Ars Fountain Homes

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced required annual inspection visit. LPA was greeted by caregiver and the reason for the visit was explained. Licensee Rowena Santos arrived shortly after to assist with facility tour. The facility is licensed to serve six (6) adults age range 60 and over. Approved for six (6) non-ambulatory of which two (2) may be bedridden in room #3 only. Approved hospice waiver for six (6). The facility is a single-story home located in a residential area of La Verne. The home consists of a living room, dining area, kitchen, four (4) resident bedrooms, two (2) bathrooms, laundry room, attached garage, front and backyard. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: The front and backyard are well maintained and there are no pools or large bodies of water. There is a covered patio providing a shaded seating area located in the backyard with sufficient seating for residents in care. Passageways and exits are free of obstructions. continued on LIC 809C continued from LIC 809 The water temperature was tested in bathroom #1 in the hallway and measured 113.3 degrees F, which is within the required 105 degrees F - 120 degrees F. Bathroom #2 water temperature measured 113 degrees F. LPA observed grab bars and non-skid mats in both the bathrooms. Resident bedrooms have the required furniture and have sufficient closet and storage space. Resident beds have the required linen and the linen is in good repair. Hallway cabinet contained PPE supplies, surplus hygiene supplies and surplus clean linens. Combination smoke and carbon monoxide detector located in the hallway of the home. There are two (2) fire extinguishers located in the dining area and in the hallway. Emergency drills conducted quarterly, last drill was 06/28/25. Kitchen was observed to be clean and free of pests. Kitchen appliances are clean and were operating at the time of the visit. Sharps are locked in a kitchen drawer and are inaccessible to residents. Cleaning supplies and disinfectants are locked under the sink and are inaccessible to the residents. Sufficient supply of 2 days perishable and 7 days non-perishable foods were observed. Dining area observed clean with sufficient seating for residents in care. Centrally stored medication is located in a locked hallway closet. Medications are documented properly and given as prescribed. Attached garage has laundry area. Washing machine and dryer wear clean and operable at the time of visit. There is a cabinet with laundry supplies, inaccessible to clients. Per California Code of Regulations, Title 22, and California Health and Safety Code, no deficiencies were cited during today’s visit. Exit interview held and a copy of this report was provided to Luis Santos due to Licensee Rowena Santos having to leave for an appointment.the state’s words, verbatim · CDSS document, Sep 26, 2025

Allegation investigated: Staff are inappropriately restraining a client in care. Staff are not administering resident's medications as prescribed. Staff did not prevent client from losing excessive weight.

Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint visit to deliver findings on the above allegations. LPA met with Administrator Rowena Santos and explained the purpose of today's visit. The investigation consisted of the following: During initial visit conducted on 7/1/25, LPA reviewed Resident #1 (R1) file and medications, LPA toured R1's room, LPA reviewed the Medication Administraton Record (MAR) that facility uses and LPA interviewed 4 staff (S1-S4) and 2 residents (R1-R2). During todays visit LPA delivered findings on above allegations and conducted a case management visit to issue citations on observations made during initial visit. (Continued on the LIC9099-C) Unsubstantiated The investigation revealed the following: Allegation: Staff are inappropriately restraining a client in care. It is alleged that the facility is using an unauthorized physical restraint on R1 that ties R1 to their bed. LPA interviewed 4 staff and 4 out of 4 staff denied the above allegation and stated that they have never used restraints on any of their residents. LPA interviewed 3 residents and 2 out of 3 residents denied the above allegation. R1 stated there was a time that staff would worry over R1 getting out of bed in the middle of the night as the risk of fall was there but they have never been restrained to their bed nor have they observed other residents being restrained in any way. LPA interviewed R2 and it was stated that they believe that R1 at one time was restrained to their bed but could not confirm as they never physically saw the restraint. Interviews with 3 other residents were not conducted due to cognitive impairments. LPA toured R1’s bedroom and looked under mattress around bed and under bed, there were no signs of restraints being any where in room or near R1’s bed. (unsubstantiated) Allegation: Staff are not administering resident's medications as prescribed. It is alleged that the facility staff are using excessive medication on R1. LPA interviewed 4 staff and 4 out of 4 staff denied the above regulation and stated that all medications, supplements and vitamins have a prescription and are administered per the doctors orders. LPA interviewed 3 residents and 3 out of 3 residents denied the above allegation and stated they feel the staff are giving their medication as prescribed and all medication looks the same with no changes noticed or concerns. Interviews with 3 other residents were not conducted due to cognitive impairments. LPA reviewed medication and the Medication Administration Record (MAR) and observed the following: MAR was not being documented properly as June 29-30, 2025 and July 1, 2025 were not signed for by the staff that assisted with administering medications each of those days, LPA spoke with S2 and S2 stated they did give the medications per doctors orders, however, they forgot to sign the MAR. LPA observed R1’s medication list provided by their doctor, there were PRN medications listed (as needed medication), however, those medications were not in R1’s Medication basket, when LPA questioned S2 about this medication they stated they have not refilled the medication for R1. (unsubstantiated) Although LPA did not find proof of R1 being over medicated, a citation will be issued today (7/8/25) for the missing PRN medication in a separate report via Case Management visit. (Continued on LIC9099-C) Allegation: Staff did not prevent client from losing excessive weight. It is alleged that since R1’s admission in December 2024, R1 has presented with documented weight loss. LPA interviewed 4 staff and 4 out of 4 staff denied the above allegation and stated that since admission R1 has gained a healthy amount of weight as their condition and appetite has improved. LPA interviewed 3 residents and 3 out of 3 residents denied the above allegation, R1 stated they have noticed a bit of weight gain within themself as they enjoy the food at the facility and their appetite has improved. LPA reviewed R1’s Physician Report dated 10/21/24 and additional medical record dated 1/10/25 both had the same weight, during initial visit 7/1/25 staff weighed R1 and LPA compared it to the weight records and it showed a weight gain of 8 pounds. (unsubstantiated) Based on statements and interviews conducted with staff/residents, review of R1's files and Medication Review, there was not enough supportive evidence to concur with the reported allegations. 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, therefore the allegations are UNSUBSTANTIATED. Exit interview held, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 8, 2025 · control 28-AS-20250627115520

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Tena Herrera conducted a Case Management Visit to address observations made during a Complaint Investigation dated 7/1/2025, complaint control # 28-AS-20250627115520. LPA met with Administrator Rowena Santos and explained the purpose for todays visit. During visit dated 7/1/25 LPA conducted a medication review and the following was observed: The Medication Administration Record (MAR) was not being documented properly as June 29-30, 2025 and July 1, 2025 were not signed for by the staff that assisted with administering medications each of those days for all residents, LPA spoke with S2 and S2 stated they did give the medications per doctors orders they just forgot to sign MAR. LPA observed R1’s medication list provided by the doctor, there were PRN medications listed (as needed medication), however, those medications were not in R1’s Medication basket, when LPA questioned S2 about this medication they stated they have not refilled the medication for R1. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed are documented on 809D. Exit interview held, a copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jul 8, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(b) · Plan of correction due date: Jul 15, 2025

87465 Incidental Medical and Dental Care (b) If the resident's physician has stated in writing that the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication, facility staff shall be permitted to assist the resident with self-administration of his/her PRN medication. This requirement was not met as evidence by: During initial visit on 7/1/25 LPA observed all PRN medications that were listed on Medication List, were missing for R1 and it was confirmed by S2 that the medication has not been ordered. During todays visit per S2 all PRN medication has been discontinued, there was no documentation stating discontinuation from doctor.the state’s words, verbatim · CDSS document, Jul 8, 2025

Plan of correction: Licensee/Administrator to provide LPA with a copy of the discontinue order for PRN's that were listed on medication list dated 7/1/25. Copy of Discontinuation Order to be emailed to LPA by POC due date. tena.herrera@dss.ca.gov

From the deficiency page — Deficiency type: Type B · Section cited: CCR87506(a) · Plan of correction due date: Jul 15, 2025

87506 Resident Records (a)The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement was not met as evidence by: During initial visit on 7/1/25 LPA observed MAR was not being signed for properly as dates 6/29/25, 6/30/25 and 7/1/25 were all missing signatures from S2 who assisted with medications. S2 confirmed medication was provided to residents, however, they forgot to sign.the state’s words, verbatim · CDSS document, Jul 8, 2025

Plan of correction: Licensee/Administrator to retrain staff on medication administration and how to properly document and utilize the MAR to avoid any confusion or discrepancies. Training Log with participant signatures must be emailed to LPA by POC due date. tena.herrera@dss.ca.gov

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced Annual Required Visit at 1:07 PM. LPA was met by Care giver Melba Fojas and explained the purpose of the visit. Administrator Apoloni Santos arrived shortly. Facility is licensed to serve residents over 60 years old six (6) can be non-ambulatory, of which two (2) may be bedridden in room #3. During today’s visit it was observed facility had bedridden resident in room one. Deficiency and civil penalty assessed. The facility is a single-story home, located in a residential area. The home consists of a living room, (4) residents’ bedrooms, (1) staff room, (2) resident bathrooms, a kitchen, dining room, attached garage, and shaded patio with seating in the backyard. LPA toured the facility and observed the following: Each client bedroom has the required furniture and bedding. There is extra clean linen and towels in a hallway closet. Smoke detectors were observed in each room and throughout the facility and are properly operating. There is 1 carbon monoxide in the hallway and is properly operating. The facility has two (2) fully charged fire extinguishers which is kept in the kitchen and hallway. Cleaning supplies and toxic substances were observed to be inaccessible to clients and locked in kitchen cabinet. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. Sharps are locked and placed in cabinet in kitchen. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction. The garage is clean and has extra supplies. SEE LIC 809C Four (4) Staff files were reviewed and included Criminal clearance record, CPR/training, and health screening with TB. Six (6) Client files were reviewed and included physicians report, TB clearance. Fire/earthquake was conducted on 06/02/2024. Infectious control plan was reviewed. The medications are centrally stored and locked in a closet at entryway of home. The facility uses the Medication Administration Record (MAR) log to document medications given. LPA reviewed medications for all clients, and they are being administered as prescribed by the physician. Deficiencies have been noted on LIC 809D under Title 22 Regulations. Exit interview was conducted and a copy of this report, LIC 809D and appeal rights were provided to Apoloni Santos.the state’s words, verbatim · CDSS document, Aug 9, 2024