Amethyst Home

Type of visit: Required - 1 Year

On today's date Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual inspection. Upon arrival LPA was greeted and granted entry to the facility by facility staff. LPA explained the purpose of the inspection and Administrator (AD) Maria Cecilla Sangrador was notified via telephone and arrived shortly afterwords to assist LPA with the annual inspection. LPA began a tour of the facility and observed the following. AD has a valid Administrator certificate valid from December 3, 2024 through December 2, 2026. The facility is a one storied home equipped with seven bedrooms and four bathrooms. Six of the seven bedrooms are utilized for residents in care, and one bedroom is utilized for live in staff. Additionally the facility is equipped with an attached two car garage. LPA observed the kitchen area to be clean and free of any mildew and debris. LPA observed the kitchen area to have a gas stove, a refrigerator, a microwave, and a dishwasher. All appliances were observed to be in good repair and tested operational. LPA observed for there to be a two day supply of perishable food and a seven day supply of non-perishable food on hand. Additionally there was a sufficient amount of emergency water on hand. LPA observed all resident bedrooms to be clean and free of any hazards and toxins. LPA observed bedrooms to be large enough to walk about freely and have all required furnishings. LPA observed bedrooms to have a chest of drawers, a bed, clean linens in good repair; meaning no strains or tears, a lamp, a chair, and enough storage space to store personal belongings. LPA observed all resident restrooms to be clean and free of any mildew and debris. LPA observed restrooms to have required furnishings including grab bars, a shower chair, and slip resistant floor matts. Hot water temperature tested between 117.8 and 120.2 degrees Fahrenheit. Continued on LIC809-C. LPA observed all smoke detectors and carbon monoxide detectors to be in good repair and to test operational. LPA observed all fire extinguishers to be fully charged and to have an updated service tag on them. LPA observed first aid kit to have all required items including scissors, tweezers, bandages, adhesive tape, a thermometer, and a first aid manual. LPA conducted a tour of the exterior of the facility and observe the following. The backyard of the facility is large enough to participate in outdoor activities upon resident request. Backyard is free of any hazards and toxins. Side exits are free of any obstacles blocking the exit route. Side doors are self latching and unlocked. LPA reviewed six resident files and two staff files. All files (Staff and Resident) had all required documents and were filed correctly. All staff training was up to date and documented correctly. LPA reviewed medications and medication administration record. Per LPA review all medications are being documented correctly and are being administered per physicians orders. Based on observations made during today's inspection no deficiencies will be issued per title 22 chapter 6 division 8 of the California Code or Regulations. An exit interview was conducted with AD and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jun 26, 2026

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct a health and safety check in regards to the quality assurance noncompliance plan. LPA was greeted and granted entry by staff. LPA met with Administrators (AD) Maria Sangrador and Manuel Abadines and discussed the purpose of the visit. LPA toured the facility, spoke to and checked on residents in care. LPA observed residents watching tv in the living room and napping in their bedrooms. Residents appeared clean and well taken care of. LPA tested the water in the resident bathrooms to be between 108.3-108.5 degrees Fahrenheit. LPA observed the toxins, sharps and medications to be locked and made inaccessible to residents. LPA observed the night lights to be operational leading from the resident bedrooms to the resident bathrooms. All staff present are background cleared and associated to the facility. LPA reviewed staff and resident files and no discrepancies were observed. Based on today's observations no deficiencies are being noted today per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Apr 7, 2026

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct a health and safety check in regards to the quality assurance noncompliance plan. LPA was greeted and granted entry by staff. LPA met with Administrators (AD) Maria Sangrador and Manuel Abadines and discussed the purpose of the visit. LPA toured the facility and checked on residents in care. LPA tested the water in the bathrooms to be between 110.6-114.8 degrees Fahrenheit. LPA observed residents relaxing and watching tv in the living room. Residents appeared clean and well taken care of. LPA observed the toxins, sharps and medications to be locked and made inaccessible to residents. LPA observed the night lights to be operational leading from the resident bedrooms to the resident bathrooms. All staff present are background cleared and associated to the facility. LPA went through the NCC compliance plan with AD and discussed what was missing from the packet. AD informed LPA that they will submit the completed packet by December 26, 2025 close of business to the Regional Office or to LPA email inbox. Based on today's observations no deficiencies are being noted today per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Dec 16, 2025

Allegation investigated: Facility staff did not prevent resident from sustaining multiple burns Facility staff did not seek timely medical attention for resident

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA was greeted and granted entry into the facility and explained the reason for the visit. The Department received a complaint on February 11, 2025, and LPA Ruppert conducted the initial 10 day visit. LPA Ruppert collected documents including Identification and Emergency Forms, Appraisal Needs & Services Plans, Physician’s Reports and Admissions Agreements. Regarding the allegations, facility staff did not seek timely medical attention for resident and facility staff did not prevent resident from sustaining multiple burns, the investigation revealed the following: On January 21, 2025, around 2:00pm Resident 1 (R1) asked Caregiver 1 (C1) for a cup of coffee. It was reported by C1 that they put the water for instant coffee in the microwave and provided R1 with the hot coffee on a side table. Substantiated C1 advised R1 to be careful due to the coffee being hot. C1 stepped away from the living room and went back to work in the kitchen. A few minutes later C1 heard R1 shout. C1 then went to R1 and R1 had spilled coffee on their left arm, left thigh and stomach. It was reported that R1 had fallen asleep with the coffee cup in their hands after not being able to sleep for four nights. C1 then took R1 to the sink to apply cold running water to their left arm and then cold damp cloth to R1’s thigh and stomach. C1 then notified Administrator Maria Sangrador who assessed R1 and observed a small blister on the left arm. Administrator stated she felt she could tend to the wounds as she is a nurse. In the week following, R1 had reported not feeling well and asked to be taken to the hospital. R1 was finally taken to the hospital on January 25, 2025, four days after the incident, due to being lethargic and non-responsive. R1 went into respiratory failure and was intubated while at the hospital. R1 was diagnosed with 2nd degree burns and pneumonia. Therefore, based on the preponderance of evidence through records reviewed and interviews the allegations facility staff did not seek timely medical attention for resident and facility staff did not prevent resident from sustaining multiple burns are determined to be SUBSTANTIATED meaning the complaint allegation is valid and that a violation has occurred. See LIC9099-D for cited deficiencies and immediate civil penalty as per Title 22 Division 6 of the California Code of Regulations. A Civil Penalty is pending determination by Community Care Licensing Division as per Health & Safety Code 1569.49 (f) An exit interview was conducted Administrator. A copy of this report, along with LIC9099-D, Appeal Rights, Civil Penalty Assessment-LIC 421 IM and the LIC 811, identifying confidential names were provided and explained. Administrator Manuel stated that R1 would not want to wear the machine due to feeling anxious when their face was covered. Interviews with 2 out of 2 staff indicated that the machine was available and working. Administrator stated took the bipap machine to Apria Healthcare in Irvine, CA in May 2025 and technician stated that the machine is working properly. Administrator stated asked company if R1 could get a smaller mask but was told due to fit the larger mask was a better fit for R1. Administrator stated that R1 would use the machine for 10 -15 mins and then switch to oxygen as that made R1 more comfortable. Therefore based on the preponderance of evidence through records reviewed and interviews the allegation facility staff are not ensuring residents medical equipment is properly utilized is determined to be UNSUBSTANTIATED, meaning although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.the state’s words, verbatim · CDSS document, Jul 29, 2025 · control 22-AS-20250211155116

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(f)(1) · Plan of correction due date: Jul 30, 2025

Basic services shall at a minimum include: Care and supervision defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidence by Licensee did not ensure resident was supervised while drinking hot coffee. This poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Jul 29, 2025

Plan of correction: Licensee purchased lids for all mugs and cups to ensure that are spill proof. Licensee to also conduct in service regarding hot beverage items. Immediate Civil Penalty assessed

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(g) · Plan of correction due date: Jul 30, 2025

Incidental Medical and Dental Care. The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health… This requirement is not met as evidence by Licensee did not seek timely medical when Resident 1 (R1) stated they did not feel well after hot coffee burns to the left arm, left thigh and stomach area. This poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Jul 29, 2025

Plan of correction: Licensee to conduct inservice regarding when to seek medical care.

Type of visit: POC

Licensing Program Analyst (LPA) Hanna Gough made an unannounced visit for the purpose of conducting a Plan of Correction inspection for two deficiencies issued on May 20, 2025 during the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator Maria Sangrador and explained the purpose of the visit. LPA toured the facility to check that the deficiencies have been corrected. LPA observed an invoice for the broken medication cart. LPA observed the medication cart to be locked making it inaccessible to residents. LPA observed an in service training log discussing sharps, toxins and chemicals that should be locked at all times making them inaccessible to residents in care. LPA observed the toxins, chemicals and sharps to be locked under the kitchen sink and made inaccessible to residents in care. Based on today’s observations the Plan of Correction has been fulfilled by the assigned Plan of Correction due date of May 21, 2025, thus clearing the Type A deficiencies CCR 87309(a) and 87465(h)(2). An exit interview was conducted with Administrator Maria Sangrador and a copy of this report was provided at the facility.the state’s words, verbatim · CDSS document, May 23, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrators Maria Sangrador and Manuel Abadines and explained the purpose of the visit. The facility currently has four residents in care of which all were seen napping and relaxing in their rooms. The facility is a one story home with six client bedrooms, one staff room, three and a half bathrooms, kitchen, living room, and attached two car garage. The facility appears clean, safe and sanitary. LPA observed departmental postings throughout the facility. All resident bedrooms had the required components and furnishings. LPA observed extra clean linens by the back resident bedrooms. LPA observed the bathrooms to have toilet paper, paper towels and non-slip mats. LPA tested the water to be between 112.2 and 127.9 degrees Fahrenheit. LPA observed activities throughout the facility for resident enjoyment. LPA observed the kitchen to be clean and free of debris and vermin. LPA observed a two day perishable and seven day non-perishable food supply on hand. LPA observed toxins, chemicals, and knives to be unlocked in a kitchen cabinet making them accessible to residents in care. LPA observed a fire extinguisher located outside the kitchen with a service date of June 18, 2024. LPA observed the centrally stored medication cart to be unlocked in the laundry room making it accessible to clients in care. LPA observed the emergency food and water supply. LPA observed the two sheds in the backyard to be used for extra storage space. LPA observed the backyard to be free of obstructions. LPA observed a shaded seating area for resident use. LPA reviewed resident files and one of four residents did not have a physicians report. LPA reviewed resident medication and no discrepancies were observed. Continue on 809-C LPA reviewed staff files and one of two staff did not have a health screening. LPA reviewed the last fire drill conducted was on December 20, 2024. All staff present are background cleared and associated to the facility. Based on today’s inspection deficiencies are being noted per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Administrators Maria Sangrador and Manuel Abadines and a copy of this report along with 809-D pages, LIC 858, LIC 859 and appeal rights were given at the time of inspection.the state’s words, verbatim · CDSS document, May 20, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted and granted entry by Administrator (AD) Maria Cecilia Sangrador and explained the purpose of the inspection. During the inspection LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: This is a one-story home with six resident bedrooms, one staff bedroom, three bathrooms and a half bathrooms, and attached two-car garage. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets. LPA observed all windows were screened. The back yard has a shaded sitting area. LPA observed residents watching television in the living room and resting in their respective bedrooms. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 110.8-111.7 F degrees LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Fire extinguisher service tag indicated it was last serviced on March 14, 2023, smoke detectors and carbon monoxide detectors tested operational with the exception of the hallway and two resident bedrooms; a Deficiency was cited on today’s date. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. Sharps were observed locked in a kitchen cabinet. All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents. Medication cart was observed to be locked; however, a needle and syringe disposal container was observed to be unlocked and accessible, sitting on top of the medication cart, overflowing with syringes causing lid to container to be unable to close as designed; a Deficiency was cited on today’s date. (Cont. LIC809-C) LPA reviewed six of six resident files and three staff files. Six out of six resident files did not have an appraisal dated in the last twelve months; a Deficiency was cited on today’s date. Staff files did not contain any documentation for initial staff training or staff training conducted in the past year and AD was unable to provide LPA with a copy of staff training conducted; two additional Deficiencies were cited on today’s date. LPA interviewed staff and residents present. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.the state’s words, verbatim · CDSS document, Jun 17, 2024

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.