Granny's Place #8

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by Caregiver Jason Alfons. Administrator (AD) Michelle Nesbitt arrived shortly after. For today’s visit, LPA observed a total of five residents in care and three staff members on duty. LPA Ramirez toured the interior and exterior portions of the facility with AD Nesbitt. The facility is a single level structure and is licensed for six non-ambulatory residents, of which six may be on hospice and zero bedridden. There are a total of seven bedrooms, of which six are private resident bedrooms, and one private bedroom for staff. LPA Ramirez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Four residents are currently using half-rails for postural support. Appropriate physician orders on file for all four residents. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of three full bathroom and four half bathrooms. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 107.2-110.9 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguishers were charged, and had a service tag dated April 8, 2026. One fire extinguisher was located by the kitchen and one in the garage CONTINUED ON LIC809-C... LPA Ramirez observed the emergency disaster and evacuation plan, which is posted by the main entrance. Licensee was advised to updated the Emergency Distaste Plan (LIC610E) dated December 2025. Facility had back-up emergency food and water supply, located in the garage. LPA observed that the First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. Medications are locked in a cabinet by the dining room. Oxygen is currently in use with adequate signs on display. There are no bedridden residents present on the premises. For the exterior portion, LPA Ramirez observed a shaded patio area with furniture, and the grounds were free of any hazards. There are two gates in the backyard, which are self-closing and self-latching. No bodies of water were observed. LPA reviewed five resident files and three staff files. LPA interviewed residents and staff present. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Nesbitt. A copy of this report was provided at the time of exit.the state’s words, verbatim · CDSS document, Apr 28, 2026

Allegation investigated: Staff physically abused resident in care. Staff emotonally abused resident in care. Staff member did not prevent other staff member from physically abusing resident in care. Staff did not provide assistance to resident in care in a timely manner Staff do not safeguard resident's possessions while in care

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 staff and explained the reason for the visit. The Department received the complaint on 01/27/2026 and LPA Mendivil conducted the initial visit on 02/05/2026. LPA Mendivil obtained copies of pertinent documents and interviewed staff and residents. Regarding the allegations staff physically abused resident in care, staff emotionally abused resident in care, staff member did not prevent another staff member from physically abusing resident in care , staff did not provide assistance to resident in care in a timely manner and staff do not safeguard resident’s possession while in care the investigation revealed the following: The Department received an Unusual Incident/Injury Report on 01/23/2026 regarding an incident that occurred on 01/19/2026 involving Resident 1 (R1) and Staff 1 (S1). It was reported by the facility that R1 approached S1 regarding a missing shrub. Unsubstantiated It was reported that R1 opened a closed door to another resident’s room to speak to S1 regarding the issue. S1 advised R1 that the gardener had disposed of the shrub. It was then reported that R1 continued to follow S1 throughout the kitchen, it was then reported S1 was at the kitchen sink and R1 was at their right side in their immediate space. It was then reported that S1 put their arms out to provide distance after R1 slipped and fell on the floor. Per the report, Former Executive Administrator Jozeff Springer was called and advised of R1’s fall. Jozeff then called Staff 2 (S2) to evaluate R1 and assist R1 up. Per report and interviews R1 was able to stand up and walk back to their room. Per report, Orange County Sheriff arrived on 01/21/2026 regarding the incident. Regarding the allegation that staff physically abuse resident in care, based on interviews with 4 out of 4 staff denied witnessing physical abuse. 1 out of 6 residents denied physical abuse and the other 4 residents were not oriented to time and space and unable to answer LPA’s questions. Per sheriff's office report they viewed surveillance video taken on 01/19/2026 and concluded that no assault and battery occurred, LPA was unable to view video as facility denied having a copy. Per interviews with 4 out of 4 staff denied emotional abuse towards residents. 1 out of 6 residents denied emotional abuse from staff. Per interviews 4 out of 4 staff denied allowing another staff member to physically abuse residents in care. Per interviews with 4 out of 4 staff denied not assisting resident timely manner. Per interviews 4 out of 4 staff denied not safeguarding residents possessions. Therefore based on the preponderance of evidence through records reviewed and interviews the allegations staff physically abused resident in care, staff emotionally abused resident in care, staff member did not prevent another staff member from physically abusing resident in care , staff did not provide assistance to resident in care in a timely manner and staff do not safeguard resident’s possession while in care are determined to be UNSUBSTANTIATED, meaning that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violation occurred. No deficiencies cited. An exit interview was conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 24, 2026 · control 22-AS-20260127093150

Type of visit: Case Management - Deficiencies

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit in conjunction with a complaint investigation 22-AS-20260127093150. During the course of the investigation LPA asked to view a video of the incident that occurred on 01/19/2026 LPA was told by Kimberly Arnett that there was no copy of the video. LPA reviewed OC Sheriff's report stating that they had access to the video on 02/18/2026. Based on observations a deficiency is being cited per California Code of Regulations Title 22. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 24, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87207 · Plan of correction due date: Mar 25, 2026

No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement was not met as evidence by staff denied there was a copy of the video from the incident that occurred on 01/19/2026 Per OC Sheriff's report, the sheriff's office was able to view it as of 02/18/2026. This poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Mar 24, 2026

Plan of correction: Licensee to provide a statement of understanding regarding making false statements.

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator staff Kimberly Arnett, Michelle Nesbitt and Jozef Springer were notified via telephone and arrived later to assist with the visit. There are currently six residents in care, none of which are receiving hospice care at this time. LPA observed residents relaxing in the facility's common living areas or in their respective bedrooms. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has six private rooms along with one locked staff room. There are two shared bathrooms as well as multiple en-suite half bathrooms throughout the facility. Bedrooms appear clean and sanitary. Four residents are currently using half-rails for postural support. Appropriate physician orders on file for all four residents. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary. Hot water temperature measured at 108F and 110F in two separate bathrooms with faucets used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning products and the medication central storage all verified to be secured. Fire extinguishers are charged and mounted, with up-to-date maintenance documented on the attached tags. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The attached garage is inaccessible to residents and used for laundry as well as additional storage of food and supplies. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. There are self-latching gates on both sides of the property and the routes of egress are free of clutter and obstructions. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed six resident records which included all necessary components. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is currently in use with adequate signs on display. There are no bedridden residents present on the premises. LPA reviewed staff records for all three caregivers present. Records were found to be complete. Training and CPR/First aid training reviewed and up-to-date. All staff are background cleared and associated to the licensed location accurately. Disaster drills are conducted quarterly. Based on the observations made during today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Apr 24, 2025