Hillsdale Senior Living

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Annual Continuation inspection from 08/17/2026. LPA met with Administrators, Janet Nowicki and Mary Ann Trinidad and stated the purpose of today's visit. LPA observed 4 staff and 6 residents at the facility. Fire extinguisher was observed and inspected on 03/10/2026. Facility smoke detectors and carbon monoxide detectors were in working condition. The last disaster drills were conducted on 5/20/2026 and 1/27/2026. LPA Rai observed a complete first aid kit at the facility. LPA Rai reviewed facility records for 2 staff and 2 residents. LPA Rai reviewed resident medications and central stored medication records. During visit on 08/17/2026, LPA Rai observed a locked storage area in the garage. The door was shut and Administrators, Janet Nowicki and Mary Ann Trinidad stated the area was used for storage area and not habitual space. Administrators opened the door for LPA Rai. LPA Rai observed a cardboard box covering the inside of the storage area and as LPA moved the cardboard box, LPA Rai observed a person sleeping in the storage area with a pillow and blankets. LPA Rai observed personal items as well as prescribed medications in the storage area. Administrators were surprised to see staff (S1) using the storage space to sleep where there is a staff room in the facility. Administrators stated they will ensure the storage room is not being used as a habitual space and they will ensure the staff room will be used instead. During today's visit, LPA Rai observed personal items removed from the room and storage boxes replaced the pillow and blanket. Administrator stated they trained the staff to ensure the storage space was not habitual space. Continuation on LIC 809-C, Page 1 of 2. Page 2 of 2. On 08/17/2026, LPA Rai observed the fridge in the kitchen. LPA Rai observed medication #1 in the sectional in the fridge door which was accessible to residents and staff. Administrators stated the insulin pen belong to a resident (R1) and needed to be refrigerated. Administrators placed the medication #1 in a bag and closed it with a band, making it inaccessible to residents in care. Administrators stated the staff would be able to access the medication when it was time to administer the medication to the resident. During today's visit, LPA Rai observed medication #1 in the fridge located in the garage which was inaccessible to residents in care as the door to the garage was locked. Administrators stated they trained the staff to ensure medication #1 was inaccessible to residents in care. Deficiencies were cited per California Code of Regulations, Title 22, please see LIC 809-D. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report was reviewed with Administrators, Janet Nowicki and Mary Ann Trinidad and a copy of the report was provided. Appeal Rights were provided. LIC 858 and LIC 859 were provided.the state’s words, verbatim · CDSS document, Aug 24, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a) · Plan of correction due date: Aug 25, 2026

87202 Fire Clearance (a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. This requirement was not met as evidenced by: Based on observation, LPA Rai observed the storage space int he garage used as habitual space wherein staff (S1) was sleeping in the storage space with a pillow and blanket which pose(s)/posed an immediate health, safety and Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 24, 2026

Plan of correction: Administrator stated to submit a written plan of action understanding regulations and training staff to ensure they follow the approved fire clearance wherein storage area is not used as habitual space by POC due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87465(h)(2) · Plan of correction due date: Aug 25, 2026

87465 Incidental Medical and Dental Care (h) (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. Based on observation, LPA Rai observed resident R1's medication #1 was in the fridge and accessible to persons in care which pose(s)/posed an immediate health, safety and Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 24, 2026

Plan of correction: Administrator stated to submit a written plan of action understanding regulations and training staff to ensure centrally stored medications are not accessible to residents by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit. LPA Rai met with Administrators, Janet Nowicki and Mary Ann Trinidad and stated the purpose of today's visit. LPA Rai observed 2 staff and 6 residents at the facility. During visit, LPA Rai toured the inside and outside of the facility. When touring the outside area of the facility, the exits were cleared of obstruction. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply areas and secured areas for cleaning supplies and laundry detergents. LPA Rai toured the facility to include 5 resident rooms, 1 staff room, living room, dining room, kitchen and garage. 5 Out of 5 resident bedrooms had available bedding, drawers, and functioning lights. The facility bathroom had available soap, paper towels, and trash cans with lids. The hot water temperature in the bathroom sinks ranged from 119.5- 120.0 degrees F. This annual inspection will be completed at a later date. This report was reviewed with Administrator, Janet Nowicki and Mary Ann Trinidad a copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 17, 2026

Allegation investigated: Staff member consumes alcohol during work hours, impairing their ability to provide adequate care and supervision, which presents a risk to residents in care.

Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegation. LPA met with Administrator Mary Ann Trinidad On April 2, 2026, the Department received a complaint alleging Staff member consumes alcohol during work hours, impairing their ability to provide adequate care and supervision, which presents a risk to residents in care. On April 3 & 6, 2026, the Department interviewed Witness W1. W1 stated the staff member who allowed drinking events at the facility was the Administrator Mary Ann. W1 stated the ADM will invite staff over to come drink at the care home for events such as a care givers birthday party. LPA asked W1 if the staff members, including ADM Marry Ann, were drinking and also providing care to residents. W1 stated the staff who were drinking were not providing care. Page 1 Out of 3. Unsubstantiated On April 6, 2026, Licensing Program Analyst Manuel Monter interviewed residents R1-R4. 3 Out of 4 residents (R1-R3), stated they haven’t seen any of the staff drinking (alcohol) in the facility. 3 Out of 4 residents (R1-R3), stated they have not seen any of the staff under the influence/drunk/intoxicated. 3 Out of 4 residents (R1-R3), stated they have never seen any of the staff under the influence/drunk/intoxicated providing care to residents. LPA interviewed resident R4. R4 did not respond to questions posed by LPA and did not provide any relevant information regarding the regulations. On April 6, 2026, Licensing Program Analyst Manuel Monter interviewed Staff S1-S3. S1 and S2 stated they have observed staff, including the administrator drinking at the facility. S3 stated he/she has never observed staff drinking alcohol at the facility. S1-S3 stated they have never seen any of the other staff under the influence / drunk / hungover. S1-S3 stated they have never seen any of the other staff under the influence / drunk / hungover and providing care. On April 6, 2026, Licensing Program Analyst Manuel Monter interviewed Administrator Mary Ann. ADM stated there have been times when the care staff at the home might drink a glass of wine during their time off, inside the staff room. ADM stated they might also drink a glass of wine in the back yard, away from the residents. ADM stated the staff, even herself might have a glass of wine, but they have never done so when they are on the clock. ADM stated there is always staff scheduled, providing care, who do not drink. On April 17, 2026, Licensing Program Analyst Manuel Monter interviewed staff S4. S4 stated he/she isn’t aware of any instance were staff were under the influence and providing care. S4 stated he isn’t aware of any instance where the ADM was drinking / under the influence and providing care to residents. S4 stated he/she is new and doesn’t know or has no knowledge regarding staff drinking. On April 17, 2026, Licensing Program Analyst Manuel Monter interviewed resident R5. R5 did not respond to questions posed by LPA and did not provide any relevant information regarding the regulations. On April 17, 2026, Licensing Program Analyst Manuel Monter interviewed Licensee Irish Ladwig, referred to as LN. LN stated there hasn't been any instance where a staff member was providing care, was also under the influence. Page 2 Out of 3. On April 24 and May 4, 2026, Licensing Program Analyst Manuel Monter interviewed staff S5-S6. S5 and S6 stated there has been many instances where staff were drinking at the facility. S5 and S6 stated they have never seen staff members who were drinking and providing care. The Department reviewed the facility’s policy update, dated April 8, 2026, subject regarding: Strict Policy on Noise, Parties, Alcohol and smoking. The policy stated effective immediately, the following policies must be observed by all staff: No parties or loud activities: such as parties, gathering, karaoke- noting loud music or noise may disturb residents, families or neighbors. Alcohol consumption is prohibited inside the facility, whether on duty or off duty. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. Page 3 Out of 3. End of Report.the state’s words, verbatim · CDSS document, May 7, 2026 · control 26-AS-20260402115440

Type of visit: Required - 1 Year

On 8/27/2025, LPA Grace Donato made an unannounced annual visit to the facility. LPA met with Administrator Mary Ann Trinidad and explained the purpose of the visit. LPA toured the facility inside and outside including resident rooms, backyard and garage area. LPA observed residents watching TV in the living room. While touring the facility it was observed that the temperature was at 75 deg F. Hot water was also tested in the resident rooms and the temperature was 107 deg F. All fire extinguishers have been checked and current. Resident bedrooms and bathrooms were observed to be in good repair 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. Three resident records and three 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. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. LPA received the LIC500 and Liability Insurance. No deficiencies are cited at this time. Report is reviewed and a copy is provided.the state’s words, verbatim · CDSS document, Aug 27, 2025

Allegation investigated: Facility not following care plan. Facility not serving quality food. Resident's needs are not being met. Not enough activities provided for residents.

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced visit to conclude the complaint investigation. LPA Rai met with Licensee, Irish Ladwig and stated the purpose of the visit. On 4/29/2022, the Department received a complaint with the above allegations. On 5/6/2022, the Department conducted the initial investigation. On 8/29/2022, the Department continued their investigation. Coninutation on LIC 9099-C, Page 1 of 4. Unsubstantiated Page 2 of 4. Facility not following care plan/ Resident’s needs are not being met. It was alleged that R1 is bedridden, and the staff do not come in a check on the resident to reposition R1. It was alleged R1 needs pillow to support his/her back based on Physical Therapy’s recommendation but staff forget to place a pillow on R1’s back. On 5/6/2022, the Department interviewed Administrator (ADM), Licensee and staff S1. 3 Out of 3 staff stated the facility follows the R1's care plan and they try their best to meet the resident’s needs. 3 Out of 3 staff stated they check on R1 and reposition R1. Based on record review of R1’s Appraisal/Needs and Services Plan dated 8/9/2021, the facility will “perform regular intentional rounding to assess need for position change, pain assessment, personal needs” and “provide assistance as needed e.g. positioning, feeling”. R1 is non-ambulatory and needs 2-person assistance or mechanical lift during transfers or when out of bed. R1 needs help with bathing and personal hygiene. During today’s visit, the Department interviewed 3 staff (S2-S4) and 2 residents (R2-R3). 1 Out of 3 staff was working at the time of the initial complaint investigation. Staff S4 stated the staff checked on R1 every hour while R1 was awake during the day. S4 stated the staff would place a pillow on the back to prevent pressure injuries but resident would remove the pillow when resident was upset and used the pillow to throw it at the staff. 2 Out of 2 residents stated the staff provide care and meet their needs and do not have issues with the staff because they are providing the care the residents need at the facility. R2 and R3 stated the staff respond quickly when residents require assistance or help and check on the residents in a timely manner. Facility not serving quality food. On 5/6/2022, the Department conducted interviews with 6 residents. 6 Out of 6 residents (R1-R6) stated the food quality is “good” and “okay”. R5 stated the food is sometimes good, but not always good. On 5/6/2022, the Department conducted an interview with Administrator (ADM), Licensee and Staff S1. ADM stated the facility does not post the food menu every week, but they follow a reference menu to prepare the food. Page 3 of 4. On 5/6/2022, LPA Steve observed fresh fruit in the kitchen. On 8/23/2022, the Reporting Party (RP) shared a text message thread between Resident R1 and R1’s friend. R1 stated he/she did not like the salad provided and thought the soup was lumpy. R1’s friend responded stated R1 did not like the salad because “maybe it is too hard for [her/him] to eat”. On 8/29/2022, the Department interviewed Administrator (ADM) who stated they do their best to accommodate to everyone’s food preferences and normally they have soup, salad, cake and an entree (example, pasta). Based on facility food menu, residents are served different choices during each meal service with multiple options if residents do not prefer the meal served. During breakfast service, residents have multiple options from eggs, pancakes, oatmeal, cereal, and fruit plate, which can come with sides of bacon, sausages, biscuits, and fruits. During lunch service, residents have multiple options of salads to choose from and variety of pork, beef, and fish entrees. During dinner service, residents have multiple options of soup to choose from and a variety of pasta and sandwich entrees. Not enough activities provided for residents. On 5/6/2022, the Department conducted interviews with 6 residents. 3 Out of 6 residents don’t remember if facility provides activities for residents regularly. R3 stated the activities are “Okay” and R5 stated the facility does not provide activities. On 5/6/2022, the Department interviewed Administrator (ADM), Licensee and staff S1. 3 Out of 3 staff stated the facility staff do not post the activities monthly, but the facility does provide the activities to residents. On 8/29/2022, the Department interviewed S1. S1 stated the staff encourage R1 to be in the living room for activities and socialization, but R1 will insult the other residents. The staff will do 1:1 activity with R1 instead of a group setting. Page 4 of 4. On 8/29/2022, the Department conducted interviews with 6 residents. 3 Out of the 6 residents do not remember if the facility provides activities. 2 Out of the 6 residents stated the activities are “okay” and provide some activities in the facility. 1 Out of the 6 residents stated the facility does not provide activities to the residents. Based on facility’s activity calendar, the facility has 4 activities scheduled each day Sunday through Saturday. Each day there is one activity residents to participate in social time, exercise, sensory/brain activities, and snack time. Based on review of R1’s Appraisal dated 8/9/2021, R1 does not need help in participating in activity program. R1 likes to stay in his/her room watching TV but will join social group if encouraged and invited. R1 is in bed most of the time and enjoys conversing with family and people he/she is familiar with. Based on the interviews conducted with clients and staff and based on observation and records review, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the above allegations did or did not occur, therefore the allegations are UNSUBSTANTIATED. No deficiencies cited from California Code of Regulations, Title 22. Exit interview conducted with Licensee, Irish Ladwig and a copy of the report was provided. Page 2 of 2. Based on review of resident (R1)’s medication Administration Record (MAR) for the month of April 2022, 11 out of 11 medications was administered as instructed by physician’s order. On 5/6/2022, the Department interviewed Administrator (ADM), Licensee and staff S1. 3 Out of 3 staff stated the medications are usually administered after breakfast and after dinner. ADM stated everything is documented, referring to the MARs (Medication Administration Record). ADM stated the facility always provides medications to the residents. On 8/28/2022, the Department interviewed S2. S2 stated R1 would spit out or throw away the medications and R1’s physician was aware. S2 stated the staff would attempt to administer the medications multiple times before they asked R1’s family members to help administer medications. S2 stated if R1’s family members were visiting, then they would request to administer R1’s medication. During today’s visit, the Department interviewed 3 staff (S3-S5) and 2 residents (R2-R3). 1 Out of 3 staff were working at the time of the initial complaint investigation. Staff S5 stated resident R1 would refuse to take medications after staff would attempt to administer medications on schedule. S5 stated resident’s family was aware of resident’s refusal to take medications and resident would refuse medications administered by resident’s family as well. 2 Out of 2 residents were at present at the facility at the time of the initial complaint investigation. R2 and R3 stated the staff administer the medications on time and there are not issues of administering the medications on time. The Department has completed the investigation of the above allegation. Based on interviews conducted and record reviews, the Department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. No deficiencies cited from California Code of Regulations, Title 22. Exit interview conducted with Licensee, Irish Ladwig and a copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 20, 2024 · control 26-AS-20220429161605

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit. LPA Rai met with Licensee, Irish Ladwig and stated the purpose of today's visit. LPA Rai observed 2 staff and 5 residents at the facility. During visit, LPA Rai toured the inside and outside of the facility. When touring the outside area of the facility, the exits were cleared of obstruction. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply areas and secured areas for cleaning supplies and laundry detergents. LPA Rai toured 5 resident bedrooms. 5 Out of 5 resident bedrooms had available bedding, drawers, and functioning lights. LPA Rai observed 5 out of 5 residents had half-bed rails and residents' file contained a written physician's order for half-bed rail. The facility bathroom had available soap, paper towels, and trash cans with lids. The water temperature in the bathroom sinks ranged from 107.1 degrees F - 107.6 degrees F. The water temperature in the kitchen sink was 110.7 degrees F. Fire extinguisher was observed and inspected on 03/06/2024. Facility smoke detectors and carbon monoxide detectors were in working condition. The last disaster drill was conducted on 06/11/2024. LPA Rai reviewed facility records for 3 staff and 3 residents. LPA Rai reviewed resident medications and central stored medication records. No deficiencies were cited per California Code of Regulations, Title 22. Technical Assistance was provided. This report was reviewed with Licensee, Irish Ladwig and a copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 20, 2024