Chateau Sabelle

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Type of visit: Office

On 09/24/2026, Regional Manager (RM) Jackie Jin, Licensing Program Manager (LPM) April Cowan, and Licensing Program Analyst (LPA) Jaime Vado met with licensee Nancy Castle and assistant administrator Armand Atienza to discuss and attend an in office Non-Compliance Conference. Regional Manager (RM) Jackie Jin, Licensing Program Manager (LPM) April Cowan, and Licensing Program Analyst (LPA) Jaime Vado met and discussed the LIC9111 Noncompliance Conference Summary and provided copies to them on this day. No additional citations cited on this day. A copy of this report is provided on this day.the state’s words, verbatim · CDSS document, Sep 24, 2026

Type of visit: Case Management - Other

On 09/15/2026, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced case management - other visit to deliver exclusion letters to the facility in person. LPA met with assistant administrator Armand Atienza and discussed the purpose of today's visit. LPA Vado delivered the exclusion letter for staff persons Emmanuel F. and Renato C. informing him that the two former staff persons are no longer allowed to enter or work at the facility. He confirmed that both no longer work at the facility and are disassociated from the facility. LPA also confirmed that the facility received an NCC letter sent to the facility. According to Arman they did confirm receipt and both him and the licensee will attend the meeting. No citations issued. Report is reviewed with Armand and copy is provided on this day.the state’s words, verbatim · CDSS document, Sep 15, 2026

Allegation investigated: -Staff did not seek timely medical attention for resident's pressure injury

On 07/13/2026, Licensing Program Analyst (LPA) Jaime Vado conducted an unannonced complaint investigation visit to deliver findings regarding the allegations received. LPA met with Nancy Castle and explained the purpose of today's visit. During the investigation by the Department, interviews were conducted, resident facility records, resident medical records were reviewed, and these records were received and maintained. It was found that caregivers S1 and S2 noticed the pressure injury on the resident and applied Medihoney and a dry sterile dressing to it the area. The administrator Nancy Castle stated that this was not reported to managment for assessment. Additionally, co-administrator Armand Atienza spoke to S1 and S2 about the pressure injury and it not being reported, and both stated that they thought someone else had already reported it. Continued on next page... Substantiated Page 2 - LIC9099 The injury began as a redness but progressed to a stage 3 pressure injury and the resident did not receive timely medical attention. S3 reported that S2 reported to him/her on an unknown date that they noticed that R1 had redness in the area of the injury and advised them to apply cream and report to the administrator. S3 explained that caregivers are responsible for reporting concerns about the residents assigned to their care to the administrators. Based on LPA interviews, Department investigation, items received, and medical records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, are being cited on the attached LIC9099D. The deficiencies for the above substantiated allegations is cited in accordance with California Code of Regulations, Title 22, Division 6 and is noted on attached LIC9099D. An immediate Civil Penalty of $500 is assessed for a violation that resulted in a resident sustaining a serious bodily injury. Additional civil penalties may be assessed. Report is reviewed with Nancy Castle and a copy is provided with appeal rights. A copy of the civil penalty will be providedthe state’s words, verbatim · CDSS document, Jul 13, 2026 · control 14-AS-20251126082125

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a) · Plan of correction due date: Jul 14, 2026

87465(a) Incidental Medical and Dental Care - (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care. This regulation has not been met as evidenced by: Based on medical records reviewed, and interviews conducted, the licensee failed to perform care and supervision to the resident to address the care need of a resident who developed an stage 3 pressure injury while in care which is considered a serious bodily injury.the state’s words, verbatim · CDSS document, Jul 13, 2026

Plan of correction: Licensee shall develop a plan of action in writing describing how the facility will ensure that appropriate care, observation of residents for injuries, and seeking timely medical attention for any findings or injuries that may develop. Immediate civil pealty is assessed in the amount of $500 due to the serious bodily injury in developing the stage 3 pressure injury.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87405(d)1 · Plan of correction due date: Jul 14, 2026

87405(d)1 Administrator - Qualifications and Duties: (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (1) Knowledge of the requirements for providing care and supervision appropriate to the residents. This regulation has not been met as evidenced by: Based on medical records reviewed, and interviews conducted, the licensee failed to perform care and supervision to a resident by not addressing the care needs of a resident who developed a stage 3 pressure injury while in care.the state’s words, verbatim · CDSS document, Jul 13, 2026

Plan of correction: Licensee shall develop a plan of action in writing describing how the administrator will demonstrate knowledge of this regulation.

Type of visit: Required - 1 Year

On 10/02/2025, Licensing Program Analyst (LPA) Vado Jaime Vado conducted an unannounced annual required inspection visit. LPA met with caregivers initially then later during the visit the licensee/administrator Nancy Castle arrived to meet with LPA. There are currently 6 residents in the facility during today's visit and 3 staff present prior to the licensee arriving. This is a multi-level facility licensed for residents age range of 60 years and over all of which may be non-ambulatory. License is approved for 4 hospice residents. Residents do not reside on the upper floor as that floor is for staff only. The physical plant was toured inside and outside of the facility to ensure the safety of the residents. There are cameras posted around the outside of the facility and in common areas inside the facility such as the dining room, hallway, and other areas. LPA observed the facility kitchen which is clean and observed appliances that are in good repair. Knives are stored and locked in a lower cabinet next to the stove. Perishable and non-perishable food supplies are in place. There are additional refrigerators in the garage area which carries additional food supplies for resident use. First aid kit is observed as complete with required items stored in the kitchen of the facility. Medications are observed to be locked in a cabinet in the dining room in a credenza. LPA observed at least two fire extinguishers in place which are currently within operating range, smoke detector, carbon monoxide detectors are observed in place through out the facility, and central heating. Continued on next... Page 2 Extinguishers are located on the second floor and in the garage with inspection tags of 06/18/2025. PPE is observed to be in place. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Last emergency/disaster drill was conducted 07/01/2025. Technical violation is discussed regarding conducting such drills quarterly. Water temperature was measured at 105F in two resident bathrooms. Cleaning supplies are observed to be locked in the garage. LPA observed all resident rooms as clean, free of odors, and contained all the required furniture per regulatory recommendations. Resident bathrooms are observed as clean and in good worker order. Shower floors are equipped with non-skid mats or flooring. Medications and logs are observed today as current. During today's inspection LPA reviewed 6 resident files. All are observed to be current. 5 staff files are also reviewed as current with first aid and training on file. Administrator certificate is observed as current expiring 04/04/2026 per certificate observed on site. The following updated forms are requested to be submitted to CCLD by 10/09/2025: • Copy of facility resident roster • LIC308 Designation of responsible staff person • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule No citations are issued during today's visit. Report is reviewed with licensee/administrator Nancy Castle and a copy is provided on this day.the state’s words, verbatim · CDSS document, Oct 2, 2025

Type of visit: Required - 1 Year

On 10/02/2024, Licensing Program Analyst (LPA) Vado Jaime Vado conducted an unannounced annual required inspection visit. LPA met with caregivers initially then later during the visit the licensee/administrator Nancy Castle arrived to meet with LPA. There are currently 6 residents in the facility during today's visit and 3 staff present. This is a multi-level facility licensed for residents age range of 60 years and over all of which may be non-ambulatory. License is approved for 4 hospice residents. Residents do not reside on the upper floor as that floor is for staff only. The physical plant was toured inside and outside of the facility to ensure the safety of the residents. There are cameras posted around the outside of the facility and in common areas inside the facility such as the dining room, hallway, and other areas. LPA observed the facility kitchen which is clean and observed appliances that are in good repair. Knives are stored and locked in a cabinet next to the stove. Perishable and non-perishable food supplies are in place. There are additional refrigerators in the garage area which carries additional food supplies for resident use. First aid kit is observed as complete with required items stored in the kitchen of the facility. Medications are observed to be locked in a cabinet in the dining room. LPA observed at least two fire extinguishers in place which are currently within operating range, smoke detector, carbon monoxide detectors are observed in place through out the facility, and central heating. PPE is observed to be in place. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Last emergency/disaster drill was conducted 04/10/2024. Technical violation is discussed regarding conducting such drills quarterly. Water temperature was measured at 105F. Cleaning supplies are observed to be locked in the garage. Continued on next... Page 2 LPA observed all resident rooms as clean, free of odors, and contained all the required furniture per regulatory recommendations. Resident bathrooms are observed as clean and in good worker order. Shower floors are equipped with non-skid mats or flooring. Facility does not handle resident monies. Medications and logs are observed today as current. During today's inspection LPA reviewed 5 resident files. 2 resident files did not have current physician reports for R2 and R3 both of whom have a diagnosis of dementia Resident with dementia require an annual physicians report. This poses an immediate health and safety risk.. Also, residents only had preplacement appraisals on file but no needs and service plans. LPA advised on having appraisal needs and service plans on file via technical assistance. 3 staff files are also reviewed as current. Administrator certificate is observed as current expiring 04/04/2026 per certificate observed on site. The following updated forms are requested to be submitted to CCLD by 10/09/2024: • Copy of all updated administrator certificate • Copy of staff first aid cards • Copy of facility's liability insurance • Copy of facility resident roster • LIC308 Designation of responsible staff person • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule • Copy of control of property or copy of lease Citations are issued on the following LIC809D. Technical violation is discussed on the following LIC9102TV and LIC9102TA. Report is reviewed with co-administrator Armand Atienza.the state’s words, verbatim · CDSS document, Oct 2, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(c)(5) · Plan of correction due date: Oct 3, 2024

87705(c)(5) Care of Persons with Dementia - Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. This regulation has not been met as evidenced by: Based on records reviewed, LPA observed that the physician's report for R2 and R3 is not current. Residents with dementia require a new physicians report annually. This poses an immediate health and safety risk to resident in care.the state’s words, verbatim · CDSS document, Oct 2, 2024

Plan of correction: Licensee shall develop a plan to maintain all residents with dementia physician's reports to be kept up to date annually. Report and evidence of R2 and R3 updated physician's report to be sent to the department.

Allegation investigated: - Staff are mismanaging resident's medications

LPA Jeung reviewed client files and reviewed Centrally Stored Medications Records for 2 clients. It is alleged that client was given a medication that had been dropped on the floor. This alleged incident is not a violation of California Code of Regulations, Title 22, RCFE regulations. Therefore, this complaint is determined to be unfounded. See Facility Evaluation Report forthe state’s words, verbatim · CDSS document, Feb 22, 2024 · control 14-AS-20240220103803

Allegation investigated: Licensee allows staff to work at facility without fingerprint clearance

LPA Jeung toured facility, including upstairs staff room and garage. There are 6 private client bedrooms--all with private half bathrooms and exits. In the staff quarters, there are heavy curtains that serve as partitions, creating privacy for 2 male staff; there is a bed in each space. There are several steps that lead to another room, which is also partitioned for 2 female staff; there is a bed in each space. In addition, there is a bathroom. Two car garage is observed to be used for storage. LPA interviewed staff on premises, including licensee/administrator, and reviewed staff files. Allegation that there are persons without criminal record clearance has been investigated by the Community Care Licensing Division of the CA Department of Social Services, and determined to be unfounded. This means that the allegation could not have happened and/or is without a reasonable basis. Unfoundedthe state’s words, verbatim · CDSS document, Feb 22, 2024 · control 14-AS-20240212083412

Type of visit: Case Management - Deficiencies

LPA Jeung observed deficiencies of the California Code of Regulations, Title 22, during complaint investigation. Citations appear on following pages. Administrator is requested to submit Personnel Report (LIC500) to CCLD within TEN days.the state’s words, verbatim · CDSS document, Feb 22, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87608(a)(5)(B) · Plan of correction due date: Feb 23, 2024

POSTURAL SUPPORTS Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement is not met, as 3 residents are observed with 2 half bed rails on their beds, forming full bed rails. Licensee failed to prohibit use of full bed rails, which poses an immediate health, safety or personal rights risk to clients in care. Clients #1, #2, #3 are observed with 2 half bed rails on their beds; C3 has 2 half rails on one side of the bed only.the state’s words, verbatim · CDSS document, Feb 22, 2024

Plan of correction: Plan/proof of corrections to be submitted to CCLD BY DUE DATE Bottom half bed rails for client #2 are removed from bed in LPA's presence

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(5) · Plan of correction due date: Mar 7, 2024

INCIDENTAL MEDICAL CARE Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement is not met, as 7 plastic medisets are observed with clients' meds in small plastic containers. Each mediset contains 6 clients' meds for one day. Licensee failed to ensure that medications are maintained in originally received container, which poses a potential health, safety or personal rights risk to clients in care.the state’s words, verbatim · CDSS document, Feb 22, 2024

Plan of correction: Staff shall immediately cease pre-pouring medications. Plan/proof of correction shall be submitted to CCLD BY DUE DATE

From the deficiency page — Deficiency type: Type B · Section cited: CCR87465(h)(6) · Plan of correction due date: Mar 7, 2024

INCIDENTAL MEDICAL CARE A record of centrally stored prescription medications for each resident shall be maintained and include names of the resident for whom prescribed, prescribing physician and pharmacist, drug name, strength and quantity, dates filled, started & expiration, prescription number and instructions: This requirement was not met, as 4 Rx medications for client #6 and 1 med and 4 OTC supplements for client #5 are not recorded on Centrally Stored Medications Records. Licensee failed to ensure meds are logged in CSMRs, which poses a potential health, safety or personal rights risk.the state’s words, verbatim · CDSS document, Feb 22, 2024

Plan of correction: Administrator to ensure that all clients' medications are recorded on Centrally Stored Medications Records. Plan/proof of corrections to be sent to CCLD BY DUE DATE