Meadowlark Gardens V

Allegation investigated: Resident was injured due to staff negligence.

Licensing Program Analyst (LPA) Jenifer Tirre, met with Administrator Sarah Wilkes for the purpose of delivering findings for the above allegations. The investigation consisted of records obtained and interviews conducted. On August 7, 2023, the department received allegations that Resident was injured due to staff negligence. The investigation was completed by the department and revealed the following: Per record review, Department requested for incident reports of which facility only had one from the months of January to August of 2023. No incident reports were found on file of incident of neglect. Per interviews with staff, staff stated they could not recall any incidents at the time of initial complaint received around august of 2023. Per interview with resident 1 (R1) stated they are moved by staff using hoyer lift to which R1 stated they have no issues or concerns regarding how staff handle them or the care being provided. CONTINUED ON 9099C Unsubstantiated At time complaint was received, reporting party did not provide name of resident allegedly injured or names of staff members involved. Reporting party did not provide a date of when incident occurred. Based on information provided from investigation, there is not enough information to corroborate the allegation resident was injured due to staff negligence deeming the allegation as UNSUBSTANTIATED meaning that although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur as reported. An exit interview was conducted with Administrator Sarah Wilkes and copy of report was provided.the state’s words, verbatim · CDSS document, Jul 9, 2026 · control 22-AS-20230807095535

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Nancy Guillen and Kevin Saborit- Guasch made an unannounced visit for the purpose of conducting a required annual Inspection. LPAs were greeted and granted entry by care provider Geene Marie Paracuelles after explaining the purpose of the visit. Administrator (AD) Ronald Wilkes was notified via telephone and later arrived to assist with the inspection. LPAs observed the Administrator certificate was current with an expiration date of September 07,2027. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents with a hospice waiver for five. The facility is a one-story home with five resident bedrooms, one staff bedroom, two bathrooms, living room, dining room and an attached garage. During the inspection, LPAs and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: LPAs observed residents watching television in the living room and resting in their respective bedrooms. LPAs observed six residents in care and five staff present. LPAs observed the See Something Say Something Poster (PUB 475) mounted on the wall by the entry door. LPAs observed resident bedrooms had the required furnishings. LPAs observed all resident beds had linens and blankets with additional linens stored in hallway cabinet. LPAs observed bathrooms were clean and equipped with grab bars and non skid floors. LPAs observed all windows were appropriately screened. Bathrooms were observed to be free of debris and mildew, faucets and toilets were tested operational. Water temperature tested between 113.3 and 113.5 degrees Fahrenheit. LPAs toured the outside of the facility and observed outdoor passageways were free of obstruction. LPAs observed the backyard had a shaded sitting area with furniture for resident use. Continued on LIC 809C LPAs observed the facility had a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged with a service date of September 9, 2025. Gas stove and dish washer were all inspected and observed to be operable. Toxic chemicals, cleaning solutions, and disinfectants were observed to be locked and inaccessible to residents in care and stored in the garage. Medication cabinet was observed to be locked and centrally stored in a storage closet hallway located near the kitchen. LPAs observed the First Aid Kit had all the required components. LPAs observed the facility conducted their last emergency disaster drill on April 27, 2026 and is conducted every 3 months. LPA Guillen began review of the records. LPA reviewed six resident records. All the required documentation was present and current in the resident's files reviewed. LPA reviewed three employee records. All employee’s present have a criminal record clearance. LPAs observed records reviewed have a current First Aid certificate. Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. Technical Advisories were issued an discussed with the licensee. An exit interview was conducted, and a copy of this report, appeal rights and Legionnaire’s Disease fact sheet was left at the facility.the state’s words, verbatim · CDSS document, May 19, 2026

The state marks this report as 7 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced visit to perform the required annual inspection. Upon arrival, LPA Haddadin was greeted by Administrator (AD) Ron Wilkes, who granted entry to the facility, and the purpose of the visit was explained. LPA Haddadin toured the interior and exterior of the facility with AD Wilkes and observed the following: The facility is a one-story home consisting of five resident bedrooms, two bathrooms, a staff room, a kitchen, a dining room, a living room, and an attached garage. During today's visit, five residents were present. LPA observed residents relaxing in their individual rooms, which were furnished with a bed, chair, and clean linen, provided adequate storage space, and were free of tripping hazards. Manual smoke detectors, carbon monoxide detectors, and exit alarms were tested and found to be operational. The bathrooms were observed to be in good repair and equipped with grab bars. Hot water temperature was measured at 116.8 degrees Fahrenheit. The facility met the minimum requirement of a two-day supply of perishable food and a seven-day supply of non-perishable food. The fire extinguisher's service date was on September 10th, 2024. The exterior of the facility featured outdoor furniture in good repair, and the grounds were free of tripping hazards, offering ample space for activities. The kitchen was in good repair, with cleaning supplies and sharp items stored securely and inaccessible to residents in care. Medications were kept locked separately in the hallway. LPA reviewed two resident files and their corresponding medications and observed no discrepancies. Additionally, LPA reviewed two staff files and found no discrepancies. All staff and resident files contained the required documentation. A review of records indicated that the facility had conducted the required quarterly emergency drill on April 20, 2025. No deficiencies were noted during today's inspection visit. An exit interview was conducted, and a copy of this report was provided to the administrator.the state’s words, verbatim · CDSS document, May 13, 2025

Type of visit: Required - 1 Year

On 08/26/24 Licensing Program Analysts (LPAs) Janette Romero and Debbie Palacios conducted an unannounced visit to the facility for a required annual inspection. LPAs met with the House Manager (HM) Sharon Pajarillaga, who was informed of the purpose of the visit. The facility has a fire clearance for six (6) non-ambulatory elderly residents and an approved hospice waiver for five (5), and LPAs were informed two (2) residents are currently receiving hospice services at the facility. During today's visit, LPAs observed two (2) staff and six (6) residents present. LPAs toured the facility with HM Pajarillaga and observed the facility is made up of a one-story home with five (5) resident bedrooms, two (2) bathrooms, a staff room, kitchen, dining room, living room, and attached garage. During the tour, HM Pajarillaga tested one (1) of the smoke alarms/carbon monoxide detectors and LPAs observed it to be operational. LPAs also observed a charged fire extinguisher mounted near the kitchen. Indoor and outdoor passageways were free of obstruction. The facility has outdoor shaded seating for the residents in care. There were no bodies of water observed on the premises. Medications are secured in a locked kitchen closet. Resident bedrooms had the required furniture and lighting. Bathrooms had grab bars near the toilets and in the showers. LPAs observed a hallway closet filled with clean linens and towels. The facility had a 2-day supply of perishable foods and 7-day supply of non-perishable food items. Staff present have a criminal record clearance and are associated with the facility. Complaint information is visibly posted near the front entrance. During a record review, LPAs reviewed Resident 1's (R1's) Physician's Report's (LIC 602A's) dated 6/26/23, 8/3/23 and 5/22/24, which identified R1 as bedridden and unable to independently transfer themselves to and from bed. LPAs also reviewed an LIC 602A dated 7/29/24, indicating R1 is non-ambulatory and unable to independently transfer themselves to and from bed. During the visit, LPAs observed HM Pajarillaga ask R1 to reposition themselves and LPAs observed R1 was unable to reposition themselves in bed. LPA's reviewed R1's Appraisal/Needs and Services Plan (LIC 625) which states R1 is bed bound. LPAs reviewed R1's hospice care plan dated 7/30/24 which notes R1 requires repositioning every two (2) hours. LPAs reviewed R1's Home Health/Hospice Documentation dated 8/23/24, which states R1 is being turned every two (2) hours. LPAs reviewed Resident 2's (R2's) LIC 602A dated 12/7/23 which notes R2 is non-ambulatory and unable to independently transfer themselves to and from bed. LPAs reviewed R2's hospice care plan dated 2/7/23, which indicates R2 requires repositioning every two (2) hours. LPA's reviewed R2's Home Health/Hospice Documentation dated 7/8/24, 7/22/24, 7/26/24, 8/1/24, 8/5/24, 8/9/24, 8/12/24, 8/16/24, 8/23/24 which note R2 requires continuous repositioning every two (2) hours. LPAs observed HM Pajarillaga ask R2 to reposition themselves and LPAs observed R2 was unable to reposition themselves in bed. Based on the aforementioned, the facility is in violation of their approved fire clearance. An exit interview was conducted and this report was reviewed and provided to HM Pajarillaga along with a Confidential Names List (LIC 811), LIC809-D and LIC421M and appeal rights.the state’s words, verbatim · CDSS document, Aug 26, 2024