Amaryllis Assisted Living

Type of visit: Required - 1 Year

On 8/11/2026 at 12:00 PM, Licensing Program Analyst (LPA) Y. Brown conducted an unannounced annual 1-year required inspection. LPA met with Administrator (ADM) Antonio Lopez and LPA explained the purpose of the visit. LPA toured the facility with the ADM including but not limited to bedrooms, bathrooms, kitchen, common area, backyard and garage. ADM currently holds a certificate (#6044517740) that expires on 9/21/2027. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 73 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 116.6 degrees Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for residents. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was observed to be last serviced on 2/12/2026. Fire drill was observed to be last conducted on 8/4/2026. The emergency Disaster plan was observed and last reviewed on 3/4/2026. First aid kit was observed to be complete. LPA reviewed four (4) staff and five (5) resident records and all were current and complete. LPA reviewed a sample of medication. Continued on LIC809C. Continued from LIC809. The following forms to be updated and submitted to CCLD by 08/18/2025: LIC610D Emergency disaster plan LIC500 (Personnel Record) LIC308 (Designation of facility Responsibility) No deficiencies were cited during visit. Exit interview conducted. A copy of this report provided.the state’s words, verbatim · CDSS document, Aug 11, 2026

Type of visit: Required - 1 Year

On 07/15/2025 at 1:30 PM, Licensing Program Analyst (LPA) Y. Brown conducted an unannounced annual 1-year required inspection. LPA met with Administrator Antonio Lopez and LPA explained the purpose of the visit. LPA toured the facility including but not limited to eight (8) bedrooms, 2 (two) bathrooms, kitchen, common area, garage, and back yard. All indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature for clients is maintained at 75 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared residents bathroom was measured at 107.3 degrees Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for residents. Smoke detectors/carbon monoxide were in operating condition during visit. Fire extinguisher was observed to be last serviced on 2/19/2025. Fire drill was observed to be last conducted on 06/25/2025. The emergency Disaster plan was observed and last updated on 2/2/2025. First aid kit was observed to be complete. Continued on LIC809C. Continued from LIC809. LPA reviewed Five (5) staff and six (6) resident records and all were current and complete. LPA reviewed a sample of medication. The following forms to be updated and submitted to CCLD by 07/22/2025: · LIC610D Emergency disaster plan (last page) · Surety Bond · LIC500 (Personnel Record) · LIC308 (Designation of facility Responsibility) No deficiencies were cited during visit. Exit interview conducted. A copy of this report provided.the state’s words, verbatim · CDSS document, Jul 15, 2025

Allegation investigated: Facility is restricting visitation

On 03/27/2025, at 12:15pm, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct initial 10-day complaint visit for the above allegation and deliver finding. LPA met with Administrator, Laly Bascao, and explained the reason for the visit. LPA spoke with Licensee, Terri Marsala, and discussed the allegations. LPA reviewed resident (R) files for R1-R7. LPA interviewed staff (S). LIC9099-C Continued Substantiated LIC9099-C (Page 5) Allegation: Facility is not checking residents blood pressure Finding: Unsubstantiated On 03/14/2025, LPA interviewed witness (W). W1 stated that the facility is not monitoring residents' blood pressure (bp) by taking their blood pressure readings. On 03/27/2025, LPA interviewed W2 that stated residents that are blood pressure medication are not getting their blood pressure monitored by facility staff. LPA interviewed S1 that stated that before a resident moves in that they will get a medication list from the hospital or skilled nursing facility that will show if the resident is on blood pressure medication. S1 stated that if the doctor's order indicates for example bp "below 140" they will not accept that resident because the facility is not a medical facility and staff are not health professionals. S1 stated that if the resident require their bp to be monitored and check daily then they will tell the resident or resident's family that they can not provide that service. LPA reviewed R1-R7 medication list and doctor's orders and there were no instructions that bp has to be monitored and checked. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided LIC9099 -C (Page 2) Allegation: Facility is restricting visitation Finding: Substantiated On 03/14/2025, LPA interviewed witness (W). W1 stated that the facility has a sign on the front door saying that medical professionals must wear full Personal Protective Equipment (PPE) before entering the facility. W1 stated that there is no mandate required that medical professionals visiting residents are required to wear full PPE. On 03/27/2025, LPA interviewed W2 that stated health professionals from home health agency are being told that they have to wear full PPE before coming inside the facility. W2 stated that there isn't any county mandate currently to require health professionals that are making home visits to have full PPE with them and to wear before entering residential home facility. On 03/27/2025, LPA interviewed S1 and S2. S1 stated that they receive notices from the county informing of contagious disease outbreaks (i.e., Covid, influenza, scabies) and some of the local facilities and that they know some of these health professionals are making visits at these facilities. S1 stated that they are protecting their residents and that they made the policy that visiting health professionals (i.e., hospice nurse, home health nurse, physical therapist, speech therapist) have to wear gown, mask and gloves. S1 stated that if the visiting health professionals do not have the PPE that they are requiring that they can go back and get the PPE and come back. S2 stated that they have told the agencies up front before any of their health agency staff arrives that they need to wear PPE. LPA observed a sign on outside front door that said, "....medical personnel must wear FULL PPE before entering facility. If you do not have FULL PPE, please reschedule your visit." Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D. Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Mar 27, 2025 · control 15-AS-20250318143742

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(1) · Plan of correction due date: Apr 7, 2025

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities...have all of the following personal rights: (1) To have a reasonable level of personal...accommodations, medical treatment...visits... This requirement is not met as evidenced by: Based on observation, interview, and record review, the licensee did not comply with the section cited above in by not allowing all home health, hospice, vendors and medical personnel enter the facility before wearing full PPE to make home health visits with residents. There is no local county or state guidance that wearing PPE gown, mask and gloves is a mandated requirement for health professionals which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 27, 2025

Plan of correction: Administrator will send an email to all home health and hospice agencies that they require all vendors need to wear mask, gloves and gown and also update the sign on outside door. Administraor will send a copy of the email and photo of updated sign to CCLD by POC due date.

Type of visit: Required - 1 Year

On 09/05/2024 at 11:10 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Laly Bascao and explained the purpose of the visit. The facility’s fire clearance was approved for capacity of nine (9) residents in which two (2) may be Bedridden. Hospice waiver for six (6) residents. Administrator certificate #6058791740 expires 02/15/2025. LPA toured facility with Laly including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 8 total bedrooms which 7 bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 76 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 105 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 01/02/2024. Emergency Disaster Plan was last posted on 02/01/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 08/15/2024. LPA reviewed seven (7) residents records. LPA reviewed four (4) staff records and 3 of 4 have current first aid training and associated to the facility. LIC809- C Continued... LIC809-C Continued... The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 09/12/2024: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Certificate Current Administrator’s Certificate - Reviewed Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Sep 5, 2024