Promise Assisted Living, Llc.

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.

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: Facility is in disrepair.

Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced complaint visit to investigate the above allegations. LPA met with Assistant Administrator Darolyn Azevedo and explained the purpose of today's visit. The investigation consisted of the following: LPA obtained copies of Staff and Residnt Rosters, copies of pest control contract and most recent service date invoices, LPA toured facility, interviewed 4 Staff (S1-S4) and 5 Residents (R1-R5). (Continued on LIC9099-C) Substantiatedthe state’s words, verbatim · CDSS document, Mar 6, 2026 · control 28-AS-20260228121123

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: Licensee is preventing resident from seeing a doctor of their choice Staff are not adequately trained Staff did not keep the facility free of cockroaches Staff did not keep the facility free of bedbugs Staff exposed residents to chemicals that are hazardou

Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complain visit in regard to the allegations listed above. LPA met with Supervisor Roxana Aparicio and explained the purpose of the visit. The investigation consisted of the following: During the initial visit conducted on 02/27/2025, LPA interviewed Staff #1 - Staff #5, Resident #1- Resident #5.LPA obtained copies of the following documents: Staff roster, Resident roster, CPR/FIRST AID for S1-S5, R1’s LIC 601 Identification and emergency information, appraisal information, and Physicians reports. LPA toured the facility and obtained copies of invoices for rodent and pest services. During today’s visit LPA Gutierrez delivered findings. SEE 9099C Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 1, 2025 · control 28-AS-20250226130647

Allegation investigated: Staff member physically assaulted resident which resulted in an injury

Licensing Program Analyst (LPA) Angelica Rea conducted a visit in response to the above allegation. On today's visit, LPA met with Assistant Administrator, Darolyn Azevedo who assisted with the visit. Regarding the allegation that : Staff member physically assaulted resident which resulted in an injury. The investigation consisted of interview(s) with Staff #1 - Staff #3, and resident #1 - resident #4. LPA also reviewed resident #5's file. The investigation revealed that former resident, (resident #5) alleged that staff #4 hit her. Staff interviewed stated that resident #5 made this allegation sometime in December of 2023. Three out of three staff interviewed denied that they have observed any staff assault any residents in care. Staff interviewed stated that the facility conducted an internal investigation, and staff #4 denied the allegation. Staff interviewed stated that there were no witnesses to resident #5's allegation. Staff #4 is no longer working at the facility, therefore LPAthe state’s words, verbatim · CDSS document, Aug 8, 2024 · control 28-AS-20240606093952

Allegation investigated: Staff are not accepting resident back after hospital stay.

Licensing Program Analyst (LPA) Tao conducted an unannounced complaint investigation for the allegation listed above. LPA met with Darolyn Azevedo, administrative assistant and explained the purpose of today's complaint investigation visit. The investigation consisted of the following: during the investigation visit, LPA obtained staff/resident roster, reviewed/obtained resident#1’s (R1) records, interviewed residents from resident#2 (R2) to resident#6 (R6), attempted but unable to reach resident#1 (R1) for interview, interviewed staff from staff#1 (S1) to staff #6 (S6), and conducted a physical plant. The investigation revealed the following: In regard of allegation, staff are not accepting resident back after hospital stay, it was alleged that the facility did not take resident back after the hospital stay. (-continued in LIC9099C-) Unsubstantiatedthe state’s words, verbatim · CDSS document, Jun 18, 2024 · control 28-AS-20240611142720

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 caused a resident to fall while in care

Licensing Program Analysts (LPA's) Angelica Rea and Christian Gutierrez conducted an unnannounced visit. LPA's met with supervisor caregiver, Roxanne Aparicio, who assisted with today's visit. The reason for the visit is to correct the date from 2/21/24 to 2/22/24 and that the findings and all other information remain the same. Regarding the allegation that Staff #1 caused resident #1 to fall while in care. An initial visit was conducted on 6/29/22. The investigation consisted of Interview(s) with Administrator, Staff #1 - Staff #4, and Resident #1 - Resident #5. Administrator and staff interviewed stated that they were not aware of the incident. Residents interviewed were not able to corroborate the allegation. Resident #1 denied that Staff #1 caused her to fall. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 7, 2024 · control 28-AS-20220623160200

Allegation investigated: Staff caused a resident to fall while in care

Licensing Program Analysts (LPAs) Angelica Rea and Sanjay Vaid conducted another visit to deliver the final results of the investigation. LPAs met with supervisor caregiver, Roxanne Aparicio, who assisted with today's visit. Regarding the allegation that Staff #1 caused resident #1 to fall while in care. An initital visit was conducted on 6/29/22. The investigation consisted of Interview(s) with Administrator, Staff #1 - Staff #4, and Resident #1 - Resident #5. Administrator and staff interviewed stated that they were not aware of the incident. Residents interviewed were not able to corroborate the allegation. Resident #1 denied that Staff #1 caused her to fall. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Unsubstantiatedthe state’s words, verbatim · CDSS document, Feb 21, 2024 · control 28-AS-20220623160200

Allegation investigated: Resident was sexually assaulted while in care. Residents are being mentally and physically abused by staff. Residents needs are not being met by the facility.

Licensing Program Analyst (LPA) Galarza conducted a subsequent visit to deliver findings on the investigation conducted by DSS Investigation Branch (IB) Investigator Laura Garcia. LPA explained the purpose of the visit to Supervisor Roxana Aparicio. The investigation consisted of: On 9/28/22, LPA Galarza conducted a physical plant tour of the facility, obtained file documents, and reviewed staff and resident files. Staff (S1)/Administrator and staff (S5 & S6) were interviewed. Copies of resident (R1-R3) and staff (S2- S3) file documents were obtained, as well as LIC 500 Personnel Report, Register of Facility Clients/Residents, incident reports, and a list of staff phone numbers. IB investigator interviewed staff (S1-S4) and residents (R2-R3), and conducted a law enforcement inquiry. LPA inter During today's visit, LPA conducted a physical plant tour and interviewed non-ambulatory residents R4- R6. ***Narrative continues next page.***** Unsubstantiatedthe state’s words, verbatim · CDSS document, Jan 23, 2024 · control 28-AS-20220927115755

Allegation investigated: Staff are not adequately supervising resident resulting in resident sustaining multiple fractures.

Licensing Program Analyst (LPA) Galarza conducted a subsequent visit to deliver findings on the investigation conducted by DSS Investigation Branch (IB) Investigator Laura Garcia. LPA explained the purpose of the visit to Supervisor Roxana Aparicio. The investigation consisted of: On 9/4/22, LPA Galarza conducted a physical tour of the facility and file review was conducted. No staff or residents were interviewed. Resident (R1's) file documents [Identification and Emergency Information, Admission Agreement, Physician's Report (3/19/2021), incomplete Oceanside Home Health Services, Inc documents (7/27/22), Preplacement Appraisal Information, Resident Appraisal, Centrally Stored Medication Record/Medication Administration Recors (Aug. 2022- Sep. 2022), three (3) incident reports dated 7/8/22, 9/4/22, 9/8/22, Admission Policies, Procedure & Care of Persons with Dementia, LIC 500 Personnel Report, and Register of Facility Residents were obtained. IB investigator obtained medical records, athe state’s words, verbatim · CDSS document, Jan 16, 2024 · control 28-AS-20220913140148

Allegation investigated: Facility does not have adequate staff to meet the needs of the residents. Facility is in disrepair. Facility staff did not ensure that residents had hot water. Facility staff did not meet resident's diapering needs. Facility staff did not ensure that residents received showers.

Licensing Program Analyst (LPA) Luis Mora conducted an unannounced complaint visit to determine the validity of the above-mentioned allegations. LPA met with Darolyn Azevedo (Administrative Assistant) and explained the reason for the visit. The investigation consisted of the following: On 03/27/23, LPA obtained copies of the resident and staff rosters, interviewed Administrative Assistant, Resident 1 - Resident 3 (R1 - R3) and toured the facility. LPA also obtained copies of estimate documents for roof and bathroom ceiling repair. Today's visit, LPA obtained copies of resident and staff rosters,and interviewed Administrative Assistant, Staff 1 - Staff 3 (S1 - S3), Resident 4 - Resident 7 (R4 - R7) and toured the facility. The investigation revealed the following: regarding the allegation "facility does not have adequate staff to meet the needs of the residents", it is alleged that on 03/18/23 during the night shift, there was a storm flood inside the facility and a staff was working althe state’s words, verbatim · CDSS document, Nov 2, 2023 · control 28-AS-20230322120637

Allegation investigated: Residents are using illegal drug substances while in care.

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced subsequent complaint visit to gather information pertaining to the above-mentioned allegation. LPA met with Assistant Administrator Dee Azevedo and explained the reason for the visit. The investigation consisted of: During the initial visit conducted on 10/03/22, LPA Gonzalez collected copies of Staff and Resident rosters. LPA also conducted a tour of entire facility inside and out with Staff 1 (S1). Facility tour consisted of observations of common areas, dining room, random resident rooms, bathrooms, patio area and kitchen. LPA observed residents in the facility, some residents were out in the patio area, in their rooms, in the lobby and dining room at the time of the visit. LPA observed the residents to identify any signs of neglect, abuse or other immediate Health and Safety threats. LPA did not observe any immediate (See LIC9099C for continuation) Unsubstantiatedthe state’s words, verbatim · CDSS document, Sep 26, 2023 · control 28-AS-20220930134740