Mission Villa Senior Living

On July 17, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced complaint visit to deliver the findings for the above allegations. LPA met with Administrator, Shayan Gheisar and explained the purpose of the visit. Regarding the allegation, staff did not provide adequate supervision resulting in resident sustaining multiple fractures, according to the reporting party, on 12/2/24, Resident 1 (R1) fell in his/her bedroom and sustained a skin tear on his/her elbow. On 12/4/24, it was observed that R1 was in pain and paramedics were called. The paramedics pointed out that R1’s leg was in a weird position and might have suffered a broken hip and leg. It was later revealed that R1 suffered pelvic fractures in three different places. During the investigation, the Department interviewed staff, reviewed R1’s file and reviewed medical records. According to R1’s service plan, it was indicated that R1 was a fall risk, required two-persons transfer, escort assistance and clRead the full finding— CDSS inspection report, July 17, 2025 · control 14-AS-20250121131044

On February 24, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced complaint visit to deliver the findings for the above allegations. LPA met with Administrator, Shayan Gheisar and explained the purpose of the visit. Regarding the allegation, Licensee did not issue a timely refund of advance fees as required, according to the reporting party, although all of Resident 1’s (R1’s) belongings were removed from the facility on 11/02/2024, the family still has not received a refund due of $2,094 for the full month fees paid up-front. During the investigation, LPA collected information and reviewed documents. Based on the admission agreement reviewed, it indicated “Within fifteen (15) days after your personal property is removed from your apartment, your estate, or other person or entity responsible for payment of fees under this Agreement, will receive a refund of any fees paid in advance covering the period after your personal property has been removed.” LPA obserRead the full finding— CDSS inspection report, February 24, 2025 · control 14-AS-20241210160828

On February 11, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted a visit to deliver a copy of amended LIC9099 and LIC9099A. LPA met with Resident Services Director, Mary Anne Rodriguez and explained the purpose of the visit. On February 11, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted a complaint visit to deliver the findings for the above allegation. LPA met with Resident Services Director, Mary Anne Rodriguez and explained the purpose of the visit. Regarding the allegation, Licensee is not ensuring that a comfortable temperature is maintained for resident(s) in care, according to the reporting party, windows are left open and the second floor gets very cold. During the investigation, LPA toured the first floor and second floor and observed all the windows closed, however according to the staff interviewed, the staff do open the windows on the first and second floor to eliminate odor. LPA observed thermostats on the first and second floor, however it waRead the full finding— CDSS inspection report, February 11, 2025 · control 14-AS-20250129113305

On January 9, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced complaint visit to deliver findings for the above allegation. LPA met with Resident Services Director, Mary Anne Rodriguez and explained the purpose of the visit. Regarding the allegation, staff did not ensure resident was adequately hydrated, according to the reporting party, on July 4th, 2024, Resident 1 (R1) was transported to Seton hospital and was admitted for dehydration and bladder infection. Based on medical documentations reviewed, it was found that R1 had a diagnosis of UTI and dehydration when admitted to the hospital. R1 was treated with multiple doses of IV fluid and clinically improved. Facility was unable to provide LPA any care notes to show that R1 was being adequately hydrated. Based on the investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. Deficiencies of the California Code of Regulations, Title, 22Read the full finding— CDSS inspection report, January 9, 2025 · control 14-AS-20240717162214

On Novemember 6, 2024, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced complaint visit to deliver findings for the above allegations. LPA met with Resident Services Director, Mary Anne Rodriguez and explained the purpose of the visit. Regarding the allegations received, due to a lack of supervision a resident had an unwitnessed fall resulting in a fractured hip, and staff did not seek timely medical care for a resident, according to the reporting party, on 4/8/24 at around 6:10am, Resident 1 (R1) was found sitting cross-legged on the bathroom floor. It was reported to the responsible party by med-tech that R1 had an unwitnessed fall, however, there were no injuries and R1 was able to stand and walk. Facility staff notified the responsible party that staff would observe R1 and notify the responsible party if there were any changes in condition or if hospitalization was required. Facility staff did not call and update the responsible party after the incident was rRead the full finding— CDSS inspection report, November 6, 2024 · control 14-AS-20240424121204

On 09/16/2024, Licensing Program Analyst (LPA) Jaime Vado made an unannounced subsequent complaint investigation visit. The purpose of this visit is to provide additional citations related to the already substantiated complaint allegations investigated on and findings were delivered on 08/20/2024. Upon further review, it was determined additional citations are needed in regards to the allegation findings delivered on 08/20/2024 where a citation was made and delivered on that date. It was found that the facility is responsible for the observation of the resident's change in food and water intake as well as the change in mental and physical changes as an indicator to health conditions discovered as a result of being sent to the emergency room. The resident lost weight while at the facility from 120lbs to 111lbs as well as was dehydrated as found during an emergency room visit made by the resident. Additionally there was a change in the resident's mental condition also found at the hospitRead the full finding— CDSS inspection report, September 16, 2024 · control 14-AS-20240514090937

*** This amended report was created in error. No changes are made to this report*** On 08/20/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to deliver findings regarding the complaint alletgations received. LPA met with business office manager Jovy Castro and explained the purpose of today's visit. During the investiation, LPA conducted interviews and reviewed documets pertinent to the investigation such as resident records and medical information. Per the medical documentation reviewed, the resident did lose weight during their time at the facility. Upon admission the weight is documented as 120lbs but after being weighed in a hospital setting the resident weighed 111lbs indicating the weight loss after approximately five weeks. Additionally, the resident was diagnosed with a condition while at the hospital which is a result of dehydration. Upon hospitalization the resident was provided fluids intravenously to aid in hyRead the full finding— CDSS inspection report, August 20, 2024 · control 14-AS-20240514090937

On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit to investigate further the allegations received and deliver findings. LPA met with administrator Karen Nickolai and explained the purpose of today's visit. During the course of the investigation LPA conducted interviews, reviewed documents, and made observations of the resident and their room. Resident appeared well kept, groomed, and their room is observed as in order. Toiletry items are provided based on resident evaluations and behaviors. Based on the investigation LPA could not prove or disprove if the allegations took place. These allegations are unsubstantiated. Based on these observations, the above allegations are UNSUBSTANTIATED. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are unsubstantiated at this time. Report is reviewed with KaRead the full finding— CDSS inspection report, December 12, 2023 · control 14-AS-20230503083207

On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to begin the investigation process regarding the received allegations. LPA met with administrator Karen Nickolai and explained the purpose of today's investigation. During the course of the investigation LPA conducted interviews with staff and made facility observations. LPA could not reach a preponderance of evidence standard to substantiate any of the allegations received as conflicting information, and one party's word over another, could not aid in the determination of any of the allegations. LPA was unable to confirm the merit of the received alletgations as LPA could not speak to the reporting party. These allegations are unsubstantiated. Based on these observations, the above allegations are UNSUBSTANTIATED. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, thereRead the full finding— CDSS inspection report, May 12, 2023 · control 14-AS-20221006165203

On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to investigate the allegation received. LPA met with the administrator and explained the purpose of today's visit. During today's visit LPA discussed the allegations and reviewed the number of possible residents with scabies as well as reviewed the facility's infection control policies. According to the reviewed items the facility is adhering to their policies at this time and scabies is not found to be wide spread through out the facility inidcating control practices are being followed. According to the administrator the facility has been reporting to public health regulalry and residents affected will have met the isolation and medication periods. This allegation is unsubstantiated. Based on these observations, the above allegations are UNSUBSTANTIATED. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the allegRead the full finding— CDSS inspection report, April 12, 2023 · control 14-AS-20230405162141

On this day, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit to deliver the findings regarding the above allegations. LPA met with the administrator Karen Nickolai and explained the purpose of today's visit. During the course of the investigation LPA conducted interviews and reviewed pertinent documents received regarding the allegations and the resident involved. LPA discovered that the facility did provide a refund to the responsible party. Illegal eviction did not occur as the facilty did not evict the resident at anytime. Lastly, there was an appraisal conducted prior to move-in of the resident that is on record. This agency has investigated the complaint alleging Staff did not conduct a preadmission appraisal for resident prior to move-in, Illegal eviction, and facility did not provide resident a refund in compliance with the admission agreement. We have found that the complaint was unfounded, meaning that the allegation was false,Read the full finding— CDSS inspection report, April 12, 2023 · control 14-AS-20210818145838