Cedarcreek Villa

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an annual inspection. LPA was greeted by staff, who allowed LPA to enter. The house manager Angel Gomez was contacted and came to the visit. There were (2) additional staff on duty. Everyone was explained the reason of the visit. The following areas were inspected: Common areas: Living/dining: All indoor passageways were free from obstruction; inside temperature was comfortable, with adequate lighting, and all areas were clean and appropriately furnished for resident’s comfort. There are (02) bathrooms, that had grab bars, and non-skid mats. Hot water measured at 106.2 degrees Fahrenheit. The garage is used for office, storage and laundry. Laundry detergents, cleaning agents and other toxins are stored in a locked cabinet in the garage and kitchen. Kitchen: Food Service/Kitchen area was sufficiently stocked with at least two (2) days perishable and seven (7) days non-perishable. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. There are (2) additional refrigerators located in the garage, stocked with food. Bedrooms: The facility has (4) bedrooms residents; with (1) room for staff. All bedrooms were properly furnished and supplied with appropriate bedding and linens. (2) rooms are shared and (2) private. Surrounding Grounds: There were no visible hazards; passageways were free from obstruction and gates were easily accessible to open. All exit doors have locks; all were operating. Fire extinguisher fully charged. First aid kit furnished fully equipped. Smoke alarms and carbon monoxide detectors were tested and operating properly. Record review: completed. Exit interview and copy of report provided.the state’s words, verbatim · CDSS document, May 18, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an annual inspection. LPA was greeted by staff, who allowed LPA to enter. The house manager Angel Gomez was contacted and came to the visit. There were (2) additional staff on duty. Everyone was explained the reason of the visit, and the Administrator was Dr. Richard Gordon was contacted and informed as well. The following areas were inspected per Title 22 regulations: Common areas: Living/dining: All indoor passageways were free from obstruction; inside temperature was comfortable, with adequate lighting, and all areas were clean and appropriately furnished for resident’s comfort. There are (02) bathrooms, that had grab bars, and non-skid mats. Hot water measured at 107.6 degrees Fahrenheit. The garage is used for office, storage and laundry. Laundry detergents, cleaning agents and other toxins are stored in a locked cabinet in the garage and kitchen. Kitchen: Food Service/Kitchen area was sufficiently stocked with at least two (2) days perishable and seven (7) days non-perishable. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. There are (2) additional refrigerators located in the garage, stocked with food. Bedrooms: The facility has (4) bedrooms residents; with (1) room for staff. All bedrooms were properly furnished and supplied with appropriate bedding and linens. (2) rooms are shared and (2) private. Surrounding Grounds: There were no visible hazards; passageways were free from obstruction and gates were easily accessible to open. There are no swimming pools or other bodies of water. All exit doors have locks; all were operating. Fire extinguisher fully charged. First aid kit furnished fully equipped. Smoke alarms and carbon monoxide detectors were tested and operating properly. Fire and earthquake drill was conducted 03/09/2025. Record review: All required documents were in file for residents and staff. Medication reviewed; no errors observed. Exit interview and copy of report provided.the state’s words, verbatim · CDSS document, May 13, 2025

Allegation investigated: Personal Rights: Staff asked residents to switch doctors and use the facility’s Administrator as their hospice doctor.

Licensing Program Analyst (LPA) Tuesday Cabiness arrived to the facility to conduct the initial investigation. LPA met with House Manager Angel Gomez and Dr. Richard Gordon and informed them the reason of the visit. The following was determined: It was alleged, staff asked residents to switch doctors and use the facility’s Administrator as their hospice doctor. On 10/14/2024 through 10/15/2024, ranging from 10am 245pm, LPA conducted interviews and reviewed resident records. From the information obtained, interviews revealed that staff have asked on several occasions for residents to change medical insurance from Kaiser, and make the Administrator, who is a medical physician, their primary doctor. According to regulations, residents have the right to select their own health care provider, without interference from staff trying to make them switch to the Administrator as their doctor. LPA determined it was a personal right violation, and it poses a potential health and safety risk to residents in care. Therefore, based on interviews, the allegation is Substantiated at this time. Citation issued, appeal rights, exit interview and copy of report provided. Substantiatedthe state’s words, verbatim · CDSS document, Oct 15, 2024 · control 31-AS-20241008144738

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(18) · Plan of correction due date: Oct 18, 2024

Additional Personal Rights of Residents in Privately Operated Facilities. (a)...residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (18)To select their own physicians, pharmacies, privately paid personal assistants, hospice agency, and and health care providers...This requirement was not met, evidenced by, during interviews it was reported to LPA that staff have asked residents to switch there doctor to Dr. Gordon, who is the Administrator. This is a personal rights issue, because residents have the right to choose. This is a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Oct 15, 2024

Plan of correction: The Administrator has AGREED to put in writing, 'that I or my staff will not provide any medical information or opinions to any of my resident". POC cleared during visit, document was emailed to LPA.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an annual inspection. LPA was greeted by house manager Angel Gomez, who allowed LPA to enter. LPA observed (2) additional staff on duty. Everyone was explained the reason of the visit, and the Administrator was contacted and informed as well. Licensing and COVID postings visibly seen throughout the facility. A physical plant tour was conducted inside and outside with house manager Angel. The following was observed: At the front entrance, LPA observed a screening area, that included a sign in sheet, infrared thermometer, hand sanitizer, gloves and masks are available. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and all over. Common areas: Living/dining: All indoor passageways were free from obstruction; inside temperature was comfortable, with adequate lighting, and all areas were clean and appropriately furnished for resident’s comfort. There are (02) bathrooms, that had grab bars, and non-skid mats. Hot water measured at 114.8 degrees Fahrenheit. The garage is used for office, storage and laundry. Laundry detergents, cleaning agents and other toxins are stored in a locked cabinet in the garage. Kitchen: Food Service/Kitchen area was sufficiently stocked with at least two (2) days perishable and seven (7) days non-perishable food. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. There are (2) additional refrigerators located in the garage, stocked with food. Bedrooms: The facility has (4) bedrooms residents; with (1) room for staff. All bedrooms were properly furnished and supplied with appropriate bedding and linens. (2) rooms are shared and (2) private. There were sufficient linens observed and available. Surrounding Grounds: There were no visible hazards; passageways were free from obstruction and gates were easily accessible to open. There are no swimming pools or other bodies of water. All exit doors have locks; all were operating. Fire extinguisher fully charged.First aid kit furnished fully equipped. Smoke alarms and carbon monoxide detectors were tested and operating properly. Record review: A complete record review of staff and residents was conducted; all required documents were in file. Medication reviewed; no errors observed.Exit interview and copy of report provided.the state’s words, verbatim · CDSS document, May 20, 2024