Young at Heart RCFE No.3

Type of visit: Case Management - Annual Continuation

On September 11, 2026, at 2:00PM, Licensing Program Analyst (LPA) Sulma Lopez arrived unannounced at the facility to conduct an annual required inspection. LPA Lopez met with Staff 1 (S1) John Trapse and explained the purpose of the visit. The administrator (A1) Lianna Sisayan arrived shortly after. The Administrator holds current certificate #7033450740 and expires on August 08, 2027. The facility is licensed for 6 non-ambulatory clients, one of which may be bedridden. There are currently 6 residents who reside at this facility. The facility has an approved hospice waiver for 2. The facility is utilizing 2 hospice placements at this time. At 2:20PM, LPA conducted record reviews of 5 staff and 6 resident files. Resident files were observed to be well maintained with current documentation. Staff files contained all the required components including personnel record sheets, health screening, TB test records, and updated training records for the current year. Medications were stored in a locked cabinet. The facility uses a MAR sheet to record all dispensed medication to residents. At 3:00 PM, LPA Lopez toured the facility with A1. LPA Lopez inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; facility bathrooms, laundry room, and outside courtyards of the facility to ensure compliance with Title 22 regulations. The facility was clean, safe, and in good repair. The facility contains smoke and carbon monoxide detectors on the ceilings. The facility's hot water temperature was 105 degrees. The fire extinguishers were serviced annually on November 13, 2025. Continued on LIC 809-C. LPA toured the resident bedrooms which were observed to clean, safe, and free of odors. The bedrooms were furnished with beds, dressers, closets, and night stands. The furniture was observed to be in good working condition. LPA toured the laundry area which contained a washer and dryer for laundry services. LPA observed that the facility stores detergent and cleaning supplies in locked cabinets. The facility had an extra supply of clean linens and towels. The living room areas were clean and free of hazards. The rooms contained ample seating for the residents. A public telephone was available for resident use. The exterior of the facility was free of hazards and the walkways were free of obstructions. The perimeter fence and exit gates were in food repair. LPA observed a shaded patio with seating available for resident use. LPA inspected the kitchen area for the ability to prepare and store food. The LPA observed the required (2) two-day perishable and (7) seven-day non-perishable food. The facility had a menu posted on the refrigerator door. LPA requested the following documents to be emailed or faxed to the Regional Office within 15 days: - LIC 500 Personnel Report, LIC 308 Designation of Facility Representative, LIC 610E Emergency Preparedness Plan. As a result of this annual inspection visit, the facility is in compliance with California Code of Regulations, Title 22 and Health and Safety Code. No deficiencies were cited. An exit interview was conducted, and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Sep 11, 2026

Type of visit: Required - 1 Year

On 8/6/2025, Licensing Program Analyst (LPA) Cynthia Tamayo arrived unannounced to conduct a Required - 1 Year visit. LPA met with administrator, Glenda Molinyawe and explained the purpose of the visit. Administrator Lianna Sisayan is out on vacation. Current LIC 308 designated S1 as Designated Facility Responsible person. This facility is licensed to serve six (6) non-ambulatory residents. Non ambulatory of which one may be bedridden in bedroom #1. Hospice waiver approved for two. The current census is 6. There is currently one resident on hospice. LPA toured the facility with S1, LPA toured the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms; resident bathrooms, laundry area, and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility to be free of odor, clean and in good repair. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises. The hot water temperature was observed to be within the required range of 105-120*F. The temperature inside the facility measured at 72*F which was within the required range of 68-85*F. LPA observed the centrally stored medications area to be locked and inaccessible to residents. LPA observed the fire extinguisher(s) and first aid kits were up to date. Smoke and carbon monoxide detector(s) in the facility were in good repair. continued on 809-C LPA observed security cameras in the hallways and common areas, there were no security cameras in private areas such as resident bedrooms or bathrooms. Licensee is in the process of requesting bedroom #1 change into a bedridden room. LPA observed an activities calendar posted in the dining room bulletin board. At around 2:50 PM, Resident Frances G was transported by Alpha 1 during this visit due to pain/ Nephrostomy tube not draining properly. S1 stated they will submit an Incident report to CCLD. LPA requested resident and staff files for review. LPA reviewed (3) staff files and (5) resident files, including criminal record clearances. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared and associated to the facility. LPA discussed LIC 624 and reporting requirements with S1. The following forms and documents were requested to be submitted within 15 days: Copy of Administrator Certificate, LIC 500 (August), LIC 610 Emergency Disaster Plan and Proof of Current Liability Insurance, LIC 308 Designation of Administrative Responsibility (current). Per the California Code of Regulations, Title 22, no deficiencies were cited. An exit interview was conducted, and a copy of this report was provided to facility.the state’s words, verbatim · CDSS document, Aug 6, 2025

Allegation investigated: Staff leaves resident soiled for an extended period of time resulting in resident developing a UTI. Staff is misusing resident's personal belongings.

On 9/24/24, Licensing Program Analyst (LPA) Tung Truong arrived unannounced to complete and deliver the findings for a complaint investigation with the allegations above. LPA met with facility staff Glenda Molinyawe and explained the purpose of the visit. Administrator Lianna Sisayan arrived a bit later. Throughout the course of the investigation, LPA conducted interviews and reviewed records. Based on records review, and staff and resident interviews, there is insufficient evidence to substantiate the allegations mentioned above. Regarding the allegation, “Staff leaves resident soiled for an extended period of time resulting in resident developing a UTI” LPA obtained the following information through interviews. Based on resident interviews, 2 out 4 indicated their diapers were not changed timely. Based on records review, there is insufficient evidence indicating that resident (R1) was left soiled for an extended period of time resulting in resident developing a urinary tract infection (UTI). R1 was admitted the hospital on 6/30/24 and 7/4/2024 and was diagnosed with Hematuria. LPA was unable to get a statement from R1 or R1’s responsibly party for further information. Continued on 9099-C Unsubstantiated Regarding the allegation, “Staff is misusing resident’s personal belongings” LPA obtained the following information through interviews. Based on staff interviews, residents all have their own supplies and were not being given to the other residents. Interviews conducted did not reveal any corroborated statements of staff is misusing resident’s personal belongings. As a result of the investigation, LPA finds the allegations above to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted and a copy of the report was provided upon exit.the state’s words, verbatim · CDSS document, Sep 24, 2024 · control 27-AS-20240710103529

Type of visit: Required - 1 Year

On 7/9/24, Licensing Program Analyst (LPA) Tung Truong arrived unannounced to conduct a Required - 1 Year visit. LPA met with facility staff Glenda Molinyawe explained the purpose of the visit. Administrator current certification expires on 8/8/2025. This facility is licensed to serve six (6) non-ambulatory of which one (1) may be bedridden. Hospice approved for two. The current census is 6 with three facility staff. LPA toured the facility with Glenda Molinyawe LPA toured the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms; resident bathrooms, garage, laundry area, and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility is clean and in good repair. LPA observed required furniture and lighting throughout the facility. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises. The hot water temperature was measured at 109.8*F which was within the required range of 105-120*F. The temperature inside the facility measured at 76*F which was within the required range of 68-85*F. LPA observed the centrally stored medications area to be locked and inaccessible to residents. LPA observed the fire extinguisher(s) and first aid kits were up to date. LPA observed smoke and carbon monoxide detector(s) in the facility were in good repair. Proof of current liability insurance was observed. Report continued on 809-C LPA requested resident and staff files for review. LPA reviewed (3) staff files and (6) resident files, including criminal record clearances. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared and associated to the facility. The following forms and documents were requested to be submitted within 15 days: LIC 308 Designation of Administrative Responsibility, LIC 500 Personnel Report, Copy of Administrator Certificate, LIC 610 Emergency Disaster Plan and Proof of Current Liability Insurance. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no violations were observed. An exit interview was conducted, and a copy of this report was provided to facility.the state’s words, verbatim · CDSS document, Jul 9, 2024

Allegation investigated: Facility staff handled resident in a rough manner. Facility staff fed a resident food that had dropped on the floor.

On 1/18/24, Licensing Program Analyst (LPA) Tung Truong arrived at the facility unannounced to deliver complaint findings. LPA met with facility staff John Trapse and explained the purpose of today visit. Throughout the course of this investigation, LPA Truong conducted interviews and reviewed facility documents. It was learned this allegation pertained to a resident that has never lived at Young at Heart No.3. As a result of this investigation, LPA finds the allegations above to be UNFOUNDED, meaning that the allegation was false, could not have happened and/or was without a reasonable basis. Exit interview was conducted and a copy of the report was provided upon exit. Unfoundedthe state’s words, verbatim · CDSS document, Jan 18, 2024 · control 27-AS-20240102091555