Glendale Golden Years Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jose Tan met with Maria Trillana for a Required One (1) Year visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at around 12:55 PM and the following was noted: There is one entrance being utilized at the facility. The facility has a total of four (4) bedrooms for residents and three (3) bathrooms. The facility is fire cleared for six (6) non-ambulatory of which two (2) may be bedridden and a hospice waiver for three (3) residents. The facility is currently occupying five (5) residents. The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. The garage is currently being used for tools, frozen food and old equipment storage. Laundry detergents, cleaning agents and other toxins are locked in a cabinet by the laundry area. Kitchen is sufficiently stocked with at least two (2) days perishable and seven (7) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents. The living and dining room are neat and clean. The facility maintains a comfortable temperature at 76°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located in the kitchen, observed to be full and last purchased on 05/24/26. The facility is equipped with sprinkler system. (continued on LIC 809-C) (continued from LIC 809) Bathrooms: There are three (3) full bathrooms designated for residents' use. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured between 113.7°F to 118.9°F. No cleaning supplies were observed in any of the bathrooms during the day of the inspection. Surrounding Grounds: Backyard and side area has sufficient space to hold outdoor activities. There is a side patio which is covered and had a full view of the neighborhood and equipped with air conditioning. There is furniture appropriate for outdoor use. There is a locked storage building for extra supplies. There is no swimming pool or any other bodies of water. Laundry area: The laundry area is located adjacent to the kitchen. Laundry detergents/cleaning supplies are stored inside the locked cabinet by the laundry area. Resident Files: LPA conducted a file review of resident records. Records were observed to be complete and updated. Staff Files: LPA also conducted a file review of staff records. Staff records were observed to be complete and updated. Medications: Medications are stored in a locked cabinet by the kitchen. Medication and Medication Records were reviewed for proper storage and documentation. First aid kits observed to have complete accessories with booklet kept by the kitchen. Garage: The garage is not attached to the home. It is located in the back. Garage is used for additional storage. It was locked during the day of the visit. Disaster drill was last conducted on 04/28/2026. Required posting observed in facility (complaint hot line poster, personal rights, etc). There was no health and safety hazard observed during the day of inspection. Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiencies observed during the visit. Exit Interview Conducted and a Copy of this Report Issued.the state’s words, verbatim · CDSS document, Jun 6, 2026

Type of visit: Required - 1 Year

At 8:45a.m., Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required One (1) year inspection to the facility. LPA met with caregivers that granted entry to the facility and explained the reason for the visit. Caregiver, Talado contacted Administrator via-phone and later Administrator joined today’s visit. At about 9:10a.m., LPA and Administrator conducted a physical plant tour inside and out. During the tour, LPA observed that the facility is a home located in a residential community. Required postings were observed in the dining area. The facility has fire sprinklers throughout the home and fire extinguishers were observed. Fire extinguisher had a purchased receipt date of 05/03/2025. The smoke/carbon monoxide detectors are hardwired, interconnected and observed to be operational. They are located throughout the facility including hallway and bedrooms. Fire Emergency drill was last conducted on 04/14/2025. During this visit the facility is at 74 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory of which two (02) may be bedridden and a hospice waiver for three (03). The facility is currently occupying four (04) residents. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Kitchen: LPA observed kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found at least two (02) days perishable and seven (07) Cont. on LIC 809-C days non-perishable food at the facility that is properly stored. Frozen foods are wrap and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the kitchen closet. Medications: are in a centrally stored and locked medication cabinet the in kitchen, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the resident’s doctor. First-aid has all proper items and were observed to be stored in locked cabinet in the kitchen. Bedrooms: LPA observed four (04) bedrooms designated for residents use. All bedrooms were toured and observed to be clean and properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Hallway is well lit. Bathrooms: LPA observed three (03) full bathrooms to be clean, sanitary and with necessary supplies. The appropriate grab bars and mats in the shower. Hot water temperature measured at a range of 118.2°F to 118.9°F and within the required range. Resident’s personal hygiene supplies are kept separate in their room. Towels and washcloths are not shared. Common Areas: These included the dining area, living and family rooms for residents. The common areas were properly furnished and observed to be in good repair. Residents dining table fits eight (08) people. No obstructions and or tripping hazards throughout the facility. There are no issues with Fire Clearance. Surrounding Grounds: Entry and exits were free of obstruction. The facility has appropriate outdoor furniture with a covered shaded area for residents and visitors. The outdoor area was enclosed, and no bodies of water were observed. Garage: The garage stores extra supplies and observed to be locked and inaccessible to residents in care. Laundry Room: LPA observed a washer and dryer machines located next to the kitchen. Linens are stored in the hallway cabinet and observed to have ample supply of clean linen, comforters, and towels in facility. Extra hygiene supplies are being stored in locked cabinet in the garage. Staff Files: were reviewed they all have criminal record clearances and associated to this facility. Staff have current first aid and training documentation showing training completed. Administrator's certificate was observed to be current. Resident Records: All four (04) resident records were reviewed. Residents’ records are complete and current at this time. Residents were also interviewed. Facility is within CA code of Regulations Title 22 or Health and Safety Code. No deficiencies were found. Exit interview conducted. Copy of report has been provided.the state’s words, verbatim · CDSS document, Jun 18, 2025

Allegation investigated: Staff did not seek timely medical attention for a resident. Staff did not meet a resident's bathing needs. Staff intimidates a resident while in care. Staff speaks inappropriately towards a resident. Staff inappropriately pushed a resident.

Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to this facility to investigate the above allegations. LPA met with Administrator, Maria Trillana, and explained the reason for the visit. ---Staff did not seek timely medical attention for a resident. It was alleged that Resident #1 (R1) had fallen two times in the last week and no medical assistance had been contacted. To investigate the allegation, LPA interviewed one (01) staff and two (02) out of three (03) residents from around 1:30p.m. to 2:15p.m. On 02/05/2025, LPA interviewed two (02) additional staff from 11:00a.m. to 12:00p.m. During interviews with staff, Staff #1 (S1) and Staff #2 (S2) stated R1 came on 11/16/2024 and did not have a fall incident for the duration of her stay. (CONT. on LIC9099-C) Unsubstantiated Staff #4 (S4) stated they do not know R1. During interviews with residents, all interviewed residents stated they feel that staff would seek timely medical assistance, if needed. Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time. ---Staff did not meet a resident's bathing needs. It was alleged that Staff #2 (S2) gave R1 a cold shower and had not bathed R1 in over one (01) week since R1’s arrival. To investigate the allegation, LPA conducted a physical plant tour at around 1:00p.m., interviewed one (01) staff and two (02) out of three (03) residents from around 1:30p.m. to 2:15p.m. On 02/05/2025, LPA interviewed two (02) additional staff from 11:00a.m. to 12:00p.m. During the physical plant tour, LPA observed that all residents were clean and well-groomed and did not experience any malodor in the facility. During interviews with staff, all staff stated all residents are bathed two (02) to three (03) times a week. S1 and S2 added that R1 would often refuse bathing. During interviews with residents, all interviewed residents stated their bathing and hygiene needs are being met. Based on observations and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time. ---Staff intimidates a resident while in care. It was alleged that Staff #3 (S3) gets frustrated and clinches their fist at R1. To investigate the allegation, LPA interviewed one (01) staff and two (02) out of three (03) residents from around 1:30p.m. to 2:15p.m. On 02/05/2025, LPA interviewed two (02) additional staff from 11:00a.m. to 12:00p.m. During interviews with staff, all staff stated they get along with all residents and do not physically intimidate them. During interviews with residents, all interviewed residents stated staff do not intimidate or get frustrated with them. Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time. (CONT. on LIC9099-C) ---Staff speaks inappropriately towards a resident. It was alleged that S3 tells R1 to "shut up" when requesting to be changed. To investigate the allegation, LPA interviewed one (01) staff and two (02) out of three (03) residents from around 1:30p.m. to 2:15p.m. On 02/05/2025, LPA interviewed two (02) additional staff from 11:00a.m. to 12:00p.m. During interviews with staff, all staff stated they do not speak inappropriately to residents or tell them to shut up. During interviews with residents, all interviewed residents stated staff treat them with dignity and respect. Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time. ---Staff inappropriately pushed a resident. It was alleged that S2 placed their hand on R1’s head and shoulder and pushed R1 aggressively into the bed or sheets. To investigate the allegation, LPA interviewed one (01) staff and two (02) out of three (03) residents from around 1:30p.m. to 2:15p.m. On 02/05/2025, LPA interviewed two (02) additional staff from 11:00a.m. to 12:00p.m. During interviews with staff, all staff stated they do not handle residents inappropriately or in a rough manner and have never physically abused or assaulted any residents. During interviews with residents, all interviewed residents stated staff are gentle and do not physically abuse them. Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time. No health and safety hazards noted during the visit. Exit interview conducted and a copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 5, 2025 · control 31-AS-20241125084432

Allegation investigated: Facility staff were not meeting residents incontinent needs.

At 9:10a.m. Licensing Program Analyst (LPA) Antonia Alvizar- Ettima conducted an unannounced subsequent visit to investigate and deliver finding for the above noted allegation. LPA was greeted by staff #1-#2 (S1-S2) granted LPA entrance and S1 contacted Administrator via phone. At 9:17a.m. S2 and LPA conducted a physical plan tour and interviewed S1-S2. At approximately 9:57a.m. Administrator/Licensee joined and explained the reason for the visit. At the time of initial visit on 01/31/2025 LPA met with staff #1-#2 (S1-S2) S2 contacted Administrator via phone. Administrator/Licensee joined the visit at 1:30p.m. The purpose of visit was explained. Physical plant tour was conducted, obtained staff contact information and staff and resident rosters. During today’s visit at 10:15a.m. LPA request and received resident #1 (R1) Physician Report, Preplacement Appraisal, Progress Notes and Daily Vital Records. Cont. LIC 9099c Unsubstantiated Staff training records were requested and received. At 10:35a.m facility records were reviewed, residents and staff were interviewed. Facility staff were not meeting residents incontinent needs. It was alleged that staff are not changing R1. Administrator indicated that it was impossible that R1 was not being changed because R1 was alert and able to communicate needs. Staff interviews revealed that incontinent residents are being changed three (03) to four (04) times a day or as needed. LPA conducted interview with staff #1(S1) involved with R1's care. S1 interview revealed that R1’s diaper was always changed otherwise R1 will scream and curse at staff. Other residents revealed that staff changes them three (03) times a day, and more often if needed. LPA was not able to interview resident (R5) due to being non-verbal. Resident (R1) no longer reside at the facility. The information revealed from records supported the information provided by the facility personnel. At the time of facility inspection, LPA observed residents and they were clean, well-groomed and no one appeared to need changing. LPA also observed the facility to be clean and did not experience any malodor. Based on observation, interviews and record review, there is no pertinent information to support the allegation. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. No health and safety hazards noted during this visit. Exit interview conducted and a copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 5, 2025 · control 31-AS-20250131124533

Type of visit: Case Management - Other

In conjunction with complaint investigation, Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted a case management visit to address the deficiencies unrelated to the complaint. During complaint #31-AS-20250131124533 investigation, at about 1:15p.m., LPA noted resident #1 (R1) was restrained to the wheelchair with a gait belt as postural support. The gait belt easy release buckle was on the back of the wheelchair. At about 1:17p.m. LPA interviewed staff #1-#2 (S1-S2) and indicated that the gait belt is used to prevent R1 from sliding off wheelchair. Interview with R1 revealed that did not know why they placed the gait belt on them. R1 illustrated that was not able to release the gait belt on their own during emergency. LPA interviewed Administrator and requested prescription for the postural supports. Administrator was unable to provide the document. Based on inspection, observation and interviews it was concluded that licensee did not ensure that postural support provided to resident not depriving residents’ movement. Resident was restrained to the wheelchair and had no ability to release it. Deficiencies will be cited and recorded on LIC809D. Exit interview conducted. Copy of report, and appeal rights issued.the state’s words, verbatim · CDSS document, Jan 31, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87608(a)(5) · Plan of correction due date: Feb 1, 2025

87608 Postural Supports (a) ...The facility shall provide... care for the resident in those activities... unable to do for themself. Postural supports may be used ...conditions. (5) Under no circumstances shall postural supports...limiting the use of a resident's hands or feet. This requirement is not met as evidenced by. The licensee did not ensure that post- ural support provided to R1 is not depriv- ing R1s’ movement. R1was restrained to the wheelchair and had no ability to release it. This possess an immediate health and safety hazard to residents in care.the state’s words, verbatim · CDSS document, Jan 31, 2025

Plan of correction: The licensee will provide in-service for postural support to ensure the safety of residents in care and will ensure care staff is schedule to assist R1. Licensee will submit in-service and staff schedule to LPA by due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abeye Duguma met with Maria Trillana for a Required One (01) Year visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at around 1:00 PM and the following was noted: There is one entrance being utilized at the facility. The facility has a total of four (04) bedrooms for residents and three (03) bathrooms. The facility is fire cleared for six (06) non-ambulatory of which two (02) may be bedridden and a hospice waiver for three (03). The facility is currently occupying four (04) residents. The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. The garage is currently being used for storage. Laundry detergents, cleaning agents and other toxins are locked away. Kitchen is sufficiently stocked with at least two (02) days perishable and seven (07) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents. The living and dining room are neat and clean. The facility maintains a comfortable temperature at 71°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located in the kitchen, observed to be full and last purchased on 05/17/2024. (continued on LIC 809-C) The residents' rooms are adequately furnished with appropriate lighting system. Hallways are well lit. Residents have enough personal hygiene product provided by the licensee. The bathroom was checked for cleanliness and proper operations. The hot water temperature was measured at 118.1°F. Towels and washcloths are not shared. There was enough clean linen available in the cabinets. LPA observed medication and first aid kit to be locked and inaccessible to residents. No health and safety hazards noted during the visit. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, May 17, 2024