Calimyrna Assisted Living

Type of visit: Required - 1 Year

On 2/19/26 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Ginalyn Quillopo, LPA was granted entry. 2 residents were present during inspection. Administrator (A1) Carlo Santos did not arrive at the facility visit. On this day the facility is in transitioning all of it's belongings including medications, resident files, and the 2 residents to a new location at 1425 W. Palo Alto Ave. Fresno, CA. 93711. A1 will continue to assume Administrator duties at the new location as it is currently undergoing the pre-licensing process through CCLD. No Inspection Tool completed on this visit because of the transitioning of the facility. Exit interview conducted. A copy of this report was distributed to Staff whose signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Feb 19, 2026

Type of visit: Required - 1 Year

On 2/19/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Ginalyn Quillopo, LPA was granted entry. 3 residents were present during inspection. Administrator (A1) Carlo Santos arrived shortly after LPA’s arrival. LPA toured facility with S1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Samples of resident’s medications were checked and observed unlocked in kitchen drawer and cabinet. Clients’ MARS was reviewed. Samples of medications were initialed before time for medications were to be administered. Fire extinguisher reviewed with a service date of: 8/15/24. Fire drill completed on 1/10/25. Clients' bedrooms were toured and reviewed. Cleaning chemicals were observed stored and locked in closet. Residents bedrooms observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 105.8 to 114.9 degrees F in 6 bathrooms. Outside of facility toured. Outside observed free of debris. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Freezer temperature observed at 0 degrees F and refrigerator temperature maintained at 42 degrees F. Smoke detectors and carbon monoxide were tested and observed to be operational. All clients’ files and staff’s files reviewed to have all the required documents. The following deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 3/5/25: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance-RCFE, Emergency and Disaster Plan (LIC 610E ), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A) A copy of this report, appeal rights and LIC-9102 were provided to A1, whose signature on this form confirms receipt of these report.the state’s words, verbatim · CDSS document, Feb 19, 2025

Allegation investigated: Staff physically assaulted a resident

On this date, Licensing Program Analyst (LPA) J. Leffall and Licensing Program Manager (LPM) S. Moua met with Licensee, Tyson Peters, Licensee, Robert McKnight and Administrator, Carlo Santos. The above allegation was discussed and finding was delivered. The Department conducted interviews and reviewed records. Based on the records reviewed, S1 slapped R1. The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Citation is issued per Title 22 on the attached LIC 9099D. Appeal rights were given and exit interview was conducted. Substantiatedthe state’s words, verbatim · CDSS document, Jul 30, 2024 · control 24-AS-20240509105631

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(3) · Plan of correction due date: Jul 31, 2024

Personal Rights of Residents in All Facilities - To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement was not met as evidenced by: Based on the records reviewed, S1 slapped R1, which poses an Immediate Health and Safety risk.the state’s words, verbatim · CDSS document, Jul 30, 2024

Plan of correction: Facility will terminate employee and retrain all staff in the facility on caring for residents.

Type of visit: Office

On 5/16/24 Regional Office Manager, B. White, Licensing Program Manager, S. Moua and Licensing Program Analyst M. Garza had an in office meeting held for an initial complaint visit (#24-AS-20240509105631). Licensee, Tyson Peters, Licensee, Robert McKnight and Administrator, Carlo Santos were present in office. Licensees, Kurt Zumwalt was unavailable for this meeting. During visit interviews were completed with Licensees and Administrator. At this time the complaint NEEDS FURTHER INVESTIGATION. During the course of the investigation it was found that S1 was not fingerprint cleared and associated. It was also found that the incident on 3/20/24 was not reported as required by completing an SOC 341 to CCL and Ombudsman. Deficiencies cited per Title 22. Civil penalty assessed for S1 not being fingerprint cleared. Exit interview completed with Licensee, Tyson Peters and Administrator, Carlo Santos. A copy of this report, deficiencies, civil penalty and appeal rights was provided.the state’s words, verbatim · CDSS document, May 16, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(1) · Plan of correction due date: May 17, 2024

Criminal Record Clearance - Obtain a California clearance or a criminal record exemption as required by the Department. Staff Monique Enez Conigliaro is not fingerprint cleared. Immediate civil penalty of $500.00 will be assessed. This requirement was not met as evidence by: LPA interviews and records reviewed it was confirmed that S1 was not fingerprint cleared or associated to the facility and was working there at the time of the incident. This poses an immediate health, safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 16, 2024

Plan of correction: Licensee has removed S1 from employment and stated that S1 will not return until fingerprint cleared and associated.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87405(d)(2) · Plan of correction due date: May 17, 2024

Administrator - Qualifications and Duties - Knowledge of and ability to conform to the applicable laws, rules and regulations. Staff Carlo Santos, who the facility refers to as the Administrator did not ensure staff was fingerprinted and cleared to work in the facility. This requirement was not met as evidence by: LPA's review of documentation. The facility failed to assure S1 was fingerprint cleared or associated to the facility and failed to report per reporting requirements (SOC 341). This poses an immediate health, safety and or personal rights risks to residents in care.the state’s words, verbatim · CDSS document, May 16, 2024

Plan of correction: Licensee stated the Administrator qualification will be reviewed. Statement for completion of the training will be sent to CCL by POC date.

Type of visit: Required - 1 Year

On 2/19/2024, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Inspection. LPA arrived introduced self, stated purpose of visit, and allowed entrance by caregiver. Administrator not available to conduct today's inspection. Carlo Santos, Co-Administrator contacted by telephone and arrived a short time later to inspection visit. Facility tour conducted. All residents were present during today's inspection. Facility observed to be clean, odor free, a comfortable temperature, and well lit. Facility has 6 private bedrooms and each bedroom has a 1/2 bathroom with grab bars available. Facility has one walk in shower room for all residents, shower room observed to have shower chair, grab bar, and non-skid flooring. Water temperature measured at 111 degrees F. Living room and dining room observed to have seating for all residents. Kitchen toured, facility observed to have a 2-day supply of perishable and a 7-day supply of non-perishable food available. All knives observed to be locked and secured and inaccessible to residents. Medication observed to be locked and secured in hallway closet. All medications observed to have original labels and be administered as prescribed. Facility is equipped with fire sprinkler system. Fire extinguisher present with a service date of 7/02/2023. Last fire drill conducted 1/10/2024 according to facility records. Outside of facility toured. All exits open free of obstruction. Resident and staff file reviewed. No deficiencies Exit interview conducted. A copy of this report provided for facility records.the state’s words, verbatim · CDSS document, Feb 19, 2024