Hazel Guest Home

Type of visit: Required - 1 Year

On 9/17/26 Licensing Program Analyst (LPA) Toni Nwala conducted an unannounced one (1) year required visit. LPA were granted entry by Administrator, Hazel Abella, who was informed of the purpose of the visit. At the time of the visit there was two (2) staff and one (1) resident present. All staff present were observed to have obtained proper fingerprint clearance and were associated to the facility. LPA observed the following during today's visit: LPA conducted a tour of the facility with Hazel Abella. Indoor and outdoor passageways were free of obstruction. There were no bodies of water located on the property. The facility has more than a two (2) day supply of perishable foods and seven (7) day supply of non-perishable foods. LPA observed two (2) refrigerators with non-perishable foods in the garage along with emergency food and water. Dishes and utensils were in sufficient supply and stored properly, and sharp items are locked. Resident bedrooms had the required bedding, furniture, and lighting. Resident bathrooms had grab bars and non-skid mats in the showers. Disinfectants and cleaning solutions were secured in a locked cabinet in the kitchen. The combined smoke and carbon monoxide detectors were tested and were observed to be operable. LPA observed charged fire extinguishers mounted throughout the facility. LPA reviewed the medication administration records along with the medications for all residents in care and did not observe any immediate concerns. LPA also reviewed all staff and resident files. Staff files reviewed have a criminal record clearance and valid first aid/CPR certification. Resident files reviewed had signed admission agreements and updated physician reports. Facility sketch and Long-Term Care Ombudsman information is posted near the entrance in the living room. During today's visit, LPA did not observe any immediate violations or concerns. An exit interview was conducted, and a copy of this report was reviewed and provided to Licensee.the state’s words, verbatim · CDSS document, Sep 17, 2026

Allegation investigated: Licensee did not seek appropriate medical attention for resident in care

On 7/25/2024, Licensing Program Analyst (LPA), Janette Romero arrived unannounced to initiate the investigation into the allegation listed above. LPA met with Administrator, Hazel Abella who was informed of the purpose of the visit. It was alleged on 7/9/2024 Administrator, Hazel Abella reported they would schedule a dentist appointment for Client 1 (C1) due to observations of bleeding gums and tooth pain while in day program. It was further alleged Administrator Abella did not seek appropriate medical attention for C1. LPA toured the facility, conducted interviews, and obtained copies of pertinent records. Administrator Abella was interviewed and reported on 7/9/2024, C1’s day program called her and informed her they observed blood coming from C1’s mouth and when asked, C1 reported they had a toothache. Substantiated Administrator Abella reported on 7/9/2024, C1 arrived to the facility from day program, and she checked C1’s mouth and did not observe any bleeding, swelling, or indication of pain. Administrator Abella reported on 7/9/2024, she called C1’s dentist office and they reported C1’s dentist was unavailable. Administrator Abella added the dentist’s office also informed her C1’s last dentist visit was on 8/8/2023 and C1’s dental insurance would not cover any dental expenses until after 8/8/2024. Administrator Abella reported prior to this incident, C1 had a dentist appointment for a routine visit scheduled on 8/12/2024. Administrator Abella reported she monitored C1’s mouth from 7/9/2024 to 7/13/2024 and did not observe any blood, so she did not feel C1 required immediate medical attention. Administrator Abella reported C1 did not express any pain or signs of discomfort, so she decided to wait for C1 to visit the dentist on 8/12/2024. Administrator Abella explained that on 7/18/2024, she received a call from Inland Regional Center inquiring about the situation. Administrator Abella reported she scheduled an appointment with a different dentist and C1 received medical attention on 7/19/2024. LPA reviewed C1’s Dental Appointment Report dated 8/8/2023, which notes C1 had a routine exam and indicated follow up was required for a specific tooth number. Administrator Abella explained the facility forgot to follow up with the dentist's office to pursue treatment for C1. LPA reviewed the visit referral for C1’s 7/19/2024 dental visit, which noted an extraction referral for the same tooth indicated on the 8/8/2023 visit. LPA reviewed C1’s Individual Program Plan (IPP) dated 6/13/2024, which notes C1 performs their own personal care activities including brushing their teeth, when reminded. Administrator Abella reported the facility reminds C1 to brush their teeth every morning and evening. C1’s IPP indicates C1 uses words to communicate, but their speech is not easily understood. LPA attempted to conduct an interview with C1 but was unable to establish effective communication. LPA reviewed C1’s admission agreement dated 2/6/2018 and subsection a(9) lists assistance with bathing and personal care as need as a basic service provided by the facility. Based on LPA’s interviews conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations (Title 22, Division 6, Chapter 1), is being cited on the attached LIC 9099 D. An exit interview was conducted, and a copy of this report was provided to Administrator Abella along with a Confidential Names List (LIC 811) and Appeal Rights.the state’s words, verbatim · CDSS document, Jul 25, 2024 · control 18-AS-20240720174927

From the deficiency page — Deficiency type: Type B · Section cited: CCR 80075(a) · Plan of correction due date: Aug 2, 2024

(a) The licensee shall ensure that each client receives necessary first aid and other needed medical or dental services... This requirement was not met as evidenced by: On 7/9/2024, the facility was informed C1 was observed with blood coming from their mouth and tooth pain and did not seek medical treatment until 7/19/2024. This poses a potential health and personal rights risks to clients in care.the state’s words, verbatim · CDSS document, Jul 25, 2024

Plan of correction: Administrator Abella reported they will conduct a staff training regarding seeking timely medical treament for clients in care. Administrator Abella added Proof of Correction (POC) will be submitted to LPA by close of business on POC due date.

Type of visit: Required - 1 Year

On 7/17/24 Licensing Program Analyst's (LPAs) Valerie Flores, Stephanie Martinez and Seo Jeon conducted an unannounced one (1) year required visit. LPA's were granted entry by caregiver, Lorna Manalo, who was informed of the purpose of the visit. At the time of the visit there was two (2) staff and one (1) resident present. All staff present were observed to have obtained proper fingerprint clearance and were associated to the facility. LPA's observed the following during today's visit: LPA's conducted a tour of the facility with staff member, Lorna Manalo. Indoor and outdoor passageways were free of obstruction. There were no bodies of water located on the property. The facility has more than a two (2) day supply of perishable foods and seven (7) day supply of non-perishable foods. LPA's observed two (2) refrigerators with non-perishable foods in the garage along with emergency food and water. Dishes and utensils were in sufficient supply and stored properly, and sharp items are locked. Resident bedrooms had the required bedding, furniture, and lighting. Resident bathrooms had grab bars and non-skid mats in the showers. Disinfectants and cleaning solutions were secured in a locked cabinet in the kitchen. The combined smoke and carbon monoxide detectors were tested and were observed to be operable. LPA's observed charged fire extinguishers mounted throughout the facility. LPA's reviewed the medication administration records along with the medications for all residents in care and did not observe any immediate concerns. LPA's also reviewed all staff and resident files. Staff files reviewed have a criminal record clearance and valid first aid/CPR certification. Resident files reviewed had signed admission agreements and updated physician reports. Facility sketch and Long-Term Care Ombudsman information is posted near the entrance in the living room. According to Manalo, there are no guns or ammunition on the premises. During today's visit, LPA's did not observe any immediate violations or concerns. An exit interview was conducted, and a copy of this report was reviewed and provided to Licensee.the state’s words, verbatim · CDSS document, Jul 17, 2024