Tuscany Villa Senior Living

Type of visit: Case Management - Deficiencies

While at the facility conducting investigation of a complaint (Control # 15-AS-20260728172630) and upon review of Resident R1's record and the Department's efax folder and facility's efax folder for incident reports, LPA observed the facility did not submit nor the Department received an Unusual Incident Report for R1 for the fall incident that happened on 7/02/26. The above were discussed with Campus Director (CD) Isabel Poderoso and over the phone with Administrator Janice Gombio. Deficiency is cited from Title 22 California Code of Regulation and listed on 809D. Failure to submit proof of correction by plan of correction due date and any repeat violation within 12 month period may result in civil penalty. Deficiency and plan and proof of correction were discussed with the Campus Director. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.the state’s words, verbatim · CDSS document, Aug 6, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1)(D) · Plan of correction due date: Aug 20, 2026

87211 Reporting Requirements (a) Each licensee shall furnish to the. ..(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence ...(D) Any incident which threatens the welfare, ... .....safety or health of any resident...... -This requirement is not met as evidenced by: -Based on records review, the licensee did not comply with the section above in not submitting the report for the fall incident for R1 which posed a potential health, safety and/or personal rights risks to person in care.the state’s words, verbatim · CDSS document, Aug 6, 2026

Plan of correction: Staff provided the incident report to LPA on this day. In addition, administrator to read the Regulation and self-certify that report will be submitted timely.

Type of visit: Case Management - Other

On 7/20/2026 at 12:50 PM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a case management visit regarding an incident report, SOC 341, self reported by the facility. LPA met with Executive Director (ED) Janice Gombio. LPA K. Nguyen conducted an interview with ED regarding the self reported incident that occurred on June 6, 2026, involving R1 and R2, who had an altercation. R1 and R2 were both ambulatory and able to verbalize. R1 came out of R1's room and reported that R2 hit R1. Immediately, ED staff came and separated R1 and R2, reassured R1 and R2 that they were in no harm. R1 wanted to go out, but staff redirected R1 because R1's partner is coming to visit. R2 was reassured that they would be moved to a different room. LPA reviewed documents including but not limited to 72-hour charting, updated services plan, including interventions to prevent the incident from happening, communication with R1 and R2 doctor. LPA toured the facility, including the residents' rooms, and confirmed that R2 has been moved out of R1's room. No deficiency noted on today's date. An exit interview was conducted, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jul 20, 2026

Type of visit: Required - 1 Year

On 1/28/2026 at 9:15AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Executive Director, Janice Gombio and explained the purpose of the visit. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, activity rooms, kitchen, common areas, and outdoor area. Freezer’s temperature was registered at 0 degree F while the refrigerator’s temperature was recorded at 40 degrees F. Hot water temperature was measured at 112.9 degrees F in a resident's bathroom. Grab bars and non-skid mats were observed. There were adequate lights in each room. Centrally stored medications were locked in medication cart. First Aid kit is complete. Smoke detectors were interconnected with sprinkler system. Carbon monoxide detectors were observed. Fire extinguishers were observed to be full and last serviced on 1/6/2026. LPA reviewed 5 residents and 5 staff files starting at 10:10AM. Residents and staff files were complete. Staff are fingerprint cleared and associated to the facility. LPA reviewed a sample of resident's medications during inspection. At 4:00PM, LPA observed physician's order for R3's Melatonin was for 5 mg. However, facility had a bottle of Melatonin 3 mg and had been administering to R3. Family dropped off the correct dosage of Melatonin during inspection. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jan 28, 2026

Allegation investigated: Resident sustained unexplained injuries while in care due to lack of supervision Facility is short staff

On 2/20/2025 at 11:45AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a complaint investigation and deliver findings regarding the allegations above. LPA met with Executive Director, Janice Gombio and informed her the reason for visit. During the investigation, LPA interviewed 1 resident, 4 staff, 2 witnesses, and complainant. LPA reviewed and obtained documents including staff roster with contact information, staff schedule, physician's report, care plan, hospice records, medical record, emergency information, care notes, and shower notes. Resident sustained unexplained injuries while in care due to lack of supervision Hospice records dated 10/11/2023 indicated that R2 had bruises. R2 was admitted to the facility on 10/17/2023 and facility notes revealed that R2 had bruises during admission. Interview with staff revealed that R2 had an unwitnessed fall on 11/6/2023. Facility incident report indicated that R2 was found in a sitting position on the floor and a bump was observed on the top of R2's head. (continue on LIC9099C...) Unsubstantiated Staff stated that residents are check on every 2-4 hours and some residents are check on more often. Facility is short staff Interview with resident indicated there are enough staff working at the facility. R1 stated when R1 had a fall, staff was there to help right away. Interview with staff revealed that there are 2 caregivers and 1 med tech working during the AM and PM shift, and 1 caregiver and 1 med tech working NOC shift. Majority of the staff stated there are enough staff to meet the needs of the residents. S1 stated even during a COVID outbreak, facility was still able to maintain the same amount of staff on the different shifts. LPA observed there were a total of 7 staff (2 house keepers, 1 med tech, 2 caregivers, activity coordinator, and administrator) present during visit on 11/8/2023. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore these allegations are UNSUBSTANTIATED. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report provided.the state’s words, verbatim · CDSS document, Feb 20, 2025 · control 15-AS-20231101141757

Type of visit: Case Management - Incident

On 2/20/2025 at 4:30PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a case management visit in regards to an incident report. LPA met with Executive Director (ED), Janice Gombio and Campus Director, Isabel Poderoso. While LPA was at the facility for another visit, ED provided LPA a copy of a recent incident report. Based on the incident report dated 2/20/2025, at around 1:35PM on 2/19/2025 staff went to the front lobby and noted the front door was propped open. Staff immediately searched the area and conducted a head count of residents. It was noted that two residents (R1 and R2) were not in the building. Staff searched for residents and called 911. R1 and R2 was found by staff and police at a nearby grocery store. R1 and R2 returned back to the facility with staff. During visit, LPA interviewed staff and reviewed R1 and R2's file including physician's report and incident report. R1 and R2's physician's report stated that R1 and R2 cannot leave the facility unassisted. Interview with staff revealed that the front door delayed egress door was propped open and there was no staff at the front desk during that time. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights provided.the state’s words, verbatim · CDSS document, Feb 20, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(4) · Plan of correction due date: Mar 6, 2025

Additional Personal Rights of Residents in Privately Operated Facilities. To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency... This requirement is not met as evidence by: Based on interviews and record review, the licensee did not comply with the section cited above by having two residents leaving the facility unassisted which poses a potential health and safety risk to the persons in care.the state’s words, verbatim · CDSS document, Feb 20, 2025

Plan of correction: Executive Director (ED) has agreed to conduct in-service training regarding front door not being propped open. ED will submit staff sign-in sheet and materials to CCLD by POC date.

Type of visit: Required - 1 Year

On 1/28/2025 at 9:45AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Executive Director, Janice Gombio and Campus Director, Isabel Poderoso. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, activity rooms, kitchen, common areas, and outdoor area. Freezer’s temperature was registered at 0 degree F while the refrigerator’s temperature was recorded at 37 degrees F. Hot water temperature was measured at 114.4 degrees F in a resident's bathroom. Grab bars and non-skid mats were observed. There were adequate lights in each room. Centrally stored medications were locked in medication cart. First Aid kit is complete. Smoke detectors were interconnected with sprinkler system. Carbon monoxide detectors were observed. Fire extinguishers were observed to be full and last serviced on 1/20/2025. There were no bodies of water observed. LPA reviewed 4 residents and 4 staff files starting at 11:25AM. LPA reviewed a sample of resident's medications during inspection. At 12:30PM, LPA observed R1, R2, and R4 does not have current reappraisal needs and service plans on file. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jan 28, 2025

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 1/26/2024 at 10:50AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Administrator, Janice Gombio and Campus Director, Isabel Poderoso. The facility’s fire clearance was approved for 31 non-ambulatory residents of which 12 residents may be under hospice care. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, activity rooms, kitchen, common areas, and outdoor area. Freezer’s temperature was registered at 0 degree F while the refrigerator’s temperature was recorded at 40 degrees F. Hot water temperature was measured at 115.7 degrees F in a resident's bathroom. Grab bars and non-skid mats were observed. There were adequate lights in each room. Centrally stored medications were locked in medication cart. First Aid kit is complete. Smoke detectors were interconnected with sprinkler system. Carbon monoxide detector was observed. Fire extinguishers were observed to be full and last serviced on 1/4/2024. Indoor and outdoor passages were free of obstruction. LPA reviewed 5 residents and 5 staff files starting at 1:10PM. LPA interviewed 3 residents starting at 12:00PM. LPA reviewed a sample of resident's medications starting at 5:20PM. LPA interviewed 3 staff starting at 5:50PM. At 2:00PM, LPA observed R1 and R2 does not have current medical assessments and R2 does not have current reappraisal needs and service plans on file. At 3:30PM, LPA observed S4 does not have health screening on file. (Continue on LIC809C...) At 5:40PM, LPA observed R2 ran out of medications (Primidone 250mg and Donepezil HCI 5mg). LPA was informed that R2 have not taken Donepezil for a few days. Staff stated that medications were ordered last week. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jan 26, 2024

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.