Clearwater At Glendora

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.

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: Licensee does not ensure an adequate supply of PPE is provided for staff. Licensee did not ensure infection control measures were properly implemented. Staff did not maintain documentation of the resident’s medical history and current health status.

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced subsequent complaint visit regarding the above stated allegations. LPA met with Michele Johnson, Executive Director and explained the purpose of the visit. The investigation consisted of the following: On 12/23/2025, LPA toured the facility, inspected PPE supplies, obtained/reviewed copies of the staff and resident rosters, Invoices for PPE supplies (last 3 months), and Resident #1 (R1) - Resident #3 (R3) files. LPA also interviewed Staff #1 (S1) - Staff #5 (S5). LPA also requested the Executive Director/House Services Director to email additional documents pertinent to the investigation. During today's visit, LPA obtained resident & staff rosters, additional documents related to the investigation such as Hospice nurse noted and interviewed Witness #1 (W1) and Resident #1 (R1) - Resident #10 (R10) from Memory Care and Assisted Living units. *****CONTINUED ON LIC 9099-C***** Unsubstantiatedthe state’s words, verbatim · CDSS document, Jan 21, 2026 · control 28-AS-20251218103514

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 prevent residents from sustaining multiple falls. Staff did not prevent residents from sustaining injuries while in care. Staff left residents in soiled depends for a long period of time.

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced initial complaint visit to investigate the above allegations. LPA met with Claudia Bauer, Business Office Director and Andrea Barraza, Memory Support Director and explained the purpose of the visit. The investigation consisted of: LPA toured the facility (Assisted Living and Memory Care Unit) and obtained the following documents: Staff and Resident rosters, Memory care staff schedule list, Fall reduction program/policy, Staff In-service training log (dementia care, fall risk, documentation, status checks and changing schedule) and Resident #1 (R1) - Resident #3 (R3)'s file such as: Identification and Emergency Information, Admission Agreement, Physician's Report, Resident Appraisal, Appraisal /Needs and Services Plan, Medication Record/list, Medication Administration Records (Dec. 2024-Jan. 2025), Incident reports (Oct. 2024-Jan. 2025), Daily care/progress notes (Nov. 2024-Jan. 2025), Incontinence change schedule (Nthe state’s words, verbatim · CDSS document, Feb 4, 2025 · control 28-AS-20250131095225

Allegation investigated: Licensee does not ensure facility is adequately staffed to meed resident's needs Staff are not providing adequate laundry services for resident's Staff leave resident's in urine soaked clothing for an extended period of time Staff are not dispensing medications as prescribed Licensee does not ensure enough staff are present to prevent inappropriate interaction between resident's Facility did not report unwitnessed falls to authorized representatives

Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complain visit in regard to the allegations listed above. LPA met with Business Director Claudia Bauer and explained the purpose of the visit. The investigation consisted of the following: During the initial visit conducted on 11/19/2024, LPA interviewed Staff #2 - Staff #9, Resident #1 - Resident #10, and toured the facility. LPA obtained copies of the following documents: staff roster, resident roster, SIR reports for unwitnessed falls, laundry schedule, receipts, and emails for dryer purchase. LPA obtained Individual service plan, progress notes and physician report for R6. During todays visit LPA Gutierrez checked medication and delivered findings. SEE 9099C Unsubstantiatedthe state’s words, verbatim · CDSS document, Dec 6, 2024 · control 28-AS-20241112145228

Allegation investigated: Staff did not prevent the resident from attacking another resident resulting in injuries. Staff did not prevent residents from disturbing other residents.

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced subsequent visit regarding the above allegations. LPA met with Michele Johnson and explained the reason for the visit. The investigation consisted of the following: On 11/7/23 LPA Galarza conducted an unannounced health and safety visit at the facility no deficiencies were noted during that visit. Documents were collected: resident #1-#3 (R1 - R3) file documents, incident reports, maintenance work orders, cycle meal menus from July to October 2023, special diet list, food handling certificates, kitchen server "to do list", dietician services agreement, resident roster, and LIC 500 Personnel Report.On 11/7/23 Investigation Bureau of the Department(IB), Investigator Laura Garcia was assigned to conducted interviews with staff, family members, and obtained medical records for R1 and R2. On 3/25/24 LPA Flores interviewed 3 staff over the phone. On 4/23/24 LPA Flores interviewed 3 additional staff and 7 residents, toured tthe state’s words, verbatim · CDSS document, Apr 23, 2024 · control 28-AS-20231031163231

Allegation investigated: Staff did not prevent a resident from biting another resident in care. Staff did not provide adequate supervision to a resident in care. Staff did not properly conduct a urine test for a resident in care. Facility illegally evicted a resident in care. Staff did not ensure that resident was fed. Staff did not ensure that resident's hygiene needs were being met.

**Please note: This report will supersede the report dated 11/30/23 to change information previously noted. However, the findings to all allegations will remain the same: Unsubstantiated.** Licensing Program Analyst (LPA) V. Maldonado made a subsequent, unannounced, complaint visit to the facility, for the purpose of investigating the above-mentioned allegations. LPA Maldonado met with Executive Director, Michele Johnson, and explained the purpose for the visit. On 11/21/23, LPA Maldonado made an initial complaint visit, to investigate the above-mentioned allegations. During the visit, LPA Maldonado obtained a copy of the resident and staff roster, and obtained the following documents for Residents# 1-3 (R1-R3): Facesheet, Physician's Report, Needs and Services Plan, and incicent reports for the months of September-Novemeber 2023. LPA also obtained Medical Records and Shower charts for R1, and Hospital Discharge documents for R2. Interviews were conducted with Staff# 1-3 (S1-S3) and Rethe state’s words, verbatim · CDSS document, Mar 19, 2024 · control 28-AS-20231115094705

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 prevent a resident from biting another resident in care. Staff did not provide adequate supervision to a resident in care. Staff did not properly conduct a urine test for a resident in care. Facility illegally evicted a resident in care. Staff did not ensure that resident was fed. Staff did not ensure that resident's hygiene needs were being met.

Licensing Program Analyst (LPA) V. Maldonado made a subsequent, unannounced, complaint visit to the facility, for the purpose of investigating the above-mentioned allegations. LPA Maldonado met with Executive Director, Michele Johnson, and explained the purpose for the visit. On 11/21/23, LPA Maldonado made an initial complaint visit, to investigate the above-mentioned allegations. During the visit, LPA Maldonado obtained a copy of the resident and staff roster, and obtained the following documents for Residents# 1-3 (R1-R3): Facesheet, Physician's Report, Needs and Services Plan, and incicent reports for the months of September-Novemeber 2023. LPA also obtained Medical Records and Shower charts for R1, and Hospital Discharge documents for R2. Interviews were conducted with Staff# 1-3 (S1-S3) and Residents# 3-6 (R3-R6). Telephone interviews were attempted with Staff# 4-6 (S4-S6), however S6 did not answer or call back. Interviews with R1 and R2 were not pissible during today's visit, dthe state’s words, verbatim · CDSS document, Nov 30, 2023 · control 28-AS-20231115094705