Bella Manor II

Type of visit: Required - 1 Year

On 03/12/2026 Licensing Program Analyst (LPA) Villegas conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one year inspection. LPA met with Chistina Atencio as the purpose of the visit was discussed. Facility is licensed to serve (6) non-ambulatory residents age range 60 and over of which (1) may be bedridden. There is an approved waiver for (6) residents. The facility does not handle any of the residents’ money. The facility has liability insurance with James River Insurance (policy # 00156516-1 Exp: 07/17/2026). The facility fees are current. The home is a single story home consisting of: (4) resident bedrooms, (2) Full bathroom, a den, living room, kitchen with dining area, laundry room, and backyard with an outdoor shaded sitting area, and a detached garage that is used for storage. Resident bedrooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed. Bathroom toilets and water faucets worked properly, showers were free of mold/mildew, and there are sufficient toiletries accessible to residents. The water temperature properly measured between 116.8 F.. A supply of perishable and non-perishable food was observed, toxins and knifes were stored and inaccessible to residents, no weapons nor bodies of water on the premises, exits and walkways are free of debris/hazards. LPA conducted a records review of 3 staff records, 4 client records, and 4 medication administration records, no discrepancies observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked with manual. The last fire was conducted on 01/14/26, (1) fire extinguisher fully charged, carbon monoxide and smoke detectors are interconnected and operational. Exit interview conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 12, 2026

Type of visit: Required - 1 Year

On 03/03/2025 at 08:35 am, Licensing Program Analyst (LPA) Zina Brown an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one year inspection. LPA met with Chistina Atencio, Administrator and the purpose of the visit was discussed. Facility is licensed to serve six (6) non-ambulatory residents age range 60 and over in which one may be bedridden. Three (3) residents are diagnosed with dementia, and all six (6) resident are on hospice (waiver approved on 10/31/2024 for six (6) residents. None of the residents are receiving home health. The facility does not handle any of the residents’ money. The facility has liability insurance with James River Insurance (NACI #41394) policy # 00156516-0 effective 08/17/2024 - 08/17/2025 (occurrence $1,000,000/general aggregate $3,000,000). The facility annual fees ($495) were paid on 01/21/2025. The home is a single story home consisting of: (4) resident bedrooms, (2) Full bathroom, den, living room, kitchen with dining area, laundry room (by the kitchen) and backyard with an outdoor shaded patio area. LPA toured the resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured at 117.1 F (in kitchen), 115.5 F (in bathroom #1 and 117.6 (in bathroom #2). Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Report continues on LIC 809-C. Between the hours of 10:11 am -11:20 am, LPA conducted a records review of (5) client records, (5) staff records, (0) clients Personal & Incidental Records and reviewed the facility disaster plan. Between the hours of 9:01 am - 9:25am, LPA reviewed (5) Client Medication Administration Records and did not observed any discrepancies at the time of visit. All client & Staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA observed the following not in compliance. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly, and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. The last disaster drill was conducted 01/06/2025. During today’s visit no discrepancies were observed. Exit interview conducted with Administrator Christina Atencio, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 3, 2025

Allegation investigated: Staff is sexually abusing resident in care.

On 11/13/2024 The California Department of Social Services (CDSS) conducted a subsequent, unannounced, complaint visit at the above-mentioned facility. Community Care Licensing Division (CCLD) staff was met by Christina Atencio, Administrator (S1), and the purpose of the visit was explained. The investigation consisted of the following: On 09/24/2024, CCLD staff requested and reviewed the following documents: Resident roster, Personnel roster/Staff schedule. Staff one through staff five (S1-S5) staff records. Resident one through resident three (R1-R3) resident records. S1 and CCLD staff toured the facility. On 09/25/2024 and 10/21/2024, CCLD staff conducted further record reviews that have been provided by S1. CCLD staff conducted a tour of the facility and interviewed four (4) out of five (5) residents (R2-R5), one (1) out of 1 witness (W3) and five (5) staff out of forty-two (42) staff (S1-S3, S5-S6). One resident denied CCLD'S interview. Report continues, see LIC9099C. Unsubstantiated The investigation revealed the following: Regarding the allegation, “Staff is sexually abusing resident in care.”, it has been alleged that residents are being sexually abused by a staff while being bathed. Record reviews have revealed the following: R1’s Preplacement Appraisal, dated 07/02/2024, indicates "Periods of confusion and disorientation. Short Term Memory Problem." and needs “help with bathing, hair care, personal hygiene.”. Admissions Agreement, dated 07/03/2024, indicates that R1 started living at the facility on 07/03/2024. Physician’s report (LIC602A), dated 06/27/2024, indicates that R1 is not “able to bathe self” and is “able to dress/groom self”, with partial supervision and that weekly Registered Nurse (RN) visits are required and have been conducted which began on 04/16/2024 lasting through 09/24/2024 and that Mental Condition: (confused/disoriented) is marked as "NO". LIC602A, dated 09/26/2024: Secondary diagnosis: "Delusional Thought". Weekly RN visits still required. Mild Cognitive Impairment (MCI) or Dementia which is checked off as: DEMENTIA. 14a. Mental Condition: (confused/disoriented) is marked as "YES". R1’s Appraisal /Needs and Services plan (ANS), dated 07/08/2024, indicates that R1: “requires extensive assistance with Activities of Daily Living (ADL's) which includes bathing, transfer, grooming and Personal hygiene. R1 has a history of Depression. Mental (Needs): "With short term memory issues" "With periods of confusion and disorientation.". ANS, dated 09/23/2024 indicates that: "R1 was observed with behavioral issues like paranoia, episodes of refusing care, does not want to be touch(ed), R1 claims will get sexually molested. Thinks staff will poison, drug them and contaminate their food. All behaviors reported to hospice and also observe change in resident cognition.". Eight (8) out of forty-two (42) staff were present during an in-service training, which was conducted on 09/23/2024 at 4:00PM, regarding "Dementia, Behavioral Problems, Sexual Harassment, Abuse reporting." which indicates that staff who were present during the in-service training have been made familiar with dementia care, applied behavioral issues, sexual harassment and abuse reporting. Interviews revealed the following: four (4) out of five (5) residents (R2-R5), one (1) witness (W3) and five (5) out of five (5) staff have denied the allegation has taken place. During today’s visit, LPA observed the following: Five (5) out of five (5) Resident(s) were moved out of their beds to the living room (R3-R5). Two (2) residents were transferred via hoyer-lift (R2 & R6), and were also moved to the living room in comfort, via wheelchair. All five (5) Residents (R2-R6) were provided their lunch and feeding assistance was provided via staff five (S5). According to CCLD’s staff record reviews, observations, and interviews conducted, there is not enough evidence to support the above allegation. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the above allegation is Unsubstantiated. An exit interview was held with Christina Atencio (S1) and a copy of this report has been provided.the state’s words, verbatim · CDSS document, Nov 13, 2024 · control 11-AS-20240923132701

Type of visit: Required - 1 Year

On 02/22/24, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Administrator Christina Atencio as the purpose of the visit was explained. The facility is licensed for six (6) non-ambulatory residents of which (1) may be bedridden ages 60 and over. Facility has an approved hospice waiver for (4). Current facility census is (5). There are no facility fees due at this time, liability insurance is active. The facility is a single-story structure located in a residential neighborhood and consists of the following: (5) resident bedrooms, (2) bathrooms, living room, dining room, family room used for activities, kitchen, washer and dryer area with linen storage, a backyard with table and chairs, and a detached garage that is used for storage. Resident bedrooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed. Bathroom toilets and water faucets worked properly, shower was free of mold/mildew, and there are sufficient toiletries accessible to residents. The water temperature properly measured between 105-120 F..Kitchen was inspected and observed to be clean and operational. A supply of perishable and non-perishable food was observed, toxins and knifes were stored and inaccessible to residents, no weapons nor bodies of water on the premises, exits and walkways are free of debris/hazards. LPA conducted a records review of (3) staff records, (2) resident records, and (2) medication administration records, no discrepancies observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. (1) fire extinguisher fully charged, carbon monoxide and smoke detectors are interconnected and operational. Landline and internet service was observed. The last fire was conducted on 01/01/24.During today’s visit no discrepancies were observed. Exit interview conducted with Administrator Christina Atencio, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 22, 2024