Advent Residential Home

Type of visit: Case Management - Deficiencies

On December 18, 2025, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced case-management visit. LPA met with Caregiver, Maylene Arboleda and explained the purpose of the visit. During the annual visit conducted on December 11, 2025, LPA observed resident room numbers 1, 2, 4, 5, and 7 with beds that have half bed rails and resident room numbers 3 and 6 with full bed rails. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809-D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with caregiver and a copy is provided.the state’s words, verbatim · CDSS document, Dec 18, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87608(a)(3) · Plan of correction due date: Dec 19, 2025

87608 Postural Supports : (a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions. (3) A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. This requirement is not met as evidenced by: Based on observation and record review, LPA observed Resident 2 (R2) who resides in Room 2 to have a half bed rail without an order from physician which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Dec 18, 2025

Plan of correction: Licensee/administrator shall remove half bed rail until R2's physician provides a written order for the half bed rail.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87608(a)(5)(B) · Plan of correction due date: Dec 19, 2025

(a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do... Postural supports may be used under the following conditions. (5) Under no circumstances shall postural supports include... limiting the use of a resident's hands or feet. (B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care... This requirement is not met as evidenced by: Based on observations and record review, Resident 3 (R3) who resides in room 3 and resident 6 (R6) who residents in room 6 were observed to have full bed rails, however both residents are no on hospice which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Dec 18, 2025

Plan of correction: Licensee/administrator shall remove the full bed rails from both R3 and R6's bed and consult with appointed physician to discuss other options for R3 and R6. Licensee/administrator shall submit a plan in writing on how to ensure R3 and R6's needs are met without full bed rails.

Type of visit: Required - 1 Year

On December 11, 2025, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced annual visit. LPA met with Caregiver, Maylene Arboleda and explained the purpose of the visit. LPA toured the facility inside and outside including all of resident rooms, common areas & kitchen. The indoor and outdoor passageway was free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a single story facility. There are 9 resident rooms, all of which are currently being utilized as single private rooms. Resident rooms were observed to be clean with all required furniture. LPA observed resident room numbers 1, 2, 4, 5, and 7 with beds that have half bed rails and resident room numbers 3 and 6 with full bed rails. 1 staff room was observed. LPA observed 3 full bathrooms and 1 half bathroom inside room #1. Bathrooms were observed clean, odor-free and equipped with grab bars. Water temperature throughout the facility measured between 126-134 degrees F. Extra linen was observed to be present. First aid kit was observed to be complete. Dining room was observed free from tripping hazards. A comfortable temperature of 70 degrees F is maintained and lighting is sufficient for comfort. LPA observed 2-day perishables and 7-day non-perishables. Medications, sharps, and chemicals were observed locked an inaccessible to residents in care. Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of October 2025. Emergency drills are logged and done every three months. LPA reviewed 6 resident records including physician's orders for bed rails and reviewed 5 staff records. Resident records are updated, complete and signed. Staff records are complete, with training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. (continue to 809C) During the visit, LPA observed Staff 1 (S1) in the kitchen cooking, however after review, S1 does not have fingerprint clearance. Civil penalty of $300.00 is being issued during the visit for S1 not being fingerprinted ($100/day x 3 days). Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809-D. Failure to correct the deficiencies may result in civil penalties. An additional civil penalty of $250.00 is issued during the visit for CCR 87303(e)(2) Maintenance and Operation due to repeat citation within the last 12 months. Citation was issued 1/8/25. Report is reviewed with Caregiver and a copy is provided.the state’s words, verbatim · CDSS document, Dec 11, 2025

Type of visit: Required - 1 Year

On January 8, 2024, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual inspection. LPA met with Administrator, Helen Malig-On and explained the purpose of the visit. LPA toured the facility inside and outside including all of resident rooms, common areas & kitchen. The indoor and outdoor passageways were free of obstruction. No accessible bodies of water of fire safety hazards observed. Living room and dining room was observed to be clean, free from tripping hazards and odor-free. A comfortable temperature of 72 degrees F is maintained and lighting is sufficient for comfort. LPA toured kitchen and observed two day perishable and seven day non-perishables. Sharps, chemicals and medications were observed to be locked an inaccessible to residents. LPA toured 9 resident rooms;all of which were observed to be private rooms. All rooms were observed to be clean with required furnishings. LPA observed 2 full bathrooms and 1 half bathrooms. Bathrooms were observed to be clean and odor-free. Water temperature throughout the facility measured between 100-123 degrees F. Extra linen was observed to be present. First aid kit was observed to be complete and present. LPA toured the garage and observed washer to be in good repair. Carbon monoxide monitor is working properly. All fire extinguishers have been checked and current as of September 2024. Emergency drills are logged and being conducted every three months. LPAs reviewed 4 resident records and 4 staff records. Resident records are updated, complete and signed. Staff records are complete, with training logs that have met the basic requirement, however LPA observed 3/5 staff members first aid training to be expired. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. Deficiency found today under Title 22, Division 6, on following page LIC 809D. LPA reviewed report with administrator and a copy is provided.the state’s words, verbatim · CDSS document, Jan 8, 2025

Allegation investigated: Facility is not providing a refund upon resident’s death.

On December 16, 2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced 10-day complaint visit. LPA met with the administrator, Helen Maligon and explained the purpose of today's visit. Regarding to the allegation of- facility is not providing a refund upon resident's death, the reporting party stated that resident #1 (R1) deceased on 11/7/2024 and the monthly payment has not been refunded. Subsequently on 12/10/2024, the reporting party contacted the Department and reported that the facility has notified them that a refund check has been mailed. As part of the investigation, LPA interviewed the administrator who stated that the refund check was not issued in a timely fashion due to miscommunication, however, on 12/10/2024, a refund was issued and she has informed R1's responsible party. Unfounded During today's visit, the facility called R1's responsible party who confirmed that the refund has been received and provided a copy of the check. After the investigation, this allegation is deemed unfounded. The agency has investigated the allegation and we have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. This report is reviewed and discussed with the administrator. A copy is provided.the state’s words, verbatim · CDSS document, Dec 16, 2024 · control 14-AS-20241210143454

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced required 1 year annual inspection visit. LPA met with administrator Helen Malig-On and explained the purpose of today's visit. LPA was allowed entry into the facility. This is a one level facility. Annual Fees are current. The physical plant was toured inside and outside to ensure the safety of the residents. LPA observed the facility kitchen which is clean and observed appliances are in good repair. Knives are stored in the kitchen locked beneath the kitchen and basement area. Cleaning solutions are also locked in the basement area as well as in the storage areas behind the facility. Perishable and non-perishable food items are observed as in place. LPA observed the medications are locked in the kitchen. The first aid kit observed as complete with required items. LPA observed that the facility is equipped with full sprinkler system, fire extinguishers are placed through out the facility last inspected 08/23/2023, smoke detector/carbon monoxide detectors are observed in place as hardwired, and central heating system is functional. Sprinkler system is noted as being inspected on 10/2023 and this inspection is valid for 5 years. Facility contains two common bathrooms with showers and one resident room that has a personal half bath. There is a staff/visitor full bathroom located adjacent to the kitchen. PPE and additional food supplies are observed as in place in rear storage area outside of the facility. Laundry area is also observed as fully operational located in the outside storage areas of the facility. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Water temperature was measured at 110F. LPA observed several resident rooms at random and all rooms are observed as clean, free of odors, and contained all the required furniture per regulatory recommendation. LPA observed call system in place for resident use. Currently there are 3 hospice residents in the facility. The facility has a waiver for 4 hospice residents. Continued on page 2... LIC809C - Required 1 Year Fire/disaster drill record reviewed last taking place on 01/23/2024. LPA conducted record reviews for 3 residents and 3 staff. Present in the facility is 9 residents and 4 staff. LPA reviewed the records indicated and all files reviewed are current. Administrator certificate is observed as expired in 10/2023. According to the administrator she has submitted renewal items in August or September 2023. Facility does not handle resident monies. The following updated forms are being requested to be received by 02/02/2024: • LIC610E Emergency Disaster Plan • LIC 308 Designation of Administrative Responsibility • LIC 500 Personnel Report • Updated administrator certificate • LIC9020 Client Roster • Certificate of Liability Insurance There are no citations issued on this day. Report is reviewed with administrator Helen.the state’s words, verbatim · CDSS document, Jan 26, 2024