Deficiencies (last 6 years)
Deficiencies (over 6 years)
7.2 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
80% worse than California average
California average: 4 deficiencies/yearDeficiencies per year
16
12
8
4
0
Census
Latest occupancy rate
44% occupied
Based on a March 2026 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy over time
Inspection Report
Complaint Investigation
Census: 44
Capacity: 99
Deficiencies: 1
Date: Mar 12, 2026
Visit Reason
The inspection was an unannounced Case Management visit triggered by an incident report regarding a medication error involving Resident 1.
Complaint Details
The visit was complaint-related due to an incident report of a medication error. Resident 1 was given medication intended for Resident 2, transported to emergency care, but suffered no adverse effects. The facility was found noncompliant and will be cited.
Findings
The facility failed to comply with medication administration protocols when Medication Aid MA1 mistakenly gave medications intended for Resident 2 to Resident 1, posing an immediate health and safety risk. The facility has since changed procedures to involve three staff members reviewing After Visit Summaries for residents seen in emergency or primary care settings. The facility will be cited for this deficiency.
Deficiencies (1)
Medication prescribed for resident R2 was given to resident R1, posing an immediate health, safety or personal rights risk to persons in care.
Report Facts
Deficiencies cited: 1
Plan of Correction due date: Mar 13, 2026
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Carla Lua | Executive Director | Met during inspection and notified of medication error incident |
| Robert Frank | Licensing Program Analyst | Conducted the inspection and signed the report |
| Victoria Bertozzi | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 45
Capacity: 99
Deficiencies: 1
Date: Feb 4, 2026
Visit Reason
The inspection was an unannounced complaint investigation triggered by an allegation that staff did not provide requested records to a resident’s representative in a timely manner.
Complaint Details
The complaint alleged that staff did not provide requested records to a resident’s representative in a timely manner. The allegation was substantiated after investigation.
Findings
The investigation found that the facility did not comply with regulations requiring prompt access to resident records, as the requested documents were not provided within the regulated two business days. The allegation was substantiated based on interviews and record review.
Deficiencies (1)
Failure to provide requested records to resident’s representative within the regulated time frame, violating CCR 87468.2(a)(19).
Report Facts
Capacity: 99
Census: 45
Plan of Correction Due Date: Feb 6, 2026
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Robert Frank | Licensing Program Analyst | Conducted the complaint investigation and facility visit |
| Carla Lua | Executive Director | Facility Executive Director involved in the investigation and findings |
Inspection Report
Complaint Investigation
Census: 41
Capacity: 99
Deficiencies: 0
Date: Jan 29, 2026
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint alleging that the facility left a resident at the hospital.
Complaint Details
Complaint alleges facility left a resident at the hospital on 11/13/2025. The resident was transported back to the facility later the same day. The allegation was determined to be unsubstantiated.
Findings
The investigation found that although the allegation may have happened or is valid, there was not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation was unsubstantiated.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Carla Lua | Executive Director | Met with Licensing Program Analyst during complaint investigation and discussed findings. |
| Robert Frank | Licensing Program Analyst | Conducted the complaint investigation visit. |
Inspection Report
Complaint Investigation
Census: 41
Capacity: 99
Deficiencies: 0
Date: Jan 29, 2026
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation of unlawful eviction of a resident at the facility.
Complaint Details
Complaint alleged unlawful eviction of Resident R1. The allegation was unsubstantiated as no eviction notice was provided and the resident remained at the facility.
Findings
The investigation found that although the facility's Executive Director stated intent to terminate a resident's agreement without providing the required eviction notice, no eviction had taken place and the resident still resided at the facility. Therefore, the allegation was unsubstantiated due to lack of preponderance of evidence.
Report Facts
Capacity: 99
Census: 41
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Carla Lua | Executive Director | Met during investigation and named in eviction allegation |
| Robert Frank | Licensing Program Analyst | Conducted the complaint investigation |
Inspection Report
Complaint Investigation
Census: 36
Capacity: 99
Deficiencies: 0
Date: Nov 7, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations of insufficient staffing and failure to meet resident care needs at Vine Ridge Senior Living Facility.
Complaint Details
The complaint alleged insufficient staffing and failure to meet resident care needs. The investigation included multiple visits, interviews, and document reviews. The allegations were unsubstantiated.
Findings
The investigation found that staffing levels were adequate across all shifts to meet resident care needs, including those of a hospice resident requiring assistance with daily activities. The allegations were determined to be unsubstantiated due to lack of preponderance of evidence.
Report Facts
Staff counts per shift: 4
Staff counts per shift: 5
Staff counts per shift: 6
Staff counts per shift: 7
Staff counts per shift: 4
Staff counts per shift: 3
Staff counts per shift: 3
Investigation period: 30
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Robert Frank | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Alexis Short | Resident Care Coordinator | Met with Licensing Program Analyst during investigation and received report |
| Victoria Bertozzi | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Annual Inspection
Census: 36
Capacity: 99
Deficiencies: 1
Date: Oct 31, 2025
Visit Reason
The inspection visit was an unannounced continuation of a required 1 Year annual case management visit to evaluate compliance with licensing requirements.
Findings
The inspection found deficiencies related to staff training documentation, specifically one staff member lacking proof of annual training and another having only 9.75 hours of the required 20 hours. All other staff and resident files were compliant, and medications were properly stored and documented.
Deficiencies (1)
Staff member S1 had no proof of annual training in their file and staff member S3 had only completed 9.75 hours of the required 20 hours of annual training.
Report Facts
Residents in care: 36
Licensed capacity: 99
Staff training hours required: 20
Staff training hours completed: 9.75
Staff members reviewed: 7
Resident files reviewed: 7
Residents medication files reviewed: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Carla Lau | Administrator | Met with Licensing Program Analyst during inspection and named in report |
| Robert Frank | Licensing Program Analyst | Conducted the inspection and signed the report |
| Victoria Bertozzi | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 36
Capacity: 99
Deficiencies: 2
Date: Oct 31, 2025
Visit Reason
The inspection was an unannounced annual case management continuation visit to evaluate compliance with licensing requirements at Vine Ridge Senior Living Facility.
Findings
The inspection found deficiencies related to staff training documentation, specifically one staff member lacking proof of annual training and another with incomplete training hours. All other staff and resident documentation were found to be in compliance, and medications were properly stored and documented.
Deficiencies (2)
Staff member S1 had no proof of annual training in their file.
Staff member S3 had only 9.75 hours of the required 20 hours of annual training.
Report Facts
Residents in care: 36
Total licensed capacity: 99
Staff file sample size: 7
Resident file sample size: 7
Required annual training hours: 20
Staff member S3 training hours completed: 9.75
Plan of Correction due date: Nov 28, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Carla Lau | Administrator | Met with Licensing Program Analyst during inspection and named in report |
| Robert Frank | Licensing Program Analyst | Conducted inspection and signed report |
| Victoria Bertozzi | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 38
Capacity: 99
Deficiencies: 1
Date: Sep 5, 2025
Visit Reason
The inspection was an unannounced 1-Year Required annual inspection of Vine Ridge Senior Living Facility to evaluate compliance with licensing requirements.
Findings
The facility was generally clean, orderly, and compliant with safety and operational standards, including emergency preparedness and environmental safety. One deficiency was found regarding a staff member not cleared in the Guardian Background check system, resulting in a citation and civil penalty. The annual inspection was not completed and will continue at a later date.
Deficiencies (1)
Staff member S1 did not receive Guardian Background Clearance prior to employment at the facility.
Report Facts
Civil Penalty: 100
Residents in care: 38
Total capacity: 99
Hospice waiver capacity: 8
Hot water sample sinks: 9
Last disaster drill date: Jun 25, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Carla Lau | Administrator/Executive Director | Met with Licensing Program Analyst during inspection. |
| Alexis Short | Resident Care Coordinator | Accompanied Licensing Program Analyst during facility tour. |
| Robert Frank | Licensing Program Analyst | Conducted the inspection. |
| Victoria Bertozzi | Licensing Program Manager | Named in report as Licensing Program Manager. |
Inspection Report
Complaint Investigation
Census: 38
Capacity: 99
Deficiencies: 1
Date: Sep 5, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that the floor in the memory care dining/common area was in disrepair and posed a trip hazard to residents.
Complaint Details
The complaint was substantiated based on the preponderance of evidence standard. The allegation was that the physical plant was in disrepair, specifically the floor in the memory care dining/common area being a trip hazard.
Findings
The investigation substantiated the complaint, finding that a large portion of the memory care dining/common area floor was bubbled, loose, and raised, creating a safety risk. The facility administrator confirmed the floor had been in disrepair for approximately three months and plans to replace it during the weekend of 9/19/2025 to 9/21/2025.
Deficiencies (1)
A large portion of the floor in the memory care dining/common area was in disrepair with bubbled and loose flooring strips posing a potential health, safety or personal rights risk to persons in care.
Report Facts
Capacity: 99
Census: 38
Plan of Correction Due Date: Sep 9, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Robert Frank | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Carla Lau | Facility Administrator | Met with Licensing Program Analyst and provided information about the floor disrepair |
Inspection Report
Annual Inspection
Census: 38
Capacity: 99
Deficiencies: 1
Date: Sep 5, 2025
Visit Reason
The inspection was an unannounced 1-Year Required annual inspection of Vine Ridge Senior Living Facility to evaluate compliance with licensing requirements.
Findings
The facility was generally clean, orderly, and compliant with safety and operational standards, including emergency preparedness and environmental conditions. One deficiency was cited for a staff member not having completed the required Guardian Background Clearance prior to employment. Additionally, flooring in the memory care unit was found to be in disrepair and will be cited under a separate complaint. The annual inspection was not completed and will continue at a later date.
Deficiencies (1)
Staff member S1 did not receive Guardian Background Clearance prior to employment at the facility.
Report Facts
Civil Penalty: 100
Residents in care: 38
Total capacity: 99
Hospice waiver capacity: 8
Hot water sample size: 9
Disaster drill date: Jun 25, 2025
Fire extinguisher service date: 202410
Smoke and CO detector inspection date: 202502
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Carla Lau | Administrator/Executive Director | Met with Licensing Program Analyst during inspection and named in report. |
| Robert Frank | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Alexis Short | Resident Care Coordinator | Accompanied Licensing Program Analyst during facility tour. |
Inspection Report
Annual Inspection
Census: 26
Capacity: 99
Deficiencies: 0
Date: Oct 28, 2024
Visit Reason
The inspection was a Required - 1 Year unannounced visit conducted to evaluate compliance with licensing regulations for the assisted living facility, including review of resident and staff records, emergency plans, and facility conditions.
Findings
The facility was found to be clean, orderly, and compliant with regulations. All reviewed resident and staff records were complete, emergency disaster drills were held as required, and safety equipment was in place and functional. No deficiencies were cited during the visit.
Report Facts
Hospice care waiver approved residents: 8
Fire clearance capacity: 99
Bedridden fire clearance: 8
Emergency disaster drills last two dates: Drills held on April 19 and July 15, 2024
Emergency supplies duration: 72
Evacuation chairs: 3
Staff records reviewed: 5
Resident records reviewed: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alexis Short | Resident Care Coordinator | Met with Licensing Program Analyst during inspection and participated in exit interview |
| Dina Alviso | Licensing Evaluator | Conducted the inspection visit |
| Bethany Moellers | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Annual Inspection
Census: 26
Capacity: 99
Deficiencies: 0
Date: Oct 28, 2024
Visit Reason
The inspection was a Required - 1 Year unannounced visit to evaluate the licensed assisted living community, including the memory care unit, for compliance with state regulations.
Findings
The facility was found to be clean, orderly, and compliant with all reviewed requirements including resident and staff records, emergency plans, infection control, and medication storage. No deficiencies were cited during the visit.
Report Facts
Hospice care waiver residents: 8
Emergency disaster drills: 2
Fire clearance capacity: 99
Bedridden fire clearance: 8
Evacuation chairs: 3
Emergency shelter in place supply duration: 72
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alexis Short | Resident Care Coordinator | Met with Licensing Program Analyst during inspection and participated in exit interview |
Inspection Report
Complaint Investigation
Census: 24
Capacity: 99
Deficiencies: 0
Date: Sep 10, 2024
Visit Reason
An unannounced complaint investigation was conducted in response to allegations including resident injury, inadequate care and supervision, residents left in soiled clothing, unsafe environment, and unsafe transfer methods.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included resident injury due to lack of supervision, inadequate care and supervision, residents left in soiled clothing, unsafe environment, and unsafe transfer methods. No evidence was found to prove violations occurred.
Findings
The investigation found no preponderance of evidence to substantiate any of the allegations. All complaint allegations were determined to be unsubstantiated after review of records, interviews with staff and residents, and observations during the visit.
Report Facts
Capacity: 99
Census: 24
Residents in memory care unit: 9
Date complaint received: Jul 10, 2024
Date of resident fall incident: Jun 20, 2024
Date of report: Sep 10, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Marisol Cuadra | Licensing Program Analyst | Conducted the complaint investigation |
| Carla Lua | Acting Administrator | Met with Licensing Program Analyst during investigation |
| Bethany Moellers | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 24
Capacity: 99
Deficiencies: 0
Date: Sep 10, 2024
Visit Reason
An unannounced complaint investigation was conducted in response to allegations received on 2024-07-10 regarding resident injury, inadequate care and supervision, soiled clothing neglect, unsafe environment, and unsafe transfer methods at Vine Ridge Senior Living Facility.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included resident injury due to falls, inadequate supervision, neglect of continence care, unsafe environment due to recliners left open, and unsafe transfer methods. Interviews, record reviews, and observations did not support these allegations.
Findings
The investigation found no preponderance of evidence to substantiate any of the allegations. Each complaint, including resident injury, inadequate care and supervision, neglect of continence care, unsafe environment, and unsafe transfer methods, was determined to be unsubstantiated.
Report Facts
Facility capacity: 99
Resident census: 24
Complaint receipt date: Jul 10, 2024
Investigation visit date: Sep 10, 2024
Memory care residents: 9
Staff per shift: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Marisol Cuadra | Licensing Program Analyst | Conducted the complaint investigation |
| Bethany Moellers | Licensing Program Manager | Oversaw the complaint investigation report |
| Carla Lua | Acting Administrator | Met with Licensing Program Analyst during investigation |
| Angie Smith | Administrator | Facility administrator named in the report |
Inspection Report
Complaint Investigation
Census: 23
Capacity: 58
Deficiencies: 0
Date: Jul 11, 2024
Visit Reason
An unannounced complaint investigation was conducted following allegations that the facility did not have a certified administrator and that staff were not properly trained.
Complaint Details
The complaint was unsubstantiated. Allegations included lack of a certified administrator and improper staff training. Evidence showed the acting administrator was pending certification and staff training met regulatory requirements.
Findings
The investigation found that the acting administrator did not have a current administrator certificate but had applied and was pending certification. Staff training allegations were unsubstantiated as records and interviews showed sufficient staffing and required training compliance. No citations were issued during the visit.
Report Facts
Facility capacity: 58
Census: 23
Staff training compliance: 6
Caregiver training compliance: 4
Administrator certificate expiration: Oct 1, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Carla Lua | Acting Administrator | Met with Licensing Program Analyst during complaint investigation |
| Larona K Farnum | Interim Certified Administrator | Provided interim certification and confirmed presence at facility 15-20 hours per week |
| Marisol Cuadra | Licensing Program Analyst | Conducted the complaint investigation |
| Bethany Moellers | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 23
Capacity: 58
Deficiencies: 1
Date: Jul 11, 2024
Visit Reason
The Licensing Program Analyst conducted an unannounced case management visit to cite deficiencies discovered during a complaint investigation related to failure to notify the Department of a change of administrator within the required timeframe.
Complaint Details
Deficiencies were cited based on a complaint investigation regarding failure to notify the Department of the change of administrator within the required 30-day period. Appeal rights were given.
Findings
The licensee failed to notify the Department in writing within thirty days of hiring a new administrator in December 2023, which is a potential risk to the health and safety of residents. Deficiencies were cited under California Code of Regulations, Title 22, Division 6.
Deficiencies (1)
Licensee did not notify the Department in writing within thirty (30) days of hiring a new administrator as required by CCR 87211(g).
Report Facts
Capacity: 58
Census: 23
Deficiencies cited: 1
Plan of Correction Due Date: Jul 19, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Carla Lua | Administrator | Acting administrator met during inspection |
| Angie Smith | Administrator/Director | Named as facility administrator/director |
| Marisol Cuadra | Licensing Evaluator | Conducted the inspection and cited deficiencies |
| Bethany Moellers | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 23
Capacity: 58
Deficiencies: 0
Date: Jul 11, 2024
Visit Reason
The inspection was an unannounced complaint investigation conducted in response to allegations that the facility did not have a certified administrator and that staff were not properly trained.
Complaint Details
The complaint investigation was unsubstantiated. The allegation that the facility did not have a certified administrator was partially true but pending certification and interim coverage was provided. The allegation that staff were not properly trained was unsubstantiated due to lack of evidence.
Findings
The investigation found that the acting administrator did not have a current administrator certificate but had applied and was pending certification. An interim certified administrator was present part-time. The allegation regarding staff training was unsubstantiated as records and interviews showed staff had required training and sufficient coverage.
Report Facts
Facility capacity: 58
Census: 23
Hours interim administrator present: 15
Number of caregivers on shifts: 2
Number of caregivers on night shift: 2
Number of medication-trained staff: 6
Number of caregiver staff assisting dementia residents: 6
Number of caregiver staff with required training hours: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Marisol Cuadra | Licensing Program Analyst | Conducted the complaint investigation |
| Carla Lua | Administrator | Acting administrator met during investigation |
| Larona K Farnum | Interim Certified Administrator | Provided interim administrator coverage during investigation period |
| Bethany Moellers | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Complaint Investigation
Census: 23
Capacity: 58
Deficiencies: 1
Date: Jul 11, 2024
Visit Reason
The visit was an unannounced case management inspection conducted to cite deficiencies discovered during a prior complaint investigation.
Complaint Details
Deficiencies were cited based on a complaint investigation regarding failure to notify the Department of administrator change within the required timeframe.
Findings
The licensee failed to notify the Department in writing within thirty days of hiring a new administrator in December 2023, which is a regulatory violation and a potential risk to resident health and safety.
Deficiencies (1)
The licensee did not notify the Department of the change of administrator in writing within thirty (30) days of the hiring of a new administrator back in December 2023.
Report Facts
Capacity: 58
Census: 23
Plan of Correction Due Date: Jul 19, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Carla Lua | Administrator | Acting administrator met during inspection |
| Marisol Cuadra | Licensing Program Analyst | Conducted the inspection and cited deficiencies |
| Bethany Moellers | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Annual Inspection
Census: 19
Capacity: 58
Deficiencies: 1
Date: Oct 12, 2023
Visit Reason
An unannounced annual required inspection of the facility was conducted to evaluate compliance with licensing regulations and facility standards.
Findings
The facility was found to be clean, in good repair, and compliant with safety and health regulations in most areas. However, deficiencies were noted in staff training documentation, with 5 out of 5 staff records lacking verification of required training and orientation.
Deficiencies (1)
5 out of 5 staff records did not maintain verification of required staff training and orientation, posing a potential health, safety, or personal rights risk to persons in care.
Report Facts
Staff records lacking training documentation: 5
Resident records reviewed: 5
Plan of Correction due date: Nov 10, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Angie Smith | Executive Director | Met with Licensing Program Analysts during inspection and reviewed report findings. |
| Bethany Moellers | Supervisor | Supervisor overseeing the licensing evaluation. |
| Christi Coppo | Licensing Evaluator | Conducted the inspection and signed the report. |
| Chris Arnhold | Licensing Program Analyst | Conducted the inspection alongside Christi Coppo. |
Inspection Report
Annual Inspection
Census: 19
Capacity: 58
Deficiencies: 1
Date: Oct 12, 2023
Visit Reason
An unannounced annual required inspection of the facility was conducted to evaluate compliance with regulations and licensing requirements.
Findings
The facility was found to be clean, in good repair, and compliant with safety and food storage regulations. However, five out of five staff records reviewed did not contain documentation of completed training records as required, posing a potential health, safety, or personal rights risk to persons in care.
Deficiencies (1)
Licensee did not maintain in the personnel records verification of required staff training and orientation in 5 out of 5 staff records.
Report Facts
Staff records lacking training documentation: 5
Facility capacity: 58
Census: 19
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Angie Smith | Executive Director | Met with Licensing Program Analysts during inspection and reviewed report findings. |
| Bethany Moellers | Licensing Program Manager | Supervisor overseeing the inspection. |
| Christi Coppo | Licensing Program Analyst | Conducted the inspection and authored the report. |
Inspection Report
Complaint Investigation
Census: 20
Capacity: 58
Deficiencies: 2
Date: Sep 5, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2023-07-03 regarding failure to reassess resident needs and overcharging for care services.
Complaint Details
The complaint investigation was substantiated for overcharging a resident due to failure to reassess care needs after a significant change in condition. The allegation that staff did not provide resident with a copy of records in a timely manner was found to be unfounded.
Findings
The investigation substantiated that the facility overcharged a resident due to lack of documented reassessment following a significant change in condition as indicated by a physician's report. Another allegation regarding failure to provide timely copies of records was found to be unfounded.
Deficiencies (2)
Licensee did not ensure that a documented reassessment was completed following the 8/29/2022 Physician’s Report indicating a significant change in the resident’s condition.
Licensee did not ensure that their plan of operation was followed by changing care level fees to reflect services provided immediately following a resident’s significant change in condition.
Report Facts
Capacity: 58
Census: 20
Deficiencies cited: 2
Plan of Correction Due Date: Sep 29, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Christopher Arnhold | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Angie Smith | Executive Director | Met with Licensing Program Analyst during investigation |
| Bethany Moellers | Licensing Program Manager | Oversaw complaint investigation |
Inspection Report
Complaint Investigation
Census: 20
Capacity: 58
Deficiencies: 2
Date: Sep 5, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit conducted due to complaints alleging that the facility did not ensure needs were reassessed for a resident in care and that the facility overcharged a resident for care services.
Complaint Details
The complaint investigation was substantiated regarding overcharging a resident due to lack of documented reassessment after a significant change in condition. The complaint alleging failure to provide timely copies of records was found to be unfounded.
Findings
The investigation substantiated that the facility overcharged a resident for care services by not documenting a reassessment following a significant change in the resident's condition as indicated in the physician's report dated 8/29/2022. Another complaint alleging failure to provide a resident with a copy of records in a timely manner was found to be unfounded.
Deficiencies (2)
Licensee did not ensure that a documented reassessment was completed following the 8/29/2022 Physician’s Report indicating a significant change in condition.
Licensee did not ensure that their plan of operation was followed by changing care level fees to reflect services provided immediately following a resident’s significant change in condition.
Report Facts
Capacity: 58
Census: 20
Plan of Correction Due Date: Sep 29, 2023
Deficiency Count: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Angie Smith | Executive Director | Met with Licensing Program Analyst during complaint investigation and named in findings |
| Christopher Arnhold | Licensing Program Analyst | Conducted the complaint investigation |
| Bethany Moellers | Supervisor | Supervisor overseeing the complaint investigation |
Inspection Report
Complaint Investigation
Census: 23
Capacity: 58
Deficiencies: 1
Date: Jan 17, 2023
Visit Reason
The inspection was an unannounced complaint investigation conducted in response to multiple allegations including failure to follow Covid protocols, failure to follow resident's care plan, reporting requirements, and neglect/lack of supervision resulting in resident elopement.
Complaint Details
The complaint investigation addressed allegations of failure to follow Covid protocols, failure to follow resident's care plan, failure to meet reporting requirements, and neglect/lack of supervision resulting in resident elopement. The Covid protocol allegation was substantiated; the care plan and reporting allegations were unsubstantiated; and the neglect/elopement allegation was unfounded.
Findings
The complaint that the facility was not following Covid protocols was substantiated with observation of staff not wearing masks. The allegations that staff were not following a resident's care plan and reporting requirements were unsubstantiated. The allegation of neglect/lack of supervision resulting in resident elopement was found to be unfounded with no deficiencies cited.
Deficiencies (1)
LPA observation that 2 of 7 staff did not have a mask on while in common areas of the facility, violating government orders requiring face coverings.
Report Facts
Facility capacity: 58
Census: 23
Deficiencies cited: 1
Plan of Correction due date: Jan 23, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Angie Smith | Administrator | Met with Licensing Program Analyst during complaint investigation and discussed findings |
| Victoria Bertozzi | Licensing Program Analyst | Conducted the complaint investigation |
| Hope DeBenedetti | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 23
Capacity: 58
Deficiencies: 1
Date: Jan 17, 2023
Visit Reason
The inspection was an unannounced complaint investigation conducted in response to multiple allegations including failure to follow Covid protocols, failure to follow resident's care plan, reporting requirements, and neglect/lack of supervision resulting in resident eloping the facility.
Complaint Details
The complaint investigation was substantiated for failure to follow Covid protocols, unsubstantiated for failure to follow resident's care plan and reporting requirements, and unfounded for neglect/lack of supervision resulting in resident eloping the facility.
Findings
The complaint that the facility was not following Covid protocols was substantiated with observations of staff not wearing masks. The allegations that staff were not following a resident's care plan and reporting requirements were unsubstantiated due to insufficient evidence. The allegation of neglect/lack of supervision resulting in resident eloping was found to be unfounded.
Deficiencies (1)
Facility staff did not wear masks in common areas of the facility, violating government orders and posing a potential risk to resident health and safety.
Report Facts
Capacity: 58
Census: 23
Deficiencies cited: 1
Plan of Correction Due Date: Jan 23, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Angie Smith | Administrator | Met with Licensing Program Analyst during complaint investigation and discussed findings |
| Victoria Bertozzi | Licensing Program Analyst | Conducted the complaint investigation |
Inspection Report
Complaint Investigation
Census: 26
Capacity: 58
Deficiencies: 0
Date: Oct 11, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2022-09-22 regarding removal of resident's personal belongings without consent and denial of entry to a resident's visitor.
Complaint Details
The complaint alleged that the facility removed a resident's personal belongings without consent and did not allow entry to a resident's visitor. The findings were unsubstantiated, meaning there was insufficient evidence to prove the allegations.
Findings
The investigation found the allegations unsubstantiated due to lack of preponderance of evidence. Staff removed moldy food items from a resident's room per facility policy, and the visitor in question did not physically attempt entry, so no denial occurred. No deficiencies were cited.
Report Facts
Facility capacity: 58
Census: 26
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Bertozzi | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Hope DeBenedetti | Licensing Program Manager | Named in report as Licensing Program Manager |
| Larona Farnum | Licensee | Met with investigator during inspection |
| Angie Smith | Administrator | Met with investigator during inspection and provided interview |
Inspection Report
Complaint Investigation
Census: 26
Capacity: 58
Deficiencies: 0
Date: Oct 11, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that the facility removed a resident's personal belongings without consent and did not allow entry to a resident's visitor.
Complaint Details
Complaint allegations included removal of resident's personal belongings without consent and denial of entry to a resident's visitor. The complaint was found unsubstantiated.
Findings
The investigation found the allegations unsubstantiated due to lack of preponderance of evidence. Staff removed moldy food items from a resident's room per safety concerns, and the visitor in question did not physically attempt entry, so no denial of access occurred. No deficiencies were cited.
Report Facts
Capacity: 58
Census: 26
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Bertozzi | Licensing Evaluator | Conducted the complaint investigation and delivered findings |
| Hope DeBenedetti | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Annual Inspection
Census: 26
Capacity: 58
Deficiencies: 1
Date: Sep 30, 2022
Visit Reason
The inspection was an unannounced Annual Required inspection focused on Infection Control procedures and practices at the facility.
Findings
The facility generally complied with infection control requirements including COVID-19 mitigation, PPE supply, and environmental safety. However, a deficiency was cited related to the elopement of a memory care resident, indicating a failure to fully address safety measures for residents with dementia.
Deficiencies (1)
Failure to comply with safety measures addressing wandering behavior of a memory care resident who eloped the facility, posing an immediate health and safety risk.
Report Facts
PPE supply duration: 30
Medication supply duration: 30
Fire extinguisher last serviced: 2021
Deficiency count: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Bertozzi | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Rachael Lanham | Administrator | Facility administrator at time of inspection. |
| Anie Smith | Administrator | Met with Licensing Program Analyst during inspection. |
| Hope DeBenedetti | Supervisor | Supervisor overseeing the licensing evaluation. |
Inspection Report
Annual Inspection
Census: 26
Capacity: 58
Deficiencies: 1
Date: Sep 30, 2022
Visit Reason
The inspection was an unannounced annual required inspection focused on infection control procedures and practices at the facility.
Findings
The facility generally maintained infection control practices including PPE supply, signage, and staff mask use. However, a deficiency was cited related to the elopement of a memory care resident, indicating a failure to meet safety measures for residents with dementia.
Deficiencies (1)
Failure to comply with safety measures addressing behaviors such as wandering for a memory care resident who eloped the facility, posing an immediate health and safety risk.
Report Facts
Capacity: 58
Census: 26
PPE supply duration: 30
Medication supply duration: 30
Fire extinguisher last serviced: 2021
Plan of Correction Due Date: Oct 1, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Bertozzi | Licensing Program Analyst | Conducted the inspection and authored the report |
| Hope DeBenedetti | Licensing Program Manager | Supervisor overseeing the inspection |
| Anie Smith | Administrator | Facility administrator met during inspection |
| Rachael Lanham | Administrator | Named as facility administrator in report header |
| Larona Farnum | Licensee | Licensee present during inspection |
Inspection Report
Plan of Correction
Census: 26
Capacity: 58
Deficiencies: 0
Date: Sep 9, 2022
Visit Reason
The visit was an unannounced Plan of Correction (POC) inspection to amend a prior report and review submitted corrections related to personnel requirements and basic services deficiencies cited on August 31, 2022.
Findings
No deficiencies were cited during this inspection. The Licensing Program Analyst cleared one deficiency after discussion with the Administrator, who agreed to submit an updated LIC500 form. The facility has a new Administrator who was notified of document submission requirements.
Report Facts
Facility Capacity: 58
Census: 26
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Angie Smith | Administrator | Met with Licensing Program Analyst during Plan of Correction visit |
| Victoria Willis | Licensing Evaluator | Conducted the Plan of Correction visit |
| Hope DeBenedetti | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Plan of Correction
Census: 26
Capacity: 58
Deficiencies: 0
Date: Sep 9, 2022
Visit Reason
Unannounced Plan of Correction visit to amend a prior report and review submitted corrections related to personnel requirements and basic services violations cited on August 31, 2022.
Findings
The Licensing Program Analyst observed compliance with the required corrections and cleared the deficiency related to basic services. No deficiencies were cited during this inspection.
Report Facts
Facility capacity: 58
Census: 26
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Angie Smith | Administrator | Met with Licensing Program Analyst during Plan of Correction visit |
| Victoria Willis | Licensing Program Analyst | Conducted Plan of Correction visit and report amendment |
| Hope DeBenedetti | Licensing Program Manager | Named in report header |
Inspection Report
Plan of Correction
Census: 25
Capacity: 58
Deficiencies: 0
Date: Aug 30, 2022
Visit Reason
Unannounced Plan of Correction visit to verify that previously cited deficiencies from August 19, 2022, have been corrected.
Findings
The facility corrected all cited deficiencies including repairs to the delayed egress door into Memory Care, fixing the exterior door to prevent automatic locking, addressing a leaking pipe causing ceiling discoloration, and is actively working with the fire department on updated fire clearance for outdoor gates. No deficiencies were cited during this visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rachael Lanham | Administrator | Met with Licensing Program Analyst during Plan of Correction visit. |
| Victoria Willis | Licensing Evaluator | Conducted the Plan of Correction visit. |
| Hope DeBenedetti | Supervisor | Supervisor named in the report. |
Inspection Report
Complaint Investigation
Census: 25
Capacity: 58
Deficiencies: 2
Date: Aug 30, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations of insufficient staffing and resident needs not being met at Vine Ridge at Cloverdale.
Complaint Details
The complaint investigation was substantiated for allegations of insufficient staffing and resident needs not being met. The allegation that the administrator lacked qualifications was unsubstantiated.
Findings
The investigation substantiated the complaints of insufficient staffing and resident needs not being met, including issues such as staff shortages causing the administrator to cover caregiving duties and residents not consistently receiving assistance with activities of daily living. The allegation regarding administrator qualifications was unsubstantiated.
Deficiencies (2)
Personnel Requirements - Facility personnel were not sufficient in numbers and competent to meet resident needs, resulting in an immediate risk to resident health and safety.
Basic Services - Facility did not ensure that residents' needs for personal assistance and care, including dressing, eating, bathing, and medication assistance, were consistently met, posing an immediate risk to resident health and safety.
Report Facts
Capacity: 58
Census: 25
Deficiencies cited: 2
Plan of Correction Due Date: Aug 31, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rachael Lanham | Administrator | Named in findings related to staffing shortages and caregiving duties |
| Victoria Willis | Licensing Program Analyst | Conducted the complaint investigation |
| Hope DeBenedetti | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 25
Capacity: 58
Deficiencies: 0
Date: Aug 30, 2022
Visit Reason
An unannounced complaint investigation was conducted regarding an allegation that the facility retaliated against a whistleblower by terminating their employment.
Complaint Details
The complaint alleged that the facility retaliated against a whistleblower by terminating their employment. Interviews revealed three employees chose to terminate employment by walking off the job. The Licensing Program Analyst was unable to confirm termination due to whistleblower status. The allegation was unsubstantiated.
Findings
The investigation found the complaint allegation unsubstantiated as there was insufficient evidence to prove retaliation occurred. No deficiencies were cited.
Report Facts
Capacity: 58
Census: 25
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rachael Lanham | Administrator | Met with Licensing Program Analyst during investigation |
| Victoria Willis | Licensing Evaluator | Conducted the complaint investigation |
Inspection Report
Plan of Correction
Census: 25
Capacity: 58
Deficiencies: 0
Date: Aug 30, 2022
Visit Reason
Unannounced Plan of Correction visit to verify that previously cited deficiencies were corrected.
Findings
The facility corrected all deficiencies cited on August 19, 2022, including repairs to the delayed egress door, exterior door locking mechanism, and a leaking pipe causing ceiling discoloration. No deficiencies were cited during this visit.
Report Facts
Facility capacity: 58
Census: 25
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rachael Lanham | Administrator | Met with Licensing Program Analyst during Plan of Correction visit |
| Victoria Willis | Licensing Program Analyst | Conducted the Plan of Correction visit |
| Hope DeBenedetti | Licensing Program Manager | Named in report header |
Inspection Report
Complaint Investigation
Census: 25
Capacity: 58
Deficiencies: 2
Date: Aug 30, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations of insufficient staffing, resident needs not being met, and administrator qualifications.
Complaint Details
The complaint investigation was substantiated for allegations of insufficient staffing and resident needs not being met, meaning the allegations were valid based on the preponderance of evidence. The allegation regarding administrator qualifications was unsubstantiated.
Findings
The complaint allegations of insufficient staffing and resident needs not being met were substantiated, with evidence showing staffing shortages impacting resident care. The allegation regarding administrator qualifications was unsubstantiated, with the administrator found qualified despite having to perform caregiving duties due to staffing shortages.
Deficiencies (2)
Facility personnel were not sufficient in numbers and competent to meet resident needs, posing an immediate risk to health and safety.
Facility did not ensure that residents received personal assistance and care as needed, including assistance with activities of daily living.
Report Facts
Capacity: 58
Census: 25
Deficiencies cited: 2
Plan of Correction Due Date: Aug 31, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rachael Lanham | Administrator | Named in findings related to staffing shortages and caregiving duties |
| Victoria Willis | Licensing Program Analyst | Conducted the complaint investigation |
| Hope DeBenedetti | Licensing Program Manager | Oversaw the complaint investigation report |
Inspection Report
Complaint Investigation
Census: 25
Capacity: 58
Deficiencies: 0
Date: Aug 30, 2022
Visit Reason
An unannounced complaint investigation was conducted regarding an allegation that the facility retaliated against a whistleblower by terminating their employment.
Complaint Details
The complaint alleged that the facility retaliated against a whistleblower by terminating their employment. The allegation was found unsubstantiated due to lack of preponderance of evidence.
Findings
The investigation found the allegation to be unsubstantiated as there was insufficient evidence to prove retaliation occurred. Interviews indicated that three employees voluntarily terminated their employment by walking off the job. No deficiencies were cited.
Report Facts
Complaint Control Number: 21
Capacity: 58
Census: 25
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rachael Lanham | Administrator | Met with Licensing Program Analyst during investigation |
| Victoria Willis | Licensing Program Analyst | Conducted the complaint investigation |
| Hope DeBenedetti | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 25
Capacity: 58
Deficiencies: 0
Date: Aug 19, 2022
Visit Reason
The visit was an unannounced complaint investigation regarding allegations related to delayed egress doors and gates in the Memory Care area of the facility.
Complaint Details
Complaint investigation visit conducted due to allegations about delayed egress doors and gates in Memory Care. Concerns about gates not alarming and staff notification failures were found. Fire department involved for further assessment. No deficiencies cited.
Findings
The investigation revealed concerns that exterior gates in the Memory Care outdoor area were not alarming when pressed and staff were not notified via their phone application when these gates were opened. One of three gates had a lock on the latch. The local fire department was called to address the gates and will provide additional information. No deficiencies were cited.
Report Facts
Capacity: 58
Census: 25
Number of gates with locks: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rachael Lanham | Administrator | Met with Licensing Program Analyst during complaint investigation |
| Victoria Willis | Licensing Evaluator | Conducted the complaint investigation visit |
| Hope DeBenedetti | Supervisor | Supervisor overseeing the investigation |
| Larona Farnum | Licensee available by phone during investigation |
Inspection Report
Complaint Investigation
Census: 25
Capacity: 58
Deficiencies: 2
Date: Aug 19, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that the facility did not follow their Covid Mitigation Plan, was not safe, sanitary and in good repair, and failed to ensure proper fingerprint clearance and association of individuals.
Complaint Details
The complaint investigation was substantiated for failure to follow the Covid Mitigation Plan and unsafe, unsanitary conditions. The allegation regarding improper fingerprint clearance and association was unsubstantiated.
Findings
The investigation substantiated that the facility did not follow their Covid Mitigation Plan, including failure to notify residents and responsible parties of Covid cases and failure to test all staff and residents. The facility was also found not safe and in disrepair due to a non-functioning delayed egress door in Memory Care and visible plumbing leaks. The allegation regarding improper fingerprint clearance and association was unsubstantiated.
Deficiencies (2)
Delayed egress doors in Memory Care are not functioning correctly and there is visible evidence of a plumbing leak on the ceiling in Assisted Living.
Door that goes into the outdoor area automatically locks which does not allow residents to wander freely, violating dementia care requirements.
Report Facts
Capacity: 58
Census: 25
Plan of Correction Due Date: Aug 20, 2022
Plan of Correction Due Date: Aug 22, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rachael Lanham | Administrator | Met with Licensing Program Analyst during investigation and involved in findings |
| Victoria Willis | Licensing Program Analyst | Conducted the complaint investigation |
| Larona Farnum | Licensee | Available by phone during investigation |
Inspection Report
Complaint Investigation
Census: 25
Capacity: 58
Deficiencies: 0
Date: Aug 19, 2022
Visit Reason
Unannounced complaint investigation visit conducted to investigate allegations regarding delayed egress doors and gates in the Memory Care area.
Complaint Details
Complaint investigation visit revealed concerns about delayed egress doors and gates in Memory Care, specifically that exterior gates do not alarm and staff are not notified when gates are opened.
Findings
Concerns were found that exterior gates in the Memory Care outdoor area do not alarm when pressed and staff are not notified via phone application when these gates are opened. One of three gates has a lock on the latch. The local fire department was called to address the gates and will provide additional information. No deficiencies were cited.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rachael Lanham | Administrator | Met with Licensing Program Analyst during complaint investigation. |
| Victoria Willis | Licensing Program Analyst | Conducted the unannounced complaint investigation visit. |
| Hope DeBenedetti | Licensing Program Manager | Named in report header. |
| Larona Farnum | Licensee available by phone during investigation. |
Inspection Report
Complaint Investigation
Census: 25
Capacity: 58
Deficiencies: 2
Date: Aug 19, 2022
Visit Reason
Unannounced complaint investigation visit conducted due to allegations that the facility did not follow their Covid Mitigation Plan, was not safe, sanitary and in good repair, and failed to ensure proper fingerprint clearance and association of individuals.
Complaint Details
Complaint was substantiated for failure to follow Covid Mitigation Plan and unsafe, unsanitary conditions. The fingerprint clearance allegation was unsubstantiated.
Findings
The investigation substantiated that the facility failed to follow their Covid Mitigation Plan, including failure to notify residents and responsible parties of Covid positive cases and failure to test all staff and residents. The facility was also found not safe and in good repair due to malfunctioning delayed egress doors and evidence of plumbing leaks. The allegation regarding improper fingerprint clearance and association was unsubstantiated.
Deficiencies (2)
Delayed egress doors in Memory Care are not functioning correctly and there is visible evidence of a plumbing leak on the ceiling in Assisted Living.
The door that goes into the outdoor area automatically locks, which does not allow residents to wander freely.
Report Facts
Capacity: 58
Census: 25
Deficiencies cited: 2
Plan of Correction Due Date: Aug 20, 2022
Plan of Correction Due Date: Aug 22, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Willis | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Hope DeBenedetti | Licensing Program Manager | Oversaw the complaint investigation |
| Rachael Lanham | Administrator | Facility administrator met with Licensing Program Analyst during investigation |
| Larona Farnum | Licensee | Available by phone during investigation |
Inspection Report
Complaint Investigation
Census: 22
Capacity: 58
Deficiencies: 1
Date: Jun 23, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2022-05-03 regarding allegations of failure to ensure residents' personal rights, retention of a resident with a prohibited condition, and failure to meet resident's care needs.
Complaint Details
The complaint investigation was substantiated for failure to ensure resident's personal rights. The allegations that the facility retained a resident with a prohibited condition (staph infection) and failed to meet resident's care needs (weeping wounds and rash) were unsubstantiated.
Findings
The complaint that the facility failed to ensure residents' personal rights was substantiated, with evidence that a resident entered other residents' rooms and took their clothes. The allegations that the facility retained a resident with a prohibited condition and failed to meet a resident's care needs were unsubstantiated based on the evidence reviewed.
Deficiencies (1)
Facility failed to ensure resident's personal rights as a resident in memory care went into other residents' rooms and went through their personal items.
Report Facts
Capacity: 58
Census: 22
Deficiencies cited: 1
Plan of Correction Due Date: Jul 1, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Willis | Licensing Program Manager | Conducted the complaint investigation and delivered findings |
| David Uballez | Administrator | Facility administrator present during investigation |
| Larona Farnum | Licensee | Facility licensee present during investigation |
| Rachael Lanham | Acting Administrator | Acting administrator present during investigation |
Inspection Report
Complaint Investigation
Census: 22
Capacity: 58
Deficiencies: 1
Date: Jun 23, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2022-05-03 alleging failure to ensure resident's personal rights, retention of a resident with a prohibited condition, and failure to meet resident's care needs.
Complaint Details
The complaint investigation was substantiated for failure to ensure resident's personal rights. The allegations regarding retention of a resident with a prohibited condition (staph infection) and failure to meet resident's care needs (weeping wounds and rash) were unsubstantiated.
Findings
The complaint that the facility failed to ensure resident's personal rights was substantiated, with evidence that a resident entered other residents' rooms and took their clothes. The allegations that the facility retained a resident with a prohibited condition and failed to meet resident's care needs were unsubstantiated due to insufficient evidence.
Deficiencies (1)
Facility failed to ensure resident's personal rights as a resident in memory care went into other residents' rooms and went through their personal items, posing a risk to personal rights.
Report Facts
Capacity: 58
Census: 22
Deficiency count: 1
Plan of Correction Due Date: Jul 1, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Willis | Evaluator / Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Hope DeBenedetti | Licensing Program Manager | Oversaw the complaint investigation and signed the report |
| David Uballez | Administrator | Facility administrator present during investigation |
| Larona Farnum | Licensee | Facility licensee present during investigation |
| Rachael Lanham | Acting Administrator | Facility acting administrator present during investigation |
Inspection Report
Complaint Investigation
Census: 26
Capacity: 58
Deficiencies: 0
Date: May 4, 2022
Visit Reason
An unannounced complaint investigation was conducted regarding an allegation that the facility administrator was not qualified due to not having an administrator certificate.
Complaint Details
Complaint alleged that the facility administrator was not qualified due to lack of an administrator certificate. The complaint was found to be unfounded.
Findings
The investigation found that the complaint was unfounded. The previous administrator had left, and the acting administrator and licensee both hold active administrator certificates and are managing the facility.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Willis | Licensing Program Analyst | Conducted the complaint investigation. |
| David Uballez | Administrator | Former facility administrator who left the facility. |
| Larona Farnum | Licensee | Met with investigator during complaint investigation. |
| Rachael Lanham | Acting Administrator | Current acting administrator with active certificate. |
Inspection Report
Complaint Investigation
Census: 26
Capacity: 58
Deficiencies: 0
Date: May 4, 2022
Visit Reason
An unannounced complaint investigation was conducted regarding an allegation that the facility administrator was not qualified due to not having an administrator certificate.
Complaint Details
The complaint alleged that the facility administrator was not qualified due to not having an administrator certificate. The complaint was found to be unfounded.
Findings
The investigation found that the complaint was unfounded. The previous administrator had left, and the acting administrator and licensee both hold active administrator certificates and are in the process of completing the change of administrator paperwork.
Report Facts
Facility capacity: 58
Census: 26
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Willis | Evaluator | Conducted the complaint investigation |
| David Uballez | Administrator | Previous facility administrator who left |
| Larona Farnum | Licensee | Met with during investigation and holds active administrator certificate |
| Rachael Lanham | Acting Administrator | Met with during investigation and holds active administrator certificate |
Inspection Report
Complaint Investigation
Census: 20
Capacity: 58
Deficiencies: 1
Date: Mar 11, 2022
Visit Reason
The inspection was conducted as a Case Management visit following an incident where a resident in Memory Care eloped the facility and staff did not respond to the delayed egress alarm.
Complaint Details
The visit was triggered by a complaint related to a resident eloping the facility and staff failing to respond to the delayed egress alarm. The deficiency was substantiated as an immediate risk to health and safety.
Findings
The facility was found deficient for not having an adequate number of direct care staff to support residents' needs, resulting in a resident eloping and staff failing to respond to the delayed egress alarm, posing an immediate risk to resident health and safety.
Deficiencies (1)
Failure to ensure an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal, evidenced by a resident in Memory Care eloping the facility and staff not responding to the delayed egress alarm.
Report Facts
Capacity: 58
Census: 20
Deficiencies cited: 1
Plan of Correction Due Date: Mar 12, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Lisa DiBartolo | Acting Administrator | Met with Licensing Program Analyst during inspection and interviewed regarding the incident |
Inspection Report
Complaint Investigation
Census: 20
Capacity: 58
Deficiencies: 1
Date: Mar 11, 2022
Visit Reason
The inspection was conducted as a Case Management follow-up on an incident where a resident in Memory Care eloped the facility and staff did not respond to the delayed egress alarm.
Complaint Details
The visit was complaint-related, following up on an incident where a Memory Care resident eloped the facility and staff failed to respond to the delayed egress alarm. The complaint was substantiated by interview and document review.
Findings
The facility was found deficient for not having an adequate number of direct care staff to support residents, resulting in a resident eloping and staff failing to respond to the delayed egress alarm, posing an immediate risk to resident health and safety.
Deficiencies (1)
Licensees who accept and retain residents with dementia did not ensure an adequate number of direct care staff to support residents' needs, as evidenced by a resident eloping and staff not responding to the delayed egress alarm.
Report Facts
Capacity: 58
Census: 20
Deficiencies cited: 1
Plan of Correction Due Date: Due date was 03/12/2022 as stated in the report
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Lisa DiBartolo | Acting Administrator | Met during inspection and interviewed regarding the incident |
| Victoria Willis | Licensing Program Analyst | Conducted the inspection and signed the report |
| Hope DeBenedetti | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 20
Capacity: 58
Deficiencies: 1
Date: Mar 11, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2022-01-27 alleging insufficient staffing and multiple resident care concerns at Vine Ridge at Cloverdale facility.
Complaint Details
The complaint investigation was substantiated for insufficient staffing, meaning the allegation was valid based on the preponderance of evidence. Other allegations related to resident feeding, medication handling, facility sanitation, resident fall, incontinence care, laundry services, and adherence to care plans were unsubstantiated.
Findings
The complaint of insufficient staffing was substantiated, indicating staff shortages leading to delayed or unmet resident needs. Other allegations including improper feeding, medication mishandling, unsafe and unsanitary conditions, resident fall, unmet incontinence and laundry needs, and failure to follow resident care plans were unsubstantiated due to lack of sufficient evidence.
Deficiencies (1)
Personnel Requirements - Facility personnel shall at all times be sufficient in numbers and competent to provide the services necessary to meet resident needs. Facility is short staffed resulting in needs being delayed or not met, posing immediate risk to resident health and safety.
Report Facts
Capacity: 58
Census: 20
Plan of Correction Due Date: Mar 12, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Victoria Willis | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Lisa DiBartolo | Acting Administrator | Met with Licensing Program Analyst during investigation |
| David Uballez | Administrator | Facility Administrator mentioned in relation to medication organization and staffing |
| Hope DeBenedetti | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Annual Inspection
Census: 21
Capacity: 58
Deficiencies: 0
Date: Oct 21, 2021
Visit Reason
The inspection was an unannounced Annual Required inspection focused on infection control procedures and practices at the facility.
Findings
The facility demonstrated compliance with infection control practices including PPE availability, staff mask usage, and cleaning protocols. No deficiencies were cited during this inspection.
Report Facts
PPE supply duration: 30
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Uballez | Administrator | Met with Licensing Program Analyst during inspection and discussed infection control and emergency plans. |
| Victoria Willis | Licensing Program Analyst | Conducted the unannounced annual inspection. |
| Hope DeBenedetti | Supervisor | Supervisor overseeing the inspection. |
Inspection Report
Annual Inspection
Census: 21
Capacity: 58
Deficiencies: 0
Date: Oct 21, 2021
Visit Reason
The inspection was an unannounced Annual Required inspection focused on the Infection Control procedures and practices of the facility.
Findings
The facility demonstrated compliance with infection control practices including PPE availability, staff mask usage, and cleaning protocols. No deficiencies were cited during this inspection.
Report Facts
PPE supply duration: 30
Medication supply duration: 30
Inspection duration hours: 3.67
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Uballez | Administrator | Met with Licensing Program Analyst during inspection and discussed infection control and emergency plans. |
| Victoria Willis | Licensing Program Analyst | Conducted the unannounced annual inspection. |
| Hope DeBenedetti | Licensing Program Manager | Named in report header and footer. |
Inspection Report
Complaint Investigation
Census: 21
Capacity: 58
Deficiencies: 5
Date: Oct 13, 2021
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to multiple allegations received on 06/28/2021 regarding facility cleanliness, adherence to mitigation plan, medication log accuracy, and medication dispensing practices.
Complaint Details
The complaint investigation was triggered by allegations received on 06/28/2021. The allegations were found unsubstantiated except for one related to medication accessibility to residents, which had been substantiated in a prior complaint received on 06/16/2021.
Findings
The investigation found that the facility was clean, the mitigation plan was being followed, and medication administration and record keeping complied with regulations. However, one allegation regarding medication accessibility to residents was substantiated in a prior complaint. Overall, the current allegations were unsubstantiated based on the evidence.
Deficiencies (5)
Facility staff do not keep the facility clean
Facility is not following their Mitigation Plan
Facility staff are not keeping accurate medication logs
Facility staff are not dispensing medications as prescribed
Facility staff do not ensure that medications are inaccessible to residents
Report Facts
Capacity: 58
Census: 21
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Uballez | Administrator | Met with Licensing Program Analyst during complaint investigation |
| David Leibert | Licensing Program Analyst | Conducted the complaint investigation |
| Carla Martinez | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Follow-Up
Census: 21
Capacity: 58
Deficiencies: 0
Date: Oct 13, 2021
Visit Reason
The visit was an unannounced follow-up to verify proof of correction for a citation issued on 2021-09-16 that required staff training.
Findings
The Licensing Program Analyst met with the administrator who provided proof of completion of the required staff training. The citation issued on 2021-09-16 was cleared and no new citations were issued during this visit.
Report Facts
Citation date: Sep 16, 2021
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Uballez | Administrator | Met with Licensing Program Analyst to discuss proof of correction |
| David Leibert | Licensing Program Analyst | Conducted the follow-up visit and accepted proof of correction |
| Carla Martinez | Licensing Program Manager | Named in report header |
Inspection Report
Complaint Investigation
Census: 21
Capacity: 58
Deficiencies: 1
Date: Oct 13, 2021
Visit Reason
Unannounced complaint investigation visit conducted due to multiple allegations including insufficient care and supervision resulting in injury, failure to seek timely medical attention, failure to address changes in resident condition, failure to meet resident care needs, violation of personal rights, and failure to report incidents as required.
Complaint Details
The complaint investigation was unannounced and addressed multiple allegations including insufficient care, failure to seek timely medical attention, failure to address changes in resident condition, failure to meet resident care needs, violation of personal rights, and failure to report incidents. The initial allegations were found unsubstantiated, but the allegation regarding hazardous products accessibility and staff training was substantiated.
Findings
The investigation found the initial allegations unsubstantiated based on staff, resident, and family interviews, observations, and record reviews indicating appropriate care and reporting. However, a separate substantiated finding was made regarding hazardous products being accessible to residents and lack of staff training on this issue.
Deficiencies (1)
87309(a) STORAGE SPACE. Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. Laundry products and cleanser observed accessible to residents posing an immediate risk to their health.
Report Facts
Capacity: 58
Census: 21
Deficiencies cited: 1
Plan of Correction Due Date: Oct 22, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Leibert | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| David Uballez | Administrator | Facility administrator met with Licensing Program Analyst during investigation |
| Carla Martinez | Licensing Program Manager | Oversaw complaint investigation |
Inspection Report
Complaint Investigation
Census: 21
Capacity: 58
Deficiencies: 0
Date: Oct 13, 2021
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by multiple allegations received on 06/28/2021 regarding facility cleanliness, mitigation plan adherence, medication log accuracy, and medication dispensing practices.
Complaint Details
The complaint investigation addressed allegations that facility staff did not keep the facility clean, were not following their mitigation plan, were not keeping accurate medication logs, and were not dispensing medications as prescribed. These allegations were found to be unsubstantiated. However, the allegation that facility staff did not ensure medications were inaccessible to residents was substantiated in a separate complaint #21-AS-202106160-85247 received on 06/16/2021.
Findings
The investigation found that the facility was clean, the mitigation plan was being followed, and medication administration and record keeping complied with regulations. There was no preponderance of evidence to support the allegations, so they were unsubstantiated. However, a related allegation about medication accessibility to residents was substantiated in a prior complaint received on 06/16/2021.
Report Facts
Facility capacity: 58
Census: 21
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Leibert | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| David Uballez | Administrator | Met with Licensing Program Analyst during investigation |
| Carla Martinez | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Follow-Up
Census: 19
Capacity: 58
Deficiencies: 0
Date: Sep 28, 2021
Visit Reason
The visit was an unannounced follow-up to verify correction of citations issued on 09/16/2021, specifically regarding staff training in medical and dental care.
Findings
No deficiencies were cited during this visit. The administrator reported that all but one staff member completed the required training, with the remaining staff expected to complete it shortly.
Report Facts
Capacity: 58
Census: 19
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Uballez | Administrator | Facility administrator who reported on staff training status |
| David Leibert | Licensing Program Analyst | Evaluator who conducted the unannounced follow-up visit |
| Carla Martinez | Supervisor | Supervisor named in the report |
Inspection Report
Follow-Up
Census: 19
Capacity: 58
Deficiencies: 0
Date: Sep 28, 2021
Visit Reason
Unannounced follow-up visit to verify correction of citations issued on 2021-09-16, specifically regarding staff training in medical and dental care.
Findings
No deficiencies were cited during this visit. The administrator reported that all but one staff member have completed the required training, with the remaining staff expected to complete it upon return from approved leave.
Report Facts
Capacity: 58
Census: 19
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Uballez | Administrator | Met with during the inspection and provided information about staff training |
| David Leibert | Licensing Program Analyst | Conducted the unannounced follow-up visit |
| Carla Martinez | Licensing Program Manager | Named in the report header |
Inspection Report
Complaint Investigation
Census: 19
Capacity: 58
Deficiencies: 2
Date: Sep 16, 2021
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 06/16/2021 regarding staff training, medication storage accessibility, and maintenance of the centrally stored medication log.
Complaint Details
The complaint investigation was substantiated for allegations that staff were not trained and medication was not stored inaccessible to residents. The allegation regarding the centrally stored medication log was unsubstantiated.
Findings
The investigation substantiated that staff were not properly trained and medication was stored in an unlocked resident room, posing immediate risk. However, the allegation regarding the centrally stored medication log not being maintained was unsubstantiated as records showed compliance.
Deficiencies (2)
Centrally stored medicines were not kept in a safe and locked place accessible only to responsible employees, evidenced by prescription eye drops found in an unlocked resident room.
Administrator failed to recruit, employ, and train qualified staff, with staff providing care and medication without required training.
Report Facts
Capacity: 58
Census: 19
Deficiencies cited: 2
Plan of Correction Due Date: Sep 20, 2021
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Uballez | Administrator | Named in findings related to staff training and medication administration |
Inspection Report
Complaint Investigation
Census: 19
Capacity: 58
Deficiencies: 2
Date: Sep 16, 2021
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 06/16/2021 regarding staff training, medication storage, and maintenance of the centrally stored medication log.
Complaint Details
The complaint investigation was substantiated for allegations that staff were not trained and medication was not stored inaccessible to residents. The allegation that the centrally stored medication log was not maintained was unsubstantiated.
Findings
The investigation substantiated that staff were not properly trained and medication was not stored inaccessible to residents, posing immediate risks. However, the allegation regarding the centrally stored medication log not being maintained was unsubstantiated.
Deficiencies (2)
Incidental Medical and dental Care. Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not met as prescription eye drops were observed in an unlocked resident’s room.
Administrator Qualifications and Duties. The administrator failed to recruit, employ, and train qualified staff and terminate unsatisfactory staff. Staff provided care without all required training.
Report Facts
Capacity: 58
Census: 19
Deficiencies cited: 2
Plan of Correction Due Date: Sep 20, 2021
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Uballez | Administrator | Named in findings related to staff training and medication administration |
| David Leibert | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
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