Casa Doris

Type of visit: Case Management - Annual Continuation

On February 26, 2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrived unannounced at this facility to conduct a case management – annual continuation visit. This is a continuation of the annual inspection visit that was initiated on February 23, 2026. LPA met with staff on duty, Tammar Guthrie, and stated the purpose of the visit. The licensee, Beatrice Clark, was notified and arrived later. Upon arrival, there were 4 residents in care with 1 staff on duty. The other staff arrived later around 1000 hours. During this visit, LPA conducted another physical inspection of the facility. Hot water temperature was at 125 degrees Fahrenheit. Later today, Beatrice adjusted the hot water tank and the hot water was measured at 116 degrees Fahrenheit. LPA conducted resident record reviews. Based on reviews of Medical Assessments (LIC602A), at least two residents (R1 and R2) were assessed to be at risks if they have access to the following items: personal care and hygiene items, disinfectants, cleaning solutions, knives, sharp objects, nutritional supplements, vitamins, and other toxic substances or similar items that could pose danger to residents. LPA conducted review of staff files: Beatrice Clark's file was not available for review. 3 care staff did not have their first aid/CPR certificate on file for review. LPA requested copy of the following facility documents: updated Liability Insurance, current Personnel Record (LIC500), and updated Designation of Responsibility (LIC308). Deficiencies are being assessed base on today's visit and on the February 23, 2026 visit. Civil penalties are being assessed based on repeat violation and background clearance violation. Exit interview was conducted with Beatrice Clark and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Feb 26, 2026

The state marks this report as 21 pages; the online copy we transcribed has 8. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On February 23, 2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrived unannounced at this facility to conduct their annual inspection visit. LPA met with staff, Tammar Guthrie (S1) and Momsey Timberlic (S2), and stated the purpose of the visit. The licensee, Beatrice Clark, was notified and stated she is unable to come to the facility at this time. Present during this visit were the two staff on duty with three residents in care. According to interviews with staff and with Beatrice, S2 is being trained by S1. Per review of Guadian and LIS, S2 is not associated to this facility. Per interview with S1, she stated that she started working at this facility one week ago, but later rescind the statement and stated she just started training today. At approximately 1600 hours, staff Shawnta Martin (S3) arrived at the facility. S3 stated she is the night staff. During this visit, LPA conducted a physical inspection of the facility, including but not limited to resident bedrooms, bathrooms, kitchen, employee office/staff room, and living room. Inspection of the kitchen: LPA found a knife inside the dishwasher that was not locked and was accessible to residents in care. LPA found two medications inside the refrigerator belonging to Resident-1 (R1). These medications were not in a locked container and were accessible to residents in care. The cabinet where medications were kept, LPA was able to open two of the doors, despite being “locked”. The locking mechanisms were secured by tape (photo taken) and LPA was able to open the doors. {1 of 2} Inspection of the room labeled “Employee Room” – it was observed to be unlocked. LPA observed medications, perfumes, and hygiene items that were accessible to residents in care. Per S1, these medications and other items belong to staff. S1 attempted to lock the door but unable to do so and stated she does not know the code. Also observed were two beds. Photo inside the Employee Room was taken. Inspection of the garage: LPA observed the door to the garage was unlocked during this visit. Inside the garage, LPA observed laundry detergents, floor cleaner, and bleach that were not in locked storage. Photos were taken. Hot water temperature was taken in the hallway bathroom and was measured at 122.4 degrees Fahrenheit. Also, inside the hallway bathroom, LPA observed cleaning supplies under the sink. Three out of four resident files were available for review during this visit. Staff files were not available for review during this visit. Files belonging to S1 and S2 were not available for review. S2 is not currently associated to this facility. According to Beatrice, she removed the staff files from this facility. Base on today’s visit, this annual inspection will require a continuation visit. Deficiencies will be cited on next visit. Exit interview was conducted; Beatrice authorized S1 to sign this report. A copy of this report was provided. {2 of 2}the state’s words, verbatim · CDSS document, Feb 23, 2026

Allegation investigated: Due to a lack of staff, resident was left on the floor for an extended period of time

On 09/16/2025, Licensing Program Analyst (LPA) Renee Campbell arrived to the facility at approximately 8:15 am to open and present findings for a complaint. LPA Campbell met with Haykush Harutyunyan, Licensee and explained the purpose of the visit. Regarding the complaint that, resident was left on the floor for an extended period of time due to lack of staff, LPA Campbell interviewed C1, C2, F1 and F2. Per C1 and C2, C1 fell while going to the bathroom during the night and was unable to get up. C1 called for help but no staff came. When C2 woke up, both parties called for help and still no staff arrived. C2 then called F1 by phone. Per F1, C2 called them at approximately 6:30 am. At the time of the call, C2 stated, “We've been yelling for them to come and no one comes”. F1 called the facility and all calls went directly to voicemail or were not answered. F1 contacted F2 as well. Using their call logs, F1 and F2 were able to confirm that this incident occurred between approximately 6:45 am and 7:30 am. This does not include the time that C1 and C2 were unable to contact staff while C1 was incapacitated on the floor. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, the following deficiency is being cited on the attached 809-D during this visit. An exit interview was conducted, and copies of the report and appeal rights left. Substantiatedthe state’s words, verbatim · CDSS document, Sep 16, 2025 · control 27-AS-20250908115645

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(f)(1)(5) · Plan of correction due date: Oct 3, 2025

Basic services shall at a minimum include: Regular observation of the resident's physical and mental condition, as specified in Section 87466, Observation of the Resident. This requirement is not met as evidenced by: Staff were unavailable to provide regular observation of R1's physical conditions which poses an immediate Health, Safet and/or Personal Risk to persons in care.the state’s words, verbatim · CDSS document, Sep 16, 2025

Plan of correction: LIcensees will provide a plan of action to ensure the deficiency will not occur again and submit a Memo of understanding to LPA Campbell for 87464 by the POC date.

Type of visit: Case Management - Deficiencies

On 09/16/2025, Licensing Program Analyst (LPA) Renee Campbell arrived to the facility regarding a case management issue. Upon entry to the facility, LPA Campbell met with two staff (S1 and S2) who were present. LPA Campbell reviewed the Licensing Information System (LIS) and Guardian portal to determine if S1 and S2 were associated at this time. It was observed that S2 was not associated to this facility as of September 16, 2025. An immediate civil penalty of $100 was issued at the time of this visit due to violation of Section 87355(e)(2). Based on the information gathered during the course of this visit, per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, the following deficiencies are being cited on the attached 809D during this visit. If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed. An exit interview was conducted, and a copy of the report will be given.the state’s words, verbatim · CDSS document, Sep 16, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Sep 26, 2025

87355 (e) All individuals subject to a criminal record review shall prior to working, residing or volunteering in a licensed facility: (2) Obtain a California clearance or a criminal record exemption as required by the Department . This requirement is not met as evidenced by: S2's name was not found in LIS and Guardian as being associated to this facility. Which poses an immediate Health, Safety or Personal Rights Risk to persons in care.the state’s words, verbatim · CDSS document, Sep 16, 2025

Plan of correction: Licensee will complete the fingerprint for all staff before allowing them access to the facility and will submit a Memo of Understanding by the POC due date.

Type of visit: Case Management - Other

On 9/10/2025 Licensing Program Analysts (LPAs) Sommer Hayes and Arvin Villanueva arrived unannounced to this facility to conduct a case management visit for the purpose of delivering an Order to Individual of Immediate Exclusion from all facilities and the Order to Licensee/Facility of Immediate Exclusion from Facility. LPAs met with Brenda Bryan and explained the purpose of the visit. Beatrice Clark arrived shortly after. Staff (S1) is excluded as a result related to this facility. LPA served notice of "ORDER TO LICENSEE/FACILITY OF IMMEDIATE EXCLUSION FROM FACILITY" for S1 who was not present at the time of visit. Administrator was advised that an immediate removal is warranted and requested the Personnel Report (LIC500) and Guardian account be updated to remove S1 from the facility staff roster. A notice of completion shall be submitted to Community Care Licensing (CCL) emailing LPA Sommer Hayes. . LPA informed the Administrator that S1 is not allowed to be employed and/or on any facility premises. The Order to Individual of Immediate Exclusion From All Facilities will be in effect as of 9/10/2025 upon receipt of the letter. A copy of the letter was given to the facility during this visit. The facility understands this is an Immediate Exclusion and has agreed S1 cannot be allowed to work, live in, and/or have contact with residents in any residential facility licensed by the California Department of Social Services unless otherwise ordered by the Department. Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed and cited. Exit interview held with Brenda Beatrice Clark, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 10, 2025

Allegation investigated: Staff did not use the proper equipment to move resident in care resulting in injuries to resident.

On 08/12/2025, Licensing Program Analyst (LPA) Renee Campbell arrived to the facility unannounced to close a complaint. LPA Campbell met with Licensee Beatrice Clark and explained the purpose of the visit. Regarding the allegation staff did not use the proper equipment to move resident in care resulting in injuries to resident, resident reported having a skin tear and reported she had hurt her arm because the bed pinched it, not because of staff. When LPA Campbell asked about the injury, X3 stated two staff had assisted her but she didn’t remember their names. The Hoyer lift was not used and was not required per the residents 602. Instead, X3 reported that staff help her out of bed 2 at a time. Based on all the information collected by the Department there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED. Unsubstantiatedthe state’s words, verbatim · CDSS document, Aug 12, 2025 · control 27-AS-20250414104810

Allegation investigated: Residents are not provided activities. Staff are not assisting residents with soiled diapers in a timely manner.

On 04/16/2025, Licensing Program Analyst, Renee Campbell arrived to the facility unannounced regarding a new complaint. LPA Campbell met Administrator Beatrice Clark and explained the purpose of the visit. Regarding the allegation that staff are not assisting residents with soiled diapers in a timely manner, LPA Campbell interviewed X2 and X3 asked how long it takes for staff to change after a toileting accident. Both X2 and X3 reported that staff assist with accidents within 10 to 15 minutes. Regarding the allegation that resident are not provided activites, X2 reported they had not been provided outings but also reported they did not wish to leave her room because she was afraid of having accidents. X2 reported they had little interest in going on outings but staff offer activites for residents in the facility. Based on all the information collected by the Department there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED. Unsubstantiated Due to the above noted information, 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, and therefore this allegation is UNSUBSTANTIATED. Per California Code of Regulations (CCRs) - Title 22, Division 6, no deficiencies cited. Exit interview was held and a copy of report was given to XXXXXXX.the state’s words, verbatim · CDSS document, Apr 16, 2025 · control 27-AS-20250414104810

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Allegation investigated: Staff member yells at resident(s) in care.

This amendment was made on 08/12/2025 to correct the name of the licensee LPA met with. On 04/16/2025, Licensing Program Analyst, Renee Campbell arrived to the facility unannounced regarding a new complaint. LPA Campbell met Admin Beatrice Clark & explained the purpose of the visit. Regarding the allegation that staff members yell at residents in care, after interviewing X2 and X3, there were no reports that staff yelled at residents other than to be heard. No staff are reported to have shouted at residents in an abusive disrespectful manner. Based on all the information collected by the Department there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED. Unsubstantiatedthe state’s words, verbatim · CDSS document, Apr 16, 2025 · control 27-AS-20250407115421

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Victoria Brown arrived announced on 2/20/25 at 10:30am and met with Applicant Beatrice Clark and stated the purpose of the visit. This visit is to conduct a Pre-Licensing Inspection. LPA was allowed entry into the facility that will be licensed and fire cleared for a capacity of 6 non-ambulatory residents. Administrator certificate expires on 10/30/25. LPA observed that the facility has submitted an Infection Control Plan. Facility is fire cleared for rooms 1-4 for Non-ambulatory residents. LPA and Beatrice Clark toured and inspected the physical plant inside and outside to ensure there are no health and safety concerns. LPA observed the kitchen area, dining area, bedrooms, bathroom, storage areas, back yard and laundry area in garage. LPA observed knives/sharps area to be locked. LPA observed required furniture, and lighting throughout the facility. The hot water temperature measured at 115.7 *F which is within the required range of 105-120*F. The temperature inside the facility measured at 76*F which is within the required range of 68-85*F. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises. The first aid kit included supplies such as sterile first aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. LPA observed area for centrally stored medications to be locked. LPA observed the fire extinguisher(s), smoke and carbon monoxide detector(s) and exit alarms on doors in the home. Facility has central heating and air. LPA observed the area where the staff and resident files will be locked and readily available for review. Component III conducted - There are no objections to licensure at this time. -Licensure pending. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no violations cited during this visit. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 20, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Interview Method: Telephone interview On 2/13/2025, applicant/administrator participated in COMP II. Identification of the applicant / administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant / administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Feb 13, 2025