Fresno Senior Living

Allegation investigated: Staff did not ensure residents emergency cord was working properly Staff did not refund resident's authorized representative the correct amount Due to lack of supervsion, resident was left on the floor for several hours

On 5/18/2026, Licensing Program Analyst (LPA) M Vega conducted a subsequent complaint investigation visit to the facility. LPA was granted entry into facility and met with Executive Director - Sarah Dennis. LPA provided information regarding visit. “Staff did not ensure residents emergency cord was working properly and Due to lack of supervision, resident was left on the floor for several hours.” Resident 1 is an independent living resident. State Licensing does not investigate complaints for the independent living areas of this facility. Facility Administrator provided several documents, and a written statement acknowledging Resident 1 resides in independent living area of this facility. The department has investigated the complaints alleging, “Staff did not ensure residents emergency cord was working properly and Due to lack of supervision, resident was left on the floor for several hours.” The department has found that the allegations were unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Continuation on LIC 9099C Unfounded Regarding the allegation, “Staff did not refund resident's authorized representative the correct amount”. Resident 1 is an independent living resident. State Licensing does not investigate complaints from the independent living areas of this facility. Facility Administrator provided several documents, and a written statement acknowledging Resident 1 resides in independent living area of this facility. LPA has investigated the complaint alleging “Staff did not refund resident's authorized representative the correct amount”. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. This agency has investigated the above allegations and have them to be UNFOUNDED. This means that the allegation was false, could not have happened or is without a reasonable basis. We have found that the complaint was unfounded, therefore we have dismissed the allegations. No deficiencies cited today, Per Title 22 Regulations. Exit interview conducted with facility Executive Director - Sarah Dennis, and a copy of this report provided for facility records.the state’s words, verbatim · CDSS document, May 18, 2026 · control 24-AS-20260212151624

Allegation investigated: Staff not preventing residents from smoking inside facility.

On 01/28/2026 Licensing Program Analyst (LPA) M Vega arrived at the facility unannounced to conduct an investigation regarding the allegation listed above. LPA met with Executive Director - Sarah Dennis and explained the purpose of today’s visit. Regarding the allegation, “Staff not preventing residents from smoking inside facility.” Resident 1 and Resident 2 are both considered to be independent living resident. State Licensing does not investigate complaints for the independent living areas of this facility. Facility Administrator provided several documents acknowledging Resident 1and Resident 2 reside in independent living area of this facility. This agency has investigated the complaint alleging, “Staff not preventing residents from smoking inside facility.” We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Nothe state’s words, verbatim · CDSS document, Jan 28, 2026 · control 24-AS-20251210165213

Type of visit: Required - 1 Year

On 01/28/26, Licensing Program Analyst (LPA) M Vega arrived at the facility unannounced to conduct Required Annual Inspection. LPA was greeted by receptionist and stated the purpose of the visit. LPA met with Executive Director (ED) - Sarah Dennis. LPA conducted tour of facility with ED. The facility was observed to be at a comfortable temperature, 72-75 degrees Fahrenheit throughout the facility. The facility was observed to be clean, in good repair, and no passageway obstructions or fire hazards observed. Fire extinguisher was observed with a service date of 01/2026 - 29/100. Dining area and Kitchen were toured. An adequate supply of perishable and non-perishable food was observed to be properly stored in walk-in freezer, walk-in refrigerator, and pantry. Refrigerator temperature was maintained at 40 degree F. and freezer was maintained at -5 degree F. LPA toured a sample of resident bedrooms. Residents' rooms were toured and observed with adequately furnished with bed, dresser, and adequate lighting. LPA toured laundry room and observed chemicals were stored and locked. Hot water temperature tested at 118.8 degrees F. LPA observed securely fastened grab bars and non-skid mat in all shower areas. Medications were stored in a locked medication room in a medication cart. Medications records were reviewed to be accurate at time of inspection. A sample of residents’ file was reviewed to have updated files. A sample of staff files were reviewed. Staff files were observed to have current records. Staff are fingerprinted clear and associated to the facility. Continuation on LIC 809C Community Care Licensing (CCL) is always striving to have facility files that reflect the most accurate & up to date information for your facility. In an effort to maintain your facility file, please submit the most current & complete forms &/or information as identified below: Residential Care Facility for the Elderly (RCFE): LIC 308 Designation of Facility Responsibility LIC 309 Administrative Organization LIC 400 Affidavit Regarding Client/Resident Cash Resources LIC 402 Surety Bond LIC 500 Personnel Report LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly LIC 9020 Register of Facility Clients/Residents Copy of current Liability Insurance Copy of current Administrator Certificate Alternate contact information including name, telephone number, & email address. Please submit the above forms/information to Fresno CCL by: 02/11/2026 As an operator of a Community Care Licensed facility it is your responsibility to be aware of and in compliance with all regulations, including Chaptered Legislation. Go to www.ccld.ca.gov to stay updated and informed.the state’s words, verbatim · CDSS document, Jan 28, 2026

Allegation investigated: Licensee does not ensure facility has a certified administrator Staff does not ensure facility is in good repair Staff does not ensure facility is kept free of pests Staff do not ensure scheduled activities are provided to residents

On 09/17/2025, Licensing Program Analyst (LPA) M Vega conducted an unannounced inspection at the facility and met with Resident Services Director - Rupinder Singh. The purpose of the visit was to conduct an investigation and deliver findings regarding the above allegations. Health and Safety tour of facility conducted. It was alleged that the Facility, Licensee does not ensure facility has a certified administrator, Staff does not ensure facility is in good repair, Staff does not ensure facility is kept free of pests, Staff do not ensure scheduled activities are provided to residents. It is determined the allegations are unfounded. Continuation on LIC 9099C Unfounded This agency has investigated the complaint alleging “Licensee does not ensure facility has a certified administrator, Staff does not ensure facility is in good repair, Staff does not ensure facility is kept free of pests, Staff do not ensure scheduled activities are provided to residents.” We have found that the complaint was unfounded per documentation reviewed and based on visual inspection of facility nothing was observed to be out of compliance, meaning that the allegations were false, could not have happened or is without a reasonable basis. We have found that the complaint was unfounded, therefore we have dismissed the complaint. A Copy of the signed report was provided to Resident Services Director - Rupinder Singh for facility records.the state’s words, verbatim · CDSS document, Sep 17, 2025 · control 24-AS-20250911105444

Allegation investigated: Facility did not safeguard resident’s property resulting in missing money

On 08/09/2025, Licensing Program Analyst (LPA) M Vega conducted a complaint investigation visit to the facility and met with Resident Services Director - Rupinder Singh. During this visit LPA delivered investigation findings regarding the above allegation. The Department has investigated the complaints alleging: Facility did not safeguard resident’s property resulting in missing money. During the course of the investigation, LPA conducted interviews, reviewed records and conducted facility tour. Based on the interviews conducted and/or records review the above allegations are found to be UNSUBSTANTIATED. Although the allegations may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. Unsubstantiatedthe state’s words, verbatim · CDSS document, Aug 20, 2025 · control 24-AS-20250516180037

Type of visit: Required - 1 Year

On 02/20/25, Licensing Program Analyst (LPA) M Vega arrived at the facility unannounced to conduct Required Annual Inspection. LPA was greeted by receptionist and stated the purpose of the visit. LPA met with Executive Director (ED) - Brandon Montelongo. LPA conducted tour of facility with ED. Residents were observed throughout the facility post lunch. Some residents were in the main lobby area playing bingo as well. The facility was observed to be at a comfortable temperature, 72-75 degrees Fahrenheit throughout the facility. The facility was observed to be clean, in good repair, and no passageway obstructions or fire hazards observed. Fire extinguisher was observed with a service date of 02/03/2025 - 29/100. Dining area and Kitchen were toured. An adequate supply of perishable and non-perishable food was observed to be properly stored in walk-in freezer, walk-in refrigerator, and pantry. Refrigerator temperature was maintained at 40-degree F. and freezer was maintained at -5-degree F. LPA toured a sample of resident bedrooms. Residents' rooms were toured and observed with adequately furnished with bed, dresser, and adequate lighting. LPA toured laundry room and observed chemicals were stored and locked. Hot water temperature tested at 120 degrees F. LPA observed securely fastened grab bars and non-skid mat in all shower areas. Medications were stored in a locked medication room in a medication cart. Medications records were reviewed to be accurate at time of inspection. Report continued LIC 809C Facility courtyard was toured and observed to be free from debris. There was outdoor seating available for the residents. A sample of residents’ file was reviewed to have updated files. A sample of staff files were reviewed. Staff files were observed to have current records. Staff are fingerprinted clear and associated to the facility. LPA requested following files: LIC 308 Designation of Facility Responsibility LIC 309 Administrative Organization LIC 400 Affidavit Regarding Client/Resident Cash Resources LIC 402 Surety Bond LIC 500 Personnel Report LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly LIC 9020 Register of Facility Clients/Residents Copy of current Liability Insurance Copy of current Administrator Certificate Alternate contact information including name, telephone number, & email address. An exit interview was conducted with the ED. No deficiencies issued during this inspection. A copy of this report was provided to the ED, whose signature on this form confirm receipt of this report.the state’s words, verbatim · CDSS document, Feb 20, 2025

Allegation investigated: Staff is overcharging resident in care.

On 08/21/2024, Licensing Program Analyst (LPA) V Gorban unannounced visited facility stated above to deliver findings, stated the purpose of the visit and was allowed entry into the facility by staff Judy Castro. Administrator (AD) Brandon Montelongo was notified of Licensing visit and was able to attend the visit. Allegation: Staff is overcharging resident in care. The Department conducted interviews and reviewed records. Based on staff interviews and records reviews the R1 is independent resident and located on independent section of the facility dedicated for independent residents. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated. No deficiencies were cited during this visit. Exit interview conducted, report signed and copy of this report provided to AD for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Aug 21, 2024 · control 24-AS-20240613084044

Allegation investigated: Staff not keeping facility free of pests.

On 08/09/2024 Licensing Program Analysts (LPA's) Sarah Hurt and Martin Vega arrived at the facility unannounced to conduct an investigation regarding the allegation listed above. LPA met with Administrator Brandon Montelango, and explained the purpose of todays visit. Regarding the allegation Staff not keeping facility free of pests.LPA's interviewed Resident 1 who stated the facility has already taken care of the pest issue. Resident 1 stated the pest issue was treated within one week of staff being informed. Facility staff was notified of pest issue on 07/31/2024, and Administrator provided invoice for pest treatment dated 08/08/2024. Resident 1's bedroom did have a pest issue, and the facility handled in a timely manner. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Nothe state’s words, verbatim · CDSS document, Aug 9, 2024 · control 24-AS-20240807101955

Allegation investigated: Staff did not ensure that resident is properly clothed.

On 08/09/2024 Licensing Program Analysts (LPA's) Sarah Hurt and Martin Vega arrived at the facility unannounced to conduct an investigation regarding the allegation listed above. LPA met with Administrator Brandon Montelango, and explained the purpose of todays visit. Reagrding the allegation Staff did not ensure that resident is properly clothed. Resident 1 is considered to be an Independent living resident. State Licensing does not investigate complaints for the Independent living areas of this facility. Facility Administrator provided several documents, and a written statement acknowledging Resident 1 resides in Independent living area of this facility. This agency has investigated the complaint alleging resident properly clothed. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Nothe state’s words, verbatim · CDSS document, Aug 9, 2024 · control 24-AS-20240807151946

Allegation investigated: Facility is not meeting resident's dietary needs. Facility staff are violating residents personal rights.

On 07/16/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Brandon Montelongo and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with the AD. Allegations: Facility is not meeting resident's dietary needs, and Facility staff are violating residents personal rights. During the facility visit on 03/06/24, interviews, and records review, these allegations are unsubstantiated. Although the allegations may have happened or valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Exit interview conducted, report signed and copy of this report provided to Administrator for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jul 16, 2024 · control 24-AS-20240305100554

Allegation investigated: Facility is not providing a healthful environment for residents in care.

On 07/16/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Brandon Montelongo and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with the AD. Allegation: Facility is not providing a healthful environment for residents in care. Based on observations during the facility visit on 7/16/24, interviews, and records review, this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated. Exit interview conducted, report signed and copy of this report provided to Administrator for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jul 16, 2024 · control 24-AS-20240506131940

Allegation investigated: Staff did not seek timely medical attention for resident

On 06/10/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Brandon Montelongo and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with the AD. Allegation: Staff did not seek timely medical attention for resident. Based of staff interviews and record reviews, once staff responded to resident call, assessment was completed on cite by facility nurse and emergency medical services was requested. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated. Report continues on LIC 9099-A Unsubstantiatedthe state’s words, verbatim · CDSS document, Jun 10, 2024 · control 24-AS-20240226134733

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(a) · Plan of correction due date: Jun 14, 2024

87411 Personnel Requirements - General, (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This was not observed as evidenced by: Based on staff interview and records review the facility failed to respond to residents call in timely manner resulted resident laying on the floor bleeding. This is poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Jun 10, 2024

Plan of correction: The facility Administrator will randomly tests call light to observe staff responding in timely manner, Administrator also provided in service training every first Thursday of the month and provide to LPA by email.

Type of visit: Case Management - Incident

On 06/10/24, Licensing Program Analyst (LPA) V Gorban conducted a case management deficiency visit to the facility. LPA introduced self, stated the purpose of the visit, and met with Administrator Brandon Montelongo. The purpose of the visit is to address an incident that occurred where R1 went AWOL on 03/03/2024. The facility was unaware when R1 AWOL the facility. The facility staff unaware of how long R1 was outside. Residents file review stated resident unable to leave facility unassisted. Therefore, as a result, a deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached 809D. An exit interview was conducted. A copy of this report and appeal rights provided to Administrator, whose signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Jun 10, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87413(a)(2) · Plan of correction due date: Jun 14, 2024

87413 Personnel - Operations. (2) Care and supervision of residents shall be provided without physical or verbal abuse, exploitation or prejudice. This was not observed as evidenced by: The facility failsed to provide supervision resulted unsupervised dementia resident found outside laying on the ground with pillow, blanket, and remote control. This is poses potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Jun 10, 2024

Plan of correction: Administrator will routine checks for elopement of residents staff hourly especially during evening and NOC shifts. In-service training is complete and will be provided to LPA by email.

Allegation investigated: Staff are not providing adequate food service

On 4/30/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Brandon Montelongo and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with the AD. Allegation: Staff are not providing adequate food service. During complaint investigation the LPA reviewed facility records, interviewed facility staff, residents, and the Administrator. Based of observations, interviews and records review no violations have been observed. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Report continues on LIC9099-A Exit interview conducted, report signed and copy of this report provided to the Administrator. Unsubstantiatedthe state’s words, verbatim · CDSS document, Apr 30, 2024 · control 24-AS-20240207152206

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(b)(9) · Plan of correction due date: May 3, 2024

87555 General Food Service Requirements (b) (9) Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service. This was not observed as evidenced by: The facility failed to follow regulation cited above. The prepared perishable food when stored in the refrigerator was not dated, that poses potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 30, 2024

Plan of correction: The facility corrected deficiency during the visit by tossing out the perishable food from the refrigerator with no dates on it. Administrator will provided kitchen staff training to LPA by email.

Type of visit: Case Management - Other

On 4/30/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Brandon Montelongo and stated the purpose of the visit. During the visit on 3/06/2024 LPA opened complaint investigation and during that visit LPA requested facility files for R1 to be submitted to Licensing by 5pm 3/20/2024. As of 4/30/2024 Licensing did not receive files requested for R1. Following Title 22 regulation, deficiency will be cited on attached LIC9099-D form Exit interview conducted, report signed and copy of this report with Appeal rights provided to Administrator for facility records.the state’s words, verbatim · CDSS document, Apr 30, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(a) · Plan of correction due date: May 3, 2024

87506 Resident Records. (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This was no observed as evidenced by: The facility failed to provide documents requested for R1 in timely manner and by due date on 3/202/24, which posses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 30, 2024

Plan of correction: Administrator will provided the files for R1 by the end of the week, 5/03/2024. Administrator will email these files for R1 to LPA by email.

Allegation investigated: Staff do not ensure the dishes are cleaned properly Staff are not serving residents food in a sanitary manor

On 4/25/24, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility with Resident Services Director (RSD) Rupinder Singh and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with RSD Allegation: Staff do not ensure the dishes are cleaned properly. During complaint investigation the department Toured the facility for observations, interviewed facility staff and the Administrator. Based of observations, records review and staff interview the dishes cleaned by machine and no concerns of dirty dishes observed by kitchen personnel. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Report continues on LIC 9099-C Unsubstantiated Allegation: Staff are serving residents food in sanitary manor. During complaint investigation LPA toured the facility for observations, interviewed facility residents, and kitchen staff. Based of observation conducted on 2/6/24 and kitchen staff and residents interview staff follow hand hygiene before serving residents with kitchen utensils to deliver food. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Exit interview conducted, report signed and copy of this report provided to RSD for facility records.the state’s words, verbatim · CDSS document, Apr 25, 2024 · control 24-AS-20240202114450

Allegation investigated: Facility is in disrepair. Staff did not ensure that residents are being fed.

On 3/29/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Brandon Montelongo and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with the AD. Allegation: Facility is in disrepair. During complaint investigation the LPA reviewed facility records, interviewed facility staff, residents, and the Administrator. Based off of records review, one of three facility elevators was in repair and is currently fixed. Allegation: Staff did not ensure that residents are being fed. Based off of records reviews and residents and staff interviews no concerns of residents not being fed. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Exit interview conducted, report signed and copy of this report provided to the Administrator. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 29, 2024 · control 24-AS-20240109164535

Type of visit: Required - 1 Year

On 02/26/24, Licensing Program Analyst (LPA) V. Gorban arrived at the facility unannounced to conduct Required Annual Inspection. LPA was greeted by receptionist and stated the purpose of the visit. LPA met with Administrator (AD) Jeralyn May. LPA conducted tour of facility with AD. Residents were observed at breakfast in the dinning room. The facility was observed to be at a comfortable temperature, 75 degrees Fahrenheit, clean, in good repair, and no passageway obstructions or fire hazards observed. Fire extinguisher was observed with a service date of 03/24/23. Dining area and Kitchen were toured. An adequate supply of perishable and non-perishable food was observed to be properly stored in walk-in freezer, walk-in refrigerator, and pantry. Food is delivered twice a week, on Wednesdays and Saturdays. Refrigerator temperature was maintained at 40-degree F. and freezer was maintained at -5-degree F. LPA toured a sample of resident bedrooms. Residents' rooms were toured and observed with adequately furnished with bed, dresser, and adequate lighting. Hot water temperature tested at 107 degrees F. LPA observed securely fastened grab bars and non-skid mat in all shower areas. Medications were stored in a locked medication room in a medication cart. Medications records were reviewed. First Aid Kit was stored in medication room and observed with all required items. LPA toured laundry room and observed chemicals were stored and locked. Report continues on LIC809-C Facility courtyard was toured and observed to be free from debris. There was outdoor seating available for the residents. A sample of residents’ file was reviewed to have updated emergency contact, Admission agreement, Needs and Services Plan and Pre-Appraisal Plan. A sample of staff files were reviewed. Staff files were observed to have current First Aid/CPR, Health screening, and Personnel record. Staff are fingerprinted clear and associated to the facility. LPA requested following files: · LIC 308 Designation of Facility Responsibility · -as applicable: LIC 309 Administrative Organization · -as applicable: LIC 400 Affidavit Regarding Client/Resident Cash Resources · -as applicable: LIC 402 Surety Bond · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly · LIC 9020 Register of Facility Clients/Residents · Copy of current Liability Insurance · Copy of current Administrator Certificate · Alternate contact information including name, telephone number, & email address. Provide requested documents by 5pm, 3/15/24 An exit interview was conducted with the AD. No deficiencies issued during this inspection. LPA will review provided fire clearance and updated facility sketch. A copy of this report was provided to the AD, whose signature on this form confirm receipt of this report.the state’s words, verbatim · CDSS document, Feb 26, 2024

Allegation investigated: Facility is not properly treating for cockroaches. Facility floor surfaces are not maintained in an odorless condition.

On 2/16/24 Licensing Program Analyst (LPA) Gorban conducted subsequent visit to deliver findings. LPA met with Administrator, Jeralyn Mai and stated purpose of the visit. Allegations: Facility is not properly treating for cockroaches and Facility floor surfaces are not maintained in an odorless condition. During the course of investigation LPA conducted interviews and record reviews. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Exit interview conducted, report signed and copy of this report provided to AD for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Feb 16, 2024 · control 24-AS-20231117151834

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Feb 20, 2024

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. This was not observed as evidenced by: Based on observations and interviews staff did not have scheduled floors maintenance, floors with spots on carpet floors of dirt all over the facility, which poses potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Feb 16, 2024

Plan of correction: Administrator provided plan of correction to carpet cleaning schedule and maintenance, including independent and assisting living portion of the facility. Dining room and facility main entrance washed monthly, every couple months facility cleaning facility hallways.

Type of visit: Case Management - Incident

On 12/20/23 at 08:17 AM, Licensing Program Analyst (LPA) V Gorban arrived unannounced to conduct a case management inspection. LPA explained the reason for inspection and met with Administrator (AD) Jeralyn Mai. LPA toured the facility inside and out to conduct safety checks. Incident 1: RO received an incident report on 12/15/23 medication error. R1 was given medication in the morning. R1 was provided with the wrong dose of medication. R1 received Clonazepam of 1,0mg. instead of 0.5mg, prescribed by physician. When interviewed, staff responded they realized error during medication count that conducted every end of the shift which is three times a day. AD notified regional office (RO) same day by incident report. Responsible Party and physician of R1 was notified same day as well by the facility. Incident 2: On 12/13/23 RO was notified of R2 official 30-day termination and notice to quit. Notice due date was 12/13/23. RO was not notified by the facility of R1 eviction. Facility did not follow title 22 states eviction procedures. Deficiencies are cited on LIC-9099. Exit interview conducted, report signed and copy of this report with appeal rights provided for facility records.the state’s words, verbatim · CDSS document, Dec 20, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(c)(2) · Plan of correction due date: Dec 20, 2023

87465 Incidental Medical and Dental Care. (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidenced by. Based interviews and incident report provided to Regional Office, R1 received a double dose of medication: 1.0mg instead of 0.5mg of Clonazepam prescribed. This is poses immediate health and safety risk of residents in care.the state’s words, verbatim · CDSS document, Dec 20, 2023

Plan of correction: Following the plan of Correction, Administrator will provide to Regional Office staff training on medication dispense and medical care by 12/20/23. POC was corrected during the visit.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87224(b) · Plan of correction due date: Dec 22, 2023

87224 Eviction Procedures. (b) The licensee may, upon obtaining prior written approval from the licensing agency, evict the resident upon three (3) days written notice to quit. The licensing agency may grant approval for the eviction upon a finding of good cause. This was not observed as evidenced by: Regional Office was not notified of eviction notice by facility and resident to be evicted from facility when title 22 was not followed which poses health and safety risk of residents in care.the state’s words, verbatim · CDSS document, Dec 20, 2023

Plan of correction: Following the Plan of Correction, Administrator will properly notify Regional Office and LPA by following Title 22 eviction procedures by 12/22/23. POC was corrected during the visit.