Manteca Rtrmt Com-Happy Lvng by Cogir/Cogir Mantec

Type of visit: Case Management - Other

LPA Johnson arrived at the care facility and met with Staff to conduct a case management visit into an incident report received on 08/10/2026. R1 On 07/30/2026 around 0800 resident was observed to have increased confusion, nonsensical speech, and visual hallucinations, 911 was called Medication technician, EMS arrived and transported resident to Doctors Hospital of Manteca ER for evaluation, she returned to the community a few hours later with a diagnosis of altered mental status, no new medications. This was reported to the department on 8/10/2026. From 6/11/2026 through 8/10/2026, R1 had five fall and as a result suffered closed head injuries, blunt head trauma, elbow contusion and skin tears. The facility conducted an assessment on 7/2/2026, however the facility did not identify that R1 as a fall risk. R1 continued to have falls and suffered three additional falls after the signed assessment on 7/2/2026. LPA was provided with an additional assessment/care plan date 7/2/2026, however it is not signed by any parties. On 8/17/2026 R1 was placed on Hospice. Continued Additional an incident report regarding R2 was received by the department on 8/24/2026. The incident happened on 08/14/2026 around 1100 resident was observed sitting in his recliner with excessive bleeding from his left forehead, he reported he had fallen and struck his head, direct pressure applied, 911 activated by Medication technician, EMS arrived and transported resident to San Joaquin General Hospital ER for evaluation, he returned to the community a few hours later with diagnoses of fall and facial laceration with sutures in place, no new medications. Per California Code of Regulations, Title 22 Division 6, Chapter 8, Deficiencies were observed during this visit. Exit interview heldthe state’s words, verbatim · CDSS document, Aug 26, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1) · Plan of correction due date: Sep 11, 2026

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement was not met as evidenced by records reviewed for R1 and R2's incidents were reported to the department outside of the seven days. This is a potential safety risk to residents in carethe state’s words, verbatim · CDSS document, Aug 26, 2026

Plan of correction: The facility will conduct an in service to address reporting requirement as outlined in the citation and provide a training log and sign-in sheets to LPA via email by POC date 9/11/2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR87464(f) · Plan of correction due date: Sep 11, 2026

87464 Basic Services: (f) Basic services shall at a minimum include:(1)Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidenced by records reviewed the facility did not identify that R1 was a fall risk and R1 suffered three falls after the signed assessment on 7/2/2026. This is a potential safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 26, 2026

Plan of correction: The facility will conduct an in service to address service plans as outlined in the citation and provide training log sign-in sheets to LPA via email by POC date 9/11/2026

Type of visit: Required - 1 Year

On 02/23/2026, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA Pascua met with Business Office Manager (BOM), Goshang Vang and explained the purpose of the visit. It was learned at this time that Facility Designated Administrator (FDA), James Hall was out of the office at this time and would meet LPA Pascua at a later time. At 2:45PM LPA Pascua was met by FDA James Hall. This facility is licensed to serve and retain 58 ambulatory residents and 26 non-ambulatory residents. This facility also has a dementia plan in file and a holds a hospice waiver for 10 residents. Current census was 51. A brief interview with FDA Hall was conducted. FDA Hall has a current and active administrator certificate #7014180740 and expires on 11/19/2027 LPA Pascua reviewed 5 staff files. 5 out 5 staff files were complete and up to date. LPA Pascua reviewed 6 resident files. It was observed that 1 out 6 residents did have an updated care plan, however, review of this resident's medical assessment showed that the resident's needs were not properly identified as assessed by the facility. Technical Assistance was provided regarding Dementia Regulations, resident assessments, and best practices regarding these topics. A brief tour of the facility was conducted. Due to insufficient time to review additional files. The department will come at a later date to complete the annual visit. The following forms were obtained during this visit: LIC308, LIC400, LIC 500, and LIC610E. There were no deficiencies observed or cited during today's annual visit. An Exit Interview was conducted and a copy of this report was provided to the administrator at the end of this visit.the state’s words, verbatim · CDSS document, Feb 23, 2026

Allegation investigated: Staff do not ensure the facility is properly maintained Staff do not provide adequate food service Staff do not ensure that calls from resident's representative are answered

Unannounced complaint visit made out to this facility on 12/24/2025 by Licensing Program Analyst, LPA, Charlie Yang who was met by the facility designated Administrator James Hall. A brief interview was conducted with the facility designated Administrator at this time. Current census was 71 residents. The purpose of this visit was to inform this facility, and it's representative, about the findings to this complaint investigation. Based on interviews conducted during this investigation, it was learned that the memory care unit was short on bowels, silverware, and cups on a regular basis. It was learned that memory care staff had to wash the dishes while trying to serve the meals to the residents so that adequate plates and bowels were sufficient to serve the meals property to the residents in care. It was learned that paper products for bowels and plates had to be retrieved from the Assisted Living portion of this facility so that the meals could be served to the residents in the memory care unit. It was learned that this has been taking place for a while and the memory care unit is constantly short on plates, bowels, and Substantiated necessary silverware. Based on interviews conducted during this investigation, it was learned that there were two primary phones being used in the memory care unit at this time. It was learned that one land line was located in the medication room and the other was in the office for the Activities Director. It was learned that there was not a direct line to the memory care unit and all calls were forwarded over from the front desk in the Assisted Living side. It was learned that memory care staff did not have direct access to the phone lines in the medication room and office of the Activities Director. It was learned that memory care staff only carried a mobile device used to communicate and receive notifications from the front desk. They were not tasked to answer or return calls from this land line in the medication room. It was learned that the medication technician only had access to the phone placed in the medication room but had other tasks and duties related to handling, dispensing, and documentation of the resident medications that took priority while on duty. It was learned that, if time permitted, the medication technician would be able to return any missed calls and voice mails at a later time during their shift. It was learned that the only other land line for the Activities Director was only accessible to this particular individual in their office. Memory care caregivers and medication technicians did not have access to receive, retrieve, or return any phone calls at this time from this particular office land line. Based on a review conducted for a physical plant review, it was observed that there were (4) individual doors located throughout this facility which had a press pad which could be used to activate and open the doors automatically leading out into the courtyard at this time. It was observed that the only door that was functioning when the press pad was activated was the door directly outside of the Assisted Living dining room. The interior pad and exterior pad, when activated, did automatically open the door at this time. It was observed that north facing door with its press pad, when activated, did automatically open the door but only functioned properly when activated from the interior. It was observed that the exterior pad was not functioning at this time when activated to automatically open up the door. It was observed that the fireside room exit door, with its interior press pad, was not functioning at this time. It was observed that the exterior press pad for the exterior door leading into the bistro area was also not functioning at this time as well. As a result of this investigation, this LPA found the allegations to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegations were valid because the preponderance of the evidence standard had been met. The following deficiencies were observed and cited on the following LIC 9099-D pursuant to Title 22 Rules and Regulations, Division 6 and Health and Safety Codes. Appeal rights were printed and a copy was left with the facility designated Administrator at this time. Exit Interviewthe state’s words, verbatim · CDSS document, Dec 24, 2025 · control 27-AS-20251203112533

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Dec 31, 2025

Maintenance and Operation The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This facility was found to be deficient as evidenced by the observation of (3) out of (4) doors leading out of this facility were not functioning properly when their press pads were activated. The doors did not automatically open when the press pads were activated posing a potential threat to the Health, Safety, and Personal Rights of all residents in care.the state’s words, verbatim · CDSS document, Dec 24, 2025

Plan of correction: The facility designated Administrator stated that all four doors will be reviewed and any found to not be functioning will be repaired/replaced as necessary to ensure proper access to/from the interior and exterior for all residents at all times. A statement of correction, along with receipts of all updated work performed for the doors, will be completed and submitted into CCL by the due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(b)(33) · Plan of correction due date: Dec 31, 2025

General Food Service Requirements Tableware and tables, dishes, and utensils shall be sufficient in quantity to serve the residents. This facility was found to be deficient as evidenced by the use of paper products for dishes and utensils in the memory care unit which posed a potential threat to the Health, Safety, and Personal Rights of all residents in care.the state’s words, verbatim · CDSS document, Dec 24, 2025

Plan of correction: The facility designated Administrator stated that the dishes, utensils, and kitchen supplies for the memory care unit will be reviewed to make sure that they are plentiful and able to meet the needs of the facility residents at all times. A statement of correction, along with copies of all updated supplies ordered for the memory care unit, will be completed and submitted into CCL by the due date.

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.313 · Plan of correction due date: Dec 31, 2025

The facility’s policy concerning family visits and communication shall be designed to encourage regular family involvement with the resident client and shall provide ample opportunities for family participation in activities at the facility. This facility was found to be deficient as evidenced by multiple phone calls and voicemails not being returned in a timely manner which posed a potential threat to the Health, Safety, and Personal Rights of all residents in care.the state’s words, verbatim · CDSS document, Dec 24, 2025

Plan of correction: The facility designated Administrator stated that the communication policy for the memory care unit will be addressed to better deal with communication coming into this unit. A statement of correction, along with updated communication plans for the memory care unit, will be completed and submitted into CCL by the due date.

Allegation investigated: Staff do not keep the facility free from infestation Staff are not following proper food handling techniques

Unannounced complaint visit made out to this facility on 12/24/2025 by Licensing Program Analyst, LPA, Charlie Yang who was met by the facility designated Administrator James Hall. A brief interview was conducted with the facility designated Administrator at this time. Current census was 71 residents. The purpose of this visit was to inform this facility, and it's representative, about the findings to this complaint investigation. Based on forms and documents gathered and reviewed during this investigation, it was learned that there were issues identified with holes and entry points being present in the kitchen area which allowed access points for pests to be able to enter into this area. It was learned that this facility was ordered to fix and repair these access points in the kitchen area in order to deny access and possibly eliminate the presence of possible pests. Based on forms and documents gathered and reviewed during this investigation, it was learned that there were issues identified with how this facility, and its staff, were handling and storing food products. Substantiated It was learned that due to the presence of rodent droppings in the facility food storage areas, several food products were improperly being stored together. In addition, food items were improperly being stored on the refrigerator/freezer floors. As a result of this investigation, this LPA found the allegations to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegations were valid because the preponderance of the evidence standard had been met. The following deficiencies were observed and cited on the following LIC 9099-D pursuant to Title 22 Rules and Regulations, Division 6 and Health and Safety Codes. Appeal rights were printed and a copy was left with the facility designated Administrator at this time. Exit Interviewthe state’s words, verbatim · CDSS document, Dec 24, 2025 · control 27-AS-20251217131604

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87555(b)(9) · Plan of correction due date: Dec 29, 2025

General Food Service Requirements Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service. This facility was found to be deficient as evidenced by the presence of food items being stored on the floors of the facility refrigerator and freezer floors which posed an immediate threat to the Health, Safety, and Personal Rights of the residents in care.the state’s words, verbatim · CDSS document, Dec 24, 2025

Plan of correction: The facility designated Administrator stated that all food items will always be stored in a proper manner at all times. A statement of correction, along with updated photos of the facility refrigerator/freezer floors will be captured, completed and submitted into CCL by the due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87555(b)(27) · Plan of correction due date: Dec 29, 2025

General Food Service Requirements All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. This facility was found to be deficient as evidenced by the presence of holes around the sink areas in the kitchen area posing a immediate threat to the Health, Safety, and Personal Rights of the residents in care.the state’s words, verbatim · CDSS document, Dec 24, 2025

Plan of correction: The facility designated Administrator stated that all holes in the kitchen area will be repaired/replaced to remove them all in order to prevent access to potential pests and vermin from entering into this facility. A statement of correction, along with receipts of contracted work, will be completed and submitted into CCL by the due date.

Type of visit: POC

Unannounced Plan of Correction visit made out to this facility on 04/02/2025 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility designated Administrator James Hall. A brief interview was conducted with the facility designated Administrator at this time. Current census was 53 residents. The purpose of this visit was to follow up on the deficiencies that were cited from a prior annual visit conducted on 02/20/2025 and to follow up on the Plan of Correction. The following deficiencies were observed and cited on 02/20/2025: The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This facility did complete the Plan of Correction and provided all of the required forms and documents at this time. Plan of Correction clearance letters were printed and copies were provided to the facility designated Administrator at this time. There were no further deficiencies observed or cited during today's Plan of Correction visit. Exit Interviewthe state’s words, verbatim · CDSS document, Apr 2, 2025

Type of visit: Required - 1 Year

Unannounced annual visit made out to this facility on 02/20/2025 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility designated Administrator, James Hall, who was briefly interviewed at this time. It was learned that there were (4) residents under the care of hospice at this time. This facility does have an approved waiver to be able to accept and retain up to (10) residents at any given time. It was learned that there were (14) residents diagnosed with dementia at this time. This facility does have an approved program to be able to accept and retain residents diagnosed with dementia at any given time. This facility does have a memory care unit on site at this time. Current census was 54 residents for both the Assisted Living and Memory Care portions of this entire facility. Tour of the facility was conducted. A tour of the facility kitchen area was conducted. Food storage units, refrigerator and freezer, were toured. It was observed that there was a sufficient supply of 2-day perishable food quantities available on site to meet the requirements at this time. Pantry area was toured. It was observed that there was a sufficient supply of 7-day nonperishable food quantities available on site to meet the requirements at this time. A sample review was conducted for the facility resident bedrooms at this time. It was observed that furniture and furnishings were observed to be functional and maintained in compliance at this time. A sample review was conducted for the facility resident restrooms at this time. Hot water temperatures were taken to make sure that they measured within the allowed range of 105-120 degrees at all times. Grab bars and non skid surfaces were observed to be present and maintained in compliance at this time. Living areas, dining areas, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Laundry rooms, located throughout several wings of this facility on the first floor, were toured. They were observed to be unlocked but did not house any detergents, bleach, or cleaning supplies at this time. Rooms designated as supply rooms, storage rooms, and equipment rooms were observed to be locked and made inaccessible to the residents at this time. Exercise room was toured. Equipment and supplies were observed to be sufficient and able to meet the needs of the residents at this time. Medication room was toured alongside the facility nurse, Karen Silva, at this time. Policies and procedures in regards to the handling, dispensing, and documentation of the resident medications were discussed with her at this time. This facility utilized mobile medication carts that were pushed out into the facility when it was time to dispense the medications to the residents. It was learned that this facility employed an E-MAR system as well as documented paperwork for the facility resident medications at this time. First aid kit, located in the medication room, was observed to contain all of the required components at this time. Fire extinguishers, located throughout this facility, were observed to have been annually inspected by the local fire extinguisher company, Johnson Controls, on 02/27/2024 and found to be in compliance at this time. A tour of the facility exterior grounds was conducted. A review of the perimeter fence, side gates, and all other exits was conducted at this time. A review of (7) facility resident files was conducted and noted on the following LIC 858. A review of (7) facility personnel files was conducted and noted on the following LIC 859. The following forms and documents were requested by this LPA to be updated and submitted into CCL: LIC 308 LIC 400 LIC 500 LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Codes. Appeal rights were printed and a copy was given to the facility designated Administrator at this time. Exit Interviewthe state’s words, verbatim · CDSS document, Feb 20, 2025

Allegation investigated: Residents needs are not being met due to a lack of staff.

On 02-07-25, Licensing Program Analyst (LPA) Kesha Lewis arrived unannounced to interview residents of the facility. LPA met with interim administrator James Hall and explained the purpose of the visit. LPA Lewis interviwed Residents R1-R5. LPA was informed facility has added rolls to support residents. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, nothe state’s words, verbatim · CDSS document, Feb 7, 2025 · control 27-AS-20241021161128

Allegation investigated: Residents needs are not being met due to a lack of staff.

On 12-04-24, Licensing Program Analyst (LPA) kesha Lewis arrived unannounced to deliver findings for the allegations above. LPA met with interim administrator Davina Barker and explained the purpose of the visit. Based on records reviewed and interviews with staff the above allegation is found to be unsubstantiated. Records show at least one (1) med tech and three (3) care staff each day on all shifts. There is not sufficient evidence to prove with a preponderance that the above allegation is valid and therefore, the allegation is determined to be UNSUBSTANTIATED. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, nothe state’s words, verbatim · CDSS document, Dec 4, 2024 · control 27-AS-20241021161128

Type of visit: POC

Unannounced Plan of Correction visit made out to this facility 04/18/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator Sheryl Bravo and briefly interviewed at this time. Current census was 74 residents. The purpose of this visit was to follow up on the most recent deficiencies that were observed and cited on the last annual visit conducted on 02/28/2024: All window screens shall be clean and maintained in good repair. In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident's dementia care needs. (A) When any medical assessment, appraisal, or observation indicates that the resident's dementia care needs have changed, corresponding changes shall be made in the care and supervision provided to that resident. Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. Proof of corrections were mailed into CCL for review by this LPA. Plan of correction letters were printed and copies were given to the facility designated Administrator at this time. There were no deficiencies observed or cited during today's Plan of Correction visit. Exit Interviewthe state’s words, verbatim · CDSS document, Apr 18, 2024

Type of visit: Case Management - Incident

Unannounced Case Management visit made out to this facility 04/18/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator Sheryl Bravo and briefly interviewed at this time. Current census was 74 residents. The purpose of this visit was to follow up on the most recent Special Incident Reports (SIRs) submitted from this facility in regards to resident care and supervision. A review of the SIRs submitted was conducted in regards to multiple falls and frequency of falls with the facility designated Administrator at this time. There were no deficiencies observed or cited during today's case management visit. Exit Interviewthe state’s words, verbatim · CDSS document, Apr 18, 2024

Type of visit: Required - 1 Year

Unannounced annual visit made out to this facility on 02/28/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated representative Karen Riggs who was briefly interviewed. It was learned that there were residents under the care of hospice at this time while other residents were receiving services through home health as well. This facility does have a hospice waiver approved for (10) residents of which there are (4) present at this time. It was learned that there weren't any residents deemed to be bedridden at this time. Current census was 52 residents. A tour of this facility was conducted at this time. Administrator certificate was observed to be present and in compliance at this time for facility designated Administrator Sheryl Bravo. Kitchen area was toured. Cabinets and drawers were reviewed. Food preparation stations, dishwashing station, and other areas intended for meal preps were toured. Food supply was reviewed for adequate 2-day perishable and 7-day nonperishable quantities at this time. This LPA did observe additional food storage units which were present and functional at this time. A tour of the dining area, living area, and all other areas intended for resident use was conducted. Medication rooms, located on each floor, were reviewed. Policies and procedures involving dispensing, documenting, and overall administration of resident medications were discussed with the facility designated medication technicians at this time. The medication carts were observed to be locked and made inaccessible to the residents at this time. A tour of the resident bedrooms and restroom was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. It was learned that there were several different floor plans for residents on the Assisted Living portion of this facility. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees. Linen closet, located in the facility laundry area, was observed to contain a sufficient supply of towels, blankets, and linens to meet the needs of the residents at this time. A tour of the Memory Care portion was conducted. Fire extinguishers, located throughout this facility, were observed to have been annually inspected on 02/27/2024 by the local fire extinguisher company, Johnson Controls, and in compliance at this time. First aid kits were observed to be present and contained all of the required components at this time. Exterior grounds of this facility were toured. A review of the facility perimeter fence, side gates, and exits was conducted. A review of (6) facility resident files was conducted and noted on the following LIC 858. A review of (6) facility personnel files was conducted and noted on the following LIC 859. The following forms and documents were requested to be updated and submitted into CCL: LIC 308 LIC 400 LIC 500 LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Codes. Appeal Rights were printed and a copy was given to the facility designated representative at this time. Exit Interviewthe state’s words, verbatim · CDSS document, Feb 28, 2024