Cambrian Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required - 1 Year visit and met with Administrator Azarel James Equing. During visit, LPA toured the facility inside and out. LPA toured the kitchen area and observed there to be locked storage areas for sharp objects and cleaning supplies. LPA observed the refrigerator and food storage areas and observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA toured six out of six bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. LPA toured the outside area and found the exits to be clear of obstructions. LPA tested the smoke detectors in each resident bedroom and in the hallways. All smoke detectors functioned properly when tested. LPA tested the carbon monoxide detector in the kitchen and it functioned properly when tested. LPA toured two out of two resident bathrooms. Each bathroom had working lights and available soap and paper towels. The water temperatures in the bathroom sinks were 111 F. See LIC809-C page for more information. Page 1 of 2. LPA reviewed the Centrally Stored Medication and Destruction Logs and Resident Records for 5 out of 5 residents and found them to be complete. LPA reviewed 5 staff records and found them to be complete. The emergency disaster drill log indicates that the last recorded drill was on 10/15/2025. No deficiencies were cited at this time as per California Code of Regulations Title 22. LPA Marrufo requests that the following documents be updated and copies sent to the department by 01/09/2026: LIC500 Personnel Summary LIC308 Designation of Administrative Responsibility Liability Insurance Current Administrator's Certificate LIC610 Emergency Disaster Plan This report was reviewed with Administrator Azarel James Equing and a copy of this report was provided. Page 2 of 2. END REPORTthe state’s words, verbatim · CDSS document, Jan 2, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection, and met with Administrator (ADM) James Equing . License, Personal Rights posters, and Administrator Certificate were observed at entrance. LPA observed 4 staff and 6 residents in the facility. LPA reviewed 3 residents files (R1 - R3) and 3 staff files (S1 - S3). 2 Out of 3 residents (R1 and R3) centrally stored medication forms were observed not matching with their medication counts. LPA toured the facility with ADM inside and out. LPA inspected living room, kitchen, dining area, 2 sitting areas, and laundry room. There are 6 single rooms for residents, and one staff live-in room in facility. 3 bathrooms were inspected. Two days perishable foods and seven nonperishable foods were observed sufficient. The temperature of the refrigerator was observed at 16 degree F, and the temperature of the freezer was observed at -1 degree F. Room temperature was observed at 72 degree F. Hot water was observed at 117 degree F. Medication cabinet, and knife closet, were observed locked. Dish washing solution bottle was observed on the top of sink in the kitchen, ADM locked the dish washing solution bottle in the closet under the sink immediately. ADM stated staff just finished using the dish washing solution after lunch. LPA checked the call bell system in resident rooms and it was functional. Door alarms were observed installed at the exit doors. First Aid box, flash lights, and night lights were observed in the facility. LPA observed 6 beds in the resident rooms with half bed rails. ADM provided 6 residents' physician reports. 1 Out 6 residents is on hospice care, and 5 Out of 6 residents having physician orders for using half bed rail. Continue on LIC809-C. The facility's last time conducted the fire drill was on 1/7/2025. Front yard and back yard were inspected. LPA observed a tree's branches blocked half of the walkway to the exit. Staff trimmed the tree branches before LPA completed the visit. No obstruction was observed to block the walkway after staff had trimmed the tree.. Deficiency noted today. See LIC809-D. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of this report was provided to ADM.the state’s words, verbatim · CDSS document, Jan 23, 2025

Allegation investigated: Facility staff did not seek medical attention for resident with lice.

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced invetigation visit to deliver the amended investigation finding report and met with House Manager (HM) Azarel James Equing. On 10/02/2023, the Department received a complaint with the allegation that the facility staff did not seek medical attention for resident with lice. On 10/12/2023, the Department conducted an initial investigation visit. LPA interviewed Licensee, Administrator, 2 staff and 2 residents. LPA toured the facility and checked the 2 residents with staff. LPA request the resident physician report and Apprsial/Need and service plan. Continue on LIC9099-C. Page 1 of 3. Unsubstantiated Facility staff did not seek medical attention for resident with lice: On 10/02/2023, LPA interviewed resident R1's family (FM). FM stated he/she went to the facility to visit R1 every week. FM stated he/she did not know R1 had lice. FM stated the facility did not notify him/her that R1 had lice. FM stated R1 moved out from the facility on 9/23/2023 and moved to another facility. FM stated on 9/25/2023 he/she received a phone call from the new facility that R1 had lice and it took 7 days to develop to the current condition of lice. On 10/12/2023, LPA interviewed 2 staff (S1, S2). S1 and S2 stated they did not know R1 had lice. Both stated residents have two showers per week and some residents have bed bath every day if the resident cannot take shower. Both stated the facility staff clean resident bedrooms every day and residents have laundry every day with or without mix of residents' clothes. Both stated the facility cleans resident Iinens 1-2 times per week. Both stated resident R1 moved out from the facility because R1's needed higher level of care. LPA interviewed Licensee (LCN). LCN stated R1 moved out from the facility because he/she needed higher level of care. LCN stated he/she received a phone call from R1's family that R1 had lice after R1 moved out from the facility two days after. LCN stated after he/she received the notice, he/she spoke to the facility staff and residents. LCN denied the facility had lice. LCN stated R1 went to day program, R1 might get lice from being outside in the community. LPA toured the facility including the common area, bathrooms and 6 resident bedrooms. LPA did not observe the sign of lice on residents. LPA interviewed Administrator (ADM). ADM stated the residents have 2 showers per week and as needed, have laundry every day and the facility changes resident's linens every week. ADM stated he/she did not receive any report from staff that R1 having lice. Continue on LIC9099-C. page 2 of 3. On 6/14/2024, LPA conducted a collateral visit at a licensed facility where R1 is currently residing to interview R1. R1 was unable to communicate due to neurocognitive disorders. LPA interviewed a staff S3. S3 stated he/she went to R1's day program to conduct a pre-assessment a week prior to 9/23/2023, the day R1 moved in to the new facility. S3 stated he/she did not find R1 had lice during the pre-assessment.. LPA interviewed 4 staff. 4 out of 4 staff stated R1 moved in the facility on 9/23/2023, and the facility staff found R1 had lice on 9/25/2023. LPA interviewed a staff S4. S4 stated the facility staff found R1 had lice on 9/25/2023, and notified R1's day program. S4 stated R1's day program staff stated that they did not find R1 had lice and the day program did not have any one with lice. Reviewed R1's resident notes, on 9/25/23, staff found R1 scratching head and lice noted in multiple areas of the head. The facility shampooed R1, and gave shower to R1. Based on the observation, records reviewed, and interviews, there was no lice found before 9/25/2023. ADM and LNS denied R1 had lice before 9/23/2023, R1's day program also denied R1 had lice before 9/23/2023. R1 moved to the new residency facility on 9/23/2023. There is no evidence to indicate that facility staff did not seek medical attention for resident with lice. The Department has investigated the above allegation. Based on interviews and observation, the department has found the above allegations is unsubstantiated. An unsubstantiated finding indicates that although the allegation may have happened and/or is valid, there is not a preponderance of evidence to show the alleged violations did or did not occur. No citation noted today per California Code of Regulations, Title 22. Exit interview was conducted with HM. This report was provided to HM for signature. A copy of the report was provided to HM. Page 3 of 3.the state’s words, verbatim · CDSS document, May 10, 2024 · control 26-AS-20231002142714

Allegation investigated: Staff are not addressing an insect infestation at the facility. Staff are not following proper food services sanitation practices.

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced investigation visit to deliver the amended investigation report and met with Administrator (ADM) Justin Ladwig. On 01/16/2024, the Department received a complaint with the above allegations. On 01/26/2024, an initial investigation visit was conducted. LPA interviewed the House Manager, 2 staff, 5 residents, a private caregiver, and a nurse. LPA obtained LIC500 personnel report, the facility cleaning schedule and the facility infection control plan/protocol. Continue on LIC9099-C. Page 1 of 3.. Unsubstantiated Staff are not addressing an insect infestation at the facility: On 1/26/2024, at 1:00PM, LPA arrived at the facility. Staff S1 opened the door for LPA. LPA toured the kitchen and the facility with S1. LPA observed dishes in the kitchen sink. S1 stated he/she and another staff just finished helping residents for lunch and was washing dishes when LPA arrived. LPA did not observe insects, cockroaches, ants on the kitchen counter or on the kitchen floor. LPA did not observe any "insect trap" on the kitchen counter or on the floor. LPA toured the dining room, living room, reading rooms, laundry room, resident rooms and restrooms. LPA did not observe insects, cockroaches, ants or any "insect traps". LPA interviewed house manager (HM). HM stated the facility had cockroaches around in the middle of last year. HM stated the facility conducted treatment for that. HM stated the facility does not have insect, cockroaches, or ants after the treatment. HM stated he/she did not see insects, cockroaches, or ants recently. HM stated facility staff clean the facility in the morning and in the evening every day. HM stated the facility staff clean the kitchen before and after each meal. LPA interviewed 2 staff (S1, S2). both staff stated the facility staff clean the facility in the morning and evening every day, and the staff clean the kitchen before and after the meals. Both stated they did not see insects, cockroaches or ants in the facility recently. LPA interviewed 5 residents. 5 out of 5 residents stated the facility is clean. 3 out of 5 residents stated they did not see insects, cockroaches, or ants in the facility. LPA interviewed a private caregiver (PC). PC stated the facility is clean and the food is good. PC stated he/she does not see the facility has any problem. LPA interviewed a nurse at the facility. The nurse stated the facility everything is good and clean. The nurse stated the facility is the top level of the facilities he/she ever visited. Based on the interviews with staff and residents and observation, no evidence to indicate that staff are not addressing an insect infestation at the facility. Continue on LIC9099-C. Page 2 of 3. Staff are not following proper food services sanitation practices: On 01/26/2024, LPA toured the facility kitchen. LPA did not observe insects, cockroaches, ants, or "insect traps" on the kitchen counter. LPA interviewed 3 staff. 3 out of 3 staff stated they did not see insects, cockroaches, or ants in the facility. 3 out of 3 staff stated the facility staff clean the kitchen before to cook meals and clean the kitchen after the meals. LPA interviewed a facility cook, he/she stated he/she did not put "insect trap" on the kitchen counter. LPA interviewed a resident R1 who stated the facility staff prepare their meals in good sanitation practices. LPA interviewed 5 residents. 5 out 5 residents stated the facility food was good. 5 out of 5 residents stated the facility has no insects or bugs and the kitchen is clean. LPA interviewed a private caregiver on site and a home care nurse on site in the facility. Both stated the facility food is good. Both stated they did not find any issue of the procedures of the facility food processing for the meals. On 6/14/2024, LPA interviewed 4 staff. 4 out of 4 stated they received the training for food preparation and food processing. 2 out of 4 staff addressed the procedures of food preparation and food processing for cooking the meals. LPA obtained and reviewed the facility Food Safety Best Practices documents. ADM stated the Food Safety Best Practice document is the guideline for staff to follow. Based on the observation, records reviewed and interviews with staff and residents, there is no evidence to indicate that the facility staff are not following proper food services sanitation practice. The Department has investigated the above allegations. Based on interviews and observation, the department has found the above allegations are unsubstantiated. An unsubstantiated finding indicates that although the allegation may have happened and/or is valid, there is not a preponderance of evidence to show the alleged violations did or did not occur. No citation noted today per California Code of Regulations, Title 22. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the report was provided to ADM. Page 3 of 3.the state’s words, verbatim · CDSS document, May 10, 2024 · control 26-AS-20240116100529

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection, and met with Administrator (ADM) Justin Ladwig . License, Personal Rights posters, and Administrator Certificate were observed at entrance. LPA observed 3 staff and 5 residents in the facility. LPA reviewed 3 residents files and 3 staff files. LPA toured the facility with ADM inside and out. LPA inspected living room, kitchen, dining area, 2 reading rooms, and laundry room. There are 6 single rooms for residents, and one staff live-in room in facility. 3 bathrooms were inspected. Grabs and non-skid mats were observed in the bathrooms. Two days perishable foods and seven nonperishable foods were observed sufficient. Room temperature was observed at 72 degree F. Hot water was observed at 119 degree F. Medication cabinet, Knife closet, and cleaning products closet were observed locked. LPA checked the call bell in resident room and the staff responded in 2 minutes. First Aid box, flash lights were observed in the facility. Front yard and back yard were inspected. No obstruction was observed to block the walkway. ADM stated the last date that the facility conducted the emergency drill was 1/12/2024. Deficiency noted today. See LIC809-D. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of this report was provided to ADM.the state’s words, verbatim · CDSS document, Jan 24, 2024