Siebenthal Care Home

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff are inappropriately restraining a resident in care. Staff are forcing residents to drink water.

On 7/29/2025 at 12:00 PM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived at the facility to conduct an unannounced complaint visit. LPA Hughes met with caregiver Ermelinda Siebenthal and explained the purpose of the visit. The current census is 6 with 2 facility staff. Staff are forcing residents to drink water It was alleged that staff are forcing residents to drink 2 to 4 metal cups of water before they are able to leave the table. This investigation consisted of facility observation, and interviews with staff and residents. On 7/1/2025 LPA Hughes conducted a visit to the facility, upon observation of the facility residents were seen sitting at the kitchen table having lunch. Interview with 3 out of 5 residents indicated that they had no concerns regarding being required to drink water. Additionally, an interview with 2 out 3 facility staff indicated that residents are required to consume water as part of their daily routine. Continuation 9099-C Substantiatedthe state’s words, verbatim · CDSS document, Jul 29, 2025 · control 27-AS-20250623163519

Allegation investigated: ) Staff gave resident medication that was not prescribed to that resident resulting in hospitalization 2) Staff handled resident in a rough manner resulting in a broken nose 3) Staff did not allow resident to visit/contact family. 4) Staff did not allow resident to leave the facility. 5) staff verbally abused residents 6) Staff financially abused residents 7) staff left residents unsupervised 8) staff forces residents to eat even when they don't want to.

Licensing Program Analysts (LPA) Kevin Gould made an unannounced inspection to the Siebenthal Care Home RCFE on 7/25/25 at 1:15pm to conclude the investigation of the above allegations and to deliver the findings. LPA Gould met with Licensee, Lita Siebenthal and together discussed the investigation details. Based on the interviews conducted during the investigation process and statements obtained during the investigation process, LPA Gould was unable to corroborate the allegations. LPA contacted the Reporting Party (RP) and all co complainants regarding the allegations. LPA conducted interviews with current staff members and any staff members present while at the location in Fort Bragg, CA. LPA was unable to interview the alleged victim as LPA does not know their current whereabouts and no current information was provided to LPA by A1. Report continued on LIC 9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Jul 25, 2025 · control 27-AS-20241015163935

Allegation investigated: Staff did not ensure that resident's dietary needs were met Staff spoke inappropriately to resident Staff not accommodating residents needs

On 7/17/2025 at 12:45 PM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to the facility to conduct a complaint visit. LPA met with administrator Lita Siebenthal and explained the purpose of the visit. The purpose of this visit is to deliver complaint findings for the above allegations. The current census is 6. A brief interview with conducted with Lita Siebenthal. Allegation: Staff did not ensure that resident's dietary needs were met It was alleged that staff did not ensure that resident's dietary needs were met. This investigation consisted of interviews with residents and care, records review, and facility observations. On 5/7/2025 LPA’s Pang Lee and Shakaricka Hughes conducted an unannounced facility visit. Interview with 2 out of 5 residents indicated that residents have no concerns about their dietary needs not being met. Additionally, a review of resident (R2) LIC 602A Physician’s report indicates that R2 has a diabetic diet. A review of the facilities methe state’s words, verbatim · CDSS document, Jul 17, 2025 · control 27-AS-20250506081827

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Neglect/Lack of Supervision: 1) Resident sustained unexplained injuries while in care. 2) Facility is retaining a resident with a higher level of care need.

Licensing Program Analysts (LPA) Kevin Gould made an unannounced inspection to the Siebenthal Care Home RCFE on 4/24/25 at 9:00am to conclude the investigation of the above allegations and to deliver the findings. LPA Gould met with Licensee, Ermelinda Siebenthal and together discussed the investigation details. Based on the interviews conducted during the investigation process and statements obtained during the investigation process, the department was unable to corroborate the allegations. The department obtained and reviewed all records from the facility for alleged victim R1 (see confidential names list, LIC 811 dated 4/24/25) and reviewed medical records provided by the hospital. The department has verified the extensive bruising are a result of reported falls and the alleged victims medication which made R1 susceptible to bruising. The department has reviewed R1's fall history and the bruising is consistent with reported falls that ocurred at the facility. Additionally, there werthe state’s words, verbatim · CDSS document, Apr 24, 2025 · control 27-AS-20241123150713

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: ) Staff yells at the residents. 2) Staff threatens the residents 3) staff hit a resident. 4) staff tie doors closed to prevent residents from leaving bedrooms.

Licensing Program Analysts (LPA) Kevin Gould made an unannounced inspection to the Siebenthal Care Home RCFE on 12/11/24 at 1:00pm to conclude the investigation of the above allegations and to deliver the findings. LPA Gould met with Licensee, Ermelinda Siebenthal and together discussed the investigation details. Based on the interviews conducted during the investigation process and statements obtained during the investigation process, LPA Gould was unable to corroborate the allegations. LPA Gould conducted interviews with four staff members (see confidential name list LIC-811 dated 12/11/24) Who all denied the above allegations. No staff interviewed witnessed any staff member yell at, threaten, or hit residents in care. LPA contacted the authorized representatives for all residents. LPA was able to conduct phone interviews with two of the five authorized representatives and both denied any concerns regarding the allegations and provided statements they are satisfied with the care theithe state’s words, verbatim · CDSS document, Dec 11, 2024 · control 27-AS-20240719112743

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Medications: 1) Staff is mishandling the residents medications 2) Staff is inappropriately administering medication Neglect/Lack of Supervision: 1) Staff did not provide adequate care and supervision to a resident.

Licensing Program Analysts (LPA) Kevin Gould made an unannounced inspection to the Siebenthal Care Home RCFE on 12/5/24 at 9:00am to conclude the investigation of the above allegations and to deliver the findings. LPA Gould met with Licensee, Ermelinda Siebenthal and together discussed the investigation details. Based on the interviews and statements obtained during the investigation process, the allegations are substantiated. LPA reviewed medication administration records for three (3) of the five (5) current resident's in care. LPA observed staff who administer medications are signing off medications administered prior to the medications being given to the resident. LPA observed one medication for R1 that is ordered to be administered every other day, documented as being administered daily. R1 has been over-medicated for the medication Ferosul as medicaion order is for every other day and is documented as adminstered daily. Report Continued on LIC 9099-C. Substantiatedthe state’s words, verbatim · CDSS document, Dec 5, 2024 · control 27-AS-20240719112743

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff physically abused residents. Staff verbally abused residents. Staff withheld food from resident. Staff did not allow resident to have a personal cell phone. Staff did not assist resident with scheduling requested medical appointments.

On 6/18/24, Licensing Program Analyst (LPA) Tung Truong arrived unannounced to complete and delivery findings for a complaint investigation received on 4/18/24. LPA met with Administrator Ermerlinda Siebenthal and explained the purpose of the visit. 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. LPA interviewed six (6) residents. Two residents were unable to corroborate due to their diagnosis of dementia. 4 out of 6 residents stated that they were unaware of any verbal or physical abused from staff. Residents reported that they have access to food and telephone. One resident reported that they have a personal cell phone. Residents also corroborated that staff assisted with scheduling medical appointments and provide transportation. As a result of the investigation, LPA finds the allegations above to be UNthe state’s words, verbatim · CDSS document, Jun 18, 2024 · control 27-AS-20240418145238

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff did not provide adequate supervision to the residents

Licensing Program Analyst (LPA) Tung Truong conducted an unannounced visit at this facility to commence a complaint investigation with the allegation above. LPA met with Administrator Ermerlinda Siebenthal and explained the purpose of the visit. Based on the interviews conducted and reviewed of records, it was learned that on 12/8/23 resident (R1) and (R2) AWOL'd out of the side gate of the facility without staff knowledge. It was learned that R1 and R2 Physician’s Report prohibited resident from leaving the facility unsupervised due to Dementia diagnosis. The administrator corroborated that she noticed the residents were not on the facility premises and proceed to search the neighborhood. R1 and R2 were found without any visible injuries and bought the residents back to the facility. It was determined that due to lack of supervision, resident R1 and R2 left the facility unsupervised on 12/8/2023. Continued on 9099-C Substantiatedthe state’s words, verbatim · CDSS document, Dec 12, 2023 · control 27-AS-20231208140918