Stoneridge Creek Pleasanton

Type of visit: Required - 1 Year

On 09/30/2023 at 9:00 AM, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced required one-year inspection and met with Aman Nagra, Resident Health Services Director, and explained the purpose of the visit. Ezekiel Griffin Executive Director later arrived at 1:10PM. This facility is an independent living part of the Community Care Retirement Communities (CCRC) composed of five separate four story per site plan - The Tahoe, Eldorado, Shasta, Mendocino and Lassen. In addition to these buildings are the Garden Terraces (GT) units - West has three floors and East has two floors. Along the perimeter of the GT units are the Villas (six category townhouses with private garages ranging from 700 sq ft to 2000+ sq ft). LPA observed the Clubhouse is the main building where management/maintenance offices are located. It also includes resident amenities such as the gardens, Bocce ball courts, Yoga studio, Wood shop, Astronomy center, Tennis courts, Safety Kiosk, Dog parks, spa/salon, game/card rooms, billiard room, theater, fitness center, library, restaurant, cafe and dining rooms. Current census is 810 residents with total capacity for 828 residents. Fire clearance was approved for 558 non-ambulatory residents which includes a hospice waiver for four (7) residents. Fire Drill was last conducted on 08/3/23. Emergency/Disaster Plan (LIC 610E) is posted near the reception desk and close to a Lan line phone. LPA reviewed fourteen (10) resident and ten (6) staff files. Staff has fingerprint clearances and are associated to the facility. Resident files contained Admission Agreements, Physicians' reports (LIC 602), Resident Appraisals (LIC 603A), Assessments, Needs/Services plans (LIC 625), Centrally stored medications (LIC 622), Advanced Health Care Directives/DPOA-H/POLST and Transfer Agreement, ID/Emergency information (LIC 601), Consent for Emergency Treatment (LIC 627C), Personal rights (LIC 613), Personal Property & Valuables (LIC621), Telecommunications Device Notification (LIC 9158), LGBT residents' Bill of Rights. LPA along with Executive Director inspected ten (10) apartment units in five separate buildings (the Eldorado, Tahoe, Shasta, Mendocino and Lassen) and units in the Garden Terraces/Villas areas. LPA observed apartment units were clean and in good repair. There were grab bars in the bathrooms. Hot water temperatures were measured at 116.0 degrees Fahrenheit (Eldorado); 117.6 degrees Fahrenheit (Tahoe); 113.1 degrees Fahrenheit (Mendocino), 113.3 degrees Fahrenheit Lassen and 110.8 degrees Fahrenheit (Shasta). 119.6 and 118.0 Fahrenheit Garden Terraces and 112.6 Fahrenheit Villa. Apartments have their own washer and dryer for use of the resident. LPA observed each apartment has a kitchen. Units are equipped with refrigerators, dish washers, stove, washer, and dryer. Lifeline emergency response buttons are in place in each bathroom. Each unit has also a check in button. Signal systems are either pendants that people wear, or they can push a panic button. There is a check in button that people press around 4:38 PM. If they do not check in, staff goes to check on them. Fire extinguishers (approx. 256) located throughout the facility's buildings were last inspected on 03/7/2023. Stryker emergency chairs were located on the second floor of each building for Emergency/Disaster preparedness. The facility has a health services office where people may come if they aren't feeling well, need blood pressure taken, or minimal wound care for surgical wounds. There are 3 large dining rooms and kitchen. Kitchen freezer was observed at zero degrees Fahrenheit, and three (3) refrigerators were at 35 degrees Fahrenheit. Food supply was checked and there is an adequate supply of 2-day perishables and 7-day non-perishables. Kitchen and food preparation areas were observed to be clean and in compliance. At the Clubhouse, LPA observed a variety of activity rooms such as the library (run by residents), game rooms, movie theater, fitness rooms. Medication room is locked. Medication technicians /Registered nurses have first aid and CPR and annual training. A certified administrator is on site 40 hours a week to oversee business operation. No deficiencies were observed in the areas that were evaluated. No citations were issued during today’s inspection. Exit interview conducted and a copy of this report provided to Executive Director.the state’s words, verbatim · CDSS document, Sep 30, 2023

Type of visit: Case Management - Deficiencies

The Continuing Care Contracts Bureau (CCCB) conducted an unannounced call with Ezekiel Griffin, Executive Director -Stoneridge (ED), on March 1, 2022 and March 9 and Warren Spieker, Managing Partner of Continuing Life, Inc. (MP) on December 14, 2022 regarding an investigation in to allegations made. During the investigation CCCB, in its review of the Budget Presentation PowerPoints found that the comparative data was missing the YTD actuals as required by H&SC 1771.8 (d). However, during the interview that occurred on December 14, 2022, between the Department and the Provider regarding the missing information, the Provider submitted the current 2023 budget presentation information, and the actual data was included. The Department has determined this is a violation of H&SC 1771.8(d) due to lack including the actual data in the prior years, however, as of the date of these findings, it has been corrected. The Department is imposing a $1,000 administrative fine as provided for in H&SC section 1793.27(a). The administrative fine shall be paid by check made payable to the CCRC Oversight Fund within 14 days of delivery these finding (9/13/2023). LIC809 AND LIC809-D shared via Teams with Ezekiel Griffin 9/16/2023 at 9:30am. Signed copied emailed.the state’s words, verbatim · CDSS document, Sep 13, 2023

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1771.8(d) · Plan of correction due date: Sep 13, 2023

In the Department's review of the Budget Presentation PowerPoints it found that the comparative data was missing the YTD actuals as required by H&SC 1771.8 (d).the state’s words, verbatim · CDSS document, Sep 13, 2023

Plan of correction: During the interview that occurred on December 14, 2022, between the Department and the Provider regarding the missing information, the Provider submitted the current 2023 budget presentation information, and the actual data was included. Provider stated that the YTD actual data will be included moving forward. The Department is imposing a $1,000 administrative fine as provided for in H&SC section 1793.27(a). The administrative fine shall be paid by check made payable to the CCRC Oversight Fund within 14 days of delivery of these findings (09/13/2023).

Allegation investigated: Provider incorrectly included litigation expenses in the monthly care fee increase calculation.

Complainant alleges that the Provider included legal expenses in the monthly care fee increase and that those costs should not be included as “projected costs, prior year per capita costs and economic indicators,” under Health and Safety Code section 1788(a)(22)(B). The Department interviewed complainant and Ezekiel Griffin, Executive Director and reviewed the following documents: • 2023 Budget Presentation • Summary of projected legal expenses for 2022 and the 2023 budgeted legal expense As to the 2022 projected legal expense and 2023 budgeted legal expense, the Department believes that legal expense to defend the community from suits can be an appropriate cost in the operation of a community. So, it does not find a violation as to the 2022 projected legal expense or 2023 budgeted legal expense. The Department has also determined that government-imposed fines and penalties, and government attorney fees do not constitute a legitimate cost of operation and may not be passed on to residents in monthly care fees; however, based on its review The Department has determined that these costs were not factored into the fee increase. Based on the review and investigation the Department finds the allegation “unsubstantiated”. Complaint finding were delivered via Teams and LIC 9099 was signed and emailed. Katie Anderson was in attendance. Unsubstantiatedthe state’s words, verbatim · CDSS document, Aug 29, 2023 · control 15-AS-20230630110029

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Allegation investigated: Provider is deliberately overstating operating costs and under estimating revenue in the budget, increasing NOI over budget Provider and managing partner failed to keep minutes pertaining to decisions made.

Complainant alleges that the Provider is deliberately overstating operating costs and under estimating revenue in the budget, increasing the Net Operating Income (NOI) over budget which is in violation of Health & Safety Code (H&SC) §1788(a)(22)(B) which states that “…changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.”, which in the complainant’s opinion excludes operating profits. The Department interviewed Ezekiel Griffin, Executive Director -Stoneridge, on March 1, 2022 and March 9 and Warren Spieker, Managing Partner of Continuing Life, Inc. on December 14, 2022 and received and reviewed the following documents: • PowerPoint presentations utilized at Budget planning meetings • FYE 2021 Quarterly Financial statements • Audited financial statements Statement of Operating Activities for the periods FYE 2019-2021 • FYE 2020 – 2023 Budget Presentation PowerPoints provided to compare. • Form 7-1 Annual Report Instructions Upon completion of review, it was observed that while the projections exceeded the actual revenue and expenses, the percentage of difference was reasonable, less than 4%. Additionally, the statutes do not dictate that a Provider must utilize a specific formula to project costs and revenues, it just states they must be based on projected costs, prior year per capita costs and economic indicators. While projected the costs were more than the actual expenses and revenue, there is no indication that the costs/expenses were deliberately overestimated, nor the projected revenue understated. The statutes do not state that a provider’s profit is disallowed by statutes determining the MCFI, however the Form 7-1 instructions do require the provider to explain how those funds will be used and or distributed. Therefore, the Department finds the allegation “unfounded” due to the satisfactory background information submitted to the Department and relayed to the residents during the budget planning meetings. -- Complainant alleges that the Provider and managing partner failed to keep minutes pertaining to decisions made that violates H&SC §1771.8(h) that requires, “… a provider shall maintain, as public information, minutes of the meetings held by the provider's governing body.” The Department reviewed the statutes associated with the allegations and confirmed that due to the Provider being a Limited Liability Company, they do not have a governing body and therefore are not required to maintain minutes. The Department has determined that this allegation is “unfounded” due to lack of evidence identifying that the Provider held meetings with a governing body. Unfoundedthe state’s words, verbatim · CDSS document, Jul 14, 2023 · control 15-AS-20220216085039

Allegation investigated: Provider failed to include resident representatives and excluded residents from budget meetings they are entitled to attend under the Health and Safety Code. Provider failed to provide residents with all budget information and documents provided to the Managing Partner. The provider included a provision in the Resident Care Agreement about raising rates that violates the Health and Safety Code.

Complainant alleges that Provider failed to include resident representatives and excluded residents from budget meetings they are entitled to attend, in addition to withholding documentation under the H&SC §1771.8(f) requires the provider to make available to resident association, governing body, or if neither exist, a committee of residents, quarterly financial statements and shall consult with the resident association, governing body, or if neither exist, a committee of residents during the budget planning process. The Department reviewed the following information: • The Bylaws of the Stoneridge Creek Resident Association and its Governing Body, the Resident Council (Bylaws) that describes the roles and duties of Resident Council, officers of the Resident Council, RLU Representative and committees. • Resident Council of Stoneridge Creek Operations Manual which further outlines the duties and responsibilities of each committee. • Quarterly Financial Reports that are distributed to the Financial Advisory Committee (FAC). The FAC is provided on a quarterly basis a financial statement of activity, comparing Budget to Actual along with a written Review of Significant Variances. The resident association or governing body can decide to delegate the review of the documents to a committee. (See, e.g. Corps Code section 311.) Based on the Bylaws and Operations Manual the resident association may establish committees. The FAC is a Standing Committee. The FAC designates a representative to meet with provider along with a resident council chair (resident representative). The Executive Director (ED), Ownership and Accounting Director consult with the resident representatives (resident council chair and a Financial Advisory Committee representative) during the Budget Planning process. These meetings are held on a monthly basis from July through November. The attendees are provided budget summaries and updates, these meeting consist of running dialogue. The ED did confirm that participants in these meeting are provided the same information and documentation. PA did interview a representative of the Financial Advisory Committee (W1) and Resident Council Chair (W2) that participated in the 2021 and 2022 budget planning process, and both were unable to say definitively that documentation was withheld during the process. PA found no evidence that access to documentation or information was withheld from the resident representatives. The Department has determined that the allegation is “unsubstantiated” due to lack of evidence showing that access to documentation or information was withheld from the resident representatives. -- Complainant alleges that the Provider included a provision in the Resident Care Agreement about raising rates that violates H&SC §1788, which contains the provisions of a contract. The Department reviewed the four current agreements that were initially approved for use by a program analyst on January 20, 2021, and they did not appear to conflict with the Continuing Care Contract Statutes. The Department has determined that the allegation is “unsubstantiated” due to lack of evidence identifying that the Provider used language regarding raising rates that violates the H&SC. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jul 14, 2023 · control 15-AS-20220216085039

Allegation investigated: Provider failed and refused to disclose to residents all the bases on which increases have been estimated.

Complainant alleges that Provider failed and refused to disclose to residents all the bases on which increases have been estimated which is in violation of H&SC §1788(a)(22)(B) states, “For monthly fee continuing care contracts, except prepaid contracts, changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.” The Department interviewed Ezekiel Griffin, Executive Director -Stoneridge (ED), on March 1, 2022 and March 9 and Warren Spieker, Managing Partner of Continuing Life, Inc. (MP) on December 14, 2022 and received and reviewed the following documents: • FYE 2020 – 2023 Budget Presentation PowerPoints provided to compare. • Budget Updates July 2022 – September 2022 • Emails between complainant and ED Based on the review of all documentation provided and the request of information by the complainant, the Providers provided information that was sufficient and thoroughly detailed the factors that went into the Monthly Care Fee Increase (MCFI). Additionally, the statutes do not specify how granular the description of the basis of increases must be as long as the factors are based on projected costs, prior year per capita costs, and economic indicators. The Department has determined that the allegation is “unsubstantiated” due to lack of evidence that the provider failed to disclose the factors used to in determining the MCFI. Amended findings were shared by via Teams with Ezekiel Griffin 9/16/2023 at 9:30am. Signed copy of LIC9099 emailed. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jul 14, 2023 · control 15-AS-20220216085039

Type of visit: Required - 1 Year

On 12/14/22 at 11:10 AM, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced required one-year infection control inspection and met with Administrator (ADM) Ezekiel Griffin at the Clubhouse. LPA explained the purpose of the visit to ADM which was to complete the required one year infection control inspection. This facility is an independent living part of the Community Care Retirement Communities (CCRC) composed of five separate four story per site plan - The Tahoe, Eldorado, Shasta, Mendocino and Lassen. In addition to these buildings are the Garden Terraces (GT) units - North has three floors and South has two floors. Along the perimeter of the GT units are the Villas (six category townhouses with private garages ranging from 700 sq ft to 2000+ sq ft). LPA observed the Clubhouse is the main building were management/maintenance offices are located. It also includes resident amenities such as the gardens, Bocce ball courts, Wood shop, Astronomy center, Dog parks, spa/salon, game/card rooms, billiard room, theater, fitness center, library, restaurant, cafe and dining rooms. Current census is 785 residents with total capacity for 828 residents. Fire Drill was last conducted in December of 2022. Emergency/Disaster Plan (LIC 610E) is posted near the reception desk and close to a Lan line phone. LPA along with ADM inspected apartment units were clean and in good repair. There were grab bars in the bathrooms. Hot water temperatures were measured at 112.5 degrees Fahrenheit. Apartments have their own washer and dryer for use of the resident. Report continue on LIC 809C... LPA observed each apartment has a kitchen. Units are equipped with refrigerators, dish washers, stove, washer and dryer. Life line emergency response buttons are in place in each bathroom. Each unit has also a check in button. Signal systems are either pendants that people wear or they can push a panic button. There is a check in button that people press first thing in the morning. If they do not check in, staff goes to check on them. Fire extinguishers (approx. 256) located throughout the facility's buildings were last inspected on 12/1/2022. The facility has a health services office where people may come if they aren't feeling well, need blood pressure taken, or minimal wound care for surgical wounds. There are 2 large dining rooms and kitchen. Kitchen freezer was observed at zero degrees Fahrenheit and three (3) refrigerators were at 35 degrees Fahrenheit. Food supply was checked and there is an adequate supply of 2 day perishables and 7 day non-perishables. Kitchen and food preparation areas were observed to be clean and in compliance. LPA reviewed 18 staff files 18 out of 18 staffs have health clearance on files. No deficiencies were observed in the areas that were evaluated. No citations were issued during today’s inspection. Exit interview conducted and a copy of this report provided to ADM.the state’s words, verbatim · CDSS document, Dec 14, 2022

Allegation investigated: Facility is in disrepair, water supply is contaminated

On 09/14/2021 at approximately 10:15am Licensing Program Analyst (LPA) Allison O'Hollaren arrived unannounced to conduct a complaint visit meeting with Administrator Ezekiel Griffin. The purpose of the visit was to deliver findings on the above allegation. During the course of the investigation, LPAs Allison O'Hollaren and Jill Clancy-Czuleger interviewed Administrator and five residents, interviewed City of Pleasanton Labratory Services Specialist (E1), collected water from five residents' (R1, R2, R3, R4, and R5) apartments, and reviewed water quality information documents, email communications with the facility and City of Pleasanton water specialist employees, and water analysis reports. During interviews and reviewing records it was revealed that the facility received Continued on LIC9099C... Unfounded a complaint from Resident R1 regarding the appearance of water. The facility paid for company, Culligan Water to test water out of R1's apartment. Email communications reveal facility consulted with City of Pleasanton employees regarding water analysis report from Culligan Water and the results show that the water from R1's apartment meets all regulatory requirements. This agency has investigated the complaint allegation. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint. Exit interview conducted with Administrator and a copy of this report provided.the state’s words, verbatim · CDSS document, Sep 14, 2021 · control 15-AS-20210817085255

Type of visit: Required - 1 Year

On 09/14/2021 at 9:09am, Licensing Program Analyst (LPA) A. O'Hollaren arrived unannounced to conduct Infection Control Inspection. LPA met with Administrator Ezekiel Griffin and explained the purpose of the visit. During the inspection, LPA toured facility including but not limited to common areas, bathrooms, dining rooms, kitchen and courtyards. LPA observed COVID-19 signage throughout the facility. Hand washing signs were posted at hand washing stations. LPA observed PPE, food and paper supplies are sufficient. COVID-19 screening questions were maintained at the facility for all staff, residents, and visitors. Hand sanitizer is provided throughout the facility. Commonly touched surfaces are disinfected frequently throughout the day. During record review, LPA observed facility has a copy of Mitigation Plan on file. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Sep 14, 2021