Damenik's Home

Type of visit: Case Management - Incident

On 5/28/2026, LPA Grace Donato conducted a Case Management-Incident visit in the facility. LPA met with Staff Benilda Briones and LPA spoke to Administrator Nicole Montilla on the phone. LPA explained the purpose of the visit. On 5/20/2026, facility sent an incident report to LPA regarding a resident (R1) being verbally abused by a staff (S1). LPA interviewed four residents. Three out of four residents mentioned that S1 always shouts at them whenever S1 goes into their room. R1 confirmed that S1 always shouts and calls him/her names. R4 wasn't able to provide any pertinent information due to neuro cognitive issues. Staff is no longer working in the facility. Based on interviews conducted, R1 confirmed what the report stated that S1 verbally abused him/her and two other residents also confirmed that they were being shouted at by S1. Deficiency is being cited today for California Code of Regulations, Title 22, Division 6, Chapter 8. See LIC 809-D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed and a copy of the report and Appeal Rights are provided.the state’s words, verbatim · CDSS document, May 28, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: May 29, 2026

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This was not met as evidenced by: Based on interviews, 3 out of 4 residents confirmed that S1 always shouts at them in the facility which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, May 28, 2026

Plan of correction: Licensee/Administrator has already conducted staff training for regarding Elder Abuse.

Type of visit: Required - 1 Year

On 2/19/2026 LPA Grace Donato conducted an unannounced annual visit to the facility. LPA met with Administrator Nikki Montilla and explained the purpose of the visit. LPA toured the facility inside and outside including a random sample of resident rooms, common areas, and kitchen area. LPA observed some residents were having breakfast in the dining room. While touring the facility it was observed that the temperature was at 69 deg F. Hot water was also tested and the temperature was at 110 deg F. The residents have adequate amount of linens and incontinence care items. All personal belongings are intact. Carbon monoxide monitor is working properly. All fire extinguishers have been checked and current. Resident bedrooms were observed to be in good repair. Bathrooms have grab bars and non-skid floors. There is adequate amount of food, 2 days for perishables and & 7 days non-perishable. Emergency drills are done quarterly. Five resident records and five staff records were reviewed. Resident records are updated, complete and signed. Staff records are complete, with training logs. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. LPA requested the LIC610E & LIC500 to be emailed. No deficiencies are cited at this time. Report is reviewed and a copy is provided.the state’s words, verbatim · CDSS document, Feb 19, 2026

Type of visit: Required - 1 Year

On 2/11/2025, Licensing Program Analyst (LPA) Grace Donato conducted an unannounced annual visit. LPA met with Assistant Administrator Nikki Montilla. LPA explained the purpose of today's visit. LPA toured the facility inside and outside including resident rooms, common areas, and kitchen area. Facility has 2 floors. Several residents were having bingo in the dining area. While touring the facility it was observed that the temperature was at 69 deg F. Hot water was also tested in the resident rooms and the temperature was 106 deg F. The residents have adequate amount of linens and incontinence care items. All personal belongings are intact. Facility has sprinkler system. All fire extinguishers have been checked and current. Resident bedrooms were observed to be in good repair and adequate lighting. Bathrooms are equipped with grab bars and non-skid floors. There is adequate amount of food, 2 days for perishables and & 7 days non-perishable. Emergency drills are logged and done every quarter. Five resident records and five staff records were reviewed. Resident records are updated, complete and signed. Staff records are complete, with training logs that have met the basic 20hr requirement. Facility has a certified administrator on site with complete certification and training requirements. Facility accepts hospice residents and are in compliance with the required waiver requirements. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. LPA requested the following documents: Liability Insurance, LIC308 & LIC500. No deficiencies are cited at this time. Report is reviewed with Administrator and a copy is provided.the state’s words, verbatim · CDSS document, Feb 11, 2025

Type of visit: Case Management - Incident

On 8/20/2024, Licensing Program Analyst (LPA) Grace Donato conducted a case management visit concerning an incident report received. LPA met with Assistant Administrators Matt Montilla & Nikki Montilla. LPA explained the purpose of today's visit. LPA visited due to the incident report received from the Ombudsman regarding a resident (R1) having fell twice in a span of 2 days, 8/14 & 8/16/2024, between 3am-5am. Both times are when the NOC shift staff is working on another resident. R1 has neuro-cognitive disorder and wandering tendencies. A floor alarm has been placed on 7/30/2024, R1 also has a body alarm. Facility has followed protocol regarding reporting requirements and what to do in cases of fall in the facility. The severity of the wandering behavior was not disclosed during pre appraisal. As of this report, facility has tried to follow up with the hospital regarding R1s well being but is not able to get any information. No citations issued today. Report is reviewed and copy is provided.the state’s words, verbatim · CDSS document, Aug 20, 2024

Allegation investigated: Resident was financially abused while in care Resident personal belongings are missing Staff did not treat resident with respect

On 4/15/2024, Licensing Program Analyst (LPA) Grace Donato conducted an unannounced complaint investigation visit. LPA met with Assitant Administrator Matthew Montilla and explained the purpose of today's visit. Regarding the allegation of Resident was financially abused while in care, Reporting Party (RP) stated that someone financially abused them at the facility by making purchases through Amazon, Uber Eats, and other platforms using their debit card. LPA interviewed three staff members. Two staff members (S1 & S2) mentioned that R1 has full control over their own finances and uses own phone to order. All staff stated that R1 likes to order from Amazon, Uber Eats & Doordash. Unfounded Regarding the allegation of resident personal belongings are missing, RP stated that many of their personal belongings are still missing, including jackets, shirts, electronics, a cell phone, a portable battery, a charger, cords, his driver’s license, a debit card, documents, and more. S1 mentioned that R1s belongings were picked up by family members. RP also stated that it was given to family members. LPA was able to interview one family member (F1) and it was confirmed that they were able to pick up R1s belongings that was already packed by the facility in storage boxes. These boxes were placed in R1s house. F1 also mentioned that the items that R1 were looking for were the ones they were wearing when an ambulance transported them to the hospital. It may or may not have been lost in transit when R1 was transported to a skilled nursing facility. Regarding the allegation of staff did not treat resident with respect, RP reported calling the facility and speaking to a staff member (S2) to inquire about missing personal belongings. However, S2 told the RP not to call the facility again. LPA interviewed S2 and stated that they said no words to R1. Based on interviews & records review the department has determined that that these allegations are false, could not have happened and/or is without a reasonable basis, therefore the allegations are UNFOUNDED. No deficiencies being cited today. Report is reviewed and copy is provided.the state’s words, verbatim · CDSS document, Apr 15, 2024 · control 14-AS-20240301133804

Type of visit: Required - 1 Year

On 1/24/24 LPA Grace Donato conducted an unannounced annual visit to the facility. LPA met with Assistant Administrator Matthew Montilla and explained the purpose of the visit. LPA toured the facility inside and outside including a random sample of resident rooms, common areas, and kitchen area. LPA observed some residents were watching TV in the living room. Another one having podiatry services. The rest of the residents are in their respective rooms resting. While touring the facility it was observed that the temperature was at 70 deg F. Hot water was also tested and the temperature was at 120 deg F. The residents have adequate amount of linens and incontinence care items. All personal belongings are intact. Carbon monoxide monitor is working properly. All fire extinguishers have been checked and current. Resident bedrooms were observed to be in good repair. Bathrooms have grab bars and non-skid floors. There is adequate amount of food, 2 days for perishables and & 7 days non-perishable. Emergency drills are done quarterly. Five resident records and five staff records were reviewed. Resident records are updated, complete and signed. Staff records are complete, with training logs that have met the basic 20hr requirement. Facility has a certified administrator on site with complete certification and training requirements. Facility accepts hospice residents and are in compliance with the required waiver requirements. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. LPA requested the Certificate of Liability Insurance to be emailed. No deficiencies are cited at this time. Report is reviewed and a copy is providedthe state’s words, verbatim · CDSS document, Jan 24, 2024