The Carlotta

Type of visit: Collateral

On July 31, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility to conduct an unannounced collateral visit, and met with Licensee, John Brennan. LPA introduced herself and stated the purpose of the visit. The collateral visit was conducted to conduct observations, interviews and records reviews pertaining to another matter. LPA Mixson toured the facility, made observation, and requested pertinent documentation. There were no health and safety concerns or issues observed during the time of this visit. The facility was clean and well maintained and there were no obstructions to the inside or outside passageways. LPA requested and received staff roster, resident roster, and a copy of the current pest control procedures. LPA was unable to locate and interview staff or resident at the facility from the time of the complaint. No further information was obtained An exit interview was conducted, and a copy of this report was provided to John Brennan, Licenseethe state’s words, verbatim · CDSS document, Jul 31, 2025

Allegation investigated: Staff does not ensure resident is provided a comfortable temperature.

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced subsequent complaint visit to the facility. LPA met with Samuel M. de Guzman III, regional operations specialist, and informed them of the purpose of this visit. During this investigation, LPA conducted interviews with staff and obtained supportive documentation for review to assist with determining the findings for the above noted allegations. The following was determined. Continued on LIC9099-C Unsubstantiated During the LPA’s tour of the facility, LPA reviewed facility records and conducted interviews with residents and staffs. Information revealed the facility did experience their centralized A/C unit to be inoperable on 7-2-2024 in an identified unit. According to information obtained during the investigation, information revealed the Administrator purchased two portable a/c units for the identified room that did not have cool temperatures. LPA confirmed the administrator purchased portable a/c units the same day it was confirmed the a/c unit was inoperable on 7-2-2024. In addition, the administrator ordered a new centralized a/c unit, the unit was delivered and installed on 7-11-2024. Based on observation/ record review/ client interviews, and staff interviews. This allegation is Unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was discussed and given to Samuel M de Guzman III, regional operations specialist. During the LPA’s tour of the facility, LPA reviewed the records and interviewed the staffs. Information revealed that the resident’s call pendent was working properly. The facility staff advised that the call button needed to be pressed and held for 2 seconds to activate. The pendent even notifies the central unit when its battery runs low. Based on observation/ record review/ client interviews, and staff interviews. This allegation is Unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was discussed and given to Samuel M de Guzman III, regional operations specialist. During the LPA’s tour of the facility, LPA reviewed the records and interviewed the staffs. Information revealed that the facility staff advised the resident the new unit was ordered on the same day that the A/C unit was determined to be inoperable. The A/C became inoperable on 7-2-2024, and the new A/C was ordered on 7-3-2024. Based on observation/ record review/ interviews client, and staff interviews. This allegation is Unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was discussed and given to Samual M de Guzman, III, regional operations specialist.the state’s words, verbatim · CDSS document, Oct 14, 2024 · control 18-AS-20240731150721

Allegation investigated: Licensee is not issuing a refund to resident's responsible party as required.

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced subsequent complaint visit to the facility. LPA met with Samuel M de Guzman III, regional operations specialist, and informed them of the purpose of this visit. During this investigation, LPA conducted interviews with staff and obtained supportive documentation for review to assist with determining the findings for the above noted allegations. The following was determined. Continued on LIC9099-C Unfounded During the LPA’s tour of the facility, LPA reviewed the records and interviewed the staffs. Information revealed that the resident’s admission agreement contains refund policy under section 7.2 and 7.3, and the facility was following the specified refund policy. Based on information obtained from interview, record reviews and observations, the allegation has been deemed as “Unfounded”. An allegation deemed unfounded means “The allegation is false, could not have happened and/or is without a reasonable basis.” Therefore, the outcome of the allegation is regarded as “Unfounded”. An exit interview was conducted, and a copy of this report was discussed and given to Samuel M de Guzman III, regional operations spcialist. During the LPA’s tour of the facility, LPA reviewed the records and interviewed the staffs. Information revealed that the resident’s responsible party was advised in person by the business office director about the facility’s refund policy and procedures at the end of July 2024. Based on information obtained from interview, record reviews and observations, the allegation has been deemed as “Unfounded”. An allegation deemed unfounded means “The allegation is false, could not have happened and/or is without a reasonable basis.” Therefore, the outcome of the allegation is regarded as “Unfounded”. An exit interview was conducted, and a copy of this report was discussed and given to Samuel M de Guzman III, regional operations specialist.the state’s words, verbatim · CDSS document, Oct 14, 2024 · control 18-AS-20240815131412

Allegation investigated: Staff are not preventing resident from sustaining falls.

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced subsequent complaint visit to the facility. LPA met Samuel M de Guzman III, regional operations specialist, and informed them of the purpose of this visit. During this investigation, LPA conducted interviews with staff and obtained supportive documentation for review to assist with determining the findings for the above noted allegations. The following was determined. Continued on LIC9099-C Unsubstantiated During the LPA’s tour of the facility, LPA reviewed the records and interviewed the staffs. Information revealed that the facility staffs encourage the resident to use the call pendent. However, the resident tried to get out of bed by themselves and slid off from bed twice. Based on observation/ record review/ client interviews, and staff interviews. This allegation is Unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was discussed and given to Samuel M de Guzman III. During the LPA’s tour of the facility, LPA reviewed the records and interviewed the staffs. Information revealed that the facility staffs explained its policy to the emergency service personnels. The facility’s policy will not allow any form of devices to block residents from falling from bed including bed rails. The facility allows bed rails only if the resident is on hospice. Based on observation/ record review/ client interviews, and staff interviews. This allegation is Unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was discussed and given to Samuel M de Guzman III.the state’s words, verbatim · CDSS document, Oct 14, 2024 · control 18-AS-20240916161808

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Seo Jeon and Abdoulaye Zerbo conducted an unannounced annual required visit. Upon entry, LPAs met with Rebecca Mudd, resident care coordinator, and informed them of the purpose of the visit. Facility Overview: The facility is a two-story building with (36) bedrooms. The facility has fenced swimming pool, 2 restaurants, movie theater, activity room, lounge, conference room and library. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 113.7°F. Continued on LIC809-C Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate. Record Review and Resident/Staff Files: LPA reviewed files for five staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Five resident files were reviewed and contained all required documentation. Health-Related Services/Incidental Medical Services: All resident medications were securely locked. LPA reviewed medications for five residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 9-26-2024, which met department requirements. All fire extinguishers have tags with monthly testing. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed and provided.the state’s words, verbatim · CDSS document, Oct 14, 2024