Katella Senior Living Community

Type of visit: Required - 1 Year

On May 4, 2026, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Operations Manager/ Administrator Jaleesa Chavez arrived shortly after to help assist with the facility inspection. Maintenance Supervisor Gerardo Tapia also assisted with inspection. The facility is licensed for one hundred and forty (140) non-ambulatory residents of which Seventeen (17) may be bedridden with approved hospice waiver for Ten (10) residents. Currently, there are Eight (8) Hospice residents present during today’s visit. This is a two story building housing 70 apartments (57 apartments in the assisted living and 13 apartments in the memory care unit). Facility offers a library, dining room, activities area as well as three outside courtyards. The facility has bathrooms located in each apartment. Facility has a Memory Care unit with secured alarmed delayed egress doors. At around 8:29AM, LPA conducted a tour of the physical plant accompanied by Operations Manager/ Administrator Jaleesa Chavez, and the following was observed: Resident rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Apartments were furnished by occupied residents. Bathroom faucets were tested and had operational water temperature measured between 109.7 to 114.8 degrees F inside resident Apartments. Water Temperature was tested inside ten resident apartments on both first and second floors. A comfortable temperature was maintained in the facility between 72 - 75 degrees F. CONTINUED ON 809C The kitchen was inspected, and sufficient two-day perishables and seven-day non-perishable foods was maintained adequately. Facility had a supply of emergency food and water located in dining room cabinet. Facility had several fire extinguishers which were mounted and fully charged. LPA observed eight fire extinguishers during visit. Medications and Medication records were reviewed, and LPA observed the records in compliance. LPA observed facility has two Evacuation chairs located at the top of stairwells located on second floor. During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents located at front reception desk. LPA observed the facility has a supply of Personal Protective Equipment (PPE). All mandated inspection control posters were located near entrance of building. Menu’s and Activity schedules were observed posted in common areas. LPA observed First Aid Kit was maintained and secured in med room. Facility has working landline phone at reception area. LPA reviewed documents that facility had last fire drill on February 11, 2026, and was conducted by Fire Safety Service. LPA reviewed records that facility had operational smoke and carbon monoxide detectors in bedrooms and common areas. Smoke and Carbon Monoxide Detectors were tested operational and passed Inspection conducted by Thunder Fire Company on January 5, 2026. The facility has current liability insurance on file effective 7/1/2025- 7/1/2026. A review of seven (7) residents (R1-R7) service files and six staff (S1-S6) personnel files revealed to be complete. The facility has the current administrator's certification on file for Jaleesa Chavez - Expiration 12/19/2026. No deficiencies during this inspection visit. An exit interview was conducted with Operations Manager/ Administrator Jaleesa Chavez, and a copy of the report was provided.the state’s words, verbatim · CDSS document, May 4, 2026

Allegation investigated: Staff do not keep the facility free from infestation Staff do not follow proper food handling techniques

Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced inspection visit to initiate complaint investigation into the above allegations. LPA explained the reason for the visit with Administrator Jaleesa Chavez. During investigation LPA toured facility, made observations, conducted interviews and requested documents. On February 27, 2026, Department received allegations that Staff do not keep the facility free from infestation and Staff do not follow proper food handling techniques. Regarding allegation Staff do not keep the facility free from infestation, the department did not observe any pests or rodents during investigation LPA toured physical plant indoors and outdoors including dumpster. Department did observe facility had pest bait traps surrounding perimeter outside areas. Department observed kitchen area had three pest crates inside kitchen. Interviews with staff revealed that twelve of twelve staff interviewed confirmed facility has Pest control company that visits facility monthly. continued on 9099C Unsubstantiated Five of twelve staff stated they have visually experienced rats outside near dumpster area during the night. Twelve of twelve staff interviewed stated they have never seen rodents inside facility. Documents reviewed revealed Facility has had a contract with Orkin since April 1, 2025 and is current until void. Orkin contract notates monthly visits are being conducted. Recent documentation from 2/19/2026 shows that three rats were caught in trap next to dumpster area. Regarding allegation Staff do not follow proper food handling techniques, investigation revealed the following: Twelve of twelve staff state that kitchen staff clean kitchen area in between meals and after meals. Interviews revealed that kitchen staff have training on cross contamination, labeling, cleanliness and food handling. Interviews revealed that only kitchen staff maintain kitchen area. Interviews revealed that staff from different departments have witnessed kitchen staff properly cleaning kitchen area. Documents revealed that kitchen staff have a daily cleaning log which revealed that prep stations and steam tables are being cleaned five to six days weekly. Based on information gathered from complaint, the allegations Staff do not keep the facility free from infestation and Staff do not follow proper food handling techniques are deemed 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 as reported. An exit interview was conducted with Administrator and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 9, 2026 · control 22-AS-20260227085942

Type of visit: Prelicensing

Licensing Program Analysts (LPA's) Jenifer Tirre and Eboni Bentley made an announced pre-licensing visit. LPA's identified themselves and discussed the purpose of the visit with Ensign Services Assisted Living Resource Eric Terrill, Ensign Licensing Manager Kristin Osuna-Larson, Ensign Services Director of Licensing and Regulatory Services Soon Burnam, Executive Director Jon Peralez, Wellness Director Michelle Drinkard, and Life & Safety Resources Eduardo Rivas. Visit is a change in ownership with residents in care. An initial application to operate a Residential Facility Care for the Elderly was submitted to CCL on May 9, 2024. There are 51 residents in care during today's visit. LPA's Tirre and Bentley along with Ensign Services Assisted Living Resource Eric Terrill, Ensign Licensing Manager Christina Osuna-Larson, Ensign Services Director of Licensing and Regulatory Services Soon Burnam, Executive Director Jon Peralez, Wellness Director Michelle Drinkard, Life & Safety Resources Eduardo Rivas toured the facility at 8:15 AM and observed the following: Structure: Facility is a two story building housing 70 apartments (57 apartments in the assisted living and 13 apartments in the memory care unit). Facility offers a library, dining room, activities area as well as two outside courtyards. Living Room/ Dining Room: Adequate seating is available in the main dining room. Bedrooms Residents: All rooms observed are equipped with appropriate lighting, chair, night stand and ample closet space. Bathrooms: All resident bathrooms have a working toilet/ wash basin as well as grab bars and non-skid surface in the shower. Emergency Phone Numbers and Exit Plan: Posted in entrance of facility. Food Service: Facility has ample perishable and non perishable food supplies. LPA's observed a posted menu with multiple choices for residents. Smoke Detectors: Carbon monoxide detectors were are operational. Smoke detectors are tested in-house and documentation was provided by Thunder Fire. Fire extinguishers observed were mounted and fully charged. During todays visit 12 extinguisher's were observed. Toxins: Secured and inaccessible to residents in care. Water Temperature: Tested and recorded between 112.6 and 118.7 degrees F in tested bathrooms. During todays visit 10 restrooms were observed. Emergency Supplies: LPA observed ample emergency food and water stored onsite in facility storage. CONT ON LIC 809C LPA's observed the emergency disaster plan and facility has submitted Infection Control Plan as well.Medications, First-Aid Kit & Book: LPA's observed first aid kit has contained required elements. Medications are stored in locked medication carts. Facility uses electronic medication administration record. Resident & Staff File: LPA's reviewed eight staff personnel files and eight resident files during the visit. All files were complete. Reading Material, Games, and Equipment: LPA's observed facility library room with reading material, activities area located in dining room had ample supplies of games, exercise equipment and craft supplies. Activities were posted in multiple locations. Outside areas: LPA observed three outside courtyard areas (two in Assisted living and one in Memory Care) with shaded areas, water fountains and garden. Fire Clearance: Approved for 140 non-ambulatory residents on November 12, 2024. LPA's observed two emergency chairs adjacent to facility staircases. Administrator's Certificate on file for Jon Peralez effective 8/21/2023 - 8/20/2025, Facility has Liability Insurance on file effective 1/1/2025 - 1/1/2026. Component III was conducted during visit. Facility is ready to be licensed. Exit interview conducted with Ensign Services Representatives Eric Terrill, Soon Burnam, Eduardo Rives and Katella Senior Living Executive Director Jon Peralez, and Wellness Director Michelle Drinkard. A copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jan 15, 2025

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity:140 Census (if any clients in care): 53 Interview Method: Virtual interview (Go To Meeting) On 1/7/2025, applicants/administrator participated in COMP II. Identification of the applicants and administrator was verified based on photo ID and other identifying personal information. During COMP II, applicants and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Jan 7, 2025