Attentive Manor II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced annual required visit. Upon entry, LPA was greeted by Hector Dorado, caregiver, and informed them of the purpose of the visit. At the time of the visit, there were two (2) staff members and four (4) residents present. Facility Overview: The facility is a one-story home with six (6) bedrooms and three (3) bathrooms, including an attached garage. There are no pools or known firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility has infection control plan in file. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 108°F. Fire extinguisher located at dining area and hallway had current inspection tags. Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Continued on LIC809-C... Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. LPA's attempt to check the administrator's certificate status was unsuccessful because the information was temporarily unavailable. Record Review and Resident/Staff Files: LPA reviewed files for two (2) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Four (4) resident files were reviewed and contained all required documentation. Health-Related Services/Incidental Medical Services: All resident medications were securely locked. LPA reviewed medications for four (4) residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 06-26-2026, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed and provided.the state’s words, verbatim · CDSS document, Jul 13, 2026

Allegation investigated: Staff are not ensuring residents medication needs are met

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced visit to the facility to initiate the investigation into the allegation listed above. The LPA met with Matt Siegel, the Licensee, and informed them of the purpose of the LPA’s visit. The LPA conducted a tour of the interior/exterior areas of the facility, conducted a review of records, and obtained pertinent documentation. On 07-30-2025, Community Care Licensing (CCLD) received a complaint report with the following allegation. It was alleged staff are not ensuring residnets medication needs are met. Information received indicated that Resident #1 (R1) has been out of prescription medication for 2 months. LPA conducted a review of records revealed R1 has never been a resident at the facility. LPA's interview with the Licensee also confirmed R1 has never been a resident at the facility. Continued on LIC9099-C..... Unfounded LPA's review of all residents' medication administration record (MAR) revealed the facility has all medications listed in the MAR. No resident is out of medication. Based on record reviews and interviews, this allegation is Unfounded. A finding of Unfounded means the allegation could not have happened, is false, and/or is without a reasonable basis. There are no deficiencies being cited, per California Health & Safety Code and Code of Regulations, Title 22. An exit interview was conducted where a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 5, 2025 · control 18-AS-20250730143223

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced annual required visit. LPA was granted entry and met with staff, Hector Dorado and administrator Christopher Peck, who was informed of the purpose of the visit. At the time of the visit there were two(2) staffs and four(4) clients present. The facility is a single story home with six(6) bedrooms and three(3) bathrooms with attached garage. There are no pools or other bodies of water located on the premises and no known firearms or other dangerous weapons are stored at the facility. The clients served are adults ages 60 and up. LPA conducted a tour of the interior and exterior, reviewed facility documents and conducted staff and client interviews. The LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan which met department requirements. LPA reviewed staff records and found that all staff had infection control training. LPA observed the client bedrooms and staff office. Physical plant, floors, windows, and doors were observed to be clean. Fixtures and furniture were in good repair were present. The outdoor area was observed to be free of hazards. LPA observed outdoor furniture and shaded area for clients. Laundry equipment was observed to be in good working condition. The sharp and dangerous objects were observed to be locked and inaccessible to clients. The smoke and carbon monoxide detectors were operational, and the hot water temperature was 107.7 degrees F. Two(2) fire extinguishers are located at dining area and hallway. Both fire extinguishers have required inspection tags. continued on LIC809C... LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. Adequate staff are present for the supervision of clients during the visit. LPA also reviewed the staff scheduled showing adequate staff coverage. Facility sketch, exit routes, personal rights, complaint information and emergency phone numbers were found posted in the facility. The listed administrator possesses a current administrator's certificate. LPA reviewed three(3) staff files and training. All staff have criminal clearance and updated training along with CPR/First Aid Certification. Three(3) client files were reviewed and possessed all required paperwork. All client medications stored in locked pantry located in the kitchen area. LPA reviewed medications for three (3) clients and found all medication listed on MARs and all required labeling was found to be in place. LPA reviewed the facility's emergency and disaster plan. LPA reviewed documentation showing the facility performs monthly fire and earthquake drills, which met the department requirements. LPA observed all facility exits were clear from obstructions. LPA observed emergency supplies in the garage. No deficiencies were cited per Title 22, Division 6 of the California Code of Regulations at this time. An exit interview was conducted where a copy of this report was provided to administrator Christopher Peck.the state’s words, verbatim · CDSS document, Jul 26, 2024

Allegation investigated: Staff was in a verbal altercation in presence of a resident.

Licensing Program Analyst (LPA) Kathleen Banrasavong made an unannounced visit to the facility to commence a complaint investigation regarding the allegation listed above. LPA met with Licensee, Matt Siegel where LPA explained the purpose of the visit and the elements of the allegation. The allegation was investigated, the investigation consisted of observation, interviews with staff members and residents, and record review. LPA was unable to obtain contact with additional witnesses. On 08/10/2023, Community Care Licensing received a complaint stating that staff was in a verbal altercation in presence of a resident. It was reported that staff members were arguing and having an inappropriate interaction in front of Resident #1. In regards to the allegation that staff was in a verbal altercation in the presence of a resident, information obtained from interviews stated that there was no verbal altercation incident that occurred in front of residents. Interviews with residents indicated that there were no issues or concerns regarding staff behaving appropriately. Interviews with residents corroborated the information obtained from staff. (Continued on 9099-C) Unsubstantiated Continuation from 9099) Based on LPA’s observation, interview conducted and record review(s), the preponderance of evidence shows that the allegations is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, a copy of this report, appeal rights was provided to the Licensee, Matt Siegel, as evidenced by his signature.the state’s words, verbatim · CDSS document, Oct 16, 2023 · control 18-AS-20230810164347