Miles Manor

Type of visit: Office

An informal conference was conducted at 2:00 PM on October 2, 2026, with Sacramento North Regional Office. The purpose of this informal conference meeting is to address and discuss concerns regarding the most recent inspections conducted at the care home, including videos obtained by the Department of an incident involving a resident inside the care home. Licensee was told that this Informal conference is a part of the Administrative Action process and that further noncompliance may result in an elevation to a formal noncompliance conference, which could lead to a referral to the Department's legal division for possible revocation of license. The following Licensing staff were present: Licensing Program Analyst (LPA) Michael Hood and Licensing Program Manager (LPM) Lauren Crocker The following facility representatives were present: Licensee, Rachel Miles, and Administrator, Kim Rosa The following topics were covered during today's meeting: · Personal Rights of the residents in care · Staff competency and expectations · Purposes of eviction process ** Report continued on 809-C ** LPA obtained video surveillance footage from a camera located in the common area of the care home and pointed towards the dining room, kitchen area, and front entrance. The footage obtained showed an incident that occurred on February 7, 2026 regarding resident (R1) that contains audio recording of the incident, including conversations between R1 and staff on and off-site. At approximately 3:50 PM, R1 is seen at the front entrance requesting for “air” and to be allowed outside with Administrator standing between R1 and the front entrance. Staff members (S1 and S2) are seen present during the incident. Video footage lasts for approximately a half hour in which R1 is prevented from going outside by Administrator and care staff. Administrator is seen on the phone while interfering with R1's ability to go outside for the entire 30 minutes of footage. Administrator is seen offering R1 PRN medication in response to R1 asking for air and requesting to go outside. Video footage shows Administrator and staff making no attempts to provide any services to de-escalate incident, including providing R1 and ability to go outside, resulting in R1 breaking a chair, throwing water, and R1 requesting law enforcement to be called. Emergency services were called to the facility and R1 was sent to the hospital. Facility representatives were notified that the Department may increase monitoring at the facility. Technical support was offered to facility representative during meeting and the facility will be referred. As a result of today's inspection, deficiencies are being cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Deficiencies are listed on 809-D page. Exit interview was conducted. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Oct 2, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(a)(1) · Plan of correction due date: Oct 3, 2026

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (1) To have a reasonable level of personal privacy in (...) communications (...). This requirement is not met as evidenced by: Based on observation and videos obtained by the Department, staff did not ensure that residents were accorded a reasonable level of personal privacy at the care home by recording audio in common areas, which poses an immediate health, safety, and personal rights risk to the residents in care.the state’s words, verbatim · CDSS document, Oct 2, 2026

Plan of correction: Licensee will provide a written statement indicating that audio will be deactivited from all indoor cameras. Licensee will submit statement to LPA by POC due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87468.1(a)(6) · Plan of correction due date: Oct 3, 2026

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (6) To leave or depart the facility at any time (...). This requirement is not met as evidenced by: Based on observation and videos obtained by the Department, staff did not ensure that resident had the ability to go outside of the care home when requested, which poses an immediate health, safety, and personal rights risk to the residents in care.the state’s words, verbatim · CDSS document, Oct 2, 2026

Plan of correction: Licensee will update resident's needs and services plan to accommodate resident's preferences and implement a program to reflect resident's choices and goals that do not violate the resident's personal rights. Licensee will submit completed plan to LPA by POC due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Oct 3, 2026

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on observation and videos obtained by the Department, staff neglected resident's requests to go outside, causing resident to escalate in behaviors, which poses an immediate health, safety, and personal rights risk to the residents in care.the state’s words, verbatim · CDSS document, Oct 2, 2026

Plan of correction: Facility will obtain de-escaltion training from an outside source for all staff, including Licensee and Administrator. Licensee will submit proof of training to LPA by POC due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87219(h)(2) · Plan of correction due date: Oct 3, 2026

87219 Planned Activities (h) The licensee shall provide sufficient space to accommodate both indoor and outdoor activities. Activities shall be encouraged by provision of: (2) Outdoor activity areas that are easily accessible to residents, protected from traffic, and have adequate shady areas. This requirement is not met as evidenced by: Based on observation and videos obtained by the Department, staff did not ensure access to outdoor space and activities for resident in care, which poses an immediate health, safety, and personal rights risk to the residents in care.the state’s words, verbatim · CDSS document, Oct 2, 2026

Plan of correction: Licensee will update activity plan to factor in accomodating the individualized needs of the residents in care and the implementation of outdoor activities. Licensee will submit a written plan to LPA by POC due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87405(h)(8) · Plan of correction due date: Oct 3, 2026

87405 Administrator - Qualifications and Duties (h) The administrator shall have the responsibility to: (8) Have the personal characteristics, physical energy and competence to provide care and supervision (…). This requirement is not met as evidenced by: Based on observation and videos obtained by the Department, Administrator did not exhibit personal characteristics or competence to provide adequate care and supervision to resident in need, which poses an immediate health, safety, and personal rights risk to the residents in care.the state’s words, verbatim · CDSS document, Oct 2, 2026

Plan of correction: Facility will obtain dementia care training and personal rights training from an outside source for Administrator. Licensee will submit proof of training to LPA by POC due date.

Type of visit: POC

Licensing Program Analyst (LPA) Michael Hood arrived at the care home and met with Administrator, Kimberly Rosa, to conduct a plan of correction (POC) visit to follow-up on a citation issued during an inspection conducted on June 18, 2026. During visit, LPA reviewed 14 of 14 resident records at the care home. LPA observed three (3) of 14 residents had moved in after citation was issued on June 18, 2026 and had Admission Agreements with refund policies that did not violate the rights of any residents including but not limited to those specified in Section 87468 and in Health and Safety Code section 1569 et seq. LPA observed 11 of 14 residents did not have an updated Admission Agreement to correct the deficiency issued on June 18, 2026. As a result of today's inspection, a civil penalty in the amount of $200 was assessed for today's date due to failure to correct a citation regarding ensuring that resident Admission Agreements did not include any provisions that violates the rights of any residents including but not limited to those specified in Section 87468 and in Health and Safety Code section 1569 et seq. LPA will return at a later date to ensure that all resident records include an updated Admission Agreement to correct deficiency issued on June 18, 2026. No deficiencies are being cited as a result of today's inspection. Exit interview was conducted. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Aug 19, 2026

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Michael Hood arrived at the care home and met with Administrator, Kimberly Rosa, to conduct a follow-up visit regarding information obtained during a separate inspection conducted on June 2, 2026. During inspection, LPA obtained a copy of resident (R1's) Admission Agreement. LPA observed the following statement under Refund Policy: "NO REFUNDS ON HOSPICE. DAILY HOSPICE RATE NOT TO EXCEED MONTHLY RATE." Per Health and Safety Code §1569.652(c), “A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual, individuals, or entity contractually responsible for the fees or, if the deceased resident paid the fees, to the resident’s estate, within 15 days after the personal property is removed.” Per Title 22, Division 6, Chapter 8, Section 87507(h)(4), “The admission agreement shall not contain the following: Any provision that violates the rights of any residents including but not limited to those specified in Section 87468 and in Health and Safety Code section 1569 et seq.” As a result of today's inspection, a deficiency is being cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Deficiency is listed on 809-D page. Exit interview was conducted. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Jun 18, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507(h)(4) · Plan of correction due date: Aug 17, 2026

87507 Admission Agreements (h) The admission agreement shall not contain the following: (4) Any provision that violates the rights of any residents including but not limited to those specified in Section 87468 and in Health and Safety Code section 1569 et seq. This requirement is not met as evidenced by: Based on records reviewed, the facility did not ensure that admission agreements for the residents did not violate rights indicated in Health and Safety Code section §1569.652(c), which poses a potential health, safety, and personal rights risk to the residents in care.the state’s words, verbatim · CDSS document, Jun 18, 2026

Plan of correction: Facility will update Admission Agreements for all residents and ensure that there is nothing included that violates any rights specified in Section 87468 and in Health and Safety Code section 1569 et seq. Facility will submit all updated Admission Agreements to LPA by POC due date of August 17, 2026.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Michael Hood and Marisa Chiarelli arrived at the facility unannounced on November 26, 2025 to conduct a Required-1 Year Inspection utilizing the inspection tool. LPAs conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are ten (10) bedrooms and eleven (11) bathrooms for resident use. LPAs observed bedrooms to be properly furnished, with appropriate bedding and lighting. Bathrooms were in sanitary condition and properly maintained. Hot water temperature was observed to be 111 degrees F. LPAs checked the kitchen area for the ability to prepare and store food. Care home has required two (2) day perishable and seven (7) day non-perishable food supply on site. LPAs observed knives, cleaning products, and other toxins to be locked away and inaccessible to residents. LPAs observed the backyard and perimeter of the care home to be free of clutter and debris. LPAs observed smoke detectors and carbon monoxide detectors are hard wired in the care home. Emergency exits were unobstructed during visit. Fire extinguishers and first aid kit is maintained and ready for emergency use. LPAs reviewed two (2) residents' medications and observed medication storage to be locked away and inaccessible to the residents. LPAs reviewed four (4) resident files and three (3) staff files. Facility has a current copy of certificate of liability insurance and LPAs requested a copy. As a result of this visit, no deficiencies were cited per California Code of Regulations, Title 22. Exit interview was conducted and a copy of the report was given at the conclusion of this visit.the state’s words, verbatim · CDSS document, Nov 26, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Cassandra Mikkelson and Michael Hood arrived unannounced to conduct an annual inspection. LPAs met with Kimberly Rosa during today's inspection. LPAs conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPAs observed ten (10) resident rooms and two (2) common area bathrooms. LPAs observed rooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition, properly maintained, and the hot water temperature was observed to be 113.1 degrees F. LPAs checked the kitchen area for the ability to prepare and store food. Care home has required (2) two day perishable and (7) seven day non-perishable food supply on hand. Smoke detectors and carbon monoxide detectors are hard wired in the care home. Fire extinguishers and first aid kit are maintained and ready for emergency use. LPAs checked medication storage and found medications to be locked away and inaccessible to the residents. LPAs reviewed six (6) resident files, three (3) staff files and two (2) resident medications. Facility has a current copy of certificate of liability insurance and LPAs requested a copy. As a result of this visit, no deficiencies were cited. Exit interview was conducted with Administrator. A copy of this report provided.the state’s words, verbatim · CDSS document, Nov 8, 2024

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: POC

Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Administrator, Kimberly Rosa, to follow-up on plan of corrections made to the facility on 11/15/2023 to be completed on 11/16/2023 and 12/08/2023. During today's visit, LPA took the temperature of the water and found temperature to be 120 degrees F. LPA observed holes in floors to be repaired, kitchen shelves to be repaired, locks on kitchen shelves to be operable, and smoke alarms to be attached to ceiling. LPA cleared deficiencies during visit. Exit interview was conducted. A copy of this report was provided. Signature on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Dec 14, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 11/15/23 to conduct a Required-1 Year Inspection utilizing the inspection tool. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are ten (10) bedrooms and eleven (11) bathrooms for resident use. LPA observed bedrooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition and properly maintained. LPA checked the kitchen area for the ability to prepare and store food. Care home has required two (2) day perishable and seven (7) day non-perishable food supply on cite. LPA observed knives, cleaning products, and other toxins to be locked away and inaccessible to residents. LPA observed the backyard and perimeter of the care home to be free of clutter and debris. LPA observed smoke detectors and carbon monoxide detectors to be operational in the care home. First aid kit is maintained and ready for emergency use. LPA checked medication storage and found medication to be locked away and inaccessible to the residents. LPA reviewed four (4) resident files and three (3) staff files. Facility has a current copy of certificate of liability insurance and LPA requested a copy. LPA also requested a copy of an active Administrator certificate, staff roster, and updated emergency disaster plan. As a result of today's inspection, deficiencies are being cited pursuant to California Code of Regulations, Title 22, Section 87303(e)(2) for hot water temperature being observed at 127.4 degrees F, and 87303(a) for disrepair of the facility. Deficiencies are listed on 809-D. Exit interview was conducted with Administrator. Copy of this report and appeal rights were provided. Signatures on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Nov 15, 2023