Wild Rose Care Home

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Alviso arrived unannounced to conduct a Case Management - Incident inspection, on 7/28/26, and met with Administrator Tilly Molina Vazquez. Licensee/Administrator, RN, Mary Garcia arrived to meet with the LPA. The purpose of this case management is to follow up on a SOC341 abuse report dated 5/12/26, and an incident report received on 5/13/26, regarding suspected theft of resident medication by a staff. Licensee had contacted licensing on 5/6/26 to report the incident, and stated they would follow with required document reports. Police were also contacted, including all required parties. All medications were observed to be locked up and inaccessible during the LPA's inspection. The narcotic medication count of pain medication was documented at a total of 14 syringes when S3 came on shift, 5/5/26; The narcotic count of pain medication was counted at nine (9) pain medication syringes at the end of S3's shift, 5/6/26. This narcotic count recorded that five (5) pain medication syringes were missing, and no record of pain medication was provided to the resident (R1). No other staff was working the shift with S3 when the five (5) pain medication syringes went missing, on shift 11pm on 5/5/26 to 7am on 5/6/26. The staff, S3, was terminated due to the facility's investigation of the incident. Licensee/Administrator Mary Garcia and Administrator Tilly Molina, will submit the requested documents as discussed during the inspection, regarding statements of all interviewed, including the declaration forms (LIC855), and termination document/information on former staff/S3. Please submit S3's training records as discussed, medication, caregiver, and any other training on record for the last year. In review of the incident and SOC341, and information obtained, it is observed by the LPA that the facility addressed the incident appropriately. The Department will review information obtained to determine if further action is needed and/or any other information/documentation is needed. No deficiencies cited during today's inspection. Exit interview was conducted with Administrators, Mary Garcia, and Tilly Molina Vazquez.the state’s words, verbatim · CDSS document, Jul 28, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alviso conducted a Required -1 Year visit, on 4/6/26 at approximately 9:40am, and met with Administrator Erika Molina who arrived from licensee's other licensed home. LPA observed a total of two (2) caregivers on duty. Facility's /Administrator Tilly Molina was contacted by staff, it was their day off, but the Administrator arrived to meet with the LPA. Facility has an approved dementia plan of operation. There is an approved hospice waiver for four(4) residents. Facility has a required infection control plan. Facility has a required emergency disaster plan. Fire clearance is approved for six (6) non-ambulatory, which includes one(1) bedridden, any resident room may be used for the bedridden clearance. LPA reviewed six (6) resident files. All files were complete. LPA reviewed five (5) staff files. All staff have required First Aid certification, and CPR certification. All staff have required criminal record clearance. All staff have annual training. Staff that handle and assist with medications have the required medication training. LPA toured the facility with Administrator Tilly. All exits were free and clear of obstruction. All walkways were clear for resident's use, for visitor's, and for staff. The facility has a hard wired smoke alarm system which worked appropriately during the inspection. All fire extinguishers were serviced and tagged. Facility carbon monoxide detector (s) as required. Continued on LIC809C... LPA observed sufficient furnishings for residents in care. All bathrooms had grab bars as required, and the roll-in-shower had non-slip mat/flooring for residents use. Facility had sufficient lighting in common areas, bathrooms, resident rooms, and hallways for resident use. Facility had sufficient food supply for residents in care. All cleaners/disinfectants were locked up and inaccessible to residents in care. All medications were locked up and inaccessible to residents in care. The facility was at a comfortable temperature during the inspection. Sufficient supply of linens, paper products, hygiene products, and personal protective equipment (PPE). Facility had emergency supplies, including food and water. LPA reviewed emergency disaster quarterly drills binder; Facility completed all required quarterly drill in 2025, and the first quarterly drill was completed on 3/28/2026, for this year. LPA is requesting the following documents be updated and submitted by 5/6/26: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E- Emergency Disaster Plan (ensure to review and update as needed/required-no changes submit copy of review page) If changes submit plan copy Infection Control Plan (ensure to review and update as needed/required- no changes submit copy of review page)- If changes submit plan copy LIC400- Handling of Client Cash Resources (include copy of surety bond if handling cash) Current Liability Insurance Resident Roster Copy of current Administrator Certificate There are no deficiencies cited during today's inspection.the state’s words, verbatim · CDSS document, Apr 6, 2026

Type of visit: Required - 1 Year

At approximately 12:30PM Licensing Program Analyst (LPAs) Stevenson and Alviso arrived to conducted an unannounced annual required inspection. LPAs observed a total of two(2) caregivers on duty. Mary Garcia, Licensee/Administrator arrived at approximately 12:40 PM Facility has an approved dementia plan of operation. There is an approved hospice waiver for four (4) residents. Facility has a required infection control plan. Facility has a required emergency disaster plan. Fire clearance is approved for six (6) non-ambulatory, which includes one (1) bedridden, any resident room may be used for the bedridden clearance. Mary Garcia has a current RCFE administrator certificate, #7003093740-expires 6/5/2025. Mary Garcia has a current RN license. At approximately 1:00PM a tour of the facility was performed with licensee Mary Garcia and all knives, and toxins/cleaners were locked up and inaccessible to residents in care. All smoke alarms and the carbon monoxide detectors were checked by the local fire Department in August of 2024, and passed inspection, All smoke alarms and the carbon monoxide detector were tested and observed to be working properly. Fire extinguishers were observed to be charged and tagged as required and are scheduled to be re-inspected in May of 2025. All exits were clear and unobstructed. Hot water was checked at 114.4.F and 110.7F. which is within regulation. Facility was clean and orderly during the inspection. The facility was observed to be at a comfortable temperature and without odors. Food supply was observed to be sufficient, healthy appearing and of good variety. LPAs reviewed medication records, records were complete; All medications were stored appropriately as required. Continued on LIC809C Continued from LIC809 At approximately 2:15PM, LPAs reviewed staff training records. Staff have required annual training, and have required first aid and CPR certifications. All staff have criminal record clearance as required. At approximately 2:40PM LPAs reviewed client files and observed the files to have all required documentation. LPA's discussed with licensee to ensure that the appraisal and needs service plans are review with and signed by pertinent parties. LPA is requesting the following documents be updated and submitted to CCL by 4/04/24. LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E-Emergency Disaster Plan (ensure to review and update as needed/required) Infection Control Plan (ensure to review and update as needed/required) Copy of Current Liability Insurance Resident Roster No deficiencies cited in today's inspection.the state’s words, verbatim · CDSS document, Mar 4, 2025

Allegation investigated: Staff raised thier voice at the resident, and pushed them out of the kitchen

Licensing Program Analyst (LPA) Alviso, conducted a complaint inspection, approximately 9:45am on 11/19/24, and met with Mary Garcia, RN, Licensee/Administrator. LPA reviewed resident (R1) records, staff records, and facility records. LPA obtained copies of requested documents. LPA interviewed staff, S1, and obtained other information from other related parties. The reporting party alleges that staff raised their voice at the resident and pushed them out of the kitchen. The investigation revealed that there was additional information reported by staff S2 to staff S1 of a resident incident that had occurred when R1 kept going into the kitchen area where the stove was hot, staff were cooking. S2 stated they may have been observed to have raised their voice when telling the resident they had to get out of the kitchen; S2 stated to S1 that they had put their hands on R1's back and pushed them out of the kitchen due to being scared they were going to touch the stove. S2 stated the staff had kept moving the resident down the hall towards their room so resident could use the bathroom,S2 still had their hands on resident's back. R1 became agitated and upset with staff, refused to continue ambulating, and slid down to the floor in a sitting position. R1 was assessed by staff, staff observed no injuries, and resident was assisted up to a standing position. Resident was assisted to their room by staff. Continued on LIC9099C... Substantiated S1 stated that they discussed with S2, and other staff, facility's dementia care policy, and rights of the residents. S1 stated that they are addressing the situation with S2 regarding caregiver responsibilities, caregiver expectations, and S2's employment status. S1 stated they will provide all documents regarding the above to the LPA. Per LPA's observations, review of records, interviews with staff, and obtained information, there is sufficient information obtained to support a violation did occur, the allegation of "staff raised their voice at the resident, and pushed them out of the kitchen " is Substantiated. This deficiency will be cited, 87468.2(a)(4)Additional Personal Rights of Residents in Privately Operated Facilities-In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs, see LIC9099D. The preponderance of evidence standard has been met, therefore the allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6, Chapter 8), is being cited. Failure to correct deficiencies by due dates, may result in additional deficiency citations and/or civil penalties being assessed. Exit interview conducted with Mary Garcia RN, Administrator/Licensee. Appeal Rights provided.the state’s words, verbatim · CDSS document, Nov 19, 2024 · control 21-AS-20241113081905

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(4) · Plan of correction due date: Nov 20, 2024

87468.2(a)(4)Additional Personal Rights of Residents in Privately Operated Facilities- To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement was not met as evidenced by: Per LPA's investigation, S2 told S1 of a resident incident that had occurred when R1 kept going into the kitchen area where the stove was on/hot, staff were cooking. S2 stated they may have been observed to have raised their voice when telling the R1 they had to get out of the kitchen; S2 stated to S1 that they had put their hands on R1's back and pushed them out of the kitchen due to being scared they were going to touch the stove. S2 kept hands on resident's back as they moved them down the hallway. This is a personal rights violation for resident (s) in care.the state’s words, verbatim · CDSS document, Nov 19, 2024

Plan of correction: CORRECTED-LICENSEE/ADMINISTRATOR HELD IN-SERVICE TRAININGS WITH ALL STAFF, INCLUDING S2 REGARDING PERSONAL RIGHTS OF RESIDENTS IN CARE, AND FACILITY'S DEMENTIA CARE/REDIRECTION POLICY. LICENSEE PROVIDED DOCUMENTATION REGARDING PLAN OF CORRECTION. POC CLEARED.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alviso conducted a Required -1 Year visit, on 3/5/24 at approximately 2:20pm, and met with Administrator Assistant Patty Thompson. LPA observed a total of two(2) caregivers on duty. Mary Garcia, Licensee/Administrator was contacted notifying her of the LPA's arrival to the facility. Garcia arrived within 30 minutes of being notified. Facility has an approved dementia plan of operation. There is an approved hospice waiver for four(4) residents. Facility has a required infection control plan. Facility has a required emergency disaster plan. Fire clearance is approved for six (6) non-ambulatory, which includes one(1) bedridden, any resident room may be used for the bedridden clearance. The LPA toured the facility with the Administrator. LPA reviewed six resident files. All resident files were complete. The LPA started a review on staff annual training. This annual will be completed at a later date.the state’s words, verbatim · CDSS document, Mar 5, 2024

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.