Care Celine I

Allegation investigated: Facility is retaining a resident with unstageable pressure injuries without adequate level of care Facility staff is medically restraining a resident Facility staff hit a resident

On May 29, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to deliver the complaint findings. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Licensee Cherry Aguila was also present and assisted on today's visit. During the course of the investigation, the Department interviewed residents, interviewed staff, reviewed and obtained pertinent documents to this complaint such as resident records, resident medication records, and staff records. Regarding the allegation, facility is retaining a resident with unstageable pressure injuries without adequate level of care, the following has been concluded: It was alleged that the facility is retaining Resident #1 (R1) with unstageable pressure injuries without adequate level of care. The Department conducted a file review for R1 and observed that R1 was admitted to the facility on February 28, 2025. The Department also observed that R1 was also admitted under hospice care on February 28, 2025. CONTINUED ON LIC9099-C Unsubstantiated The Department observed that R1 remained under hospice care until she moved out of the facility on June 30, 2025. The Department reviewed the hospice care records and wound care specialist reports from R1. Per the hospice care records, R1 was admitted to the facility without any pressure injuries. On April 15, 2025, R1 was first observed to have wounds to her left and right thigh. On May 1, 2025, R1 was observed to have a third wound to her right thigh superior. Based on a review of the hospice care records and wound care specialist reports for R1, the three wounds were not classified as an unstageable pressure injuries. The three wounds were also not classified as stage three or stage four pressure injuries. R1 was receiving hospice care visits two or three times each week to treat the wounds. In addition, R1 was also receiving visits from a wound care specialist to treat the three wounds. Based on a review of records for R1, the facility was able to provide adequate care for R1 and was within the limitations of their license to continue retaining R1 as a resident of the facility. The Department conducted five staff interviews. The five staff interviewed confirmed that R1 had wounds on her body, however, the five staff denied that the wounds were unstageable. Regarding the allegation, facility staff is medically restraining a resident, the following has been concluded: It was alleged that facility staff is medically restraining R1. The Department was unable to conduct an interview with R1 for this allegation, due to R1 passing away on October 2, 2025. During the investigation, the Department reviewed the medication and medication administration records for the residents of the facility, including for R1. The Department did not observe any medication errors or discrepancies in the medication records reviewed. The Department conducted five resident interviews. Two residents were unable to qualified for an interview due to their current cognitive conditions. However, the three other residents denied the allegation and reported that they have never been restrained by staff in any way. The Department also conducted three staff interviews for this allegation. Three out of the three staff interviewed denied the allegation and reported that residents have not been medically restrained in any way. During the investigation, the Department was unable to obtain any evidence to corroborate the allegation. Regarding the allegation, facility staff hit a resident, the following has been concluded: It was alleged that facility staff hit R1 and Resident #2 (R2). The Department was unable to conduct an interview with R1 for this allegation, due to R1 passing away on October 2, 2025. The Department was also unable to conduct an interview with R2 for this complaint, due to R2 moving out of the facility on June 2, 2025. The Department conducted five resident interviews. Two residents were unable to qualified for an interview due to their current cognitive conditions. However, the three other residents denied the allegation and reported that they have never been hit by a staff. CONTINUED ON LIC9099-C The Department conducted five staff interviews for this allegation. Five out of the five staff interviewed denied the allegation and reported that residents have never been hit by staff. The five staff also reported that they have never observed a staff hit a resident. Based on the evidence gathered during the investigation, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, the three allegations are deemed UNSUBSTANTIATED. An exit interview was conducted with Licensee Cherry Aguila and a copy of the report was provided to the facility at time of visit.the state’s words, verbatim · CDSS document, May 29, 2026 · control 22-AS-20250430084905

Type of visit: Required - 1 Year

On December 16, 2025, at 10:15 AM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim was greeted and granted entry by staff. LPA Kim met with Licensee (LI) Cherry Aguila and explained the purpose of the visit. The facility is licensed to operate for five (5) nonambulatory residents and one bedridden only and have a hospice waiver for three (3) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, one (1) staff room, three (3) bathrooms, living area, dining area, kitchen, outdoor covered patio, and an attached two car garage. LPA Kim toured inside and outside of the physical plant with LI Aguila. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident's personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, and Resident Room 4. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 112.2 degrees F to 114.9 degrees F. A comfortable temperature of 74 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. Evaluation Report Continues on LIC 809-C The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, emergency water, and emergency supplies were stored in the garage. The facility has one (1) fire extinguisher that is charged and mounted in the kitchen and last inspected on November 19, 2025. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were operable. First Aid kit had all the necessary elements. Certificate of Liability Insurance is effective from February 20, 2025, to February 20, 2026. Emergency drill was last conducted on November 4, 2025. LPA Kim conducted an audit of resident files (R1-R2), staff files (S1-S2), and medication and medication administration record were all in order and complete. LPA Kim conducted interviews with two (2) residents and one (1) staff. No deficiencies were cited during the inspection visit. An exit interview was conducted, and a copy of this report was provided to Licensee Cherry Aguila.the state’s words, verbatim · CDSS document, Dec 16, 2025

Type of visit: Required - 1 Year

On December 16, 2024, at 1:00pm, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim was greeted and granted entry by Caregiver (CG) Monaliza Reyes. LPA Kim met with Licensee (LI) Cherry Aguila and explained the purpose of the visit. The facility is licensed to operate for five (5) nonambulatory residents and one bedridden only, and have a hospice waiver for three (3) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, one (1) staff room, three (3) bathrooms, living area, dining area, kitchen, outdoor covered patio, and an attached two car garage. LPA Kim toured inside and outside of the physical plant with LI Aguila. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident's personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, and Resident Room 4. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 112.4 degrees F to 114.2 degrees F. A comfortable temperature of 76 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, emergency water, and emergency supplies were stored in the garage. The facility has one (1) fire extinguisher that is charged and mounted in the kitchen, and last inspected on June 3, 2024. Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were operable. A working telephone (714-485-2641) remains available. First Aid kit had all the necessary elements. Certificate of Liability Insurance is effective from February 20, 2024, to February 20, 2025. LPA Kim conducted an audit of resident files (R1-R4), staff files (S1-S3), and medication and medication administration review. LPA Kim conducted two (2) staff interviews. Deficiencies were cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights were provided to Licensee Cherry Aguila.the state’s words, verbatim · CDSS document, Dec 16, 2024