Regency Retirement

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hiratsuka arrived unannounced at the facility to conduct a required annual inspection. LPA toured the facility with the caregivers on duty. Administrator arrived during visit. Today's inspection, LPA and Caregiver conducted a tour of the facility to ensure the health and safety of residents in care. Areas toured included but not limited to five residents bedrooms, bathroom, kitchen, staff room, laundry room, garage and the common areas. LPA observed facility to have the mandated required posters. LPA observed toxins and sharps to be stored separately in a locked space. LPA observed medications to be locked and secured in the closet. LPA observed residents room to be clean and free from malodor. In areas toured, no immediate health and safety personal rights violations observed. LPA reviewed staff and resident files. Several topics were discussed. No deficiencies cited.the state’s words, verbatim · CDSS document, May 6, 2026

Allegation investigated: Staff did not seek timely medical care for resident

On March 13, 2026, Licensing Program Analyst (LPA) Cassie Yang arrived at the facility and delivered the finding for the allegation cited above. LPA met with Administrator and explained the purpose of the visit. During the course of investigation, LPA conducted extensive file reviews and interviews. For the allegation, Staff did not seek timely medical care for resident, interview with Administrator revealed that it is facility's protocol to contact emergency medical services if a resident has a fall, reports chest pains and/or not on baseline. During day of incident, resident (R1) had an appointment which then at the appointment, R1 was sent out for medical attention as R1 looked off baseline. File review of R1's charting notes did not have any documentation regarding R1 complaining of chest pains. LPA was unable to speak to R1 as R1 sustained a stroke and was nonverbal during LPA's visit. R1 has since been relocated to skilled nursing for rehabilation. File review of R1's LIC 602 revealed R1 is often disoriented and confused of time and year. Please continue on LIC 9099-C. Unsubstantiated LIC 9099-C Interview conducted with Assistant Administrator revealed she was working at the facility when R1 left the facility for a medical appointment. There was no report of chest pain, nausea and/or vomiting. R1 was observed to be on baseline, as R1 was informing staff when R1 needed to be changed and reminding staff of R1's medical appointment. Based on information obtained, the allegation is unsubstantiated. As a result of this investigation, LPA finds allegation to be (US) 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 with administrator and report copy provided.the state’s words, verbatim · CDSS document, Mar 13, 2026 · control 59-AS-20260204094924

Type of visit: Case Management - Deficiencies

On November 18, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived at the facility unannounced at the facility to conduct a case management visit regarding a deficiency LPA observed in the email submitted to LPA by Administrator on November 14, 2025. LPA met with Assistant Administrator and explained the purpose of the visit. Today's visit, LPA and Assistant Administrator discussed the eviction procedures. LPA provided a copy of CCR 87224 Eviction Procedures. LPA and Assistant Administrator discussed that a written report of any eviction shall be sent to the licensing agency within five (5) days. At this time, Assistant Administrator was informed that the provided eviction letter for resident (R1) was noncompliance to Title 22. The letter is to be revised to Title 22 requirement and resubmitted to resident, responsible party and Community Care Licensing. The previously given eviction letter given to R1 on October 16, 2025, effective November 16, 2025, has been determined to be invalid. As a result of today’s visit, deficiencies cited. Exit interview conducted and a copy of the report and appeal rights provided.the state’s words, verbatim · CDSS document, Nov 18, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(f) · Plan of correction due date: Nov 25, 2025

87224 Eviction Procedures (f) A written report of any eviction shall be sent to the licensing agency within five (5) days. This requirement is not met as evidenced by: Based on file review, Licensee did not comply as an eviciton letter was issued to R1 in October 2025 but Licensing was not provided a written report until November 14, 2025 which poses a potential risk for residents in care.the state’s words, verbatim · CDSS document, Nov 18, 2025

Plan of correction: Licensee was provided a copy of CCR 87224 Eviction Procedures. Licensee is to review the regulation and submit a statement of understanding by POC due date of November 25, 2025. Failure to issue plan of correction by due date may result to $100 civil penalty per day until received.

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced to conduct a required annual inspection. LPA met with Licensee and explained the purpose of the visit. Today's visit, LPA is conducting an annual inspection but this report is being generated to clear the Post-Licensing inspection in the system. There are no citations issued on this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, May 15, 2025

Type of visit: Required - 1 Year

On May 15, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a required annual inspection utilizing the care tool. LPA met with Licensee and Administrator and explained the purpose of the visit. Facility census is six residents in care with three residents on hospice services, facility is licensed for six non-ambulatory residents hospice waiver for six. LPA observed five residents to be resting in bed, and one in the common area watching television. Today's inspection, LPA and Licensee conducted a tour of the facility to ensure the health and safety of residents in care. Areas toured included but not limited to five residents bedrooms, bathroom, kitchen, staff room, laundry room, garage and the common areas. LPA observed facility to have the mandated required posters. LPA observed fire extinguisher present with service date of March 18, 2025. LPA observed toxins and sharps to be stored separately in a locked space. LPA observed medications to be locked and secured in the closet. LPA observed residents room to be clean and free from malodor. In areas toured, no immediate health and safety personal rights violations observed. File review of Infection Control Plan and Emergency Disaster Plan, LPA observed Licensee to have recently reviewed and updated plan for year of 2025. LPA observed documentation of quarterly fire drills to be conducted at the facility. File review of staff files conducted and observed the required documents and training present on file. File review of residents records was completed. Continue report on LIC 809-C LIC 809- C LPA and Licensee discussed staff training and medication administration. LPA informed Licensee if staff are to administer medications in the future, to ensure proper training are conducted. LPA provided Licensee a copy of Health and Safety Code 1569.69 Employees assisting residents with self-administration of medication; training requirements Inspection tool completed and found facility to be in compliance. No deficiencies cited. Exit interview and a copy of report provided.the state’s words, verbatim · CDSS document, May 15, 2025

Type of visit: Prelicensing

On May 22, 2024 at 1pm, Licensing Program Analyst (LPA) De Anna Williams-Lyons arrived unannounced to conducted an Pre-licening Inspection of the facility to ensure compliance with Title 22 regulations. LPA Lyons met with Balwinder Rai , the Licensee who assisted LPA in today’s inspection. The Administrator certificate expires 3/22/2025. The facilities Administrator’s Certificate, Emergency Disaster Plan, Resident’s Rights and Facility Sketch was available for viewing. The room temperature was 71 degrees F which is within range. LPA inspected the interior and the exterior of the facility including the common living spaces, the kitchen, resident bedrooms and bathrooms. In the kitchen area, cabinets and drawers were reviewed. Knives and sharp objects were reviewed to make sure that they were locked and made inaccessible to the residents at all times. LPA observed there to be a sufficient amount of 2-day perishable and 7-day non-perishable food. Hot water temperatures were taken and measured at 114 degrees F, which is within the allowed range of 105-120 degrees. There’s appropriate lighting throughout the facility. The facility is a one-story home. Living rooms, dining room, and areas designated for resident use were toured. Furniture and furnishings were observed to be sufficient and in good repair. Resident bedrooms and bathrooms were toured. There are 6 Bedrooms in this home. All rooms had the required items of furniture. Window screens were on and in good repair. Bathrooms were clean, sanitary and odorless and consisted of grab bars and non-skid mats. The sink, toilet, bathtub and shower operate properly. The facility has a sufficient supply of linens, towels, bedding, etc. for residents in care. Washer and dryer was present and operating properly. Toxic substances, laundry and cleaning supplies were inaccessible. To continue see 809 -C... First aid kit was present and included the required scissors, tweezers, thermometer and guide. Fire alarms, smoke alarms, and carbon monoxide detectors operate properly. Fire extinguisher is maintained and ready for emergency use. LPA inspected the exterior grounds of this facility. There are no bodies of water on the premises. The perimeter fence, side gates, and latches were in good repair. Passageways are free of obstruction and potential hazards. There’s a centralized storage area for resident’s medication. Medication cabinet was locked. The facility Medication Administration Record will be used. Per California Code of Regulations, Title 22, No citations were issued. LPA recommends this home to be licensed. Licensure pending approval from Central Application Unit . An exit interview was conducted and a copy of this report was given to Balwinder.the state’s words, verbatim · CDSS document, May 22, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Interview Method: Telephone interview On 5/9/2024, applicant/administrator participated in COMP II. Identification of the applicant / administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant / 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, May 9, 2024