Alejandro's RCFE

Type of visit: Case Management - Licensee Initiated

Licensing Program Analyst (LPA) Rankin conducted a case management closure visit to the facility above. LPA met with the Licensee Venier Alejandro and explained the purpose of the visit. LPA did a walk thorough of the home. The home is empty with no residents at the facility. The last resident relocated on 8/13/2025, confirmed in conversation by the LPA. The home is actively being cleaned out of items at time of visit. All evidence of residents personal items has been removed. The closure date of 8/14/2025 is the official date no longer in business. Administrator surrendered license to LPA on visit. Licensee completed requirements for closure, 60-day letters were sent to residents and all residents were relocated. Exit interview conducted and copy of report printed for Licenseethe state’s words, verbatim · CDSS document, Aug 14, 2025

Allegation investigated: Facility failed to provide utilities

On 8/13/25 at 12:38 pm, Licensing Program Analyst (LPA) Rankin conducted a 10-day complaint visit to the facility above. LPA met with Venier Alejandro Licensee and explained the purpose of the visit. During the visit LPA interviewed 1 staff, the Licensee, and via a phone call, the Administrator Aurea Alejandro. LPA toured facility, no residents are present, rooms have furniture, but no personal belongings. Staff were cleaning out kitchen when LPA arrived. On the allegation: Facility failed to provide utilities It was alleged that the facility had shut off power to part of the facility intentionally. LPA went to all rooms turning on and off lights. LPA went to the back half of the facility where 3 bedrooms and one bathroom is located, and found that 2 rooms and the bathroom did not have power. Staff stated the power went off yesterday and they weren’t sure why. LPA was shown a breaker panel which appeared to have all power switchs on. LPA flipped one breaker switch that seemed to not be all the way on, and the power immediately came on. Based on LPA’s observations, and interviews conducted, the preponderance of evidence standard has not been met; therefore, the above allegation is found to be UNSUBSTANTIATED. Unsubstantiated Eviction is due to closure of the facility which requires a 60 day written notice and per regulations requires the resident and their representative to receive documents including copy of resident current service plan, a relocation evaluation, list of referral agencies, the rights of the resident to contact department to investigate reasons given for eviction…, contact information for the local long-term care ombudsman, including address and telephone number. LPA reviewed the eviction document received by the Community Care Licensing agency on 6/20/25, letter dated 6/13/25 and noted that all elements required above were not provided to the resident. Date of eviction noted was 8/13/25. Call was made to the ombudsman on 8/13/25, in which the representative alleged facility required R1 to leave today (8/13/25). LPA received a complaint and conducted a visit on 8/13/25 and it was explained by the administrator and Licensee that R1 was not forced to leave, that the administrator and representative communicated for the past 6 months prior, that R1 was on notice of the intent to sell the facility, but that the facility was willing to keep R1 until a place could be secured. No other written communication was made available to the LPA. It is unclear whether further discussion occurred between R1 and their representative or not, but the letter of eviction does not follow required Health and Safety guidelines. Based on LPA’s interviews, and records reviewed, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. Pursuant to Health and Safety Code section 1569.682(a)(2)(A) through (F), the following deficiencies are cited (refer to LIC9099-D). Exit interview conducted, appeal rights discussed, and a copy of this report issued.the state’s words, verbatim · CDSS document, Aug 13, 2025 · control 29-AS-20250813120622

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.682(a)(2)(A) · Plan of correction due date: Aug 22, 2025

1569.682(a)(2)(A)licensee ...shall, prior to transferring a resident...as a result of the forfeiture of a license...take all reasonable steps to transfer affected residents safely...at a minimum, do all of the following:...(2)Provide each resident or the resident’s responsible person with a written notice no later than 60 days...The notice shall include all of the following:(A) The reason...with specific facts... (B)A copy...resident’s current service plan.(C)The relocation evaluation. (D) A list of referral agencies. (E) The right of the resident ...to contact the department to investigate the reasons... (F) The contact information for the local long-term care ombudsman..This requirement is not met based on interview and record review when facility did not provide A-F in the written eviction letter which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 13, 2025

Plan of correction: Administrator agrees to provide LPA with a statement that the eviction process has been reviewed and is understood for future processes.

Allegation investigated: Facility restrained resident

Licensing Program Analyst (LPA) Rankin conducted a subsequent complaint visit to the facility above to issue final findings. LPA met with Licensee Venier Alejandro and explained the purpose of the visit. During the initial visit on 6/5/25 LPA Rankin toured the facility, interviewed staff, viewed video of resident behaviors, and obtained relevant documents. Additional interviews were conducted with relevant parties on 6/4/25 and 6/5/25. On the allegation – Facility restrained resident: It was alleged on two occasions Resident 1 (R1) was observed with a fabric wrap around R1’s waist and that R1 was strapped into the wheelchair to restrain R1 from getting out of the wheelchair. During LPA’s visit on 6/5/25, both licensee and Staff 1 stated, “yes” to R1 having a seatbelt on when in the wheelchair. In both separate interviews the care staff stated it was out of concern for R1 falling, especially due to R1’s constant movements. Substantiated Concern was that R1 would fall on R1’s face and cause injury. LPA was allowed to review a video showing that R1, while seated in the wheelchair tried to get out of the wheelchair multiple times. In the video R1 was seen scooting while in the wheelchair, R1 swung arms wide, bent fully at the waist and was reaching around their legs and wheels for no clear reason. R1 was not verbal in the video, and did not express any verbal requests, just constant movement and trying to grab at items around them and various attempts to get out of the chair. Interviews and record review confirmed R1 is not able to self-release their wheelchair seat belt. Interview on 6/5/25 at 4:46 p.m. with nurse practitioner stated they know R1 to be aggressive, can hit, and has extreme behaviors, but at this time, they do not believe an order was approved to allow for seat belts as R1 was placed into care at the facility while practitioner was unavailable. Based on LPAs observations, interviews conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. Pursuant to Title 22, California Code of Regulations, the following deficiencies are cited (refer to LIC9099-D). Exit interview conducted, appeal rights discussed, and a copy of this report issued.the state’s words, verbatim · CDSS document, Jun 6, 2025 · control 29-AS-20250604140707

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87608(a)(1) · Plan of correction due date: Jul 6, 2025

(a)(1) Postural supports shall be limited to…soft ties, used to achieve proper body position and balance…or to position rather than restrict movement… Based on interviews and records review, the licensee did not comply with the section cited above when staff used a wheelchair seat belt to keep resident from standing up, which posed a personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jun 6, 2025

Plan of correction: Licensee agrees to conduct a one-hour Postural Support and one-hour Personal Rights training with all staff and provide a sign in sheet to the LPA within 30 calendar days, of all staff who attended, the dates and hours the staff was trained and who provided the training.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Miller arrived at 11:00 am and made an unannounced 1-year required annual visit to the facility above. LPA met with Venier Alejandro, Licensee and explained the purpose of the visit. A tour of the inside and outside of the facility was conducted. The following was inspected and noted during the annual visit: Infection Control: The facility has a current Infection Control Plan. The bathrooms have toilet paper, paper towels, and hand soap. The facility has EPA approved disinfectants sprays and cleaners. The facility has a 30-day supply of PPE. Quarantined or isolated individuals will have meals and medication delivered to rooms. Staff are trained on infection control and the use of Personal Protective Equipment (PPE). Physical Plant & Environment Safety: The fire extinguisher was last charged and inspected on 8/12/24. The facility had 6 resident bedrooms of which 3 are vacant and 4 bathrooms. The facility has smoke and carbon monoxide detectors that were tested and are working. The lighting and lamps are sufficient for the use of the facility and for resident comfort. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The showers have non-skid mats and textured bottom. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. LPA observed disinfectant and cleaning solutions kept locked under the kitchen sink. LPA observed that Medication Storage cabinet was locked. LPA observed that sharps drawer containing knives was locked. Continued 809-C The facility has sufficient space inside and outside for activities and visiting. The facility has a fenced backyard for client use with plenty of shade. The facility has telephone and internet service for resident use. Operational Requirements: The facility has a current plan of operation on file with the department. The Facility is operating in compliance with the granted fire clearance. The facility is approved for a capacity of 6. The fire clearance is granted for 1 ambulatory, 3 non-ambulatory of which 2 may be bedridden. There is a hospice waiver for 4. Staffing: The facility currently employs 4 employees and 1 administrator. Staff records are kept confidential. Files reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, Criminal Record statements, and Fingerprint clearance/Associations/exemptions. Administrator Certificate expires 3/11/26. Personnel Records & Training: The facility keeps confidential files for each staff member. Staff have annual training for various subjects/topics and hours for 2023 and 2024. Resident Records & Incident Reports: The facility keeps separate files on each resident confidentially. Facility does submit incident reports to the department when required. LPA reviewed 3 resident files for signed Admission Agreements, Personal Rights, Safeguard for property and valuables, Physicians report, Pre-appraisals, Appraisals Needs and Services Plan, Emergency and ID forms. All forms were legible. Food Service: The facility has 2 day perishables and 7 day non-perishables to meet the food service requirement. The freezer is kept at 0 degrees and the refrigeration is kept at 40 degrees or lower. All food is covered, stored, and marked appropriately. Continued 809-C Incidental Medical Services: The facility uses the Medication Administration Record (MAR) along with the Centrally Stored Medication and Destruct Records (CSMDR). LPA reviewed residents’ medications, no labels were altered, no medications were expired and all medications were kept in their original containers. Disaster Preparedness: The current emergency disaster forms were posted. The facility last conducted a quarterly disaster drill 8/8/24. Emergency exits and telephone numbers were posted. A set of keys is available for staff on all shifts to access full facility in an emergency. Residents with Special Health Needs: The facility does accept dementia residents in care. The facility has 1 self-latching gates on one side of the home. The facility does not have delayed egress, locked doors or gates. Exit door alarms are working. Exit interview conducted and copy of report printed for Licensee.the state’s words, verbatim · CDSS document, Nov 8, 2024

Allegation investigated: Staff did not issue a refund to the party that paid the rent

Licensing Program Analyst's (LPA's) De Leon and Rankin conducted a 10-day Complaint visit to the facility above. LPA met with Venier D. Alejandro, Administrator and explained the purpose of the visit. LPA interviewed witness 1 (W1) on 04/09/2024 at 1:35pm. LPA interviewed staff 1(S1) and staff 2 (S2) around 12:00pm on 04/10/2024. LPA requested the following records: Resident 1's (R1's) Incident & Death Reports, Admission Agreement, Pre-Placement Apprisal, ID & Emergency Information, and Resident Personal Property and Valuables and Discharge Paperwork from Marian Regional Medical Center. On the allegation: Staff did not issue a refund to the party that paid the rent. LPA conducted interviews with staff and witness regarding the facility not issuing a refund to the responsible party (RP) of R1. Continued 9099-C Substantiated Administrator did not issue a refund of the rent paid after the death of the resident due to charging R1 for optional items and services for Hospice fees. Administrator did not understand that Hospice fees were not written in the admission agreement (AA) or an addendum to the AA to be able to charge these optional items and services to R1. Administrator agreed to issue a refund to R1's RP. The RP paid rent for March 2024 in the amount of $3700.00. R1 passed away and belongings were packed up from R1's room on 03/07/2024. The facility owes the RP a refund for 24 days at a daily rate of $119.35 per day for a total amount of $2864.40. Based on the evidence this allegation is deemed Substantiated at this time. Exit interview conducted, deficiency cited, copy of report and appeal rights printed for Administrator. On the allegation: Staff did not safeguard resident personal belongings. LPA interviewed staff and witness which revealed on 03/08/2024 RP came to the facility and asked about R1's belongings but was unable to pick them up at that time. Due to R1 not having next of kin upon death the Santa Barbara Public Administrator was involved and the facility kept all R1's belongings waiting for someone to pick up and no one ever came to the facility to pick them up. R1's personal belongings were still at the facility on LPA's visit. Administrator safeguarded R1's belongings and will provide them to RP or Public Administrator for pickup. Based on the evidence this allegation is deemed Unsubstantiated at this time. Exit interview conducted and copy of report printed for Administrator.the state’s words, verbatim · CDSS document, Apr 10, 2024 · control 29-AS-20240410112611

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507(5)(A)(1) · Plan of correction due date: Apr 17, 2024

(5) Refund conditions.(A)...refund for advanced monthly fees will be returned in the event of a resident’s death, ... the resident’s responsible person or other individual or individuals as identified in the admission agreement. This is evidenced by: Based on interviews the Licensee did not comply with the regulation above a refund was not issued to R1's RP which poses a potential personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Apr 10, 2024

Plan of correction: Administrator agreed to issue refund to RP within 7 days and provide a copy of the check to LPA.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jenny Olson arrived at the facility unannounced to conduct a required annual visit at 10:20 a.m. When LPA arrived, there was three staff and five (5) residents present. LPA was greeted by Administrator and informed them of the reason for the visit. LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN: Knives are stored in a locked drawer in the kitchen. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Common areas: Living and dining room furniture were observed to be in good condition. At around 11:00 p.m., smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. There is a fireplace in the living room, which is screened and inaccessible. LPA observed required postings throughout the common space. The fire extinguisher was charged and serviced 7/10/2023. The backyard has a covered outdoor area equipped with furniture for client use. No bodies of water noted. The washer and dryer are in the garage. Restrooms: The three (3) resident restrooms were clean and sanitary and in operating condition with non-skid mats. The bathrooms were sufficiently stocked with soap and paper towels. Bedrooms: There are five (5) resident rooms, which were furnished. A linen closet was located outside of the rooms, which stocked extra linens and towels. Records: LPA reviewed staff and resident records around 10:30 a.m. LPA reviewed five (5) staff files for, but not limited to, the following: personnel records, health screening, criminal record statements, current first aid certification. All files were complete. Continued on 809-C LPA reviewed five (5) resident files for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, and current needs and services plan. All files were complete. MEDICATIONS: The medications are centrally stored and locked in a cabinet in the living room. LPA advised the Administrator to ensure that all the necessary information is properly documented on the CSMAR. INFECTION CONTROL: The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. The facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The facility’s policies and procedures as it pertains to infection control are adequate. LPA interviewed two (2) staff members and two (2) Residents. During today’s visit, the LPA obtained copies of the following: staff roster. Exit interview conducted. A copy of the report was printed and emailed.the state’s words, verbatim · CDSS document, Nov 13, 2023

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.