Loma Clara Senior Living

On 4/29/2025 LPA Grace Donato made an unannounced complaint investigation visit and deliver findings. LPA met with Executive Director (ED) Eugenia Smith. LPA explained the purpose of the visit. Regarding the allegation of Staff did not provide adequate supervision resulting in resident pushing another resident in care, reporting party (RP) stated that the resident (R1) was at the facility for just about a year and was forced out due to an incident that occurred on 8/9/2024. R1 pushed another resident (R2), and they fell. RP provided more information about the incident. RP shared that there was a first incident that happened between R1 & R2. RP was told by the staff that they couldn’t prove this happened where R1 went into R2s room and grabbed R2s arm. This is what RP was told. The MedTech’s said R1 was out the door already. page 1 of 3 UnsubstantiatedRead the full finding— CDSS inspection report, April 29, 2025 · control 26-AS-20240916090052

On April 17, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced complaint visit to deliver the findings for the above allegation. LPA met with Business Office Director, Cassandra Pace and explained the purpose of the visit. Regarding the allegation toxins are left accessible for the residents, according to the reporting party, there was sunscreen, razor blades, perfumes and shampoo left under the sink and inside the shower of a resident’s room. During the investigation, LPA observed 8 out of 10 resident apartments contained toxins and sharps that were accessible to residents. The toxins and sharps included items such as: hygiene products (shampoo, conditioner, soap, toothpaste), lotions, hair spray, perfumes, and electric razors. According to the Generations Director, these residents are not allowed to have access to hygiene items per their physician's report. The facility has been having issues with locking their cabinets due to the damaged locks. Based on oRead the full finding— CDSS inspection report, April 17, 2025 · control 26-AS-20220623122726

Licensing Program Analyst (LPA) Christine Kabariti arrived unannounced to deliver the findings for the above allegations. LPA met with Executive Director, Eugenia Smith. On 11/22/2022, the Department received the complaint. On 12/02/2022, the initial complaint investigation was conducted. The following documents were obtained to include facility's admission agreement, R1's physician's report, needs and services plan, medical notes, physician's order, progress notes, and safeguard of personal properties and valuables form. It was alleged that staff did not ensure that resident (R1)’s medical device (oxygen concentrator) was working properly. It was alleged that on 10/25/2022, R1’s concentrator was not putting out air. Page 1 of 4. UnsubstantiatedRead the full finding— CDSS inspection report, April 4, 2025 · control 26-AS-20221122103149

Licensing Program Analyst (LPA) Christine Kabariti arrived unannounced to deliver the findings regarding the above allegations. LPA met with Executive Director, Eugenia Smith. On 03/20/2025, the Department received the complaint. On 03/27/2025, the initial complaint investigation was conducted. The following documents were obtained to include: resident rosters, staff schedule from January – March 2025, resident (R1)’s physician’s reports, needs and services plan, medication administrator record from January – March 2025, med tech communication notes, progress notes from January – March 2025, medical records, physician communication records, outside agency documentation, and the private caregivers shift notes. Page 1 of 2. SubstantiatedRead the full finding— CDSS inspection report, April 4, 2025 · control 26-AS-20250320085458

Licensing Program Analyst (LPA) Christine Kabariti arrived unannounced to open the initial complaint investigation. LPA met with Business Office Director, Cassandra Pace. On 03/10/2025, the Department received the complaint. On 03/12/2025, the initial complaint investigation was conducted. The following documents were obtained to include: resident roster in Generations (aka memory care), staff schedule in Generations, resident (R1's) physician's report, services plan, progress notes from January - March, face sheet, and other medical correspondence. It was alleged that a facility staff had physically abused a resident (R1) by picking him/her up, carrying him/her, and putting him/her down causing R1 to have shoulder and hip pain. The alleged staff was described to be a tall male caregiver. Page 1 of 2. UnfoundedRead the full finding— CDSS inspection report, March 12, 2025 · control 26-AS-20250310163510

Licensing Program Analysts (LPAs) Christine Dolores and Marcella Tarin arrived unannounced to deliver the findings of the above allegations. LPAs met with Executive Director, Eugenia Smith. On 02/03/2022, the Department received the complaint. On 02/10/022, the initial complaint investigation was conducted. The following documents were obtained to include R1’s admission agreement, physician’s report, health care directive, POA documents, Trustee document, and correspondence. PAGE 1 OF 2. Unfounded— CDSS inspection report, September 5, 2024 · control 26-AS-20220203140916

Licensing Program Analysts (LPAs) Christine Dolores and Marcella Tarin arrived unannounced to open the initial complaint investigation. LPAs met with Executive Director, Eugenia Smith. On 08/26/2024, the Department received a complaint regarding the above allegations. On 09/05/2024, the initial complaint investigation was conducted. The following documents were obtained to include resident (R1)'s physican report, service plan, progress note, identification and emergency contact information, 2 staff statements, 1 staff member's contact information, and email correspondence. PAGE 1 OF 2. UnfoundedRead the full finding— CDSS inspection report, September 5, 2024 · control 26-AS-20240826104640

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to deliver the finding for the above allegation. LPA met with Interim Executive Director, Becca Black. On 01/23/2023, the Department received the complaint. On 02/01/2023, the initial complaint investigation was conducted. It was alleged R1’s rate increased from being provided a one-to-one companion after an unwitnessed fall, despite the disapproval from R1’s representative. From 02/01/2023 – 07/12/2023, documents were obtained to include resident (R1)’s admission agreement, physician’s report, service plan, care assessment, progress notes, invoice, and facility’s schedule of care fees. SEE LIC9099-C. UnsubstantiatedRead the full finding— CDSS inspection report, July 14, 2023 · control 26-AS-20230123104002

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to deliver the complaint findings for the above allegations. LPA met with Interim Executive Director, Becca Black. On 08/30/2022, the Department received a complaint regarding the above allegations. On 08/31/2022, the initial complaint investigation was conducted. Throughout the investigation, the following documents were obtained to include resident (R1)’s physician’s report, service plan, medical records, hospice records, death report, death certificate, progress notes, and staff schedule from June 2022 – August 2022. Based on record review, on 07/10/2022, resident (R1) tested positive for COVID-19. SEE LIC9099-C. SubstantiatedRead the full finding— CDSS inspection report, July 14, 2023 · control 26-AS-20220830100730

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to deliver the findings for the above allegations. LPA met with Executive Director (ED), Jairus “Jett” Cabuena. On 08/29/2022, the Department received the complaint and conducted the initial complaint investigation. From 08/29/2022 – 01/31/2023, the following documents were obtained to include R1’s residence and care agreement, progress notes, service agreement, care assessment, physician’s report, medical records, R2 – R4’s files, staff schedule and profiles, and resident list. On 08/24/2022, R1 sustained a witnessed fall resulting in hospitalization due to laceration and a fracture. It’s alleged the facility did not follow R1’s care plan by not providing a two-person assist. See LIC9099C. UnsubstantiatedRead the full finding— CDSS inspection report, February 1, 2023 · control 26-AS-20220829084324

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to open a complaint investigation. LPA met with Memory Care Director (MCD), Maria Martinez and Executive Director (ED), Jairus “Jett” Cabuena. During today’s visit, LPA toured the Memory Care section with MCD to include 10 out 25 resident apartments, bathrooms, activity room, 2 out of 2 stairwells, and exterior. LPA interviewed 3 staff members. Documents were obtained to include the generations roster, R1's residence and care assessment, physician reports, service plan, care assessment, progress notes, R2 - R3's physician's report, and facility's in-service training. See LIC9099-C. SubstantiatedRead the full finding— CDSS inspection report, February 1, 2023 · control 26-AS-20230123104002