Woodruff Care Home Inc

Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint visit regarding the above allegation. LPA met with Khrysta Margaros (Assistant Administrator) and explained the reason for the visit. The investigation consisted of the following: LPA obtained copies of the staff/residnet rosters, and conducted interviews with 8 Residents (R1-R8) and 6 Staff (S1-S6). (Continued on LIC9099-C) Unsubstantiated— CDSS inspection report, October 23, 2025 · control 28-AS-20251020162944

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced complaint visit regarding the above stated allegation. LPA met with Gemma Deoso, Administrator and explained the reason for the visit. The investigation consisted of the following: LPA obtained copies of Resident & Staff Rosters, conducted a tour of facility such as common areas, focusing on the residents' rooms, Electrician's contact information and Resident #1 (R1) files such as; Identification and Emergency Information Sheets, Physician Reports, and Resident Appraisal. Between 2:03pm-2:48pm, LPA measured the room temperature using the infrared thermometer in (12) random residents rooms on the ground and 2nd floors, (Room numbers: 107, 110, 111, 113, 119, 126, 235, 236, 239, 240, 242 and 246). LPA also interviewed the Administrator, Staff #1 (S1) - Staff #3 (S3), and Resident #1 (R2) - Resident #10 (R10). ******CONTINUED ON LIC9099-C***** SubstantiatedRead the full finding— CDSS inspection report, July 17, 2023 · control 28-AS-20230714100240

Licensing Program Analyst (LPA) Cynthia Chan conducted the complaint investigation for the allegations listed above. LPA arrived unannounced and met with Assistant Administrator, Khrysta Margaros. The purpose for the visit was explained. Administrator, Gemma Deoso, arrived shortly thereafter to assist with the visit. The investigation consisted of the following: LPA obtained copies of the staff and resident rosters, staff in-service training log, and reviewed Resident's #1 (R-1) file. LPA also toured the facility, interviewed the Administrator, Staff #1 - #4, and Residents #1 - #6. The investigation revealed the following: For allegation - Staff spoke inappropriately to resident in care. During the visit today, LPA interviewed the Administrator, Staff, and Residents. UnsubstantiatedRead the full finding— CDSS inspection report, June 22, 2023 · control 28-AS-20230613104451

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegation. LPA met with Administrator Gemma Deoso and explained the reason for the visit. The investigation consisted of: LPA conducted interviews with Administrator Gemma Deoso, Staff 1-2 (S1-2) and Residents 1-6 (R1-6). LPA collected copies of Staff and Resident rosters. LPA reviewed R1-2's facility files and collected copies of documents relevant to the investigation. (See LIC9099C for continuation) Unsubstantiated— CDSS inspection report, June 13, 2023 · control 28-AS-20230607152031

Licensing Program Analyst(s)(LPA) Mary Flores conducted an unannounced initial complaint investigation visit regarding the above allegation. LPA met with Gemma Deoso Administrator and explained the reason for the visit. The investigation consisted of the following: LPA requested a copy of staff/resident roster, face sheet, physician's report, preplacement appraisal information, resident personal property and valuables, for resident #1 (R1) and #2(R2). LPA interview residents 1 - 5 and staff 1-5. The investigation revealed the following: Regarding allegation: Staff did not prevent resident from stealing another resident's personal belongings. It is alleged R2 is continuously stealing R1's personal items; such as phone, debit card, and clothing. R1 stated a phone was stolen from her by R2 and charges to R1's debit card were made for amounts R1 usually does not make. In addition, personal documents have gone missing. Per R1 there was no police report file regarding missing items. (CONTINURead the full finding— CDSS inspection report, June 13, 2023 · control 28-AS-20230605141305

Licensing Program Analyst (LPA) Bennette Pena conducted a 10-day complaint visit to investigate the allegations listed above. LPA met with Administrator, Gemma Deoso and explained the purpose of the visit. Administrator and S1 assisted LPA Pena with the visit. The investigation consisted of the following: LPA obtained copies of Resident & Staff Rosters, Plumber's invoice dated 3/16/2023, random resident admission agreement, House rules and Housekeeping job description. LPA toured the facility’s common areas such as residents rooms, bathrooms and designated smoking areas with S1. Between 11am-11:50am, LPA conducted the hot water temperature check in (8) random residents’ rooms on the first and second floor, (Room numbers: 107, 110, 116, 129, 235, 236, 240, 242). At 2:30pm, LPA measured and inspected (3) random residents rooms (Room numbers: 121, 126 & 127) using an infrared thermometer to measure the room temperature (photos taken). LPA interviewed the Administrator, Staff #1 (S1) – StaRead the full finding— CDSS inspection report, June 5, 2023 · control 28-AS-20230531105328

Licensing Program Analysts (LPA) Bennette Pena conducted an unannounced complaint visit regarding the above allegation. LPA met with Staff #1 (S1) and explained the reason for the visit. The investigation consisted of the following: LPA obtained Resident & Staff Rosters, In-service training/meeting record (Report suspected Abuse of Dependent Adults & Elders/Mandated Rights, Personal Rights). LPA also toured the facility with the Asst.Administrator which included all the common areas and a random sample of resident bedrooms. LPA also interviewed Staff #1 - Staff #5 and Resident #1 (R1) - Resident # 6 (R6). LPA attempted to interview night shift Staff #6 (3x), (2:15pm, 3:54pm and 4:17pm) and left a voice mail message, but S6 did not return the call. *****CONTINUED ON LIC9099-C***** UnsubstantiatedRead the full finding— CDSS inspection report, March 29, 2023 · control 28-AS-20230328111454

Licensing Program Analysts (LPA) Kimberly Ramirez and LPA Tena Herrera conducted an announced subsequent complaint visit stemming from initial complaint visit dated 11/22/2021. LPA’s met with Administrator Carmen Galicia and explained the purpose of the visit. The investigation consisted of the following: A physical plant inspection of the facility was conducted at 10:02 am. Staff (S1-S5) and residents (R1-R4). LPA’s requested a copy of LIC 500, resident roster, Resident R1 face sheet, R1 Emergency contact sheet, R1 Physician orders, R1 medical records, LIC 624, Post Discharge Plan of Care and Outside Agency Documentation log. See LIC 9099-C for continuation. UnsubstantiatedRead the full finding— CDSS inspection report, February 16, 2023 · control 28-AS-20211117125615

This is a corrected verison of previous complaint report dated 02/16/2023. Verbiage was corrected on LIC 9099. Licensing Program Analysts (LPA) Kimberly Ramirez and LPA Tena Herrera conducted an announced subsequent complaint visit stemming from initial complaint visit dated 11/22/2021, conducted by LPA Gonzalez. LPA’s met with Administrator Carmen Galicia and explained the purpose of the visit. The investigation consisted of the following: A physical plant inspection of the facility was conducted at 10:02 am. Staff (S1-S5) and residents (R1-R4) were interviewed. LPA’s requested a copy of LIC 500, resident roster, Resident R1 face sheet, R1 Emergency contact sheet, R1 Physician orders, R1 medical records, LIC 624, Post Discharge Plan of Care and Outside Agency Documentation log. See LIC 9099-C for continuation. UnsubstantiatedRead the full finding— CDSS inspection report, February 16, 2023 · control 28-AS-20211117125615

On 02/02/23 at 9:26 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced complaint visit to the facility. Upon arrival LPA met with Carmen Galicia (Administrator) and explained the purpose of the visit. During today’s visit LPA and administrator toured the facility and tested the call button in rooms 110, 113, 119, 129, 132, 233 and 246. LPA obtained resident/ staff roster, Resident #1 Physicians report, Photo of R1's medication and Resident #1 Physicians orders. LPA also interviewed: Administrator and a total of two (2) staff who shall be referred to as S1, and S2. LPA interviewed a total of 6 residents who shall be referred to as: R1 through R6. Report continued 9099c UnsubstantiatedRead the full finding— CDSS inspection report, February 2, 2023 · control 28-AS-20230125151435

Licensing Program Analyst (LPA) V. Maldonado made an unannounced subsequent complaint visit at the facility for the purpose of investigating the above mentioned allegation. LPA Maldonado met with Administrator Carmen Galicia and explained the purpose for the visit. On 04/27/20 at 8:48 AM the LPA Arterberry interviewed a resident who shall be referred to as R1. On 04/27/2020 at 11:25 AM the LPA also interviewed the administrator. The following documents were supplied by the administrator for R1: Woodruff Care Home Identification Page/Face Sheet, 30-Day Notice of Eviction dated 03/31/2020, House Rules, Psychiatric Progress Notes dated 04/20/2020, Individualized Service Plan (ISP), Resident Assessment Form, Lakewood Regional Medical Center Discharge Instructions and Unusual Incident Reports (SIR). (Report Continued on LIC9099-C...) UnsubstantiatedRead the full finding— CDSS inspection report, December 12, 2022 · control 28-AS-20200421112512

On 11/03/2022 at 9:15 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted a subsequent complaint visit to investigate the allegations listed above. LPA met with Administrator Carmen Galicia and explained the reason for the visit. The initial complaint visit was conducted on 9/20/2022. During the initial visit LPA Baptiste conducted a health and safety check. LPA conducted a tour of the facility, inside and out. LPA requested copies of staff and resident roster along with Resident #1 (R1) Face sheet, Psychiatric assessment dated 5/12/2020, Physicians’ orders dated 7/12/22, Resident assessment, Individualized service plan and Physicians report. LPA also obtained Resident #2 (R2) Face sheet, Physician’s report dated 7/06/2022, Resident assessment, Individual Service Plan, Comprehensive assessment dated 5/13/22, Physicians orders dated 8/7/022 and Order Summary Report from Valley Convalescent Hospital. Report continued on 9099c UnsubstantiatedRead the full finding— CDSS inspection report, November 3, 2022 · control 28-AS-20220916162018

On 9/29/2022 at 9:00 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted a subsequent complaint visit to investigate the allegations listed above. LPA met with Administrator Carmen Galicia and explained the reason for the visit. The initial complaint visit was conducted on 8/30/2022. The investigation consisted of the following: During the initial visit, LPA toured the facility with the administrator and obtained the resident/ staff roster, R1's discharge paperwork dated 7/25/22, 8/19/22, 8/24/22, and 8/26/22. LPA received a copy of Incident reports dated 7/25/22, 8/1/22, and 8/19/2022, Pest control reports dated 8/10/22 and 8/17/2022, Laundry schedule, list of R1’s medications, and a copy of R1's MAR. LPA interviewed residents R1 through R6. LPA Interviewed administrator and staff S1. During the subsequent complaint, LPA received written notice from R1's primary care provider confirming that R1 is negative for scabies. Report continued on 9099c UnsubstantiatedRead the full finding— CDSS inspection report, September 29, 2022 · control 28-AS-20220823114418