was unsecured with no staff supervision, posing an immediate risk to residents in care.
Type A
Report Facts
Residents with tampered medication cards: 10Residents present during observation of unsecured medication cart: 16Plan of Correction due date: Jan 22, 2024
Employees Mentioned
Name
Title
Context
Christopher Arnhold
Licensing Program Analyst
Conducted the case management visit and authored the report
Larona Farnum
Facility staff met during the visit and reviewed the report findings
Bethany Moellers
Licensing Program Manager
Supervisor named in the report and responsible for oversight
The visit was an unannounced case management visit conducted in response to two unexpected deaths that occurred at the facility.
Findings
The Licensing Program Analyst reviewed records and found that the facility had updated care plans and conducted safety checks for one resident who declined and later was found unresponsive. The facility appropriately contacted emergency personnel and made all required notifications. No citations were issued during this visit.
Employees Mentioned
Name
Title
Context
David Uballez
Administrator
Met with Licensing Program Analyst during the case management visit and involved in review of records related to unexpected resident deaths.
Christopher Arnhold
Licensing Program Analyst
Conducted the unannounced case management visit and reviewed facility records.
Unannounced visit/investigation of a complaint received on 07/20/2023 regarding staff entering a resident's room and searching through personal belongings.
Findings
Investigation found that a staff member searched through a resident's belongings without permission, substantiating the allegation. The resident's family did not find anything missing, and the staff member was terminated following an internal investigation.
Complaint Details
The complaint was substantiated based on interviews and video evidence showing staff searched resident's belongings without permission. The facility conducted an internal investigation resulting in termination of the staff member.
Severity Breakdown
Type A: 1
Deficiencies (1)
Description
Severity
Failure to ensure resident was granted privacy in their belongings, posing an immediate personal rights risk to residents in care.
Type A
Report Facts
Capacity: 108
Employees Mentioned
Name
Title
Context
David Uballez
Administrator
Met with Licensing Program Analyst during investigation and discussed findings
Christopher Arnhold
Licensing Program Analyst
Conducted the complaint investigation and authored the report
An unannounced annual required inspection was conducted to evaluate compliance with licensing regulations at the senior care facility.
Findings
The facility was found to be clean, well-maintained, and compliant with safety and food storage regulations. However, 6 of 7 staff records lacked documentation of required training hours, posing a potential health and safety risk.
Deficiencies (1)
Description
Licensee did not comply with training requirements in 6 of 7 staff records; records did not indicate staff received the required number of training hours including dementia care and other specified training.
Report Facts
Staff records non-compliance: 6Staff records reviewed: 7Resident records reviewed: 5Census: 78Total capacity: 108
Employees Mentioned
Name
Title
Context
David Uballez
Executive Director
Met with Licensing Program Analyst during inspection and discussed training requirements
An unannounced complaint investigation was conducted in response to allegations that facility staff were not answering phones in a timely manner and that the facility did not communicate to authorized representatives about changes in resident medical conditions.
Findings
The investigation found that phone calls after hours are handled by medication technicians, caregivers, or managers on duty, with voicemail as a backup. Responsible parties are notified immediately in emergencies and as needed for minor changes. There was insufficient evidence to substantiate the allegations, and no citations were issued.
Complaint Details
The complaint investigation was unsubstantiated due to lack of preponderance of evidence to prove the alleged violations occurred.
Report Facts
Capacity: 108Census: 75
Employees Mentioned
Name
Title
Context
David Uballez
Executive Director
Met with Licensing Program Analyst during investigation
An unannounced complaint investigation was conducted in response to an allegation that the facility was not following appropriate COVID protocols.
Findings
The investigation found no supporting evidence to substantiate the allegation. Staff were instructed to stay home if ill, and interviews with all staff present did not support the complaint. The allegation was determined to be unsubstantiated and no citations were issued.
Complaint Details
The complaint was unsubstantiated due to lack of preponderance of evidence to prove the alleged violations occurred.
Report Facts
Capacity: 108Census: 76
Employees Mentioned
Name
Title
Context
David Uballez
Executive Director
Met with Licensing Program Analyst during investigation
An unannounced complaint investigation was conducted following allegations received on 06/30/2022 regarding inadequate staffing, personal rights violations, and medication administration issues at the facility.
Findings
The investigation found no evidence to substantiate the allegations. Staffing levels and training were adequate, residents' needs were met, and medication was administered as prescribed. No citations were issued.
Complaint Details
The complaint was unsubstantiated due to lack of preponderance of evidence proving the alleged violations occurred.
Unannounced visit/investigation of a complaint received on 2022-04-05 regarding allegations of unexplained resident injury, failure to report injury, and rough handling by staff.
Findings
The investigation found that the resident's injury was due to a witnessed fall and was properly reported with an unusual incident report. There was no evidence supporting rough handling by staff. The allegations were unsubstantiated and no citations were issued.
Complaint Details
The complaint was unsubstantiated due to lack of preponderance of evidence to prove the alleged violations occurred.
Report Facts
Complaint Control Number: 21Capacity: 108Census: 72
Employees Mentioned
Name
Title
Context
Christopher Arnhold
Licensing Program Analyst
Conducted the complaint investigation and delivered findings
Larona Farnum
Administrator
Met with Licensing Program Analyst during investigation
Unannounced annual required infection control inspection focusing on the Infection Control procedures and practices of the facility.
Findings
The facility was found to be clean, with proper temperature and unobstructed exits. Infection control measures including PPE supplies, Covid Mitigation plan approval, and medication security were in place. No deficiencies or citations were found during the inspection.
Report Facts
Medication supply: 30
Employees Mentioned
Name
Title
Context
Larona Farnum
Administrator
Met with Licensing Program Analyst during inspection.
Christopher Arnhold
Licensing Program Analyst
Conducted the annual infection control inspection.
An unannounced annual required inspection was conducted focusing on the Infection Control procedures and practices of the facility.
Findings
The facility was found to be clean, with all safety equipment operational and food storage compliant. PPE supplies and COVID mitigation plans were in place. No deficiencies or citations were found during the inspection.
Report Facts
Medication supply: 30
Employees Mentioned
Name
Title
Context
Barbara Beck
Director of Care Services
Met with Licensing Program Analysts during inspection
Unannounced complaint investigation visit conducted due to allegations that facility staff did not safeguard resident's personal property and did not prevent residents from engaging in a physical altercation.
Findings
Based on interviews and record reviews, the facility followed regulations regarding resident property and prevention of resident assaults. There was no preponderance of evidence to substantiate the allegations, which were therefore deemed unsubstantiated. No citations were issued.
Complaint Details
The complaint investigation was unsubstantiated. Although the allegations may have happened or are valid, there was not sufficient evidence to prove the alleged violations did or did not occur.
Report Facts
Capacity: 108Census: 75
Employees Mentioned
Name
Title
Context
Christopher Arnhold
Licensing Program Analyst
Conducted the complaint investigation and delivered findings
Larona Farnum
Executive Director
Met with Licensing Program Analyst during the investigation
This visit was an unannounced complaint investigation conducted due to allegations that staff were not seeking proper medical attention for residents and were mishandling residents' medications.
Findings
The investigation found that the facility conducts assessments for residents who suffer injuries or report feeling unwell, follows emergency protocols, and staff adhere to physician orders and document correctly. The allegations were unsubstantiated due to lack of preponderance of evidence, and no citations were issued.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included failure to seek proper medical attention and mishandling of medications, but evidence did not prove violations occurred.
Report Facts
Facility capacity: 108
Employees Mentioned
Name
Title
Context
Christopher Arnhold
Licensing Program Analyst
Conducted the complaint investigation and delivered findings
Larona Farnum
Executive Director met with during the investigation
David Uballez
Administrator
Facility administrator named in the report
Bethany Moellers
Licensing Program Manager
Named as Licensing Program Manager on the report
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