Pasadena Highlands

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: Staff did not provide resident records to resident's authorized representative.

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced subsequent complaint investigation visit on 09/20/2025, to deliver findings regarding the above allegation. On 09/18/2025, LPA Ramirez conducted an unannounced initial complaint investigation. Due to time constraints, additional interviews needed and additional time to review records, a need further investigation was documented. During today’s visit, LPA Ramirez was greeted by Director of Marketing and Sales- Cynthia Leon and explained the purpose of the visit. The investigation consisted of the following: LPA Ramirez requested and obtained copies of Staff Roster, copies of the following for Resident#1 (R1): Medical Records request, Authorization Attachment, HIPPA Compliant Authorization for the Release of Patient Information, Durable Power of Attorney, Declaration of Custodian of Records, Admission Agreement, and physical plant tour. LPA Ramirez conducted the following interviews: Staff#1 - 3 interviews (S1 – S3the state’s words, verbatim · CDSS document, Sep 20, 2025 · control 28-AS-20250912094702

Allegation investigated: Staff did not safeguard resident's personal belongings.

Licensing Program Analyst (LPA) Elizabeth Irra conducted an initial visit to investigate the above allegation. LPA met with Kay Cano and discussed the purpose of today’s visit. During this investigation, LPA obtained a copy of the staff and resident rosters, reviewed R-1’s file and obtained relevant documentation, interviewed Staff #1 (S-1) through Staff #5 (S-5) and interviewed Resident #1 (R-1), Resident #4 (R-4) and Resident #5 (R-5) . LPA attempted to interview Resident #2 (R-2) and Resident #3 (R-3) and was unsuccessful. All interviewed residents are residing in the memory care unit (where allegation allegedly occurred) and the census for the memory care unit is (35). LPA was unable to interview additional residents from this unit. Refer to LIC 9099C for the continuation of this report. Unsubstantiatedthe state’s words, verbatim · CDSS document, Sep 12, 2025 · control 28-AS-20250910125946

Allegation investigated: Staff did not answer resident's calls for assistance timely resulting in hospitalization

Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complain visit in regard to the allegations listed above. LPA met with Med-Tech Cherry Castro and explained the purpose of the visit. Administrator Kay Cano was notified by telephone. The investigation consisted of the following: During the initial visit conducted on 07/22/2025, LPA toured the facility, interviewed Administrator, and obtained copies of the following documents: staff roster, resident roster, R1’s physicians reports, admission agreement, identification information (LIC 601), facility service plan, health and services evaluation results, meal orders, hospital discharge paperwork, medication list, and facility notes. During visit on 08/14/2025 LPA Gutierrez interviewed staff #1, interviewed staff# 2- Staff #4 by telephone, and residents #1-residents #6. On 08/22/2025 Staff five (S5) was interviewed over the telephone. During today’s visit LPA delivered findings. See 9099C Substantiatedthe state’s words, verbatim · CDSS document, Aug 24, 2025 · control 28-AS-20250717082326

Allegation investigated: Staff did not provide adequate supervision resulting in resident sustaining multiple falls and injuries Staff performed an unsafe transfer resulting in resident sustaining an injury Resident developed a pressure injury due to staff neglect Resident’s condition worsened due to staff neglect Staff isolated resident in her room

Licensing Program Analyst (LPA) Glenn Trueman conducted an unannounced subsequent complaint investigation visit for the allegation listed above. LPA Trueman met with Administrator Kay Cano and the purpose of the visit was discussed. At today's visit 05/22/24 LPA has completed the following: LPA collected a copy of the staff and resident roster, LPA Interviewed Staff #1- #2 (S1-S2) and Residents #2 - #8 (R2-R8). LPA reviewed Resident R1's file and the facility submitted the Physician's Report, Emergency ID, Special Incident Report's (SIR's) and Pre-placement Appraisal. Documentation from the primary care doctor, and documentation from Huntington Health Hospital were also submitted. The investigation revealed the following: In regards to the allegation Staff did not provide adequate supervision resulting in resident sustaining multiple falls and injuries, based on interviews conducted and information gathered it was revealed by Unsubstantiatedthe state’s words, verbatim · CDSS document, May 22, 2025 · control 28-AS-20240725110705

Allegation investigated: Staff did not adequately address a change in resident’s condition. Staff did not inform resident's representative of incident(s) as required

**This is a subsequent visit to amend and supersede the reports dated 02/24/2025. The reason for the amendment is to remove confidential information listed on the initial report. The findings will remain unsubstantiated. ** On 02/24/2025, LPA Vaid conducted an Initial 10-Day complaint investigation regarding the above allegations. LPA was met by Adrienne Hurd-Assistant Executive Director. LPA discussed the purpose of the visit. LPA toured the facility with Adriene and did not observe any health and safety concerns. Investigation consisted of the following: interview of Staff #1 - Staff #7 (S1-S7); interviews of residents from resident#1-resident #10 (R1-R10); requested, obtained, and reviewed client #1 face sheet, admissions record, physicians report, preplacement appraisal, health services evaluation and service plan, mini-mental state examination. Staff roster and client roster. Continued 809C..... Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 21, 2025 · control 28-AS-20250219084240

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 did not adequately address a change in resident’s condition. Staff did not inform resident's representative of incident(s) as required.

LPA Vaid conducted an Initial 10-Day complaint investigation regarding the above allegations. LPA was met by Adrienne Hurd-Assistant Executive Director. LPA discussed the purpose of the visit. LPA toured the facility with Adriene and did not observe any health and safety concerns. Investigation consisted of the following: interview of Staff #1 - Staff #7 (S1-S7); interviews of reisdents from resident#1-resident #10 (R1-R10); requested, obtained, and reviewed client #1 face sheet, admissions record, physicians report, preplacement appraisal, health services evaluation and service plan, mini-mental state examination. Staff roster and client roster. Regarding the allegation:Staff did not adequately address a change in resident’s condition. It is alleged that R1 is experiencing progressive behvioral expressions related to dementia and the facility is not addressing the changes in R1's condition and should have R1 placed in memory care or higher-level care facility. CONTINUED ON 9099C......the state’s words, verbatim · CDSS document, Feb 24, 2025 · control 28-AS-20250219084240

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 did not properly handle resident's wound care. Due to staff neglect, resident's wound worsened while in care. Staff did not note changes in resident's medical condition. Staff did not seek resident timely medical attention. Staff did not provide resident's family with a copy of the resident's wound care plan. Facility retained a resident requiring a higher level of care.

Licensing Program Analyst (LPA) Mary Flores conducted a subsequent complaint investigation visit at the facility regarding the above allegations. LPA met with Cynthia Leon and explained the reason for the visit. The investigation consisted of the following: On 11/20/23 LPA Rea conducted an initial investigation visit and requested some documents. On 8/29/24 LPA Flores was assigned the investigation. On 9/3/24 LPA Flores conducted interviews over the phone with facility’s administrator and resident #1(R1)’s family representative and requested facility records and medical records. On 9/6/24 LPA interviewed Hospice care staff and requested R1’s medical records. On 9/24/24 LPA conducted interviews with 9 residents over the phone. On 9/25/24 LPA conducted an additional interview with one resident. On 10/7/24 LPA interviewed 3 staff over the phone. On 10/9/24 LPA interviewed 2 staff over the phone. On 10/12/24 LPA delivered findings for this complaint. (CONTINUED ON LIC 9099C) Unsubstantiatethe state’s words, verbatim · CDSS document, Oct 12, 2024 · control 28-AS-20231115111536

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 do not keep the facility free from pest.

Licensing Program Analyst (LPA) Glenn Trueman conducted an unannounced complaint investigation visit for the allegation listed above. LPA Trueman met with Administrator Kay Cano and the purpose of the visit was discussed. At today's visit 07/02/24, LPA has completed the following: LPA collected a copy of the staff and resident roster, LPA Interviewed Staff #1- #3 (S1-S3) and Residents #1-#8 (R1-R8). LPA toured the physical plant including the outside gardens and along the walls. LPA inspected the facilities food supply, kitchen area and dining room, LPA reviewed documentation of pest control services contracted by the facility for the last 2 months. The investigation revealed the following: In regards to the allegation Staff do not keep the facility free from pest, based on interviews conducted and information gathered it was revealed that 8 out of 8 residents stated that the food service is good and that they had never observed roaches, rodents or flies and had not been told by anyonethe state’s words, verbatim · CDSS document, Jul 2, 2024 · control 28-AS-20240627153804

Allegation investigated: Staff do not keep the facility free from pest Staff do not properly sanitize kitchen items Staff do not keep the facility free from mildew Staff do not follow proper food handling techniques

*** This report supersedes report dated 5/2/24 to revise (1) of (4) allegations to an accurate description and provide additional details in the report. Findings delivered have not changed*** Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced subsequent complaint investigation visit for the allegation(s) listed above to redeliver findings. LPA Villalobos met with Administrator Kay Cano and the purpose of the visit was discussed. As of todays, LPA has completed the following: LPA collected a copy of the staff and resident roster, LPA Interviewed Staff #1-#8 (S1-S8) and Residents #1-#10 (R1-R10), LPA toured the physical plant including the outside gardens and along the walls, LPA inspected the facilities food supply, kitchen area and dinging room, LPA reviewed documentation of pest control services contracted by the facility for the last month, and reviewed work orders requested by facility residents for the last month. The investigation revealed the following: Contthe state’s words, verbatim · CDSS document, May 14, 2024 · control 28-AS-20240425201839

Allegation investigated: Staff do not keep the facility free from rodents Staff do not properly sanitize kitchen items Staff do not keep the facility free from mildew Staff do not follow proper food handling techniques

Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced initial complaint investigation visit for the allegation listed above. LPA Villalobos met with Administrator Kay Cano and the purpose of the visit was discussed. LPA conducted the following on todays visit: LPA collected a copy of the staff and resident roster, LPA Interviewed Staff #1-#8 (S1-S8) and Residents #1-#10 (R1-R10), LPA toured the physcial plant including the outside gardens and along the walls, LPA inspected the facilities food supply and kitchen area, LPA reviewed documentation of pest control services contracted by the facility for the last month, and reviewed work orders requested by facility residents for the last month. The investigation revealed the following: Continued on LIC 9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, May 2, 2024 · control 28-AS-20240425201839

Allegation investigated: Wrongful Eviction.

Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced initial complaint investigation visit for the allegation listed above. LPA Villalobos met with Administrator Kay Cano and the purpose of the visit was discussed. LPA conducted the following: Interviewed staff #1-#6 (S1-S6), Interviewed residents #1-#6 (R1-R6) , interviewed R1 and R2's Responsible Party (W1), collected copies of the staff and resident roster, and collected and reviewed documents from R1 and R2's file. The investigation revealed the following: In regards to the allegation "Wrongful Eviction" it was alleged that the facility is wrongfully evicting R1 and R2 due to false belief that the residents are unable to follow facility policies... Continued on LIC 9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 19, 2024 · control 28-AS-20240312142800

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.