Astoria at Oakdale

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Jason Lund arrived at facility unannounced to conduct case management. LPA Lund met with Administrator Alexis Alvarez and explained the purpose of the visit. Census: 42 LPA Lund met with Administrator Alexis Alvarez to go over how the Sage Fall detection system works. Administrator Alexis Alvarez went over the way it was used by the facility. Documentation for Sage Fall detection system was reviewed by management and met requirements and was approved. An exit interview with Administrator Alexis Alvarez and a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 24, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jason Lund arrived unannounced at the facility to conduct a one year required annual inspection. The LPA Lund met with Administrator Alexis Alvarez and explained the reason for the visit. The facility is a one- story building that is licensed for forty-five residents. The facility had a hospice waiver for five. Census: 42 LPA Lund & Administrator Alexis Alvarez toured/inspected the facility. The LPA Lund inspected the common areas, including gathering areas, dining rooms, and hallways. These areas were clean, uncluttered, decorated, and bright with natural light. The LPA observed that these areas were pest-free and odor-free. There was enough furniture to accommodate all residents for dining. The LPA Lund inspected the kitchen was clean and free of grease, food debris, and spills. The facility had a seven- day nonperishable and two- day perishable supply of food. Staff took the temperature of food and drink for every meal and every day of the week to ensure food safety. Temperatures of refrigerators and freezer interiors were also logged daily and the ambient temperature monitored. LPA Lund inspected the residents’ bedrooms and bathrooms; bedrooms were clean and had the required furniture. The bathrooms were also clean, odor-free, and had non-slip mats, grab bars, and modifications as needed to accommodate the rooms' residents. LPA Lund inspected the Medication Room. The facility used an electronic system for tracking medication and care plans. Resident medications were kept in a dedicated, locked room, and in a locked medicine cart when being passed. Medications were separated by resident and stored in their original bottles with intact labels. Narcotics were kept in a separate locked area and logged in a binder on paper forms. LPA Lund inspected the grounds, walkways were free of obstruction, front, side, and back yards had green grass and many shade trees and was in compliance. B.I.C company serviced the facility's fire suppression system on 04/07/2026, including its sprinkler system, smoke and carbon monoxide detectors, fire alarms and fire extinguishers was in compliance. The LPA Lund reviewed eight resident files and eight staff files. The resident and staff files were organized and contained all the required documentation. As a result of this inspection, no deficiencies were cited. The facility was in compliance with California Code of Regulations (CCR), Title 22, Division 6. An exit interview was conducted with the Administrator Alexis Alvarez, and a copy of this was left.the state’s words, verbatim · CDSS document, Sep 24, 2026

Type of visit: Required - 1 Year

On 07/24/2025, Licensing Program Analyst (LPA) Triel Ellen Lindstrom arrived unannounced at the facility to conduct a required annual inspection. The LPA met with Designated Facility Administrator (DFA) Alexis Alvarez. The LPA introduced herself, explained the purpose of the visit, and conducted an interview with the Administrator. The DFA accompanied the LPA on a tour of the facility. The facility is a one story building that is licensed for forty-five residents. The facility had a hospice waiver for five. The census was thirty-five at the time of this inspection. The LPA toured the common areas, including gathering areas, dining rooms, and hallways. These areas were clean, uncluttered, decorated, and bright with natural light. The LPA observed that these areas were pest-free and odor-free. There was enough furniture to accommodate all residents for dining, as well as for spending time with visitors. The LPA toured the kitchen and interviewed the new Culinary Services Manager. Kitchen staff do a deep clean monthly. The kitchen was clean and free of grease, food debris, and spills. The facility had a seven day nonperishable and two day perishable supply of food. Staff took the temperature of food and drink for every meal and every day of the week to ensure food safety. Temperatures of refrigerators and freezer interiors were also logged daily and the ambient temperature monitored. The stove hood was last serviced on May 25, 2025 by AFS Fire1. The LPA observed resident bedrooms and bathrooms. The bedrooms were clean and had the required furniture in it. The bathrooms were also clean, odor-free, and had non-slip mats, grab bars, and modifications as needed to accommodate the rooms' residents. The LPA measured the temperature of the This is page 2 of the report. water in a resident bedroom and it measured at 118 degrees Fahrenheit. The LPA pushed the call button in a resident bathroom and a caregiver responded within four minutes. The LPA toured the Medication Room and interviewed a Med Tech. The facility used an electronic system for tracking medication and care plans. Resident medications were kept in a dedicated, locked room, and in a locked medicine cart when being passed. Medications were separated by resident and stored in their original bottles with intact labels. The Director of Nursing conducts monthly audits of residents' medications. Narcotics were kept in a separate locked area and logged in a binder on paper forms. The LPA toured the grounds. The walkways were free of obstruction. The front, side, and back yards had green grass and many shade trees. The LPA observed shaded seating areas and ornamental decor outside. The LPA interviewed the Maintenance Director. A company called B.I.C serviced the facility's fire suppression system on 07/23/2025, including its sprinkler system, smoke and carbon monoxide detectors, and fire alarms. The LPA observed a work order from 07/23/2025 that confirmed this service. The fire extinguishers are checked The LPA observed residents eating a meal, visiting with each other, and playing bingo. The LPA reviewed three resident files and three staff files. The resident and staff files were organized and contained the required documentation. The staff were First Aid trained and had criminal background clearances. The LPA requested that updated copies of these documents be submitted to Licensing. These documents can be sent to LPA at ellen.lindstrom@dss.ca.gov. (1) LIC 308 Designation of Facility Responsibility (2) Copy of a valid Administrator Certificate (3) LIC 610 Emergency Disaster Plan (4) Proof of Liability Insurance (5) LIC 500 Personnel Report (6) LIC 309 Administrative Organization As a result of this inspection, no deficiencies were cited. The facility was in compliance with California Code of Regulations (CCR), Title 22, Division 6. An exit interview was conducted with the DFA, to whom a copy of this LIC809 report was provided. Their signature below confirms receipt of this document.the state’s words, verbatim · CDSS document, Jul 24, 2025

Type of visit: Case Management - Other

On 8/29/24 Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a case management. LPA Jensen met with Executive Director Jacqueline Hernandez and explained the purpose of the visit. As part of separate complaint investigation (see complaint # 27-AS-20240607111426) LPA Jensen reviewed resident records for Resident 1 (R1). The records reviewed included Medication Administration Records, Physician communication forms, Physician Report, Needs and Service Plan, Observation Records and Task administration records. Based on the record review it was learned that their were numerous occasions documented between May 4th and June 4th wherein R1 refused medications, refused assistance with toileting and refused assistance with grooming. This change in behavior constitutes a change in R1's condition and as such warrants obtaining a new medical assessment. Consultation was provided (see LIC 9102) An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 29, 2024

Allegation investigated: Staff did not change dirty sheets Staff left resident in dirty clothes Staff are not following incontinence care plan

On 8/19/24 Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to complete a complaint investigation in to the above listed allegations. LPA Jensen met with Executive Director (ED) Jacqueline Hernandez and explained the purpose of today's visit. During the course of the investigation LPA Jensen conducted interviews, site inspections, reviewed resident file documentation and photographs. Photographs that were submitted show R1 to have soiled sheets and clothes. During an interview with the ED, she confirmed that R1 was found by their responsible party in soiled clothing and with soiled bedding due to incontinence. It was also confirmed through an interview with the ED that facility staff was experiencing difficulty following R1's incontinence care plan due to R1's behavioral issues which have since been addressed through medical interventions. Based on the interviews conducted and the documents/photographs reviewed the allegations are SUBSTANTIATED. A finding of SUBSTANTIATED means that the preponderance of evidence standard has been met. Deficiencies are being cited pursuant to the California Code of Regulations, Title 22. An exit interview was conducted and copy of this report and appeal rights provided. Substantiated behavior issues associated with the progression of disease. The facility has since taken action to implement medical interventions which have remedied the issue. On 3 separate occasions LPA Jensen toured the facility common areas and resident rooms and did not detect any incontinence odors. Based on a lack of evidence to support neglect the allegation is UNSUBSTANTIATED. A finding of UNSUBSTANTIATED means that although the allegation may have happened. The preponderance of evidence does not prove it. Allegation 2: Staff do not ensure residents room is cleaned properly During the course of the investigation LPA Jensen inspected resident rooms on 3 separate occasions. All rooms appeared sanitary. LPA Jensen also conducted staff interviews. All staff interviewed consistently stated that rooms are cleaned as needed and deep cleaned weekly. LPA Jensen reviewed photographs of the room for R1 which shows an unsanitary room however there was no evidence to support how long the room was in this state. Based on LPA Jensen's observations, interviews conducted and the lack of evidence to support a violation of regulations the allegation is UNSUBSTANTIATED. A finding of UNSUBSTANTIATED means that although the allegation may have happened. The preponderance of evidence does not prove it. An exit interview was conducted and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Aug 19, 2024 · control 27-AS-20240605153232

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87307(a)(3)(C) · Plan of correction due date: Aug 19, 2024

Personal Accomodations ...the licensee shall assure provision of: Clean linen, including blankets, bedspreads, top bed sheets, bottom bed sheets, pillow cases, mattress pads...This requirement was not met as evidenced by: Based on the ED's own admission and photographs taken the resident had soiled bed sheets. This poses a potential risk to the health, safety and personal rights of residents in care.the state’s words, verbatim · CDSS document, Aug 19, 2024

Plan of correction: The Licensee has completed in service training related to these matters. No further plan of correction is required.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87464(f)(4) · Plan of correction due date: Aug 26, 2024

Basic services shall at a minimum include: ...Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing. This requirement was not met as evidenced by: Based on the ED's own admission and photographs taken the resident was observed wearing soiled clothing. This poses a potential risk to the health, safety and personal rights of residents in care.the state’s words, verbatim · CDSS document, Aug 19, 2024

Plan of correction: The Licensee has completed in service training related to these matters. No further plan of correction is required.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87625(b) · Plan of correction due date: Aug 26, 2024

Managed Incontinence ...the licensee shall be responsible for the following: Ensuring that incontinent residents are kept clean and dry...This requirement was not met as evidenced by: Based on ED's own admission and photographs taken R1's incontinence care plan was not followed causing R1 to be in soiled clothing and with soiled bedding. This poses a potential risk to the health, safety and personal rights of residents in care.the state’s words, verbatim · CDSS document, Aug 19, 2024

Plan of correction: The Licensee has completed in service training related to these matters. No further plan of correction is required.

Type of visit: Case Management - Annual Continuation

On 8/6/24 Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to continue an annual inspection. LPA Jensen met with Executive Director Jacqueline Hernandez and explained the purpose of today's visit. LPA Jensen toured the grounds and observed all paths to be free of obstruction. There are shaded areas and patio furniture available for residents to enjoy outdoor activities. There is a separate enclosed area for memory care residents secured by delayed egress. Raised garden beds and other outdoor activity equipment is in place. LPA Jensen observed the outside perimeter wooden fence to require maintenance or replacement in the near future. Technical assistance was provided. LPA Jensen toured the interior of the facility. Adequate lighting and furnishings were observed. Postings for the Ombudsman and abuse reporting were observed in the front entrance. The emergency disaster plan was posted and current. The thermostats were set between 71 degrees Fahrenheit and 73 degrees Fahrenheit for the comfort of the residents. LPA Jensen toured the kitchen. All food is labeled and dated. There is a two day supply of perishable food and a 7 day supply of non-perishable food. Fresh fruit was available. LPA Jensen observed lunch service which consisted of baked beans, ham and zucchini. There was chocolate cookies, and water with fresh orange slices available on stations throughout the hallway. Carpeting in the memory care unit is currently being replaced one room at a time so as not to create a disruption for residents. LPA Jensen numerous activities available for client engagement. An exercise class for residents was being conducted during the course of this visit. All common areas were sanitary and well maintained. LPA Jensen toured the medication room and found it to be compliant. All toxins were observed to be locked and inaccessible to residents in care. No toxins are stored with any food items. All resident rooms were equipped with the required furniture. Continued on LIC 809C.... LPA Jensen reviewed 5 staff files that included the files for all care givers present during the course of this inspection. All staff members had criminal background clearance. All training records reviewed were up to date. Technical assistance was provided on training avauilable through the California Department of Aging. All 5 staff files were determined to be complete and in compliance. LPA Jensen reviewed 5 resident files and found them to be complete and in compliance. LPA Jensen interacted with several residents during the course of this inspection and all residents stated they are satisfied with the care being received. The call signal system was activated and found to be in good working order. The facility maintains emergency lighting. The carbon monoxide detector was tested and found to be in good working order. The fire extinguishers were last serviced in March of 2024 and are in compliance. The Ansul system was last serviced in March of 2024 and is in compliance. The facility has a current infection control plan. LPA Jensen also provided technical assistance on hospice care, safeguards for personal property and valuables and activities that foster a sense of purpose. LPA Jensen requested the following documentation be emailed within the next 7 days: -LIC 500 -current liability insurance The facility was determined to be in substantial compliance and no deficiencies are being cited as a result of this survey. An exit interview was conducted. *This report was amended to correct a typographical error in line item 21*the state’s words, verbatim · CDSS document, Aug 6, 2024

Type of visit: Required - 1 Year

LPA Jensen arrived at facility to conduct an annual inspection. LPA Jensen met with Administrative assistant Margarita Guizar and explained the purpose of today's visit. Due to equipment issues LPA was unable to complete the visit and will return at a later date.the state’s words, verbatim · CDSS document, Aug 5, 2024