Casa Del Sol II Residence

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Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to conduct an annual inspection. LPA introduced herself and met with Vida Zelaya-LVN who was informed of the purpose of the visit. The facility is a two-story building located in a residential-commercial neighborhood with, a dining room, 3 bedrooms, 3 bathrooms, and an indoor/outdoor activity area. Age range 60 and over. 2 Ambulatory and 4 non-ambulatory, Room #3 approved for 2 Non-Ambulatory, Rooms #1 and #2 approved for 1 Non-Ambulatory for each room. The facility does not handle any of the residents’ finances. At 11:45 AM, LPA reviewed four (4) residents files for admission agreements, updated physician reports, needs and services plans all of which appeared to be all current. LPA also reviewed four (4) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings which were all current. At 12:15 PM, LPA and Silvia Figueroa- Support staff toured the physical plant. There were no bodies of water or obstructions on the premises. LPA observed that the bedrooms have the required furniture which appeared to be in good repair. The rooms also have adequate lighting, and storage for the residents’ personal belongings. LPA inspected a total of seven (7) bedrooms and seven (7) bathrooms that were found to be clean and operational. At 3:15 PM, LPA toured the kitchen and dining area and there was sufficient seating for dining. There was a menu available for review. LPA observed a 5-day supply of perishables and a 7-day supply of non-perishable food available for the residents in care which was adequately maintained. LPA observed fully charge fire extinguishers throughout the facility and last inspected on 8/16/2025. The smoke and carbon monoxide detectors were in operable condition. The water temperature ranged from 115.5°F to 116.2°F, and the temperature throughout the facility ranged from 74°F to 78°F. During the visit, LPA observed that the facility was clean, sanitary, and appropriately furnished. LPA also observed cleaning supplies, toxins, and sharp objects were stored inaccessible to residents in care. Based on the observations made during today’s visit, no deficiencies were cited. An exit interview was conducted, and this report was discussed and provided to Vida Zelaya-LVN at the conclusion of the visit with appeal rights.the state’s words, verbatim · CDSS document, Sep 25, 2025

Allegation investigated: Staff made inappropriate comments towards resident. Staff are not treating resident with respect.

On January 22,2025, an associate from the California Department of Social Services/Community Care Licensing (CDSS/CCL) conducted an initial unannounced complaint visit. The Medicaton Nurse, Vida Zelaya, greeted the associate. The associate explained that the purpose of this visit was to investigate the allegations mentioned above. The investigation included a tour of the facility, interviews, and the collection of records. Interviews were conducted with staff members #1, #2 (S1-S2) and residents members #2 through #5 (R2-R5). The associate reviewed several documents, including the Personnel Schedule Sheet (dated 01/01/25), the Facility Roster (dated 0916/24), and Resident #1 (R1's) service records and other records associated with this complaint. (Evaluation Report continues LIC 9099-C) Unsubstantiated INVESTIGATION REVEALED THE FOLLOWING: Allegation #1: Staff made inappropriate comments towards resident. Allegation #2: Staff are not treating resident with respect. The complaint stated that the facility staff made inappropriate comments towards Resident #1 (R1) and did not treat (R1) with respect. It specifically noted that Staff #1 and Staff #2 (S1-S2) made unkind and rude remarks and failed to show respect towards (R1). The complaint mentioned that (R1) was temporarily relocated to this facility due to the Eaton fire disaster and no further details were provided regarding these allegations. On January 22, 2025, between 10:30 AM and 12:00 PM, the Department interviewed Staff #1 and Staff #2 regarding the allegations that they had made inappropriate comments and treated (R1) disrespectfully. (S1) and (S2) denied making impolite comments or suggesting any mistreatment of (R1). (S1) explained that (R1) had been relocated to this facility during the Eaton Fire in Pasadena, which occurred from January 9 to January 14, 2025, along with three other residents identified as Resident #2, #3, and #4 (R2-R4). According to (S1), (R1) is diagnosed with a mental health disorder but is independent and capable of completing all activities of daily living. (R1) only requires supervision and medication management. It was noted on (R1’s) Medication Administration Record that (R1) had refused to take prescribed medication for multiple days upon being transferred to Casa Del Sol II Residence. A single missed of medication can affect mood or behavior, potentially causing feelings of anger, agitation, or depression (reference: National Institute of Health). (S1) reported that (R1) was reluctant to cooperate with the assistance provided by care staff members, and the activities were documented in (R1’s) progress communication notes. On January 22, 2025, between 10:30 AM and 12:00 PM, the Department interviewed witnesses, identified as Witness # 1 and Witness #2. They could not corroborate the allegations in question. (W1), the facility administrator, and (W2), a med-tech at Pasadena Adult Living Center, confirmed that they faced challenges in providing services to Resident #1 (R1). They noted that the actions of the care staff were often misinterpreted as unruly or discourteous, particularly when dealing with (R1), who only needed redirection. (Evaluation Report continues LIC 9099-C) (W1) reported that Residents #2, #3, and #4 (R2-R4) had positive feedback about the staff and their experiences at Casa Del Sol II Residence. (W2) added that (R1) frequently refused medications, which often led to (R1) exhibiting derogatory behaviors. On January 22, 2025, between 11:30 AM and 12:30 PM, the Department interviewed resident members identified as R2, R3, R4, and R5 regarding the allegations. (R2-R5) were unable to validate the accusations. They described their experiences with the staff as positive, respectful, and professional, stating that they had not witnessed any verbal or physical mistreatment that would infringe upon the residents' rights. An interview with Resident #1 (R1) was not possible as calls went unanswered. The Department reviewed several documents regarding Resident #1 (R1). These included the physician's report (dated February 1, 2024); the Appraisal/Need and Service Plan (dated January 10, 2025); Facility Progress Notes (dated from January 10 to January 15, 2025); the Nurse's Admission Record (dated January 10, 2025); Identification and Emergency Information (dated April 21, 2022); the Self-Administration of Medication Assessment Record (dated January 10, 2025); and the Medication Administration Record covering (dated December 15, 2024, to January 13, 2025). The review verified that (R1) is diagnosed with a mental illness, has refused to take medication for (23) consecutive days, and exhibits deprecating behaviors. Based on the gathered information, there is insufficient evidence to support the stated allegations. Based on the information collected from the facility inspection, observations, interviews, and records analysis, the Department found no evidence to support the above allegations. While the allegations may be valid or have occurred, there is insufficient evidence to establish whether the alleged violations took place or did not. Therefore, the allegations are deemed unsubstantiated. An exit interview was conducted with Veda Zelaya, and copies of the reports were provided. This report serves as an amendment to clarify the findings. It does not supersede the complaint investigation findings reflected in the report created 01/22/25.the state’s words, verbatim · CDSS document, Jan 22, 2025 · control 11-AS-20250114112502

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced required 1- year visit with the primary focus on Infection Control measures and using the new CARE Inspection Tool. Upon arrival at the facility, LPA Bunker conducted a risk assessment. Based on the assessment, the facility is clear of COVID-19 infection. LPA was properly screened for COVID-19 symptoms and temperature was checked. LPA Bunker met staff member LVN Vida Zelaya and explained the purpose of today's Annual Inspection. LPA verified that the facility has an approved mitigation plan report. There are currently five (5), residents in placement. The facility's annual fees are current. Staff member Ms. Vida and LPA Bunker toured the facility. The facility is a two-story building located in a residential-commercial neighborhood with, a dining room, 3 bedrooms, 3 bathrooms, and an indoor/outdoor activity area. Bedrooms #1-3 are designated as the client's bedrooms. The residents' bedrooms had the required furniture, bed linens, and closet/drawer space to accommodate them comfortably. Resident bathrooms were checked. The toilets and water faucets worked properly, the grab bars were secure, the shower was free of mold/mildew and a non-skid mat was in place. Resident bath towels, toiletries, and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Food and meals are prepared in the main kitchen located in the skilled nursing facility and are brought to the residents on carts. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly, and the fire extinguisher was fully charged. During the visit, LPA observed the facility's infection control practices. LPA observed a screening station with sanitizer at the facility entrance and additional sanitation supplies in the nursing office that were inaccessible to the residents. LPA observed a sign-in sheet and temperature log for visitors. LPA's temperature was checked during the visit. LPA observed staff wearing masks. Each resident has their own individual room for isolation and required postings are throughout the facility. Due to time constraints, LPA was unable to complete the visit and will return back at a later date to complete the visit.the state’s words, verbatim · CDSS document, Sep 11, 2024