Citrus Hills Assisted Living

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegations received on October 28, 2024. LPA was greeted and granted entry into the facility and met with Clinical Director (CD) Angelica Perez Penate. LPA explained the reason for the visit. This Department has investigated the complaint alleging staff inappropriately had resident sign documents without authorized representative knowledge. Regarding the allegation the following was revealed: During the course of the interviews with residents, Resident 1 (R1) reported that he signed his health insurance documents with his consent. Per R1 he switched to a better insurance. Per R3 he signs his own documents and reported that he has not changed his health insurance. During the course of the interviews with staff, Staff 1 (S1) reported that the residents chose their new insurance and stated that the facility is here to protect the residents' Health and Safety. During the couRead the full finding— CDSS inspection report, January 22, 2025 · control 22-AS-20241028095754

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannouced visit to conduct a 10 day visit. LPA was greeted and granted entry into the facility by Receptionist Cindy Mora and explained the reason for the visit. Administrator Charles Marinko arrived shortly after. The Department received a complaint that alleged the facility does not have hot water. During the visit LPA Mendivil toured the faciltiy with Maintenance Director Jesse Chrisman. LPA observed water tanks on the roof the facility. In addtion, LPA Mendivil interviewed staff and residents. Regarding the allegation that the facility does not have hot water, the investigation revealved the following: LPA Mendivil tested 2 out of 4 Spa Restrooms which contains 2 sinks and a shower, the other 2 spa bathrooms were occupied. Spa Bathroom on the first floor by Room 106 tested at 125 degrees for both sinks and 106 for the shower. Spa bathroom located on the second floor by room 217 the sinks tested at 119 degrees andRead the full finding— CDSS inspection report, December 24, 2024 · control 22-AS-20241223142646

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegations received on September 10, 2024. LPA was greeted and granted entry into the facility and met with Executive Director (ED) Charlie Marinko. LPA explained the reason for the visit. This Department has investigated the complaint alleging that staff did not prevent outbreak of bedbugs and staff damaged and did not return resident’s personal belongings. Resident 1 (R1) was admitted to the facility on April 29, 2022. Documents reviewed included the Physician Report (LIC602) dated April 29, 2022 for R1. Per Physician report R1’s diagnosis is Lumbar stenosis. Regarding the allegation that staff did not prevent outbreak of bedbugs, the following was revealed: During the investigation LPA reviewed documents including the Terminix Commercial invoices dated January 30, 2024, to July 03, 2024. Per Terminix Commercial invoice during these visits Terminix conducted a generalRead the full finding— CDSS inspection report, December 11, 2024 · control 22-AS-20240910121745

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to continue the investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit. During the course of the investigation, LPA toured the facility and interviewed staff and residents as well as reviewed and obtained pertinent documentation such as hospice records. Regarding the allegations that facility staff did not notify resident's physician about changes in resident's condition and resident sustained pressure injuries while in care, the investigation revealed the following: Resident 1 (R1) admitted into the facility on 04/06/2019 with an initial hospice admission on 12/25/2020 for protein calorie malnutrition. Resident re-certified for hospice 03/17/2021. Hospice records and physician report dated 03/30/2021 indicated resident had multiple skin tears. Hospice documentation shows resident was being seen multiple times a week fromRead the full finding— CDSS inspection report, October 23, 2024 · control 22-AS-20210623133139

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to continue the investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit. During the course of the investigation, LPA toured the facility and interviewed staff and residents as well as reviewed and obtained pertinent documentation such as training records. Regarding the allegation that staff are not properly trained, the investigation revealed the following: LPA reviewed training records for Staff 1 (S1). LPA observed required training hours including required medication training. Based on record review, the allegation is deemed unfounded, meaning the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted and a copy of this report was provided to facility representative. UnfoundedRead the full finding— CDSS inspection report, October 23, 2024 · control 22-AS-20211105101618

Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Samer Haddadin conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegations and to deliver the findings of the investigation. LPAs were greeted and granted entry into the facility and met with Receptionist Cindy Mora. LPAs explained the reason for the visit. Administrator (AD) Itzayana Barba Aguirre was notified by staff via telephone. This agency has investigated the complaint alleging that facility staff are not providing a clean and sanitary environment for residents in care, facility staff are not ensuring that resident grab bars are safe for residents in care and facility staff are not keeping the facility free of insects. Regarding the allegations, the following was revealed: During the course of the interviews six of eight individuals interviewed denied that staff are not providing a clean and sanitary environment for residents in care. During the course of the interviewRead the full finding— CDSS inspection report, October 3, 2024 · control 22-AS-20240925145424

Regarding the allegation: Facility does not provide nutritious, well balanced meals. 10 of 10 individuals interviewed were unable to corroborate the complaint allegation. All the residents interviewed know they have an alternative menu available to them and if they don’t like whats being served they can request something else. 3 of the residents interviewed stated if they don’t want what the kitchen is serving, they will go and buy themselves something to eat, and all three of the residents who made that statement are aware they can order off the alternative menu as well.1 resident that was interviewed said, the food is terrible, but said it’s not the staff’s fault, they do the best they can. It’s the material they use. Staff 2 (S2) explained how the alternative menu works and stated 10:30 am is the cut off time for lunch and 3:30 is the cut off time for dinner. S2 stated it’s easy to prepare something for breakfast, but if the resident wants something like a breakfast burrito, they neRead the full finding— CDSS inspection report, August 29, 2024 · control 22-AS-20240820120724

Licensing Program Analyst (LPA) Jerome Haley made unannounced visit to investigation a complaint received August 20, 2024. LPA Haley was greeted by staff and explained the reason for the visit before entering the facility. The complaint investigation consisted of interviews with facility staff, residents, document review and observation. Regarding the allegation: Facility is allowing Residents to smoke in non-designated smoking areas. 3 of 10 individuals confirmed the complaint allegation, including one resident who admitted to smoking outside on the patio area outside the resident’s room. The resident stated they never smoke inside the room. During the interview the resident walked outside to shoe LPA Haley where the resident smokes at. While on the patio, LPA Haley observed several cigarette butts in two different areas on the patio. Photos were taken. Continued on LIC9099C SubstantiatedRead the full finding— CDSS inspection report, August 29, 2024 · control 22-AS-20240820120724

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings of the investigation into the allegation listed above. LPA met with Ryan Mims the maintenance supervisor and explained the reason for the visit. The investigation into the allegation revealed the following. It was alleged that the facility got rid of Resident 1's (R1) clothes without their approval or knowledge. R1 reported that his clothes went missing around the time he went to the hospital and when he returned his clothes were gone. The Administrator reported that staff was told to wash the clothes. The maintenance supervisor reported that he told housekeeping to wash the residents' clothes in hot water and then to return them to the residents. The maintenance supervisor reported that they do not know what housekeeping did with the clothes. LPA verified on the facility visit on June 6, 2024 that R1 did not have any clothes in their room. Resident 2 (R2) reported that staff told him theRead the full finding— CDSS inspection report, June 20, 2024 · control 22-AS-20240530105511

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegation listed above. LPA met with Administrator Itzyzna Aguirre and explained the reason for the visit. The investigation into the allegation staff did not ensure the facility was kept free of bed bugs revealed the following. It was alleged that the facility did not address the issue of bed bugs being present in resident rooms at the facility. LPA interviewed staff and residents at the facility. LPA and the Administrator toured the facility. LPA did not observe any bed bugs or any insects in the facility or the rooms that were alleged to have bed bugs. On May 1, 2024 Resident 1 (R1) reported they saw bed bugs in their room. The maintenance director reported they were notified about the bed bugs on May 1, 2024 and they called the pest control company to the facility to treat the room. A review of facility records shows that the room in qRead the full finding— CDSS inspection report, June 6, 2024 · control 22-AS-20240530105511

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced complaint visit to deliver findings on the above allegation received on February 23, 2024. LPA was greeted and granted entry into the facility and met with receptionist Cindy Mora. LPA explained the reason for the visit. This Department has investigated the complaint alleging that staff did not seek timely medical attention for a resident. Resident 1 (R1) was admitted to the facility on July 28, 2023. Documents reviewed included the Physician Report (LIC602) dated July 27, 2023 for R1. Per Physician report R1 is able to communicate their needs. During the investigation LPA reviewed documents including the Unusual Incident/Injury Report (UIIR) dated January 17, 2024 for R1. Per UIIR on January 12, 2024 R1 had an unwitnessed fall and R1 was helped up. Per UIIR wound care was completed on R1's skin tear. During the course of the interviews with residents, R1 reported that she has not had a fall that made her headRead the full finding— CDSS inspection report, May 15, 2024 · control 22-AS-20240223130422

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced complaint visit to deliver findings on the above allegation received on February 23, 2024. LPA was greeted and granted entry into the facility and met with receptionist Cindy Mora. LPA explained the reason for the visit. This Department has investigated the complaint alleging that staff do not assist resident with meeting medical needs. Resident 1 (R1) was admitted to the facility on September 27, 2022. Documents reviewed included the Physician Report (LIC602) dated March 27, 2024 for R1. Per Physician report R1's diagnoses are hemiplegia and bullous pemphigoid. Per the Mayo Clinic bullous pemphigoid is defined as a rare skin condition that causes large, fluid filled blister. During the course of the interviews with witnesses, Witness 1 (W1) reported that during an assessment on April 4th, 2024 that she did not noticed boils all over R1's body. During the course of the interviews with residents, R2 reported thRead the full finding— CDSS inspection report, May 15, 2024 · control 22-AS-20240223161833

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to initiate an investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit. During the course of the investigation, LPA toured the facility, interviewed staff and resident as well as reviewed and obtained pertinent documentation such as medication administration record. Regarding the allegation that facility staff who are not skilled professionals are performing glucose testing on resident, the investigation revealed the following: Resident 1 (R1) requires glucose testing. Physician report dated 08/31/2022 indicated resident is able to manage medications as well as perform own glucose testing. However, two out of three med techs as well as resident confirm staff is assisting with glucose testing. Staff are not appropriately skilled professionals. Based on interviews conducted, the preponderance of evidence standard has been met,Read the full finding— CDSS inspection report, February 6, 2024 · control 22-AS-20240129094914

On this Day Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA was greeted and granted entry into the facility by Wellness Director Yairell Garica and explained the reason for the visit. The department received a complaint on 08/02/2023 and LPA Mendivil conducted the initial 10 day visit on 08/11/2023. During the course of the visit LPA Mendivil interviewed residents and staff and obtained copies of pertinent records. Regarding the allegation resident eloped due to staff negligence, the investigation revealed the following: Based on interviews with Staff 1 (S1) Resident 1 (R1) had made it out of the facility shortly after R1 had been admitted to the facility. After this incident R1 was given a wander guard which would sound an alarm if the R1 was to leave the building. Per review of a LIC 624 Unusual Incident/Injury Report dated 08/07/2023 Cont on LIC 9099-C SubstantiatedRead the full finding— CDSS inspection report, September 26, 2023 · control 22-AS-20230802103141

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced complaint visit to deliver findings on the above allegation received on 05/15/23. LPA was greeted and granted entry into the facility and met with Operations Manager (OM) Itzayana Barba Aguirre. LPA explained the reason for the visit. This agency has investigated the complaint alleging that facility staff did not ensure that resident received prescribed medication while in care. LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent documents. Regarding the allegation, the following was revealed: Eight of ten individuals interviewed reported that medications are always given and on time. As for the remaining two individuals, one individual confirmed the allegation and the other reported that they do not distribute medication. During the investigation LPA reviewed documents including the Physician Report (LIC602A) dated 11/21/22 for Resident 1 (R1). Per Physician Report R1 is not ablRead the full finding— CDSS inspection report, July 6, 2023 · control 22-AS-20230515083103

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of delivering findings into the investigation of the allegation listed above. On April 28, 2023, LPA conducted an initial investigation visit at the facility with the assistance of Citlalli Galeana, Wellness Coordinator. LPA obtained the facility's current census of 88 residents, the facility roster on an updated form LIC500, internal incident reports and Special Incident Reports transmitted to the Department for the months of March and April 2023, as well as the physician reports, service plans, needs assessments and plan of care print-outs for five current residents. Two staff interviews and three resident interviews were either conducted or attempted during the visit. CONTINUED ON FORM LIC9099-C UnsubstantiatedRead the full finding— CDSS inspection report, May 11, 2023 · control 22-AS-20230426090325

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegation listed above. LPA met with Health and Wellness Director Yairell Garcia and explained the reason for the visit. The investigation revealed the following. It was alleged that the facility did not have Resident 1's (R1) Hydrocodone-Acetaminophen oral tablet 5-325MG (PRN) refilled timely and R1 did not have the PRN medication from 4/17/23 until the morning of 4/20/23 even though they requested the medication. Staff interviewed reported that the medication was ordered, the pharmacy and doctor were contacted. Staff reported that it takes time for a medication order to process and the medication must be approved by the resident's physician before a prescription is filled. A review of R1's medication administration record for April 2023 shows that R1 did not take any Hydrocodone-Acetaminophen from 4/16/23 to 4/19/23. R1 has resided at thRead the full finding— CDSS inspection report, May 4, 2023 · control 22-AS-20230426173357

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced complaint visit to deliver findings on the above allegations received on 03/15/23. LPA was greeted and granted entry into the facility and met with Operations Manager (OM) Itzayana Barba Aguirre and explained the reason for the visit. This agency has investigated the complaint alleging that resident was issued an unlawful eviction and resident was physically attacked by another resident due to lack of care and supervision. LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent documents. Regarding the allegation, the following was revealed: During the investigation LPA reviewed documents including the Resident Handbook and House Rules. The Resident Behavior Code section under the Resident Handbook and House Rules states the following: “The following behaviors…may result in a 30-day notice of termination of your Residency Agreement: Residents must not be disruptive…and must not be phRead the full finding— CDSS inspection report, April 6, 2023 · control 22-AS-20230315110649

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced complaint visit to deliver findings on the above allegation received on 02/02/23. LPA was greeted and granted entry into the facility and met with Wellness Coordinator (WC) Citlali Galeana and explained the reason for the visit. This agency has investigated the complaint alleging that resident was issued an unlawful eviction. LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent documents. Regarding the allegation, the following was revealed: Five of eight individuals interviewed reported that Resident 1 (R1) got into a physical altercation with another resident on 01/29/23. Per Unusual Incident/Injury Report dated 01/31/23 R1 “punched R2 with a closed fist on left side of face” during a verbal altercation in the dining room. During the investigation LPA reviewed documents including the Resident Handbook and House Rules. The Resident Behavior Code section under the Resident HandbooRead the full finding— CDSS inspection report, March 2, 2023 · control 22-AS-20230202112845

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegations. LPA Lyman was allowed entry into the facility and met with Operations Manager (OM) Itzy Barba and explained the purpose of the visit. During the course of the investigation, LPA interviewed staff and resident as well as reviewed and obtained pertinent documentation such as credit card authorization statement and admission agreement. Regarding the allegation that facility staff charged residents card without authorization and staff yelled at resident, the investigation revealed the following: Resident 1 (R1) signed an authorization for recurring automated credit card payment for rent. Signed authorization indicates agreement to deduct rent on the 1st day of each month. Staff 1 (S1) indicates verbal agreement for card authorization on the 4th day of the month as a courtesy to R1. On Saturday, February 4, 2023, R1's card was authoRead the full finding— CDSS inspection report, February 16, 2023 · control 22-AS-20230210113449

Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Andrea Mendivil conducted an unannounced complaint visit to deliver findings on the above allegation received on 01/12/23. LPAs were greeted and granted entry into the facility and initially met with Wellness Coordinator (WC) Citlali Galeana. Operations Manager (OM) Itzanaya Barba Aguirre and Wellness Director Yairell Garcia arrived shortly after. LPAs explained the reason for the visit. This agency has investigated the complaint alleging that facility does not have enough staff to meet resident's needs. LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent documents. Regarding the allegation, the following was revealed: Five of eight residents interviewed reported being satisfied with staff and expressed that staff are “courteous” and “attentive.” One of the remaining three residents reported hearing complaints of dissatisfaction with staff services from fellow residents. The remaining two residentsRead the full finding— CDSS inspection report, February 3, 2023 · control 22-AS-20230112164247

Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Patricia Velazquez conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegation and to deliver the findings of the allegation. LPAs Ramirez and Velazquez were allowed entry into the facility and initially met with Medication Technician Sarah Tanner and explained the purpose of the visit. Operations Manager Itzayana Barba Aguirre arrived later to assist with the visit. On today's visit LPAs Ramirez and Velazquez conducted interviews with residents and staff. LPAs also reviewed and obtained copies of facility, resident and staff records. During the course of the investigation the following was revealed: LPAs Ramirez and Velazquez conducted interviews with residents and staff. During the resident interviews LPAs observed a cigarette on a small table next to Resident (R) #1's bed that was lit and smoke emanating from the cigarette. As LPAs were entering R1's room, R1 immediately disRead the full finding— CDSS inspection report, January 20, 2023 · control 22-AS-20230112164247

Licensing Program Analyst (LPA) Patricia Velazquez conducted an unannounced subsequent complaint visit to deliver the findings of the investigation into the above allegations. LPA Velazquez was allowed entry into the facility and met with Operations Manager Itzayana Barba Aguirre and explained the purpose of the visit. On today's visit LPA Velazquez conducted interviews with staff. During the course of the investigation, LPAs Ruth Martinez, Rosie Quiroz and Patricia Velazquez conducted interviews with the complainant, residents, and staff. LPAs Quiroz and Velazquez obtained facility, resident, and staff records. The records reviewed included Resident Admission Records, Physician's Reports, Service Plans, an Unusual Incident Report for Resident (R) #1 for an incident that occurred on May 31, 2020, Medication Review Reports, Resident Progress Notes and R1's Death Report. Regarding the allegation: Facility does not provide a safe environment for resident, during the course of the investigRead the full finding— CDSS inspection report, January 12, 2023 · control 22-AS-20200506165246