Four Seasons Assisted Living Center Llc

Licensing Program Analyst (LPA) Erica Mosley conducted an initial 10-day complaint visit to investigate the above allegation. Upon arrival at approximately 9:40 am, LPA Mosley was greeted by Activities Coordinator/ Social Worker, Ulka Sanghavi who called the Administrator to inform them of the visit. The Administrator Clarizze Punit was not able to attend and designated Ulka Sanghavi to sign the report and the reason for the visit was explained. On 09/30/2024, the Department received a complaint regarding the following allegation, Resident moved to higher level of care without consent. LPA toured the physical plant areas inside and outside to ensure there are no immediate health and safety hazards and facility is in compliance with Title 22 Regulations. Report Continued on LIC9099C... UnsubstantiatedRead the full finding— CDSS inspection report, October 2, 2024 · control 29-AS-20240930164354

At approximately 9:55am Licensing Program Manager (LPM) KaSandra Lopez, and Licensing Program Analyst (LPA) Erica Mosley conducted an initial 10-day complaint visit to investigate the above allegation. Upon arrival, LPM Lopez and LPA Mosley were greeted by Activities Coordinator/ Social Worker, Ulka Sanghavi who called the Administrator to inform them of the visit. The Administrator Clarizze Punit arrived later during the visit at 10:08am. The LPM and LPA met with Administrator and explained the reason for the visit. On 09/20/2024, the Department received a complaint regarding the following allegation, Facility staff are withholding mail from resident(s). LPM and LPA toured the physical plant areas inside and outside to ensure there are no immediate health and safety hazards and facility is in compliance with Title 22 Regulations. Report Continued on LIC9099C... UnsubstantiatedRead the full finding— CDSS inspection report, September 27, 2024 · control 29-AS-20240920151349

Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to deliver final findings for the above allegations. During today’s visit, LPA met with Administrator Clarizze Punit and explained the reason for today's visit. On 06/08/2023, the Department received a complaint alleging “financial abuse” and that “Staff have not ensured resident’s (R1) dwelling lock/key operate properly”. It was alleged that R1 was confronted by administration staff and a rent bill for $15,820.98 was presented to R1 for the period from 9/8/2021-6/8/2023. On 06/13/2023, LPA Angel A. conducted staff and resident interviews beginning at 1:00 p.m., conducted a facility tour starting at 01:20 p.m. and obtained pertinent document. LPA Angel A. conducted a subsequent visit on 08/08/2023. During this subsequent visit from approximately 12:45pm – 3:25pm, LPA reviewed additional records, met with staff and residents including R1. The interviews conducted did not reveal any financial abuse or rRead the full finding— CDSS inspection report, July 29, 2024 · control 29-AS-20230608083803

Licensing Program Analyst (LPA) Martha Arroyo conducted an unannounced initial complaint investigation for the above allegation. Upon arrival, LPA with the Administrator, Clarizze Punit and the reason for the visit was explained. Entrance interview. During today’s visit, LPA toured the facility to ensure there are no health or safety concerns at 10:30 a.m., conducted interviews with the Administrator and one staff between 10:23 a.m. and 10:57 a.m., conducted a resident file review at 11:05 a.m., and obtained copies of pertinent documents relevant to the investigation. It was alleged that staff are not following physician’s order. It was reported that Resident #1 (R1) is to receive Hydrocodone – Acetaminophen (Norco) every eight (8) hours and as needed, but facility staff is only providing Norco to R1 every other day. Continued on LIC 9099C... UnsubstantiatedRead the full finding— CDSS inspection report, April 4, 2024 · control 29-AS-20240328080922

Licensing Program Analyst (LPA) Emily Peraldi conducted a subsequent visit to this facility today to deliver findings. At 11:25 a.m., the LPA met with and explained staff, Ulka Sawghavi reason for the visit. At 12:45 p.m., the Administrator, Clarizze Punit arrived at the facility. During the initial visit on 01/11/2022 between 10:15 a.m. and 12:00 p.m., LPA Salia Walker conducted an interview with one (1) staff and the Administrator at the time, Melissa Christopher. On 01/11/2022, LPA Walker also reviewed and obtained copies of pertinent documents. On 04/01/2022, LPA Walker conducted a subsequent visit between 9:30 a.m. and 3:30 p.m. and during the subsequent visit, LPA Walker conducted a physical plant tour, interviewed residents and facility staff. During today’s visit on 03/07/2024, starting at 11:39 a.m., LPA Peraldi along with the staff conducted a physical plant tour. During todays visit, between 11:40 a.m. and 12:16 p.m., LPA Peraldi conducted interviews with seven (7) out of twRead the full finding— CDSS inspection report, March 7, 2024 · control 29-AS-20220103090532

Licensing Program Analyst (LPA) Angel Ascencio conducted a subsequent visit to the above facility. LPA Ascencio met with Ulka Sawghavi at 10:45 a.m. Entrance interview conducted. On 06/16/2023, the Department received a complaint alleging that facility food is not of good quality, resident is being harassed by staff and that staff are refusing laundry services. On 06/19/2023, starting at 4:20 p.m., an interview with Resident #1 (R1) revealed that they do not have any complaints about the food being served. Additionally, the food is always delicious and nurturing. Lastly, R1 states that the food is great on most days, the other days, it is ok. Interview with six (6) residents on 06/26/2023 revealed that the food is good. The food comes from the skilled nursing facility (SNF) and is delivered to the residential dining room. The staff assist with plating the food and can serve the food at a hot temperature most of the time. Continued on LIC 9099 - C UnsubstantiatedRead the full finding— CDSS inspection report, August 8, 2023 · control 29-AS-20230616132318

Licensing Program Analyst (LPA) Angel Ascencio conducted a subsequent visit to the above facility. LPA Ascencio met with Staff Ulka Sawghavi at 12:45 p.m. Entrance interview conducted. On 06/08/2023, the Department received a complaint alleging that staff did not seek medical attention for resident in care, staff threatened a resident in care, staff spoke inappropriately to a resident in care, and staff do not serve nutritious meals. On 06/26/2023, interview with Resident #1 (R1) starting at 12:12 p.m. revealed that sometime in 2021, R1 was living in the second (2nd) floor, walked up the stairs and had a fall. R1 indicated that the elevator was not working to go up to the second floor. R1 added that when they fell, R1 felt pain in their abdomen and groin area. R1 stated they were not seen by a doctor and that Administrator Melissa Christopher observed the incident and assisted R1 back to their room. Continued on LIC 9099 - C UnsubstantiatedRead the full finding— CDSS inspection report, August 8, 2023 · control 29-AS-20230608083803

Licensing Program Analyst (LPA) Angel Ascencio conducted a subsequent visit to the above facility. LPA Ascencio met with Interim Administrator Aaron Mayes at 10:00 a.m. Entrance interview conducted. On 06/13/2023, the Department received a complaint alleging that an illegal eviction had occurred. On 06/13/2023, LPA Ascencio conducted Staff #1 (S1) interview starting at 2:24 p.m. Interview with S1 revealed that Resident #1 (R1) was admitted to the hospital on 06/08/2023 due to having lower abdominal pain. At the facility, R1 was unfortunately becoming more dependent on the caregivers to do all activities of daily living (ADL).R1 needed to improve or move to a skilled nursing facility (SNF). When R1 was at the hospital, we did receive a call from a social worker indicating that R1 was ready for discharge. We recommended R1 go to a SNF, and when R1 is better, they can return to the facility. Lastly, S1 stated they did not issue an eviction notice as R1 is still paying rent until they areRead the full finding— CDSS inspection report, August 2, 2023 · control 29-AS-20230613130839

Licensing Program Analyst (LPA) Angel Ascencio conducted an initial 10-day complaint visit to the above facility. LPA Ascencio met with staff Ulka Sawghavi at 09:45 a.m. Entrance interview conducted. On 06/21/2023, the Department received a complaint regarding the facility elevator is in disrepair and resident was injured while in care. On 06/26/23, starting at 09:50 a.m., interview with Staff #1 (S1) revealed that the elevator stopped working on 06/24/2023. S1 proceeded to call the elevator company who came out that same day and fixed the elevator. While the elevator was inaccessible, facility staff assisted the residents who lived in the second (2nd) floor up and down the stairs. Continued on LIC 9099 - C UnsubstantiatedRead the full finding— CDSS inspection report, June 26, 2023 · control 29-AS-20230621083720

Licensing Program Analyst (LPA) Angel Ascencio conducted an initial complaint visit to the above facility. LPA Ascencio met with Staff Member Ulka Sawghavi at 1:00 p.m. Entrance interview conducted. Administrator Clarizze Punit was not available as Administrator is on leave. On 06/08/2023, the Department received a complaint alleging that the facility has bed bugs/roaches. On 06/13/2023, LPA Ascencio conducted interview with Staff #1 (S1) at 1:00 p.m. Interview with S1 revealed that a fumigation company comes in once a week for routine pest control. The pest control company ask if we have any active bed bug cases or cockroaches, but we haven’t had any in a while. Later that same day, interviews with five (5) residents, starting at 1:20 p.m. revealed that residents have not seen or had bed bugs in their room, but they have seen cockroaches. Interviews stated the cockroaches come and go but every now and then, they are seen in the hallway, on their wall, or in their dresser. Continued onRead the full finding— CDSS inspection report, June 13, 2023 · control 29-AS-20230608083803

Licensing Program Analyst (LPA) Angel Ascencio conducted an initail 10-day complaint investigation to the above facility. LPA met with Administrator Clarizze Punit at 10:12 a.m. Entrance interview conducted. On 05/12/2023, the Department received a complaint regarding staff threatened resident of eviction and staff spoke inappropriately to resident. On 05/16/2023, LPA Ascencio conducted an interview with Administrator Punit at 10:15 a.m. Interview with Administrator Punit revealed that Resident #1 (R1) has been living at the facility for over a year and is on the Assisted Living Waiver Program (ALW). Monthly, the ALW program pays a majority of R1's boarding and care fees, while R1 is responsible for what ALW does not cover. Administrator Punit stated R1 has not been paying their portion since moving in last year, raking up a fee of over $15,000. Administrator Punit also mentioned that they have spoke to R1 various time regarding the billing statement and possible eviction for non-paymeRead the full finding— CDSS inspection report, May 16, 2023 · control 29-AS-20230512112322

Licensing Program Analyst (LPA) Elsie Campos arrived unannounced for an initial complaint visit for the above allegations. The LPA met with Administrator Clarizze Punit and explained the reason for the visit. During today's visit, the LPA conducted a brief facility tour at 10:40 a.m., interviewed administrator at 11:00 a.m., interviewed residents at 11:10 a.m., 2:35 p.m. and 2:37 p.m. interviewed staff at 12:20 p.m. and 2:05 p.m. and reviewed documents at 2:30 p.m. Unsubstantiated— CDSS inspection report, July 27, 2022 · control 29-AS-20220720134605

Licensing Program Analyst (LPA) Elsie Campos arrived unannounced for a subsequent complaint visit to deliver the findings for the above allegations. The LPA met with Med Tech Socorro Rosas and explained the reason for the visit. The LPA contacted the Administrator via telephone and also explained the reason for the visit. The Administrator authorized Med Tech Socorro Rosas to sign for the report. During the initial visit on 1/19/22 the LPA interviewed the administrator at 3:45 p.m. and reviewed documents. The LPA conducted a subsequent visit on 4/1/22 and interviewed staff at 9:35 a.m., 1:00 p.m., 1:45 p.m., 1:57 p.m., and 2:20 p.m. The LPA reviewed documents at 9:40 a.m., conducted a brief plant tour at 10:40 a.m. and interviewed residents at 11:15 a.m. and 11:50 a.m. During the subsequent visit on 4/11/22 the LPA interviewed staff at 10:25 a.m., 10:48 a.m., 11:15 a.m.,11:38 a.m., 3:00 p.m., 3:33 p.m. and 3:48 p.m. The LPA interviewed residents at 1:05 p.m., 1:10 p.m., 1:25p.m., 1:30Read the full finding— CDSS inspection report, April 15, 2022 · control 29-AS-20220114163908

Licensing Program Analyst (LPA) Elsie Campos arrived unannounced for a subsequent complaint visit to deliver the findings for the above allegation. The LPA met with Social Worker/Administrator Assistant Ulka Sanghavi and explained the reason for the visit. During the initial visit conducted on 12/28/2021, LPA’s Salia Walker and Elsie Campos conducted a brief facility tour at 10:22 a.m., interviewed administrator at 10:36 a.m., interviewed staff at 11:05 a.m., interviewed resident at 11:25 a.m. and reviewed documents at 12:20 p.m. During a visit conducted on 3/30/2022, LPA Elsie Campos conducted an interview with the administrator at 12:20 p.m., collected documents at 12:50 p.m. and reviewed documents at 2:15 p.m. During a visit conducted on 4/1/2022, LPA Campos interviewed staff at 9:35 a.m., 1:00 p.m., 1:45 p.m., 1:57 p.m., and 2:20 p.m., reviewed documents at 9:40 a.m., conducted a brief plant tour at 10:40 a.m. and interviewed residents at 11:15 a.m. and 11:50 a.m. Continued on LICRead the full finding— CDSS inspection report, April 6, 2022 · control 29-AS-20211223133434

Licensing Program Analyst (LPA) Elsie Campos arrived unannounced for a subsequent complaint visit to deliver the findings for the above allegation. The LPA met with Social Worker/Administrator Assistant Ulka Sanghavi and explained the reason for the visit. During the initial visit conducted on 1/19/2022, LPA Elsie Campos conducted an interview with the administrator at 3:45 p.m. The LPA reviewed and obtained copies of documents pertinent to the investigation. During a visit conducted on 4/1/2022, LPA Campos interviewed staff at 9:35 a.m., 1:00 p.m., 1:45 p.m., 1:57 p.m., and 2:20 p.m., reviewed documents at 9:40 a.m., conducted a brief plant tour at 10:40 a.m. and interviewed residents at 11:15 a.m. and 11:50 a.m. Continued on LIC 9099-C UnsubstantiatedRead the full finding— CDSS inspection report, April 6, 2022 · control 29-AS-20220113145359

Licensing Program Analyst (LPA) Elsie Campos arrived unannounced for a subsequent complaint visit for the above allegations. The LPA met with Administrator Melissa Christopher and explained the reason for the visit. During the initial visit conducted on 12/28/2021, LPA’s Salia Walker and Elsie Campos conducted a brief facility tour at 10:22 a.m., interviewed administrator at 10:36 a.m., interviewed staff at 11:05 a.m., interviewed resident at 11:25 a.m. and reviewed documents at 12:20 p.m. Today, the LPA interviewed the administrator at 12:20 p.m., collected documents at 12:50 p.m. and reviewed documents at 2:15 p.m. Continued on LIC 9099-C UnsubstantiatedRead the full finding— CDSS inspection report, March 30, 2022 · control 29-AS-20211223133434