Amethyst Grove of Rocklin

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Melissa Parks arrived on Thursday July 16, 2026, to conduct the unannounced annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed resident (6) and staff (2) files. Resident file contained the required paperwork. All staff files contained the required paperwork and training. LPA and House Manager Windy toured the facility together to ensure the health and safety of resident in care. The following areas were inspected: resident bedrooms, bathrooms, kitchen, garage and backyard. Facility was current on fire drills. Facility had a fully stocked first aid kit. All required postings were observed. All chemicals and knives were kept locked and inaccessible to residents. Water temperature was within the required range. LPA requested a copy of the current liability insurance by end of month. Exit interview conducted. No deficiencies cited. A copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jul 16, 2026

Type of visit: Required - 1 Year

On 07/14/25 Licensing Program Analyst (LPA) Graham Gunby arrived unannounced at the facility to conduct a required 1-year annual inspection. LPA met with Manager, Windy Centeio, and explained the purpose of the visit. LPA and manager conducted a tour of the interior and exterior of the facility. Areas toured included but not limited to: resident rooms, bathrooms, kitchen, dining room, common areas, and back yard. LPA observed medications, cleaners, and sharps to be locked and inaccessible to residents. The residence was found to be clean, safe, sanitary and in good condition. LPA observed the facility to have the mandated posters posted. Fire extinguishers are maintained and ready for emergency use. Facility has required food supplies. There are appropriate staff present to meet the needs of residents. LPA conducted a file review of six (6) resident files and four (4) staff files. Resident and staff files had all the required documents present in files. No deficiencies cited. Exit interview conducted and a copy of the report was emailed to Administrator.the state’s words, verbatim · CDSS document, Jul 14, 2025

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Graham Gunby arrived at the care home today and met with the Manager, Windy Centeio, to conduct a required annual and post licensing visit. For more information on the post licensing visit please see LIC 809 dated 07/14/2025. No deficiencies cited for the post licensing visit.the state’s words, verbatim · CDSS document, Jul 14, 2025

Allegation investigated: Staff are retaining a resident that requires a higher level of care

Licensing Program Analyst (LPA) Melissa Parks arrived unannounced on Thursday August 1, 2024 to complete and deliver findings to a complaint received on 6/18/2024. LPA met with Administrator Marc and explained the purpose of the visit. Throughout the course of the investigation, LPA interviewed the Administrator, staff, and R2. LPA reviewed R1’s medication list, physicians report, care plan, and incident reports. The result of the investigation is as follows: LPA interviewed staff who stated that R1 had episodes of aggression towards staff and residents. Staff stated that, at times, they were unable to redirect R1. R1 has had episodes of kicking, biting, and hitting staff. Additionally, R1 has attempted to attack other residents at the facility. LPA reviewed an incident report dated 5/15/2024 which details how R1 charged at R2. Staff intervened and R1 began to hit them. LPA reviewed an incident report dated 5/9/2024 which stated that R1 punched staff resulting in a black eye. Staff stated that R1 has a 1:1 for 6 hours a day, three times per week. Substantiated However, staff stated that they are unable to manage R1’s behaviors when there is not a 1:1 present. Based on the information detailed above, LPA finds the allegation to be substantiated. A finding that the allegation is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Deficiency cited on 9099-D. Appeal rights were given. Exit interview conducted. A copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Aug 1, 2024 · control 59-AS-20240618122446

From the deficiency page — Deficiency type: Type A · Section cited: ILS 1569.312(e) · Plan of correction due date: Aug 2, 2024

Basic services requirements Every facility required to be licensed under this chapter shall provide at least the following basic services: (e) Monitoring the activities of the residents while they are under the supervision of the facility to ensure their general health, safety, and well-being This requirement was not met as acting physically aggressive with staff and residents. This poses a direct threat to the health and safety of residents in care.the state’s words, verbatim · CDSS document, Aug 1, 2024

Plan of correction: Administrator agrees to submit a plan to follow regarding residents requiring higher level of care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Melissa Parks arrived on Monday May 20, 2024 to conduct the unannounced annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA Parks reviewed resident (5) and staff files (3). All resident files contained the required paperwork. Staff files contained the required paperwork and training. LPA Parks and Administrator Marc toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, living room, kitchen, garage, and backyard. In the areas toured, there were no health or safety violations observed. Facility was clean and well organized. Facility is current on fire drills. First aid kit is fully stocked. All required posting were observed. All knives/sharps are kept locked and inaccessible to residents. LPA obtained a copy of the current liability insurance. Administrator to email LPA an updated LIC500 by 5/24/2024. No deficiencies cited. Exit interview conducted. A copy of this report was emailed to the facility.the state’s words, verbatim · CDSS document, May 20, 2024

Allegation investigated: Facility is not adequately staffed to meet the needs of the residents in care. Staff did not allow a resident to utilize the call button.

Licensing Program Analyst (LPA) Melissa Parks arrived unannounced on Thursday March 7th, 2024, to complete and deliver findings to a complaint received on 1/9/2024. LPA met with Administrator Marc and explained the purpose of the visit. Throughout the course of the investigation, LPA interviewed the Administrator, staff, and R1’s hospice team. LPA reviewed R1’s file at the facility including physicians report, MARs, medication count sheet, and medication list. The result of the investigation is as follows: LPA learned from interviews that the facility utilized staffing agencies to supplement caregivers when needed. During the last two weeks of December, one of the primary caregivers was out sick and the facility was not able to obtain coverage with the staffing agency. Per interviews, this left one caregiver to provide care and supervision for 6 residents which lead to delayed breakfast and care services. Additionally, interviews acknowledged that a staffing agency staff refused care for residents during NOC shift. Substantiated Based on the information detailed above, LPA finds the allegations to be substantiated. A finding that the allegation is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Deficiency cited on 9099-D. Appeal rights were printed and given. Exit interview conducted. A copy of this report was left at the facility. Based on the evidence provided, the preponderance of evidence standards was not met, therefore, the above allegation is found to be UNFOUNDED. An unfounded allegation means that the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted. A copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Mar 7, 2024 · control 59-AS-20240109152358

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2 · Plan of correction due date: Mar 28, 2024

Additional Personal Rights of Residents in Privately Operated Facilities (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement was not met as evidence by interviews acknowledging the facility was short of staff. Administrator to submit staffing plan in order to fill gaps in schedule due to staff illness, etc.the state’s words, verbatim · CDSS document, Mar 7, 2024