Casa De Las Campanas

Allegation investigated: Provider made material misrepresentations to depositors, prospective residents, or residents of a continuing care retirement community via the information provided on their Disclosure Statement.

This report is an amendment to the 9099 dated August 1, 2025. Licensing Program Analyst Hall delivered complaint findings to the Health Center Administrator of Casa de las Campanas on August 21, 2026 via phone. The California Continuing Care Contracts Bureau (CCCB) received a complaint on November 28, 2023 alleging that Casa de las Campanas materially misrepresented its financial position in its Disclosure Statement by overstating Operating Income through the inclusion of non-operating revenue. The complaint was initially investigated by CCCB financial analyst Jennifer Houston and determined to be unsubstantiated. Continued on 9099C Unsubstantiated The matter was reopened in January 2026 after the department received additional information and supplemental information was received in July 2026. CDSS staff, reviewed audited financial statements and reconciliations submitted by the provider, Generally Accepted Accounting Principles (GAAP), Financial Accounting Standard Board (FASB), Commission on Accreditation of Rehabilitation Facilities aka CARF International (CARF) and California Business and Professions Code section 651. Allegation: Provider made material misrepresentations to depositors, prospective residents, or residents of a continuing care retirement community via the information provided on their Disclosure Statement. UNSUBSTANTIATED. The review confirmed that the figures reported in the Disclosure Statement as “Income from Ongoing Operations/Operating Income” included resident revenue, investment and dividend income, realized investment gains, and gains/support. The Department further confirmed that, with these included sums, the figure generally aligned with the audited financial statements, with minor discrepancies noted. The Department noted that neither the continuing care contract statutes nor GAAP provide a single mandatory definition of “Operating Income” for nonprofit organizations, nor do they explicitly prohibit inclusion of investment-related income in such calculations. Additionally, the Department utilizes CARF ratios to assess the financial viability of CCRCs. CARF recognizes that financial statement reporting can vary significantly among providers and auditors. To promote consistency in its financial ratio analysis, CARF applies specific protocols to audited financial information. For purposes of calculating margin ratios, CARF treats interest earnings and net assets released from restriction as operating revenues, and its Ratio Pro spreadsheet includes interest and dividends in operating revenue. CARF also notes that providers with established ongoing development efforts may find it useful to calculate the ratios to include those activities as well. Consequently, the Department cannot find that the provider materially misrepresented operating income when it included such sums in the “Income from Ongoing Operations/Operating Income” line of its disclosure statement. Continued on 9099C.2 Furthermore, the Department reviewed the monthly care fee increase for FYE 2023 and determined that it met the applicable statutory requirements. The applicable statutes do not require the information supporting the monthly care fee increase to reconcile with the “Income from Ongoing Operations/Operating Income” amounts reported in the Disclosure Statement. Based on the investigation, the preponderance of evidence standards has not been met. Therefore, the above allegation is determined to be UNSUBSTANTIATED. A finding that the allegation is UNSUBSTANTIATED means that the allegation may have happened or may be valid, but there is not a preponderance of evidence to prove that the alleged violation occurred.the state’s words, verbatim · CDSS document, Aug 21, 2026 · control 08-AS-20231128124359

Allegation investigated: Staff did not ensure the fire alarm was not in disrepair. Faciity does not have a qualified skilled professional for residents.

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced visit to conduct a complaint investigation and delivered findings regarding the above mentioned allegations. LPA was welcomed by, identified themselves to, and discussed the purpose of their visit to Director of Residential Health Shila Jurado and Executive Director Stefanie Thune-Barnes. Note, LPA did step out for lunch from 12:15-1:15pm. On 07/27/2026, the Department received a complaint where it was alleged that the facility did not maintain their fire panel in good operating condition and that there were no licensed nurses present during overnight shifts. The Department’s investigation consisted of an unannounced facility visit, records review, and interviews with staff, residents, and outside sources. [Continued on LIC 9099-C, page 1 of 3] Unsubstantiated [Continued from LIC 9099] Per interviews with staff, in the evening of 7/26/26, a staff member had notified managerial and maintenance staff of a beeping alarm on the fire panel in the Assisted Living area of the facility. Per staff interviews, it was determined that a node in the panel was not working properly, and that maintenance staff had responded that same evening to take a look at it. Per maintenance staff interviews, the issue was determined to not be urgent based on the section of the panel indicating the node issue. It was also revealed that the facility conducts weekly testing of fire alert systems and so an order was requested with the facility's fire tech vendor to take a look at the node during the next scheduled visit on 8/3/26. File review of an email from facility staff to the vendor company dated 7/28/26 confirmed the request for the tech take a look at the node. An additional email dated 8/5/26 from the vendor company confirmed the work completed during the visit on 8/3/26. File review of maintenance records from June through August 2026 verified that a fire tech has come out to the facility on a weekly basis. Interview with an outside source from the fire tech company confirmed that the facility reached out on 7/28/26 about the issue and also revealed that node alerts do not necessarily indicate that a fire alarm system is non-functioning. Interviews with residents did not reveal any concerns about fire safety in the facility. The facility had demonstrated that it was aware of the work needed for the panel's repair and had taken timely action to do so based on the level of urgency determined. In regards to the second allegation of the facility not having a qualified skilled professional, specifically nurses, present at the facility during overnight shifts, file review and interviews indicated that there were appropriately skilled/trained staff present during overnight shifts. Additionally, as community care facilities are non-medical facilities, there are no requirements for licensed medical staff to be present. Per regulation 87415 pertaining to night supervision, overnight staff "shall be familiar with the facility's planned emergency procedures, shall be trained in first aid as required in Section 87465, Incidental Medical and Dental Care Services and shall be available as indicated below to assist in caring for residents in the event of an emergency." [Continued on LIC 9099-C, page 2 of 3] [Continued from LIC 9099-C, page 3 of 3] Regulation 87415 also lists the ratio of overnight staff needed per census of the facility. As the facility currently has a census of 515 residents, they would require at least five (5) staff present and awake at the facility overnight, another present staff member on call (not necessarily awake), and another staff member on call and able to arrive to the facility within 10 minutes. File review of staff schedules for the month of July 2026 revealed that there were at least two (2) nurses and at least four (4) caregivers at the facility (not counting the facility's Skilled Nursing Facility (SNF) present or non-care staff) during overnight shifts, thus meeting required staffing ratios. File review of staff training records for several night shift staff revealed that they had record of all required training. Based on interviews and records review, while the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred – therefore the allegations have been determined to be UNSUBSTANTIATED. An exit interview was conducted with Residential Health Director Jurado to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Aug 5, 2026 · control 08-AS-20260727143036

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to conduct a Required Annual Inspection. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Residential Care Coordinator Silvia Cruz. According to the facility’s license, the facility has a maximum capacity for five-hundred eighty-two (582) residents, of which two-hundred twenty-seven (227) may be non-ambulatory but none may be bedridden, and of which twenty (20) may be under hospice care. During this annual inspection, there were a total of five hundred and three (503) residents in care, of whom one-hundred fifty four (114) were non-ambulatory, and none were bedridden. Ten (10) of the residents were under hospice care. The facility’s license included endorsement for use of delayed-egress doors in the facility’s dementia-care unit. LPA reviewed records for multiple residents and multiple staff. LPA interviewed multiple residents and multiple staff. LPA, accompanied by Silvia Cruz, also toured the interior and exterior of the facility, and inspected common areas and multiple resident rooms. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Multiple resident pendant, push-button, and pull-cord call devices were tested. Doors, windows and screens, toilets, and showers were working. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility’s ambient internal temperature was compliant at 74 F. (CONTINUED ON NEXT PAGE) [CONTINUED FROM LIC 809] Where tested, hot water temperature at taps accessible to residents were all compliant: Bedroom #476A Sink was 117.1 F, Bedroom #478 Sink was 117.2 F, Bedroom #18 Sink was 113 F, Bedroom #16 Sink was 106 F. Appliances to preserve perishable food were also all compliant in temperature. There was at least two (2) days of perishable food, and at least seven (7) days of non-perishable food present, all safely stored. Plenty of cooking and dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, active fireplaces, or open-faced heaters accessible to residents. Medications were labeled, as required, and stored in locked areas. Confidential records were stored in locked areas. The facility’s swimming pools were secured behind locked fences and gates, consistent with regulation. Per Executive Director Stefanie Thune-Barnes no firearms or ammunition are kept at the facility. Fire detection system, carbon monoxide detectors, nighttime lighting, emergency lighting, and facility telephone were all working. The facility’s fire extinguishers were serviced within the last twelve (12) months. Required licensing postings were observed in visible areas of the facility. Fire/disaster drills were performed at required intervals. There were reserve supplies of Personal Protective Equipment (PPE). Licensee presented proof of current business liability insurance. No deficiencies were cited during this annual inspection. An exit interview was conducted with Silvia Cruz, Executive Director Stefanie Thune-Barnes and Director of Residential Health Shila Jurado (via telephone), to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.the state’s words, verbatim · CDSS document, Apr 6, 2026

Allegation investigated: Facility staff financially abused resident in care.

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced visit to deliver findings for a complaint investigation regarding the above mentioned allegation. LPA was welcomed by, identified themselves to, and discussed the purpose of their visit to Residential Administrator Tyre Richards. On 08/07/2025, the Department received a complaint where it was alleged that a resident (identified as R1) had tried to withdraw a substantial amount of cash from their bank, stating that the purpose of the money was to give to a friend. Per the complaint, it was believed that the friend in question was a caregiver at the facilty. The Department’s investigation consisted of unannounced facility visits, records review, and interviews with staff, residents, and outside sources. [Continued on LIC 9099-C] Unfounded [Continued from LIC 9099] R1 resides in the independent living portion of the facility and has no diagnosis of cognitive impairment. Per review of R1's physician's report dated July 2004, it is noted that R1 can manage their own cash resources. The department had requested from the facility if there was a more recent physician's report on file and it was revealed that R1 had not had any changes in condition that required an updated report. However, the facility conducts annual assessments to monitor resident status. Per review of facility assessments on R1 conducted September 2022, September 2023, and October 2024, R1 is noted to be independent and does not require care and supervision. Per interview with R1, it was revealed that they have a private caregiver from an outside agency that assists with household tasks, errands, and appointments. R1 explained that they were aware their private caregiver could not accept money or tips from R1. When asked about the incident described in the complaint allegation, it was revealed R1 was preparing for a trip and preferred to travel with cash. R1 revealed they were uncomfortable and offended with being questioned about their reasons for withdrawing money and so they provided the first statement that came to mind. An outside source interview revealed they had no concerns regarding R1's cognitive status or concerns about R1 being financially abused. This interview corroborated that R1 preferred to travel with cash on hand. The Department has investigated the complaint alleging financial abuse. We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have dismissed the complaint. An exit interview was conducted with Residential Administrator Richards to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Jan 6, 2026 · control 08-AS-20250807160532

Allegation investigated: Lack of supervision.

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced visit to deliver findings for a complaint investigation regarding the above mentioned allegation. LPA was welcomed by, identified themselves to, and discussed the purpose of their visit to Residential Administrator Tyre Richards. On 10/22/2025, the Department received a complaint where it was alleged that a private caregiver for a resident at the facility was clocking in for shifts at the facility they were not physically present for. Per the complaint, this had been going on for a period of three (3) weeks. The Department’s investigation consisted of unannounced facility visits, records review, and interviews with staff and outside sources. [Continued on LIC 9099-C] Unfounded [Continued from LIC 9099] Per records review of admission/discharge records for R1, it was revealed that R1 had been residing in the SNF for over a year and a half, pre-dating the timeline of the complaint. The Department has no jurisdiction in Skilled Nursing Facilities (SNFs) as they are regulated by the Department of Public Health, therefore there is no indication of a violation of Community Care Licensing Regulations. Review of facility staff association records did not reveal any matches to the caregiver named in the complaint. The agency has investigated the complaint alleging lack of supervision. We have determined that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have dismissed the complaint. An exit interview was conducted with Residential Administrator Richards to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Jan 6, 2026 · control 08-AS-20251022140438

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Case Management visit to follow up on an incident reported to Community Care Licensing. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Executive Director (ED) Stefanie Thune-Barnes and Health Services Administrator Brooke Patterson. Director of Residential Health Shila Jurado and Residential Administrator Tyre Richards joined later during the visit. Community Care Licensing received an Incident Report on 9/5/25 in which it was reported that on 9/3/25, a memory care Resident (identified as R1), was discovered on the floor during rounds and that they had sustained an open wound to the back of their head. Per the report, R1 was unable to state how they had fallen. Emergency services were contacted and R1 was taken to the hospital where they received staples to close their wound. R1 was discharged back to the facility same day. Per the report, R1's responsible party, primary care physician, and hospice agency were notified. During today's visit, LPA conducted interviews and file review. A health and safety visit with R1 could not be completed as R1 had passed away shortly after the incident from their hospice diagnosis. Due to time constraints, LPA was unable to complete a determination regarding this case management visit, and additional visits may be necessary to complete review of this incident. At this time, LPA observed no health and/or safety concerns and no deficiencies were cited during today's visit. An exit interview was conducted with Residential Administrator Richards to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Dec 22, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Case Management visit to follow up on an incident reported to Community Care Licensing. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Executive Director (ED) Stefanie Thune-Barnes and Health Services Administrator Brooke Patterson. Director of Residential Health Shila Jurado and Residential Administrator Tyre Richards joined later during the visit. Community Care Licensing received an Incident Report on 11/12/25 in which it was reported that on 11/6/25, an Independent Living Resident (identified as R1), contacted the facility's reception to request medical assistance. Upon arrival, staff noted bruising along R1's face, back, and arm. Per the report, R1 stated they had a series of falls throughout the week that they did not report, and the most recent being that morning. Staff noted additional bruising along R1's right rib cage. Emergency services were contacted and R1 was taken to the hospital where they were treated for multiple rib fractures. R1 was discharged 11/9/25 with medication changes for possible infection and given a walker. Per the report, R1's neuro and cognitive testing came back normal. During today's visit, LPA conducted interviews and file review. Additionally, LPA conducted a phone call with R1. Interviews corroborated that the facility responded immediately once notified of the incident and arranged for medical care. File review of R1's records note R1 to be independent in all Activities of Daily Living (ADLs). [Continued on LIC 809-C] [Continued on from LIC 809] As the facility responded accordingly once notified of the incident and arranged for proper and prompt medical care, no violations were observed during today's visit and no deficiencies cited. An exit interview was conducted with Residential Administrator Richards to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Dec 22, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Case Management visit to follow up on an incident reported to Community Care Licensing. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Executive Director (ED) Stefanie Thune-Barnes and Health Services Administrator Brooke Patterson. Director of Residential Health Shila Jurado and Residential Administrator Tyre Richards joined later during the visit. Community Care Licensing received an Incident Report on 12/1/25 in which it was reported that on 11/26/25, an Independent Living Resident (identified as R1), contacted the facility's reception through their pull cord. Upon arrival, staff noted R1 on the floor between their bathroom and bed. Per the report, R1 verbalized that they had hit their head and presented with disorientation. Resident was transported to the hospital by emergency services where they were diagnosed with a closed head injury and shoulder injury. Resident returned to the facility's Skilled Nursing Facility (SNF) for rehabilitation. During today's visit, LPA conducted interviews and file review. Additionally, LPA conducted a visit with R1 and interview did not reveal any licensing or regulatory concerns. File review of R1's records reveal that R1 was part of the independent living community of the facility. As the facility responded accordingly once notified of the incident and arranged for proper and prompt medical care, no violations were observed during today's visit and no deficiencies cited. An exit interview was conducted with Residential Administrator Richards to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Dec 22, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Case Management visit to follow up on an incident reported to Community Care Licensing. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Executive Director (ED) Stefanie Thune-Barnes and Health Services Administrator Brooke Patterson. Director of Residential Health Shila Jurado and Residential Administrator Tyre Richards joined later during the visit. Community Care Licensing received an Incident Report on 11/3/25 in which it was reported that on 10/31/25, a memory care Resident (identified as R1), was noted to have small sores behind their knee due to a below the knee splint from a prior injury. Resident was transported to the hospital where they were treated for the injury and the skin assessed. Per the report, R1 returned to the facility same day and that their prior leg injury was stable. R1's responsible party and primary care physician were notified. During today's visit, LPA conducted interviews and file review. Additionally, LPA conducted a visit with R1. Due to time constraints, LPA was unable to complete a determination regarding this case management visit, and additional visits may be necessary to complete review of this incident. At this time, LPA observed no health and/or safety concerns and no deficiencies were cited during today's visit. An exit interview was conducted with Residential Administrator Richards to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Dec 22, 2025

Allegation investigated: Provider made material misrepresentations to depositors, prospective residents, or residents of a continuing care retirement community via the information provided on their Disclosure Statement.

Staff Services Manager I (SSMI) contacted Brooke Harris, Administrator, via telephone on August 1, 2025, to deliver complaint findings over the phone, SSMI explained the purpose of the call. The California Continuing Care Contracts Bureau (CCCB) received a complaint on November 28, 2023, alleging that Casa de las Campanas (CDLC) violated Health and Safety Code (H&SC) section 1793.21(t) by materially misrepresenting its financial position in the Disclosure Statement provided to prospective residents. Specifically, the complaint claimed that CDLC consistently overstated its Operating Income on the form, misleading potential residents into believing the organization was in a stronger financial position than it actually was. The Disclosure Statement is a required document under H&SC section 1789.1, intended to provide an accurate and transparent financial overview to prospective residents. (Report continued on LIC 9099C) Unsubstantiated The complainant alleged that the Operating Income line item was inflated by including non-operating revenues, thereby violating H&SC section 1793.21(t). At the time of review, California Department of Social Services (CDSS) financial analyst, Jennifer Houston, contacted CDLC CEO Dave Johnson to understand how the Disclosure Statement figures were prepared. Mr. Johnson provided a reconciliation of the relevant line items used to calculate Operating Income. According to CDLC, the Operating Income figure included the following items from the Fiscal Year Ending (FYE) 2023 Audited Financial Statements: · Resident Revenue (excluding entrance fee amortization) · Investment and Dividend Income · Realized Gains from Investments · Gains and Support Upon review, these figures reconciled with the audited financial statements. One discrepancy was noted: CDLC reported $176,000 in contributions on the Disclosure Statement, compared to $340,000 reported in the audited financials. It is important to note that while the term “Operating Income” is not explicitly defined in the Continuing Care statutes, or under frameworks like Generally Accepted Accounting Principles (GAAP) or IRS guidelines, it is commonly understood to reflect income from core operational activities, typically excluding non-operating items such as investment gains and interest income. However, there is no statutory or regulatory provision that explicitly prohibits the inclusion of such items in the Disclosure Statement calculation. The FYE 2023 Audited Financial Statements and the reconciliations provided by CDLC align with the financial figures included in the Disclosure Statement. CDLC’s Consolidated Statement of Activities separates Revenue and Support from Other Support, and these figures correspond to those used in the Disclosure Statement. (Report Continued on LIC 9099C...) Per H&SC section 1789.1(2), the Disclosure Statement must include detailed financial information, including operating income (excluding amortization of entrance fees), operating expenses, net income from operations, interest expense, unrestricted contributions, and other specified data. The reviewed documentation supports that CDLC substantially complied with these requirements. Based on the documentation reviewed, including audited financial statements and reconciliations provided by the provider, the allegation that Casa de las Campanas materially misrepresented its financial position is unsubstantiated. Exit interview conducted. Copy of report sent to the Executive Director via e-mail to sign and return a copy to CCCB either by fax or email, a copy should be retained for facility records as well.the state’s words, verbatim · CDSS document, Aug 1, 2025 · control 08-AS-20231128124359

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to continue a Required Annual Inspection which began on 01/21/2025. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Director of Residential Health Shila Jurado. According to the facility’s license, the facility has a maximum capacity for five-hundred eighty-two (582) residents, of which two-hundred twenty-seven (227) may be non-ambulatory but none may be bedridden, and of which twenty (20) may be under hospice care. Per LPA observation, review of sampled LIC602 Physician’s Reports, facility records, and staff interviews: During this annual inspection, there were a total of four-hundred eighty-two (482) residents in care, of whom one-hundred nineteen (119) were non-ambulatory, and none were bedridden. Six (6) of the residents were under hospice care. The facility’s license included endorsement for use of delayed-egress doors in the facility’s dementia-care unit. During this inspection, LPA observed and tested the function of the two (2) delayed-egress doors, finding they were operational and consistent with regulatory requirements. LPA reviewed records for multiple residents and multiple staff. LPA interviewed multiple residents and multiple staff. LPA, accompanied by Licensee’s staff, also toured the interior and exterior of the facility, and inspected common areas and multiple resident rooms. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Multiple resident pendant, push-button, and pull-cord call devices were tested; all successfully transmitted signals to staff pagers/devices and were able to be reset. Doors, windows and screens, toilets, and showers were working. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility’s ambient internal temperature was complaint at 74 F. [CONTINUED ON LIC 809] [CONTINUED FROM LIC 809] Where tested, hot water temperature at taps accessible to residents were all compliant: Bedroom #1 Sink was 112.5 F, Bedroom #15 Sink was 113.4 F, Bedroom #17 Sink was 112.1 F, Bedroom #475 Sink was 111.2 F, Bedroom #482 Sink was 109.6 F, Bedroom #485 Sink was 111.6 F, and Bedroom #488 Sink was 112.1 F. Appliances to preserve perishable food were also all compliant in temperature: Main Kitchen Walk-In Refrigerators were 40 F or colder, and Main Kitchen Walk-In Freezers were 0 F or colder. Assisted Living, Memory Care, and Medication Room Refrigerators and Freezers were also complaint in temperature. There was at least two (2) days of perishable food, and at least seven (7) days non-perishable food present, all safely stored. Plenty of cooking and dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, active fireplaces, or open-faced heaters accessible to residents. Medications were labeled, as required, and stored in locked areas. Confidential records were stored in locked areas. The facility’s swimming pools were secured behind locked fences and gates, consistent with regulation. Per the Licensee, no firearms or ammunition are kept at the facility. Fire detection system, carbon monoxide detectors, nighttime lighting, emergency lighting, and facility telephone were all working. The facility’s fire extinguishers were serviced within the last twelve (12) months. Required licensing postings were observed in visible areas of the facility. Fire/disaster drills were performed at required intervals. There were reserve supplies of Personal Protective Equipment (PPE) and staff had been trained on PPE within the last twelve (12) months. Licensee presented proof of current business liability insurance. No deficiencies were cited during this annual inspection. However, LPA issued one (1) Technical Violation (TV) regarding adding three (3) more stairwell evacuation chairs (refer to the LIC9102-TA page); the facility presently has sixteen (16) of these chairs. An exit interview was conducted with Shila Jurado, to whom a copy of this report, the LIC9102-TV page, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.the state’s words, verbatim · CDSS document, Feb 13, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Director of Residential Health Shila Jurado. During today’s visit, LPA briefly toured the facility, reviewed staff records, and interviewed staff. No deficiencies were cited during today’s visit. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection. An exit interview was conducted with the Jurado, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Jan 21, 2025

Allegation investigated: Provider made material representation about accepted heathcare and changes to the Continuing Care Contracts that were not previously approved by residents or the Continuing Care Contracts Bureau

Complainant alleges that the Provider made material misrepresentation about accepted healthcare and changes were made to the Continuing Care Contracts that were not previously approved by residents or the Continuing Care Contracts Bureau. The Department interviewed complainant and Kim Dominy, Executive Director and reviewed the Continuing Care Contract, Quick Guide: Insurance for Health Center Stays and documentation that was provided to Casa residents regarding Medicare vs Medicare Advantage HMOs. The continuing care contract required residents to “enroll at your own expense in Medicare (Parts A and B)”. Furthermore, the contract states “If you choose HMO coverage rather than Medicare, Casa reserves the right to charge you market rates for any services you receive”. On September 22, 2023, Provider provided a Quick Guide which included a list of approved insurers and insurance companies that will no longer be contracted with Casa effective January 1, 2024. The document clarifying coverage does not constitute a change of the contract. Sections IV(F) and (J) of the Casa Contract provide that Casa de las Campanas is able to be paid for its services by Medicare or from a third party on similar terms and at the same rate, requiring residents to obtain Medicare Parts A and B or the equivalent. Thus the Casa Contract properly reserved for the provider the right to reject Medicare Advantage HMO type polices. Based on the review and investigation the Department finds the allegation “unsubstantiated”. Complaint finding were delivered telephonically and LIC 9099 was signed and emailed. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 7, 2024 · control 08-AS-20231115144424

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Amy Rodgers, made an unannounced visit to conduct the required One-Year Inspection to ensure substantial compliance with Title 22 regulations. LPA Rodgers was granted entry into the facility by Director of Residential Continuing Care Shila Jurado, identifying herself and stating the purpose of the inspection. This facility serves five hundred eighty-two (582) residents 60 and above; of which two hundred twenty seven (227) may be non-ambulatory. Twenty-seven (27) whom may be Dementia Residents in the delayed egress unit. Approved hospice waiver for twenty (20). A tour of the facility was conducted which included a sample of resident units, the dining area, recreation rooms, and food storage areas. This a muti-story, muti-unit complex with memory care on the ground level of the ‘Sur” building. Facility does feature delayed egress doors or a locked perimeter in the memory care unit. There are 3 pools on site, of which two are located outdoors. All pools on site are only accessible by key. Each resident had clean and sufficient bed linens. All residents’ rooms were equipped with required furnishings. Lighting was present in the bedrooms. Residents’ bathrooms were observed to be sanitary and operational. Toilets and showers were equipped with grab bars. Hot water temperature in residents’ bathrooms were compliant. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were in working order. LPA reviewed fire clearance inspections documents as well as inspections logs for generators. First aid bag(s) were complete and readily accessible in all the medical rooms. Required licensing postings were observed in visible areas of the facility. PPE supplies are on site. Passageways were free from obstructions. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] Facility has a two-day supply of perishable food and a seven-day supply of nonperishable food items. Emergency food supplies were kept in a underground garage locked storage area. Food supply is replenished frequently by outside vendors. Food was observed to be properly stored and labeled. The food service area was observed to be neat and clean. Food menus and activities schedule were posted. Chemicals and cleaning supplies were stored in a locked closed room not assessable to residents. Centrally stored medications were properly stored and locked in cabinets. Medication logs and medications reviewed were current and medications appear to be administered according to the label instructions. Staff records review verified that all staff records were complete and compliant. Resident records were reviewed and confirmed compliant. Administrator’s certification is current. LPA reviewed the theft and loss policy and procedures. LPA conducted a review of In-service training procedures. Transportation procedures are compliant. There is designated gym area and several large activity rooms as well as gathering areas throughout the facility. At the time of visit, LPA observed one large group activities in which many residents in the memory care unit were participating. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. No deficiencies were issued at the time of visit. An exit interview was conducted with Executive Director Kimberly Dominy to whom copies of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jan 11, 2024

Allegation investigated: Staff drinking while on duty

Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced complaint investigation to conduct additional interviews, and deliver complaint findings. The LPA introduced himself and disclosed the purpose of the visit to Administrator Brooke Harris. Throughout the investigation, the Department secured pertinent records and conducted interviews with internal and external sources. It was alleged staff were drinking while on duty. On 7/17/23, It was reported to the department that during a meeting, staff had consumed alcohol prior to returning to their regular duties. Interviews with internal sources revealed an additional incident where it was reported staff may have consumed alcohol. Additional interviews denied the consumption of alcohol while on duty, or did not corroborate staff had witnessed any staff had consumed any alcohol while on duty. Unsubstantiated Based on the evidence gathered, there was not a preponderance of evidence to prove the alleged violation occurred, therefore, the allegation was unsubstantiated. An exit interview was conducted with Harris, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058) were provided via electronic mail. An electronic mail read receipt confirms the documents were received by the administrator.the state’s words, verbatim · CDSS document, Nov 27, 2023 · control 08-AS-20230717163138