Serenity Living

Type of visit: Case Management - Legal/Non-compliance

On 09/03/26 Licensing Program Analyst (LPA) M. Garza arrived at the facility to complete an unannounced case management visit. LPA met with Direct Care Staff (S1), Elaine Salcedo, explained reason for visit and was permitted entry into the facility. Licensee, Josiane Jones was present and in the office located in the back room. LPA observed 3 residents present during todays visit. All residents present in the living room area. 2 of 3 residents observed watching television and 1 resident observed sleeping in chair in living room. This case management visit is being conducted for complaint #24-AS-20230825152929. Purpose of this visit is to return the facility's sign-in logs. During visit on 09/01/2026 LPA requested sign in logs from 2020 through 2026. Licensee, Josiane Jones was contacted via telephone. LPA was informed by S1 the records were in storage (not located at the facility) per Licensee. Records were provided to the Department on 09/02/2026. Facility provided sign-in logs for 2024 (January -July), 2025 and 2026. The sign-in log for 2023 was not provided. During the todays visit, LPA inquired about 2023 and August 2024 through December 2024 sign-in logs. S1 stated LPA would have to speak with Licensee, Josiane. Licensee came from office and stated the records provided were "all they had" and did not have the remaining records. Deficiency cited on 809D per California Code of Regulations, Title 22. If not corrected, this will have a direct or potential impact to residents in care. Exit interview completed with Staff, Elaine. A copy of this report, deficiency and appeal rights provided.the state’s words, verbatim · CDSS document, Sep 3, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87755(c) · Plan of correction due date: Sep 18, 2026

87755 Inspection Authority of the Licensing Agency (c) The licensing agency shall have the authority to inspect, audit, and copy resident or facility records upon demand during normal business hours. Records may be removed if necessary for copying. This requirement was not met as evidence by: records reviewed. Licensee did not comply with the section cited above in that LPA requested sign in logs from 2020 through 2026 on 09/01/26. LPA was informed records were in storage (not located at the facility). Records were provided to the Department on 09/02/2026. Facility provided sign-in logs for 2024 (January -July), 2025 and 2026. The sign-in log for 2023 was not provided. During visit on 09/03/26, LPA inquired about 2023 and August 2024 through December 2024 sign-in log. Licensee stated the records provided were for "3 years" and were "all they had". Licensee did not have the remaining records.This poses a potential health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: Recheck will be completed for the missing files (2023 and August-December 2024). Facility has generated a new sign in sheet. Records will be retained at the faciltiy for the 3 years required in a file cabinet and available upon requrest. Licensee will provide the plan of correction in writting and a copy of the new sign in sheet to CCL by POC date.

Type of visit: Case Management - Legal/Non-compliance

On 09/01/26 Licensing Program Analyst (LPA) M. Garza arrived at the facility to complete an unannounced case management visit. LPA met with Direct Care Staff (S1), Elaine Salcedo, explained reason for visit and was permitted entry into the facility. Tour of the facility was completed inside and out. LPA observed 3 residents present during todays visit. All residents present in the living room area. There was no music playing or television on. The room was silent. 1 of 3 residents observed to be eating breakfast. This case management visit is being conducted for complaint #24-AS-20230825152929. Purpose of this visit is to collect the facility's sign in logs from 2020 through 2026. Licensee, Josiane Jones was contacted and informed S1 the records were in storage (not located at the facility). Per S1 the records can be taken to the office by close of business 09/02/2026. During visit LPA had a discussion with S1 who confirmed that 2 of 3 residents were utilizing a bed alarms. Upon review of records it was observed that the records do not contain a prescription for bed alarms. Facility does not have an activity calendar. Interview with 1 of 3 residents disclosed they walk in the facility, watch television and from time to time read books that are in the cabinet in the living room. S1 disclosed that R3 does not like to participate in any activities. No deficiencies cited during todays visit. Exit interview completed with S1. A copy of this report provided.the state’s words, verbatim · CDSS document, Sep 1, 2026

Type of visit: Case Management - Annual Continuation

On 08/26/26 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Elaine Sauceda. LPA was granted entry. 3 clients were present during inspection. Administrator (A1) Josaiane Jones arrived shortly after LPA’s arrival. LPA toured facility with A1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at -4 degrees F and refrigerator temperature was maintained at 36 degrees F. Cleaning chemicals was observed stored and locked in garage area. Fire extinguisher was observed with a service date of: 7/14/26. Fire drill last completed on 8/10/26. Clients' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 110.8 to 117.1 degrees F. in 2 bathrooms. Outside of facility toured. Side gates were self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Medications were checked and observed kept locked in medication cart. Clients’ MARS was reviewed. Samples of medications, and medication logs were reviewed with no errors. Carbon monoxide and smoke detectors were tested and observed to be operational. All clients’ file reviewed to have all the required documents. Samples of staff files were reviewed and observed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 9/9/26: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization LIC 309, Affidavit regarding Client/Resident Cash Resources LIC 400, Liability Insurance-RCFE, Emergency and Disaster Plan LIC 610E, Personnel Report LIC500, Register of Facility Clients/Residents for LIC9020A A copy of this report was distributed to Administrator whose signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Aug 26, 2026

Type of visit: Case Management - Legal/Non-compliance

On 08/21/2026 Licensing Program Analyst (LPA) M. Garza arrived at the facility for an unannounced case management visit. LPA met with House Manager, Elaine Salcedo, explained reason for visit and was permitted entry into the facility. LPA completed tour of the facility and a health and safety check on residents in care. Licensee, Josiane Jones arrived some time later. This case management is being conducted for as part of increased monitoring for the facility. LPA requested a register of current facility residents, medical assessments for 3 of 3 residents in care and discharge paperwork for R3. No deficiencies cited during todays visit. Exit interview completed with Licensee, Josiane. A copy of this report provided.the state’s words, verbatim · CDSS document, Aug 21, 2026

Type of visit: Required - 1 Year

On 9/20/25 Licensing Program Analyst arrived at the facility to complete an unannounced annual visit. LPA met with Care Giver, Alexandria Zacarias, explained reason for visit and was permitted entry into the facility. Licensee, Josiane Jones and Care Giver, Elaine Salcedo arrived some time later. LPA completed a tour of the facility inside and out. A health and safety check was completed on residents in care. 3 resident was present during visit. Currently no residents are on hospice, receiving home health services or on oxygen. Pathways and doors were clear and free from obstruction. Facility was without odor. Common areas were adequately furnished. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Last fire drill on conducted on 6/29/25. Resident rooms observed to have the required furnishings and with adequate lighting. Sharps, chemicals and medications were located in locked cabinets/closets and cupboards. LPA observed sufficient seating under covered patio areas. The following issues were observed during today’s visit: Emergency and disaster plan incomplete. Let us know posting incorrect size. Deficiencies cited per California Code of Regulations, Title 22, on the attached 809D. If not corrected, the violation with have a direct risk to the health, safety and/or personal rights of residents in care. LPA requested the following documents to be submitted to CCL by 09/26/2025: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Exit interview was conducted with Licensee. A plan of correction was developed by Licensee and reviewed by LPA. A copy of this report, deficiencies, and appeal rights were discussed and provided. TSP was offered and accepted. LPA will make referral to TSP.the state’s words, verbatim · CDSS document, Sep 20, 2025

Type of visit: Case Management - Health Checks

On 5/28/25 Licensing Program Analysts (LPAs) M. Garza and M. Medina arrived for an unannounced case management visit. LPAs met with Designee, Elaine Salcedo, explained reason for visit and were permitted entry into the facility. Licensee, Josiane Jones was contacted and arrived some time later. LPAs completed a tour of the facility inside and out. Currently the facility has 4 residents in care. 3 observed in living area sitting in recliners and 1 in bed sleeping. Currently there are no residents receiving hospice services or home health services. This case management visit is being conducted to complete a health and safety check on residents in care and to gather documentation (residents census, staff schedule with contact information, emergency contact information, resident roster and staff roster) and verify an uncleared staff is not working at the facility. During visit LPAs observed the following: bed in bedroom #2 was without box springs (Licensee stated son preferred this way due to height with box spring). A smell of urine/feces, sufficient lighting was not supplied and the light switch was not functioning in bedroom #3. Room was observed to be dark with only 1 lamp providing light (Licensee and staff stated it was getting repaired today). Medicine closet was observed unlocked and accessible to residents in care (staff stated they were working in there upon LPAs arrival). Deficiencies cited per Title 22, Division 6, Chapter 8, deficiencies are being cited on the attached 809D's. If not corrected the violations will have a direct and immediate risk to the health, safety and or personal rights of residents in care. Exit interview completed with Licensee, Josiane. A copy of this report, deficiencies and appeal rights were discussed and provided. A plan of correction was developed by the Licensee and reviewed with the LPAs.the state’s words, verbatim · CDSS document, May 28, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87462(h)(2) · Plan of correction due date: Jun 13, 2025

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) 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 evidence by: LPAs observation, the licensee did not comply with the section cited above in that LPAs observed the medication closet off the kitchen to be unlocked and accessible to residents in care. This poses an immediate health, safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 28, 2025

Plan of correction: Training will be completed with all staff. In- service sign in sheet will be completed and submitted to CCL with training material by POC date as proof of correction.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87303(a) · Plan of correction due date: Jun 13, 2025

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidence by: LPAs observation, the licensee did not comply with the regulation cited above in that, a smell of urine and feces, sufficient lighting was not supplied and the light switch was not functioning in bedroom #3. This poses a potential health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 28, 2025

Plan of correction: Bedding was immediately removed. In the future bedding will be removed and changed immediately and sanitation will be completed. Training will be completed with all staff. In-serivce sign in sheet and training material will be submitted to CCL by POC date as proof of correction.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87307(a)(3)(A) · Plan of correction due date: Jun 13, 2025

87307 Personal Accommodations and Services (a) Living accommodations and grounds...The following provisions shall apply: (3) Equipment and supplies necessary...: (A) A bed for each resident...Each bed shall be equipped with good springs, a clean and comfortable mattress, available pillow(s) and lightweight warm bedding. Fillings and covers for mattresses and pillows shall be flame retardant. Rubber sheeting shall be provided when necessary. This requirement was not met as evidence by: LPAs observation, the licensee did not comply with the regulation cited above in that, of bed in bedroom #2 was without box springs. This poses a potential health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 28, 2025

Plan of correction: Licensee stated they will obtain a letter from the family stating they do not want a box spring for the bed. This will be kept in resident file for future reference. A copy of the letter will be submitted to CCL as proof of correction.

Type of visit: Required - 1 Year

On 10/17/2024 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA was met by Direct Care Staff, Elaine Salcedo LPA introduced self, explained reason for visit and was permitted entry into the facility. Licensee, Josiane Jones was contacted and arrived some time later. LPA completed a health and safety check on residents in care. LPA toured the facility inside and out. Residents observed in common areas. Currently there are no residents receiving hospice services. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 8/14/24. Last fire drill on 5/26/24. Resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in linen closets. Sharps were located in locked closet near laundry room. LPA observed sufficient seating under covered patio areas. The following issues were observed during todays visit: chemicals and items posing a harm to residents in R3's bedroom closet, in the laundry room and in the garage unlocked and accessible to residents in care. Water temperature measured at 129.8 degrees F in the kitchen. LPA requested the following documents to be submitted to CCL by 10/25/24: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Exit interview completed with Licensee, Josiane Jones. A copy of this report, deficiency and appeal rights provided.the state’s words, verbatim · CDSS document, Oct 17, 2024

Type of visit: Case Management - Other

On 1/16/2024 Licensing Program Analyst (LPA) M. Garza completed an unannounced Case Management visit. LPA met with Direct Care Staff, Elaine Salcedo explained reason for visit and was permitted entry into facility. Licensee, Josiane Jones was contacted and informed LPA was present at the facility and the reason for visit. Licensee provided permission for Staff to complete visit and sign report. LPA completed a health and safety check on residents in care. Residents observed in common areas. During visit LPA collected and removed resident files (3) and an overflow file (1) from facility. Files will be retuned to the facility within 3 business days. No deficiencies cited during todays visit. LPA conducted an exit interview with Direct Care Staff, Elaine. A copy of this report provided.the state’s words, verbatim · CDSS document, Jan 16, 2024

Type of visit: Required - 1 Year

On 11/30/23 Licensing Program Analysts (LPA's) M. Garza and L. Salazar arrived at facility for an unannounced annual inspection visit. LPA's was met with Care Staff, Elaine Sauceda. LPA's introduced selves, explained reason for visit and were permitted entry into the facility. Licensee, Josiane Jones was contacted and arrived some time later. LPA's completed a health and safety check on residents in care. 3 of 3 residents observed having breakfast in the living room area. LPA's toured the facility inside and out. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 8/22/23. Last fire drill on 9/16/23. 3 of 4 resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in linen closets and in good repair. Sharps located in a locked laundry room closet. LPA's observed sufficient seating under covered patio areas. LPA L. Salazar completed records review. The following issues were observed at time of visit: Water temperature in bathroom #1 measured at 127.8 degrees F. Water temperature in kitchen measured at 138.7 degrees F. Food was stored in closet off the kitchen and observed to be locked. Medications were located off the kitchen in a closet and observed to be unlocked. Sign on kitchen cabinet towards living room stating "effective immediately, staff only beyond this point (no exceptions)", R1 has full bed rails, chemicals observed in hallway closet unlocked, freezer in garage needs to be defrosted, side gate #1 observed to be without latch, side gate #2 observed to be without latch and locked, right side back yard fence leaning and in need of repair. CONT... CONT... LPA's requested the following documents to be submitted to CCL by 12/7/23: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. The following resources were provided to Licensee: Entrance Checklist (LIC 9242), Resources for Dementia training, Training Regulation (87707), Function Capabilities Form (LIC 9172), Reappraisal regulation (87463), Medication Training Regulation (H&S 1569.9), and TSP for Hospice Care and Medication Guide, Due to time constraints LPA's will return to complete an annual continuation visit. Deficiencies (if any) will be cited at that time. Exit interview completed with Licensee and a copy of this report was provided.the state’s words, verbatim · CDSS document, Nov 30, 2023

Type of visit: Case Management - Annual Continuation

On 11/30/23, Licensing Program Analysts (LPAs) L. Salazar and M. Garza arrived to the facility unannounced to conduct the required annual visit. LPAs were greeted by caregiver, stated the purpose of the visit and were allowed entry into the facility. Licensee was notified and arrived shortly after. LPA L. Salazar reviewed staff and resident records. LPA M. Garza documented details of the annual visit on a separate report.the state’s words, verbatim · CDSS document, Nov 30, 2023