Astera Care Home

Allegation investigated: Staff mismanaged resident's medication. Staff do not provide adequate care for residents.

On this day, June 19, 2026, Licensing Program Analyst (LPA) Delmundo arrived unannounced to continue the investigation of the above allegations and close the complaint. LPA met with staff, Aaron Salvador and Mark Kevin Salvador, and informed the reason for visit. LPA called and spoke over the phone with Sharon Aranha, licensee- administrator (ADM). ADM arrived at around 12:20 pm. During the course of investigation, LPA reviewed resident's records and obtained copies of Admission Agreement, LIC602A Physician's Reports, doctor's order of medications, LIC622 Centrally Stored Medication and Destruction Record and Medication Administration Record. LPA interviewed the following: staff (S1 and S2) on 4/01/26 and 6/19/26; residents (R2, R3) on 6/19/26; ADM on 6/19/26. Allegation: Staff mismanaged resident's medication. The reporting party (RP) indicated that R1 reported that staff do not provide R1 appropriate medications. ............continued on 9099C Unsubstantiated LPA reviewed doctor's order of medications, LIC622 Centrally Stored Medication Records and Destruction Record and Medication Administration Record. S1 and S2 stated they administered medications to R1. S1 stated R1 was moved-in by EMTs who brought R1's medications and Discharge Summary from Skilled Nursing Facility (SNF) with list of medications, however, 6 of the medications listed were not with them. S1 stated they followed-up with R1's case manager and was told that it will be relayed to the doctor but at that time R1 didn't have a primary care physician. S1 and administrator stated R1 wanted to go back to SNF and stayed in the facility for less than a month. LPA was not able to obtain information from R1 due to R1 was no longer at the facility when complaint was received. Therefore, the allegation is unsubstantiated. Allegation: Staff do not provide adequate care for residents. The reporting party (RP) indicated that R1 reported that the facility provides poor care. LPA reviewed LIC602A Physician's Report which showed R1 able to feed self and able to care for own toileting needs and just needs stand by assist in bathing and minimum assistance with dressing/grooming. Both S1 and S2 stated they assisted R1 with activities of daily living but R1 refused. LPA interviewed R2 who stated the staff assist whenever they need assistance. R2 further stated the staff are great. LPA was not able to obtain information from R3 pertaining to the allegation but stated they are okay. LPA was not able to obtain information from R1 due to R1 was no longer at the facility when complaint was received. Therefore, the allegation is unsubstantiated. Based on information gathered and LPA was unable to obtain information from R1, the above allegations are unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No deficiency cited. Exit interview conducted and copy of this report provided.the state’s words, verbatim · CDSS document, Jun 19, 2026 · control 15-AS-20260327101704

Type of visit: Required - 1 Year

On this day, June 19, 2026, at 11:35 am, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA was granted entry by staff, Aaron Salvador, and informed the reason for visit. LPA also met with other staff, Mark Kevin Salvador. LPA called and spoke over the phone with Sharon Aranha, licensee- administrator (ADM). ADM arrived at around 12:20 pm. LPA inspected the facility inside and out with Aaron Salvador, LPA inspected the kitchen, dining room, living and family rooms, bedrooms, bathrooms, garage, front, side and backyard. Facility has sufficient perishable and non-perishable foods. Smoke and carbon monoxide detectors were tested and observed in operating condition on this day. Hot water temperature in the common bathroom was tested and measured at 105 degrees Fahrenheit. Facility conducts disaster drills every month and records showed last conducted June 14, 2026. Fire extinguisher checked, observed fully charge with purchase receipt dated July 11, 2024. LPA reviewed 5 residents and 3 staff files, and interviewed 2 residents. Medications were checked and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. Facility does not handle residents' cash resources. LPA observed the following: -at 11:35 am, overgrown weeds and bulk of fallen dried leaves in the side yard. .....continued on 809C CONTINUATION FROM PAGE 1 On this same day, LPA obtained updated/current copies of the following documents: 1. LIC308 Designation of Facility Responsibility 2. LIC500 Personnel Report 3. LIC610E Emergency Disaster Plan (9 pages) 4. $3M Liability Insurance certificate. Deficiency is cited from Title 22 California Code of Regulations, 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 administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.the state’s words, verbatim · CDSS document, Jun 19, 2026

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Allegation investigated: Staff do not provide a safe environment for residents.

On this day, April 1, 2026, at 5:25 pm, Licensing Program Analyst (LPA) Delmundo arrived unannounced to investigate the above allegation. LPA met with Aaron Salvador, staff, and informed the reason for visit. LPA also spoke over the phone with Sharon Aranha, administrator, and met with other staff, Mark Kevin Salvador. It was alleged that resident (R1) felt unsafe due to the cleanliness of the facility. LPA toured the facility inside out with Aaron Salvador. LPA inspected the living and family rooms, bedrooms, toilets, side and backyard. LPA observed the facility clean, but because LPA was unable to interview R1 due to R1 is no longer at the facility, the allegation is closed as unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No deficiency cited. Exit interview conducted and copy of this report provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Apr 1, 2026 · control 15-AS-20260327101704

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: Case Management - Deficiencies

On this day, April 1, 2026, while at the facility investigating a complaint (Control # 15-AS-20260327101704) and upon records review and inspection of the facility with Aaron Salvador, staff, Licensing Program Analyst (LPA) Delmundo observed the following: -at 5:54 pm, knife, tree trimmer, shovel, rake in unlocked storage in the side yard. -residents (R1 and R2) do not have Pre-Admission Appraisal and R1 without LIC601 Identification and Emergency Contact Information. The above observations were discussed with Sharon Aranha, administrator (ADM), over the phone, in the presence of the staff. Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates and any repeat violation within 12 month period may result in civil penalty. Deficiencies and plan and proof of corrections were discussed with ADM. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided to the staff.the state’s words, verbatim · CDSS document, Apr 1, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Apr 2, 2026

87309 Storage Space and Access (a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage... -This requirement is not met as evidenced by: -Based on observation, the licensee did not comply with the section in unlocked storage which posed an immediate safety and/or personal rights risks to persons in care.the state’s words, verbatim · CDSS document, Apr 1, 2026

Plan of correction: Staff locked the storage. In addition, administrator to in-service the staff and submit copy of training topic with attendees signatures by 4/02/26.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87457(c) · Plan of correction due date: Apr 15, 2026

87457 Pre-Admission Appraisal (c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of their individual service needs in comparison with the admission criteria .......... -This requirement is not met as evidenced by: -Based on records review, the licensee did not comply with the section above in not completing the Pre-Admission Appraisal for R1 and R2 which poses a potential health, safety and/or personal rights risks to persons in care.the state’s words, verbatim · CDSS document, Apr 1, 2026

Plan of correction: One of the 2 residents is no longer at the facility. Administrator to do the Pre-Admission Appraisal for the other resident and submit copy by 4/15/26.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87506(a) · Plan of correction due date: Apr 15, 2026

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 requirement is not met as evidenced by: -Based on records review, the licensee did not comply with the section above in not completing the LIC601 for R1 which poses a potential personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 1, 2026

Plan of correction: R1 is no longer at the facility. Administrator to read the Regulation and ensure compliance. Self-certtification to be submitted by 4/15/26.

Type of visit: Case Management - Annual Continuation

On 6/30/2025, at 10:45 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Continuation of the Required 1 Year inspection began 6/16/2025. Upon entry, the LPA informed Caregivers Lillybeth Nagata and Aaron Salvado of the purpose of the visit. Licensee / Administrator Sharon Aranha arrived at approximately 11:00 AM. The LPA confirmed the safety of the facility. The LPA reviewed 4 staff records. No citations were issued during the inspection. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jun 30, 2025

Type of visit: Required - 1 Year

On 6/16/2025, at 12:45 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Required 1 Year inspection. Upon entry, the LPA informed Caregivers Lillibeth Nagata and Aaron Salvado of the purpose of the visit. Licensee / Administrator Sharon Aranha arrived at approximately 1:45 PM. The LPA inspected the inside and outside of the facility, which included the kitchen, dining room, common areas, bedrooms, garage, and the back yard. An adequate amount of food supplies were observed, more than the required minimum of 2 days of perishable and 7 days of non-perishable food. The central storage for medications was locked. The cleaning supplies and dangerous objects were inaccessible to residents. The facility has working smoke and carbon monoxide detectors. The staff of the facility conduct disaster / emergency and fire drills on a quarterly basis. The fire extinguisher was replaced on 7/11/2024. The indoor temperature was 72.3 degrees Fahrenheit. The maximum hot water temperature was 106.7 degrees Fahrenheit. The LPA reviewed facility records and 5 resident records. No citations were issued during the inspection. The Required 1 Year inspection is incomplete. The LPA will return unannounced at a future date and time to complete the inspection. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jun 16, 2025

Type of visit: Required - 1 Year

On this day, June 21, 2024, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA was granted entry by staff, Aaron Salvador. LPA called and spoke over the phone with Sharon Aranha, administrator, and informed the reason for visit. LPA also met with other staff, Mark Kevin Salvador. Administrator arrived at 12:29 p.m. Facility has submitted the LIC808 Mitigation Plan but not the LIC9282 Infection Control Plan. LPA requested for LIC9282 on June 23, 2023 which LPA has not received up to this day. LPA inspected the facility inside and out with Mark Kevin Salvador, LPA inspected the kitchen, dining room, living and family rooms, bedrooms, bathrooms, garage, front, side and backyard. Facility has sufficient perishable and non-perishable foods. Facility has smoke and carbon monoxide detectors that were checked and observed in operating condition. Hot water temperature in the ensuite bathroom was tested. Facility conducts drills every quarter and records showed fire drill last conducted 5/01/24. LPA reviewed 5 residents and 4 staff files, and interviewed 2 staff and 2 residents. Medications were checked and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. Facility does not handle residents' cash resources. LPA observed the following: -at 11:57 a.m., hot water was at 124 degrees Fahrenheit. -at 11:58 a.m., Ca-Rezz incontinent wash in one of the residents' rooms. -at 12:03 p.m., razor in the cabinet in the common bathroom. -at 12:06 p.m., Ca-Rezz continent wash and ointment in another resident's room. .....continued on 809C (page 2) Page 2 -at 12:45 pm.m, trash cans in 2 residents rooms without lids. -at 2:00 pm to 2:35 p.m., staff (S2, S3, S4) who were hired 10/18/23 have only total 21 hours of training on file and no medication training. -at 3:30 p.m. to 4:00 p.m, , residents (R1, R2, R3, R4 and R5) have no Pre-admission Appraisal on file. R4's LIC602A Physician's Report indicated R4 needs assistance with all activities of daily living (ADLs); however, LPA observed R4 feeding self during lunch. R5's LIC602A Physician's Report indicated R5 needs assistance on with all ADLs. LPA received a copy of $3M Liability Insurance certificate on this day. Administrator to submit copies of the following updated documents by July 5, 2024: 1. LIC308 Designation of Facility Responsibility 2. LIC500 Personnel Report 3. LIC610E Emergency Disaster Plan (9 pages) 4. LIC9282 Infection Control Plan Deficiencies are cited from Title 22 California Code of Regulations, and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates, and any repeat violation within 12 month period may result in civil penalties. Deficiencies and plan and proof of corrections were discussed with the administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.the state’s words, verbatim · CDSS document, Jun 21, 2024