Apple Garden Seniors

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPA was granted entry into the facility and met with Administrator, George Karkaletsis. The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (6), and a current census of (6). LPA conducted a general inspection of facility, which included, but was not limited to, the following: Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility's outdoor activity space is shaded and protected by self-latching gates. The facility is maintained at a temperature of 74 degrees fahrenheit(F). Resident bedrooms were furnished with beds, night stands, chairs, bed linen and bedroom lighting. Resident bathroom fixtures were operating properly. The hot water temperatures in the bathrooms measured at 105 degrees (F). The facility is equipped with fully charged fire extinguisher, smoke/carbon monoxide alarms, night lights, door signal system, emergency supplies/water, laundry equipment, and telephone service. The facility has posted in a common area: Ombudsman poster, facility license, evacuation plan and emergency telephone numbers. Sharps and cleaning supplies were kept locked and inaccessible to residents in care. An emergency&disaster plan, infection control plan, and liability insurance is maintained at the facility. Food Service: The facility's kitchen area was maintained cleaned. A 7-day supply of non-perishable and a 2-day supply of perishable foods was maintained at the facility. The facility maintains a sample menu for review. Care & Supervision: The facility staff schedule reflects 24 hours a day, 7 days a week staff coverage. Health Related Services: Resident medications were centrally stored in a locked cabinet. The facility maintains a first kit with manual. Review of medications for four (4) residents reveals, the facility utilizes a Medication Administration Record (MAR) to document when residents medication are administered by staff. Resident #1 (R1), Resident#2 (R2), and Resident #3 (R3) had prescribed medications in their medication basket that was not listed/maintained on their MAR. Record Review: Four (4) resident files were reviewed for admissions agreements, physician’s reports, preplacement appraisals, needs and services plans. Review of a resident files reveals, there was no documentation of a current hospice care plan maintained for Resident#4 (R4). Four (4) staff files were reviewed for First Aid/CPR certifications, criminal record clearances, job training, and health screenings. Review of staff files reveals, staff#1(S1) who administers medication to residents did not have annual medication training on file. Staff#2 (S2) did not have documentation of an annual dementia, postural support, hospice training on file. Based on LPA observations and records reviewed, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations and Health & Safety Codes. An exit interview was conducted where this report was discussed and a copy with appeal rights was provided to the Administrator at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jun 22, 2026

Allegation investigated: Neglect of a resident resulting in serious bodily injury.

Licensing Program Analyst (LPA Jacqueline Shaw-Ross made an unannounced visit to deliver findings for the allegation listed above. LPA met with Gloria Dupio, Caregiver and explained the purpose of the visit. LPA also spoke with Administrator, George Karkaletsis, by telephone and the purpose of the visit was explained. The investigation consisted of observations, interviews and a review of documentation. On 05/05/2021, the Department received a complaint alleging neglect of a resident resulting in serious bodily injury. It was reported that on 05/04/2021, Resident 1 (R1) fell from the toilet and struck their head on the bathtub resulting in lacerations. It was reported R1 resided at the facility for six months and had six (6) falls. On 05/07/2021, a video visit was conducted where R1 was observed to have purple -colored bruises located around their right eye and on top of their nose, a cut above their eyebrow, and approximately four (4) visible butterfly stitches above R1’s right eyebrow, as well as gauze on the right side of their forehead. The interview of R1 was not successful due to R1’s cognitive impairment. The Administrator reported that two staff members were on duty at the time of the 05/04/2021 incident: the Administrator and Staff 1 (S1). Continue on LIC 9099-C.... Unsubstantiated According to the administrator, S1 was “either in the kitchen or in R1’s bedroom” and responded immediately when called to the bathroom. An interview with S1 was attempted but not successful. The administrator explained R1 could only be transferred using a back and forth motion and was unable to grasp the toilet’s side handles for support. A review of R1’s physician’s report dated 07/09/2018 revealed R1 was non ambulatory and unable to manage toileting independently but did not indicate whether a two person assist was required. The Resident Appraisal dated 06/30/2018 was reviewed and the section for toileting assistance was left blank. Hospice progress notes, dated 04/13/2021, documented that R1 required maximum assistance, was incontinent, nonverbal, unable to follow commands, and exhibited significant weaknesses. Hospice Care Coordination notes, dated 04/23/2021 and 04/19/2021, documented R1 required “Max Assist for cares such as bathing, dressing, incontinence cares, positioning, transfer, and feeding,” but did not specify whether a two person assist was required. The administrator reported it was a “normal fall” and stated the wheelchair had been placed to R1’s left side by the sink, after the administrator positioned R1 on the commode. The administrator reported taking their hands off R1 for only a few seconds before R1 fell, hitting their head on the shower edge and then falling to the floor. It was reported that facility staff contacted hospice immediately. Hospice arrived within approximately 10 minutes, completed a visual assessment, and instructed staff to call paramedics. Attempts to locate and interview the hospice worker who responded were unsuccessful. Medical records from the day of the incident indicated R1 sustained two forehead lacerations, which were closed using Dermabond strips. R1 was released the same day and returned to the facility. The report that R1 had experienced six falls since admission was investigated. However, only one fall—reported in April 2021—could be verified. That incident resulted in no injuries, and no additional documentation was available to corroborate the other alleged falls. Based on observations, interviews, and a review of records, the allegation of neglect of a resident resulting in serious bodily injury is unsubstantiated. An unsubstantiated finding means the preponderance of evidence standard has not been met. A copy of this report was reviewed and provided to Gloria Dupio, Caregiver.the state’s words, verbatim · CDSS document, May 6, 2026 · control 18-AS-20210505155953

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Magda Malcore and Eldin Serrano made an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPAs met with Administrator George Karkaletsis and were granted entry to the facility. The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (6), and a current census of (5). LPAs conducted a general inspection of the facility, which included, but was not limited to, the following: Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility's outdoor activity space is shaded and protected by self-latching gates. The facility is maintained at a comfortable temperature of 78 degrees F. Resident bedrooms were furnished with beds, night stands, chairs, bed linen and bedroom lighting. Resident bathroom fixtures were operating properly. The hot water temperatures in the bathrooms measured at 105 degrees F. The facility is equipped with operating smoke/carbon monoxide alarms, laundry equipment, and telephone service. The facility has posted in a common area: Ombudsman poster, facility license, community care licensing poster, and emergency telephone numbers. Sharps and cleaning supplies were kept locked and inaccessible to residents in care. The facility has insurance documentation, emergency disaster plan, and infection control for review. Food Service: The facility's kitchen and dining areas were maintained clean. Non-perishable and perishable food supply was sufficient for the number of residents in care. Care & Supervision: The facility staff schedule reflects 24 hours a day, 7 days a week staff coverage. Health Related Services: Residents medications were centrally stored in a locked cabinet. The facility has a first aid kit and manual. Record Review: Resident files were reviewed for admissions agreements, physician’s reports, preplacement appraisals, needs and services plans. Staff files reviewed for First Aid/CPR certifications, criminal record clearances, training, and health screenings. An exit interview was conducted where this report was discussed and a copy was provided to the Administrator at the conclusion of the visit.the state’s words, verbatim · CDSS document, Aug 8, 2025

The state marks this report as 10 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPA met with Administrator, George Karkaletsis, and was granted entry to the facility. The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (6), and a current census of (6). LPA conducted a general inspection of facility, which included, but was not limited to, the following: Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility's outdoor activity space is shaded and protected by self-latching gates. The facility is maintained at a comfortable temperature. Resident bedrooms were furnished with beds, night stands, chairs, bed linen and bedroom lighting. Resident bathroom fixtures were operating properly. The hot water temperatures in the bathrooms measured at 107.7 degrees F. The facility is equipped with operating smoke/carbon monoxide alarms, laundry equipment, and telephone service. The facility has posted in a common area: Ombudsman poster, facility license, evacuation plan and emergency telephone numbers. Sharps and cleaning supplies were kept locked and inaccessible to residents in care. The facility's insurance and emergency disaster plan is current. Food Service: The facility's kitchen area was maintained cleaned. Non-perishable and perishable food supply was sufficient for number of residents in care. The facility’s refrigerator and freezer were operating properly. Care & Supervision: The facility staff schedule reflects 24 hours a day, 7 days a week staff coverage. Health Related Services: Resident medications were centrally store in a locked cabinet; however, resident #1 (R1's) and resident #2 (R2's) medications were stored in a weekly pill container and not in their original containers. LPA observed two (2) medications belonging to R1 that were not on their medication list. Deficiencies cited. Record Review: Resident files were reviewed for admissions agreements, physician’s reports, preplacement appraisals, needs and services plans. LPA observed Resident #3 (R3's) hospice plan does not accurately state the condition of R3's need for hospice services. Staff files reviewed had First Aid/CPR certifications, criminal record clearances, training, and health screenings. Based on LPA observations and records reviewed, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where this report was discussed and a copy with appeal rights was provided to the Administrator at the conclusion of the visit.the state’s words, verbatim · CDSS document, Sep 16, 2024

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.