Golden Manor Retirement Center

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff did not report resident's incident to appropriate parties Staff failed to take action on change of condition

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Staff S1 and explained the reason for the visit. Today's visit is a subsequent visit to conduct additional Interviews in regards to the above allegations. Shortly thereafter Administrator Maria Jacobo arrived. The initial visit was conducted on 05/23/25 and included the following: Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Administrator Maria Jacobo and explained the reason for the visit. On 05/23/2025 Administrator Maria Jacobo was interviewed. Staff S1 was interviewed. Resident and Staff Roster submitted. File was reviewed for Resident R 1 and VA Medication List, MAR Log for May 2025, Physician's Report , Special Incident Report (SIR) and ID page submitted. At today's visit 12/18/25 interviews were conducted with Client's C2-C9. Unsubstantiatedthe state’s words, verbatim · CDSS document, Dec 18, 2025 · control 28-AS-20250516113955

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff abandoned resident Illegal eviction

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Staff Carmen Virrueta and explained the reason for the visit. The purpose of the visit is to conduct a 10 day complaint visit in regards to the above allegations. At today's visit the following was done: On 10/27/2025 Staff Carmen Virrueta was interviewed. Staff S1 and Staff S2 were interviewed. Resident and Staff Roster submitted. Resident's R2-R8 were interviewed. Interview conducted with family member of Resident R1. File was reviewed for Rsident R 1 and VA Medication , Physician's Report , Special Incident Report (SIR) and ID page were submitted. In regards to the allegation Staff abandoned resident, based on interviews conducted and information gathered it was revealed by the family member of Resident R1 who stated that the facility did nothing wrong and that they are nice people. Unsubstantiatedthe state’s words, verbatim · CDSS document, Oct 27, 2025 · control 28-AS-20251022084029

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff at facility failed to properly store medication

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Staff Robert Blanco and explained the reason for the visit. The purpose of the visit is to conduct a 10 day complaint visit in regards to the above allegation. At today's visit the following was done: On 10/03/2024 Resident and Staff Roster submitted. Interviews were conducted with the Administrator and Staff S1 and Resident's R2, R3, R5 and R6.. Resident R1 and R4 were unable to be interviewed because of being hospitalized. File for Resident R1 was reviewed and Admissions Agreement and Physician's Report were submitted. LPA conducted a tour along with Staff S1 which included Rooms 3, 12, 13, 14, 17 and 27. LPA reviewed doctor's orders for Resident R2- R6. In regards to the allegation Staff at facility failed to properly store medication, based on interviews conducted and information gathered it was revealed by the Administrator and Staff S1 that they were informed during a tour othe state’s words, verbatim · CDSS document, Oct 3, 2024 · control 28-AS-20240926144908

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff did not maintain a safe environment for residents. Facility is not in good repair. Facility has bedbugs. Facility does not provide meals and snacks for diabetic diet. Facility does not provide adequate food service. Resident is not receiving mail. Resident did not get 60-day notice of rent increase. Facility does not provide activities.

Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent complaint investigation for the allegations listed above. LPA met with Administrator, Maria Jacobo, and explained the purpose of the visit. On 7/8/21, LPA Glenn Trueman conducted the initial visit and interviewed the administrator and a resident. On 10/30/23, LPA Chan toured the facility and randomly selected 8 rooms (rooms #4, #11, #23, #26, #36, #44, #51, and #68) to inspect. Interviews were held with the administrator, 5 Staff, and 8 Residents. LPA also reviewed 5 resident files. The investigation revealed the following: 1. Allegation - Staff did not maintain a safe environment for residents. It was alleged that the staff allow people to smoke inside their rooms, allow to sell marijuana, and have registered sex offenders at the facility. LPA interviewed administrator, staff, and residents. Unsubstantiatedthe state’s words, verbatim · CDSS document, Oct 30, 2023 · control 28-AS-20210629134833

Allegation investigated: Resident sustained bruising at the facility. Facility is not maintained clean. Residents are not fed nutritious foods at the facility. Residents do not have access to healthcare while at the facility. Facility house-keeping staff is bathing residents at the facility.

Licensing Program Analyst (LPA) Tena Herrera made an unannounced subsequent visit to the facility and met Administrator Maria Jacobo, the purpose for todays visit was explained. The investigation consisted of the following: On 12/23/21 LPA Glenn Truman conducted the initial 10 day visit and interviewed Resident's 1-6 and Staff 1-2, toured dining room, observed dinner meal being served and obtained copies of Resident and Staff Rosters. LPA Tena Herrera conducted a subsequent on 9/21/23, obtained a copy of the Staff/Resident rosters, copies of the 4 rotating food menus, toured the facility with Administrator Maria Jacobo, observed lunch being served for day, interviewed 6 Staff and 8 residents, and obtained copies of staff trained to assist residents with Activities of Daily Living. (continued on 9099-C) Unsubstantiatedthe state’s words, verbatim · CDSS document, Sep 21, 2023 · control 28-AS-20211222080952

Allegation investigated: Resident sustained injuries while in care. Staff allowing residents access to medication room.

The purpose of the visit is to add additional details to the 9099 A and 9099 D. Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Administrator Maria Jacobo and explained the reason for the visit. The visit is a subsequent visit to investigate the above allegations and deliver findings. The initial visit was conducted on 06/30/2021 and the following was done: The purpose of the visit is to conduct a Health and Safety check. Tour of the facility was conducted at 2:00 PM with LPA and Administrator and included the following: 1st floor rooms 1-32 and 2nd floor rooms 33-80, dining room, kitchen, activity room, library, med room, nurses room and 2 outdoor patios. LPA Trueman conducted interviews with the Administrator and S 1 from 2:25 PM to 2:50 PM. At today's visit 08/17/2023 from 8:45 AM to 9:15 AM Staff S 2- S 4 were interviewed. From 9:15 AM to 10:40 AM Resident's R2- R 11 were interviewed. In regards to Resident sustained injurithe state’s words, verbatim · CDSS document, Sep 12, 2023 · control 28-AS-20210629154733

Allegation investigated: Facility did not follow mask use guidelines. Facility staff did not have adequate PPE. Facility is not cleaning and disinfecting as needed to prevent spread of infection.

Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent visit to investigate the above allegations. Upon arriving at the facility, LPA met with Assistant Administrator - Carmen Virrueta and Administrator Maria Jacobo who later assisted with the visit, the purpose of today’s visit was explained. The investigation consisted of the following: On 12/16/2021 LPA Glenn Trueman conducted the initial visit and interviewd 3 Staff, due to insufficient information available at the time further investigation was needed. During todays visit LPA Herrera obtained the following documents: Resident/Staff Roster, Infection Control Plan, Covid-19 Mitigation Plan Report, and training logs for ongoing Covid training. Observed sinage thoughout the facility for disinfection, cough ettiquette, and hand washing procedures, along with a storage room filled with PPE supplies that included: masks, disposible gowns, face shields, gloves, hand sanitizer, and antigen Covid tests. Interviewedthe state’s words, verbatim · CDSS document, Sep 7, 2023 · control 28-AS-20211208141338

Allegation investigated: Staff did not ensure the activities calendar was posted Staff are not providing activities to residents in care Staff did not ensure the menu was up to date and posted

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Administrator Maria Jacobo and explained the reason for the visit. The purpose of the visit is to conduct a 10 day complaint visit in regards to the above allegations. At today's visit the following was done: On 08/31/2023 Resident and Staff Roster submitted. Interviews were conducted with Administrator and Resident's R1-R 6 from 1:10 PM to 2:20 PM. In regards to the allegation Staff did not ensure the activities calendar was posted, based on interviews conducted and information gathered 6 of 6 residents stated that the activities calendar has not been posted. Interview with Administrator who confirmed that activities calendar was not posted when Ombudsman had visited the facility on 3 different occasion's. At today's visit LPA did not observe the Activity calendar posted. Based on LPAs observations and interviews which were conducted the preponderance of evidence standard has beethe state’s words, verbatim · CDSS document, Aug 31, 2023 · control 28-AS-20230823145835

Allegation investigated: Resident sustained injuries while in care. Staff allowing residents access to medication room.

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Administrator Maria Jacobo and explained the reason for the visit. The visit is a subsequent visit to investigate the above allegations and deliver findings. The initial visit was conducted on 06/30/2021 and the following was done: The purpose of the visit is to conduct a Health and Safety check. Tour of the facility was conducted at 2:00 PM with LPA and Administrator and included the following: 1st floor rooms 1-32 and 2nd floor rooms 33-80, dining room, kitchen, activity room, library, med room, nurses room and 2 outdoor patios. LPA Trueman conducted interviews with the Administrator and S 1 from 2:25 PM to 2:50 PM. At today's visit 08/17/2023 from 8:45 AM to 9:15 AM Staff S 2- S 4 were interviewed. From 9:15 AM to 10:40 AM Resident's R2- R 11 were interviewed. In regards to Resident sustained injuries while in care, based on interviews conducted and information gathered intervithe state’s words, verbatim · CDSS document, Aug 17, 2023 · control 28-AS-20210629154733