Rancho Vista Senior Living

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 neglect resulted in resident sustaining two head injuries Staff neglect resulted in resident sustaining multiple falls Staff did not assist resident with dental hygiene as needed Staff did not provide copy of written admission agreement to resident's responsible person at admission Staff retained a resident beyond their scope of care

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to the facility to conclude an investigation into the allegations listed above. LPA met with Beatrice and explained the purpose of the visit. Executive Director Diane Domingo was contacted by telephone. On March 15, 2024, Community Care Licensing received a complaint alleging neglect resulted in resident sustaining two head injuries and staff neglect resulted in resident sustaining multiple falls, staff did not assist resident with dental hygiene as needed, staff did not provide a copy of written admission agreement to resident’s responsible person at admission, staff retained a resident beyond their scope of care. LPA conducted interviews with Administrator, staff, and additional witnesses. LPA also conducted a review of pertinent documentation. LPA was unable to interview Resident #1 (R1) to obtain pertinent information due to R1 no longer living at the facility since February 28, 2024. R1’s spouse confirmed that R1the state’s words, verbatim · CDSS document, Jun 11, 2025 · control 18-AS-20240315160442

Allegation investigated: Lack of supervision resulted in resident sustaining an injury and hospitalization Lack of supervision resulted in resident left on the floor for an extended amount of time Staff did not ensure resident was provided fluids resulting in dehydration Staff did not give resident's medication as prescribed Staff did not ensure resident was nourished Staff did not assist resident with CPAP machine Resident did not have a call assistance button or a pendant Staff left resident in wet briefs for an extended period of time resulting in sores Facility’s screen door was in disrepair

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to the facility to conclude an investigation into the allegations listed above. LPA met with Diane Domingo and explained the purpose of the visit. On January 26, 2024, Community Care Licensing received a complaint alleging lack of supervision resulted in resident sustaining an injury and hospitalization and lack of supervision resulted for staff failing to seek timely medical, Staff did not ensure resident was provided fluids resulting in dehydration, staff did not give resident’s medication as prescribed, staff did not ensure resident was nourished, staff did not assist resident with CPAP machine, resident did have a call assistance button or pendant, staff left resident in wet briefs for an extended period of time resulting in sores, facility’s screen door was in disrepair. LPA conducted interviews with Administrator, staff, residents, and additional witnesses. LPA also conducted a review of pertinent documentation.the state’s words, verbatim · CDSS document, Jun 5, 2025 · control 18-AS-20240126104012

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: Facility does not have sufficient staff to meet the care needs of residents. Staff does not ensure facility has sufficient quantity of food for residents in care. Staff do not ensure proper sanitary practices are followed while providing bathing services to residents in care.

On 03/30/25 at 8:10 am Licensing Program Analyst (LPA) Villegas conducted an initial complaint visit regarding the allegation(s) above. LPA met with Executive Director Diane Domingo as the purpose of today’s visit was explained. The investigation consisted of the following: On 03/29/25 LPA Villegas obtained copies of the resident roster, list of residents that require bed baths, facility menus dated January 2025, February 2025, and March 2025, alternative menu, and requested copies of the following documents for resident #1 (R1) emergency ID form, physicians report dated: 10/3/23, physicians orders dated: 8/15/23, PRN authorization form dated 8/23/23, needs and service plan dated: 4/14/23. On 03/29/25 LPA conducted a tour of the facility kitchen and observed the lunch service from 11:15am- 12pm. On 03/29/25 between 1pm-3pm LPA conducted Interviews with staff #1-7 (S1-S7), and between 3pm-3:25pm LPA conducted interviews with resident# 1-5 (R1-5). On 03/29/25 LPA conducted a file reviewthe state’s words, verbatim · CDSS document, Mar 30, 2025 · control 18-AS-20240327103809

Allegation investigated: Staff yelled at another staff member in the presence of multiple residents. Staff made residents feel uncomfortable.

On 03/30/25 at 8:15 am Licensing Program Analyst (LPA) Villegas conducted a subsequent complaint visit regarding the allegation(s) above. LPA met with Executive Director Diane Domingo as the purpose of today’s visit was explained. The investigation consisted of the following: On 03/29/25 LPA Villegas obtained copies of the resident roster, and requested the following documents for resident #1 (R1): emergency ID form, physicians report dated: 4/6/23, physicians orders dated:8/15/23, PRN authorization letter dated: 8/22/23, preplacement appraisal dated: 11/8/22, needs and service plan dated: 12/7/23, resident assessment dated: 12/7/23, medication refusal notifications dated: 7/3/23, 7/9/23, 7/20/23, 7/30/23, 8/7/23, and documentation on increase/transfer/level of care dated 6/5/23. on 3/25/25 LPA conducted phone interview with R1, on 03/29/25 from 1pm-3pm LPA conducted Interviews with staff #1-7 (S1-S7), and between 3pm- 3:25pm LPA conducted interviews with resident # 2-5 (R2-R5). On 03/the state’s words, verbatim · CDSS document, Mar 30, 2025 · control 18-AS-20230727083953

Allegation investigated: Staff handles resident in a rough manner. Staff threatens resident. Staff does not treat resident with dignity and respect. Staff stole resident’s personal belongings.

On 3/30/2025 at approximately 8:15 AM, LPA Alfonso Iniguez conducted an unannounced subsequent complaint visit. At approximately 8:30 AM, LPA Iniguez met with Diane Domingo / Executive Director. LPA Iniguez explained the purpose of this visit. Investigation Consisted of: LPA obtained and reviewed the following documents: Personnel Report or LIC 500 dated: 3/18/25, (R#1)’s Physicians Report for Residential Care Facilities for the Elderly or LIC 602A dated: 10/3/24 and (R#1)’s, (R#1)’s Client/Resident Personal Property and Valuables or LIC 621 dated: 12/5/23, (R#1)’s Inventory List from hospital dated: 11/27/23, and facility staff training records regarding residents personal rights dated: 2024. Evaluation Report continues LIC 9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 30, 2025 · control 18-AS-20240708162702

Allegation investigated: Facility failed to provided a comfortable environment for resident.

On 03/20/25, Licensing Program Analyst (LPA) Antonine Richard conducted a subsequent unannounced complaint visit to the facility above. LPA met with Executive Director (ED) Diane Domingo and explained the purpose of today's visit. The investigation consisted of the following: On 03/29/25, at 8:30 am, LPA obtained copies of the resident roster and facility roster. On 03/29/25, between 1:00 pm and 2:00 pm, LPA interviewed five (5) residents #2, (R2-R6), and between 2 00 pm to 3: 30 pm, LPA interviewed six (6) staff, #1-6, (S1-S6), and (ED)Diane Domingo and other pertinent records associated with this complaint. On 03/30/25, at 8:30 am LPA, Richard reviewed and obtained the following documents for resident #1 (R1): Admission Agreement (dated 12/13/22), Physician report (dated 12/16/21), and Needs and Service Plan LIC625 (dated 01/19/21). LPA was unable to interview Resident #1 (R1), as R1 passed away on 04/18/2023. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 30, 2025 · control 18-AS-20230309130057

Allegation investigated: Facility does not provide meals in the quantity necessary for resident

/30/2025, at 8:15 am, Licensing Program Analyst (LPA) Antonine Richard conducted a subsequent unannounced complaint visit to the facility above. LPA met with the Executive Director, Diane Domingo, and explained the purpose of today's visit. The investigation consisted of the following: On 03/30/25, LPA obtained copies of the resident roster, staff roster, facility menus (dated January 2025, February 2025, and March 2025), and a copy of the alternative meal menu. On 03/29/25, between 11:00 am and 12:00 pm, LPA Richard toured the kitchen and observed lunch being served. On 03/29/25, between 1:00 pm and 2:00 pm, LPA interviewed five (5) residents #2 (R2- R6). Between 2:00 pm 3 and 30 pm, LPA interviewed six (6) staff, #1-6 (S1-S6), Executive Director Diane Domingo (ED), and other pertinent records associated with this complaint. On 03/30/25, LPA Richard reviewed and obtained copies of the following documents for Resident #1 (R1): Admission Agreement (dated 03/05/2023), Physician Report (dthe state’s words, verbatim · CDSS document, Mar 30, 2025 · control 18-AS-20231016150752

Allegation investigated: Insufficient staff resulting in staff not checking on residents

On 03/29/2025, the California Department of Social Services (CDSS) Community Care Community Care Licensing (CCL) Licensing Program Analyst (LPA) Socorro Leandro conducted an initial unannounced complaint visit. LPA Leandro met with Sales Director, Alma Chavez and the purpose of the visit was explained. LPA was granted entry to the facility. The investigation consisted of the following: On 01/30/2024, a facility tour was conducted. On 03/29/2025, a facility tour was conducted, records were reviewed, and interviews were conducted. The facility tour consisted of 8 resident rooms. Interviews conducted consisted of 7 staff interviews [Staff (S1) to Staff 7 (S7) were interviewed] and 8 resident interviews (R1 to R8 were interviewed). Facility records reviewed consisted of Rancho Vista Senior Living Census 2025 and Staff Schedule for February 2025, March 2025, and April 2025. Substantiatedthe state’s words, verbatim · CDSS document, Mar 29, 2025 · control 18-AS-20240123120244

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 do not meet resident's dietary needs Staff did not meet resident's toileting needs Staff did not answer resident's call button in a timely manner

On February 26, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility to deliver the allegation findings and met with Business Office Manager, Jhonalyn Libunao. On April 25, 2023, Community Care Licensing received a complaint alleging that staff are not meeting resident’s dietary and toileting needs and staff do not answer resident’s call button in a timely manner. During the investigation LPA conducted interviews, record reviews, and made observations. It was reported that staff left Resident #1 (R1) sitting on the toilet for 30 minutes or more. It was also reported that it takes facility staff an extended amount of time to answer call buttons. Concerns were also reported that R1 was being charged for a puree diet but was not receiving pureed foods. Unsubstantiatedthe state’s words, verbatim · CDSS document, Feb 26, 2025 · control 18-AS-20230425102920

Allegation investigated: - Facility did not allow resident to choose hospice service

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to deliver findings regarding the above-mentioned allegation. LPA identified herself and was granted entry by concierge Terri Park. LPA stated the purpose of the visit and reviewed the findings of the complaint with Angeles Frasier, Resident Service Coordinator. The Department’s investigation consisted of interviews with staff and outside sources, and records review of relevant documents pertinent to this investigation. On August 30, 2021, it was alleged that the facility denied resident from receiving hospice services of their choosing. It was alleged the resident's #1 (R1) hospice agency was denied access to see the resident by facility staff when they arrived to provide R1 with their initial services. During the initial visit on September 1, 2021, LPA spoke with the now-former Executive Director (ED), Karen Enciso, who informed LPA the resident did not have a hospice order on file and needed to verthe state’s words, verbatim · CDSS document, Feb 26, 2025 · control 08-AS-20210830151620

Allegation investigated: - Unlawful Eviction(s)

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to deliver findings regarding the above-mentioned allegation. LPA identified herself and was granted entry by concierge Terri Park. LPA stated the purpose of the visit and reviewed the findings of the complaint with Angeles Frasier, Resident Service Coordinator. The Department’s investigation consisted of interviews with staff and outside sources, and records review of relevant documents pertinent to this investigation. On February 15, 2022, it was alleged the facility unlawfully evicted resident(s). It was alleged resident #1 (R1) was unlawfully being evicted from the facility due to an underlying medical condition the facility was aware of and rendering services for. During the initial visit on February 17, 2022, LPA spoke with the Executive Director, Michael McCoy, who informed LPA the facility had sent the residents’ families a notice that was not meant to be served as an eviction. (Continuation othe state’s words, verbatim · CDSS document, Feb 26, 2025 · control 08-AS-20220215090659

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: - Licensee is not allowing resident access to telephone. - Licensee is not allowing resident to receive visitors.

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to deliver findings regarding the above-mentioned allegations. LPA identified herself and was granted entry by Executive Director Michael McCoy. LPA stated the purpose of the visit and reviewed the findings of the complaint with Memory Care Director Starsha Clark. The Department’s investigation consisted of interviews with staff and outside sources, records review of relevant documents pertinent to this investigation, and LPA observations. On August 12, 2021, it was alleged that the facility did not allow resident access to a telephone, and the facility did not allow resident to receive visitors. It was alleged that the facility did not allow the resident #1 (R1) to communicate with their visitors via telephone and did not make other attempts to contact R1 via facility telephone during this time. According to RP the resident was sleeping when they made the attempt to contact R1. (Continuation on LIC90the state’s words, verbatim · CDSS document, Mar 13, 2024 · control 08-AS-20210812164031

Allegation investigated: - Staff are not allowing resident to leave the facility.

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to deliver findings regarding the above-mentioned allegation. LPA identified herself and was granted entry by Executive Director Michael McCoy. LPA stated the purpose of the visit and reviewed the findings of the complaint with Executive Director Michael McCoy and Memory Care Director Starsha Clark. The Department’s investigation consisted of interviews with staff and outside sources, and records review of relevant documents pertinent to this investigation. On September 2, 2021, it was specifically alleged that the facility did not allow the resident to leave the facility to conduct his daily activities with them or other acquaintances. (Continuation on LIC9099-C) Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 13, 2024 · control 08-AS-20210902145842

Allegation investigated: - Facility staff neglected to assist residents with incontinence care - Facility staff neglected to keep residents room clean from odors

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to deliver findings regarding the above-mentioned allegations. LPA identified herself and was granted entry by Jonalyn Libunao, Business Office Manager. LPA stated the purpose of the visit and reviewed the findings of the complaint with Executive Director (ED) Michael McCoy,and Esmeralda Reyes, Resident Service Director (RSD). The Department’s investigation consisted of interviews with staff and outside sources, records review of relevant documents pertinent to this investigation. On November 25, 2020, it was alleged that the facility staff neglected to assist residents with incontinence care; and facility staff neglected to keep residents’ room free from odors. It was specifically alleged that resident #1 (R1) was not changed throughout the night and had dried fecal matter stuck to their skin. Interviews with former and current staff said that they did not have any issues with changing residents. Thethe state’s words, verbatim · CDSS document, Jan 31, 2024 · control 08-AS-20201125155602

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 do not ensure resident’s room is clean and sanitary Resident’s room is malodorous

Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced visit to the facility to initiate an investigation regarding the allegations listed above. LPA was granted entry and met with Memory Care Director Starsha Clark who was informed of the purpose for this visit. LPA toured the facility, reviewed records, conducted interviews, and took copies of pertinent information. Regarding the allegation "Staff do not ensure resident’s room is clean and sanitary” and "Resident’s room is malodorous", LPA conducted interviews with staff, residents, and Resident One (R1) that does not corroborate with the allegations. LPA’s initial walkthrough of the facility was conducted and revealed room #406, #409, #411, #412, and #416 and their attached bathrooms to be clean and in good repair. LPA's observations during the tour of the facility revealed the residents’ rooms are clean and organized, no observable dirty clothes on any of the floors, and there were no strong orders of any kind presethe state’s words, verbatim · CDSS document, Oct 26, 2023 · control 18-AS-20231025125859

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 neglected Resident resulting in worsening of pressure injury

On 9/18/2023, at about 12:05 PM, Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced visit to deliver investigative findings. After introducing and identifying himself, LPA was granted entry into the facility and met with Mike McCoy, Executive Director, to whom LPA disclosed the findings of the investigation. On 7/10/2020, it was reported to Community Care Licensing Division (CCLD) that neglect/lack of supervision for Resident 1 (R1) resulted in R1 being admitted to the hospital with an unstageable pressure injury. The Department’s investigation into the above-listed allegation consisted of review of facility and outside source records and interviews with staff and outside sources. Interviews with facility staff revealed that R1 was admitted to Pacific Senior Living-Vista on 05/13/19. On 05/08/19, R1 was assessed by a hospice agency. R1 was provided a Plan of Care and began receiving hospice services prior to moving into Pacifica Senior Living-Vista. Records indicate Rthe state’s words, verbatim · CDSS document, Sep 18, 2023 · control 08-AS-20200710144934