Citrus Pines Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with staff, Jhamil Espino, Jacob Espino and Administrator, Janelyn Kelly. Several health care staff and family members visited during today's inspection. The facility is licensed for (6) residents, (5) of whom may be non-ambulatory and (1) may be bedridden. There is (1) resident currently on hospice. (4) residents were eating lunch in the dining room at the start of the inspection. LPA and Administrator toured the interior/exterior of the facility including the common areas, (6) private resident bedrooms, (4) resident bathrooms, kitchen, laundry, and activity area. LPA observed the facility to be clean, in good repair and odor-free. Bathrooms have the necessary grab bars, skid-resistant flooring, shower chair, trash can and hygiene supplies. There is sufficient 2+day perishable, including fresh produce, and 7+day non-perishable supply of food, as well as an emergency supply of food/water. Sharps and toxins are locked are in the kitchen. There are sufficient linens/towels/blankets and PPE supplies. Inside temperature measured 72*F and hot water measured 109* in the kitchen. Fire extinguisher last serviced June 8, 2026. Required postings are visible in the common area. Outside, there is (1) unlocked exit gate and walking trail in the back and a front courtyard . There are non-audio cameras in the common areas. LPA reviewed (2) resident files and (4) staff files. Files are complete and contain current documentation. Medications were reviewed for (2) residents- orders match medications being administered. Facility uses an electronic record system. Administrator has current RCFE Administrator certificate. All staff are cleared and associated. Copy of current insurance obtained. LPA requested updated LIC308 and LIC500 by 7/28/26. There were no deficiencies observed. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Jul 21, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection after reviewing hospice records for resident (R1), who passed in March 2026. LPA met with Janeyn Kelly, Administrator, and explained the purpose of the inspection. Also present were staff, Jhamil Espino, Jacob Espino and Hazel Polig. LPA reviewed multiple pages of hospice records from when (R1) was admitted to service on February 20, 2026 through their passing on March 4, 2026. Paperwork showed that (R1) had an admitting hospice diagnosis of Gastrointestinal Hemorrhage and a related diagnosis of total body rash, Bi-lateral edema, and jaundice. The hospice notes state the the hospice nurse reviewed medications with (R1's) family member and collaborated with the facility administrator on the plan of care. On February 20, 2026, (R1) stated they had no pain, but itching from the rash, and difficulty seeing and hearing. The notes also state (R1) was observed to have a healing cut on their head from a fall, and sutures were removed recently. The hospice Plan of Care requires (R1) be placed on bedrest and receives care for incontinence/catheter. The hospice notes reflect that various hospice personnel visited (R1), multiple times a week and the facility was advised to continue monitoring (R1) for proper positioning, skin measures, bowel/urinary incontinence regimen, pain management, pain assessment and fall risk assessment. (R1) had an unwitnessed fall on February 28,2026 (8:30 am) and sustained abrasions on both legs. Hospice staff promptly applied wound care and conducted a neurologic assessment. Notes say (R1) did not have a loss of consciousness or mental status change. Facility staff was advised to continue monitoring (R1) and contact hospice immediately if (R1) begins to show any signs/symptoms such as headache, fever, vomiting, confusion, seizures, vision changes, or bleeding. Facility staff was also provided with education and support to monitor for signs of pain to administer medication needed. *report continued on 809C-.. 809C-. The administrator stated that hospice discussed medications at the start of hospice services, and no discrepancies were ever noted or discussed. LPA observed the electronic medication record that Omeprazole 20 mg was scheduled for twice daily, per the orders. LPA and the administrator, and staff, also reviewed hospice visit notes from the initial visit on February 20, 2026, and Omeprazole 20 mg is noted as to be given twice daily. The electronic system will signal on the computer if a dosage is not administered per orders. Notes from March 3, 2026, state that (R1's) family member was concerned about (R1) showing signs/symptoms of pain and anxiety, Omeprazole and morphine were administered by hospice staff, and (R1) tolerated it well. Both family and facility staff were advised to contact hospice with any additional questions/concerns. It's noted that on March 4, 2026, (R1's) family member was especially concerned about (R1's) pain level and a social worker and nurse each conducted visits to assess (R1) and provide support to the family member. Both the family member and facility staff were advised to contact hospice staff with any concerns, or a change in condition. Hospice notes state that they received a phone call from the facility on March 4, 2026 (1728 hours) that (R1) had passed, and hospice staff arrived shortly and pronounced (R1) deceased at 1806 hours. LPA was provided with copies of several text communications sent from the Administrator to (R1's) family member conveying changes in (R1's) condition regarding their appetite, input, urine output, itching from their rash. It appears the facility followed the hospice care plan and were in regular communications with the hospice company and resident's family. There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Jul 10, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection following (3) incident reports submitted to the Department for resident (R1). LPA met with Janeyn Kelly, Administrator, and explained the purpose of the inspection. Also present were staff, Jhamil Espino, Jacob Espino and Hazel Polig. LPA was advised that (R1) was currently attending a medical appointment outside the facility and there were (4) residents present. LPA and the Administrator discussed the following incidents where (R1) was sent out for emergency treatment, and documentation was reviewed. On May 24, 2026 (11:00 pm), (R1) called staff for assistance after blood was coming out of a dialysis shunt on their left arm. The administrator applied direct pressure and immediately contacted 9-1-1. (R1) was transported to the emergency room (11:15 pm), returned to the care home on May 25, 2026 (8:00 am) and was able to go to their scheduled dialysis appointment (8:35 am) that same day. (R1) will continue to receive care from dialysis and home health nurses, and the facility will monitor for any signs of bleeding. On May 26, 2026 (3:45 pm), (R1) called for staff assistance after falling on the floor, trying to reach for a paper, and complained of pain in their hands/wrists. (R1) was taken out (4:15 pm), for further medical evaluation and medications review related to new medications prescribed for a skin rash. (R1) returned the same day (8:40 pm) with a new order for pain management and to taper Gabapentin. No fracture was found. (R1) was advised by hospital staff to continue with routine scheduled dialysis (3 times weekly). On May 27, 2026, (R1's) dialysis session was not completed due to a blood clot on their AV shunt. (R1's) primary care physician and pharmacy recommended to increase Eliquis dosage; however, (R1) declined due to side effects. *report cont on 809C.. 809C- On May 28, 2026 (10:30 pm), (R1) was observed to be lethargic, sleeping the whole day and off baseline. 9-1-1 was contacted and transported (R1) to the ER (11:00 pm). (R1) was admitted to the hospital and remained hospitalized until June 12, 2026, due to a sepsis diagnosis. During their hospital stay, (R1) received IV antibiotics, had a new surgical shunt inserted, and was advised to continue with dialysis schedule three times weekly. Hospital discharge papers show (R1) followed up a few days for post-operative care and with their primary care physician a week later. LPA observed that (R1's) care plan was updated on June 13, 2026 and a new physician's report was obtained following (R1's) discharge from the hospital. The Administrator stated that (R1's) skin rash is improving and they are back to baseline. LPA observed (R1) return to the community, from dialysis, around 12:00 pm during today's inspection, and resting in their room. LPA spoke to (R1), who was eating lunch with other residents, and they stated they are doing better. It appears the facility took appropriate action in contacting emergency personnel to send (R1) out for further medical evaluation, on several occasions. LPA observed multiple visitors, including home health personnel, arrive during today's inspection. LPA toured and observed the facility to be clean, in good repair and odor free. There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Jul 10, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection following (1) incident report submitted to the Department. LPA met with Janeyn Kelly, Administrator, and explained the purpose of the inspection. Also present was staff, Jacob Espino. LPA and the administrator discussed the incident report and reviewed the recent hospital discharge paperwork (May 21, 2026), noting resident (R1) was seen for a rash and Dysphonia and prescribed (3) new medications and a creme. The administrator stated (R1) was seen for a rash in February 2026 and was prescribed Triamcinolone Acetonide 0.1% Cream, to be applied two times daily, as needed. The administrator stated the rash did not improve with the cream, and home health nurses have been monitoring the rash at weekly visits and communicating with the primary care physician. The administrator stated that upon observing a new rash on (R1's) lower legs and feet, (R1) was sent to the emergency room on May 21, 2026. The administrator stated (R1) indicated several skin tests were completed and labs drawn, and nothing concerning was found. (R1) was asked to see a Dermatologist for a specific diagnosis. LPA and the administrator spoke with (R1) today who was resting in their room. LPA observed a rash on (R1's) lower legs/feet. (R1) indicated it is itchy and stated they tried to contact their health care provider several times to schedule an appointment with the Dermatologist. The administrator will follow up and assist (R1) in contacting the health care provider if an appointment isn't able to be scheduled in the next few days. Additionally, the administrator and (R1) will continue communicating with home health. LPA toured the facility and observed it to be clean, in good repair and odor free. The facility took appropriate action in seeking emergency medical care. There are no deficiencies issued in this report. Copy of report provided.the state’s words, verbatim · CDSS document, May 22, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection regarding (2) incident reports submitted to the Department. LPA met with Janeyn Kelly, Administrator, and explained the purpose of the inspection. Also present were staff, Jhamil Espino and Jacob Espino. LPA observed (4) residents present enjoying live music outside on the patio. LPA and administrator discussed resident (R1) who had an unwitnessed fall on March 8, 2026 (4:30 am). (R1) sustained a skin tear on the left side and some bruising. Home Health nurse was called and completed an assessment and medications review. Safety precautions remained in place. (R1) was very lethargic and wouldn't wake up in the morning on March 13, 2026 (9:00 am). Home health was contacted, assessed resident and recommended (R1) be sent to the Emergency Room. (R1) returned later in the day (11:30 pm) and was advised to consult with their Primary Care Physician (PCP) before administering Trazadone again, due to it causing drowsiness. (R1) met with their PCP on March 18, 2026 and there were no new medications prescribed during that visit. (R1) has additional medical appointments scheduled in the next few months. Staff will continue to provide a consistent, daily routine and sleep schedule, and communicate with (R1's) family member regarding any concerns with sleep or behaviors, as a result of (R1) suffering a stroke in January 2026. LPA observed (R1) to be enjoying live music on the patio and reading a newspaper on the couch later during the inspection. The facility will continue to document efforts made with (R1's) care and routine. It appears the facility timely notified home health when (R1) had a fall or change in condition. There are no deficiencies issued in this report. Exit interview. Copy of report provided to Administrator.the state’s words, verbatim · CDSS document, Mar 25, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection regarding (2) incident reports submitted to the Department. LPA met with Janeyn Kelly, Administrator,and explained the purpose of the inspection. Also present were staff, Jhamil Espino, Jacob Espino and Flocerfida Manalac. LPA observed (4) residents present and (1) resident return from receiving medical care outside of the facility. LPA and administrator discussed resident (R1) who had an unwitnessed fall on February 11, 2026 (10:00 am) in their room. The administrator stated (R1) was observed to be kneeling by their bed and was possibly trying to stand up before falling. (R1's) family member, who was present, indicated (R1) was just moved to another room, and the furniture has a different configuration, which may have confused (R1). LPA observed (R1) preparing to go to a follow up medical appointment to have (6) staples (observed) removed. The administrator stated that lights are continuously kept on in (R1's) room, and there have been no subsequent falls. Staff are providing frequent checks for any assistance needed and (R1) is more cooperative in allowing staff to help with personal hygiene than when moving in a few months ago. Resident (R2) went to the Emergency Room on February 13, 2026, after the Administrator noticed (R2) to be showing chest congestion/cough. (R2) was admitted with a diagnosis of Pneumonia and given IV antibiotics. An antibiotic was prescribed effective February 18, 2026 and to be given for (3) days, and (R2) has less of a cough now. Hospital discharge paperwork show there is a follow up video appointment on February 19, 2026 with the primary care physician and Home Health has been ordered for Physical Therapy and Nursing. LPA observed (R2) to be resting in their bed and stated they are doing better since returning from the hospital. LPA and the Administrator toured the facility and observed the facility to be clean, safe, and in good repair. There are no citations issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Feb 18, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection related to a recent incident report submitted to the Department. LPA met with Janeyn Kelly, Administrator, and explained the purpose of today's inspection. Also present was Jhamil Espino and Nikolas Martinez, caregivers. LPA observed (4) residents present during the inspection and was advised (1) resident was currently receiving medical care outside of the facility. LPA and Administrator discussed the incident report submitted to the department on October 14, 2025 regarding resident (R1) sustaining a skin tear on October 10, 2025. While staff was providing incontinent care and repositioning resident, (R1) sustained a skin tear on the top of their right hand near the thumb. Staff believed it was caused from a metal clip on the bed remote cord that was attached to the bed rail but has been removed following the incident. The caregiver immediately applied pressure to the skin tear and contacted the administrator who provided first aid treatment. The facility contacted the hospice nurse and family member also. The hospice doctor visited (R1) the following day, October 11, 2025, and did not see any concerns that the nurse could not handle. (R1) has nursing visits with a hospice nurse at least twice weekly and a home health aide five times week. LPA observed a home health aide arrive during today's inspection. LPA observed (R1) to have a clean, wrapped bandage over the area of their right hand and to be comfortably resting in bed. The administrator stated (R1) has not complained of any pain and is not able to take the bandage off anymore since earlier this week when the nurse used additional first aid tape. LPA toured the facility and observed it to be clean, orderly and without any odors. The residents appeared to all be comfortably resting after breakfast. The facility promptly responded by applying first aid care and notifying hospice and the family following the incident. The facility will continue to monitor (R1's) right hand. There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Oct 22, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with Janelyn Kelly, Administrator, and explained purpose of inspection. Also present were staff, Nicolas Martinez, and Licensee, Jhamil Espino. The facility is licensed for (6) residents, (5) of who may be non-ambulatory and (1) may be bedridden. There is (2) residents currently on hospice. All residents were resting in their rooms at the start of the inspection. LPA and Administrator toured the interior/exterior of the facility including the common areas, (6) private resident rooms, (4) resident bathrooms, kitchen, laundry, and activity area. Staff reside in an adjoining area of the facility, separated by a locked door. LPA observed the facility to be clean, in good repair and odor-free. Bathrooms have the necessary grab bars, non-skid flooring, trash can and hygiene supplies. There is sufficient 2+day perishable and 7+day non-perishable supply of food, as well as an emergency supply of food/water. Perishable food is dated to ensure freshness. Sharps and toxins are locked are in the kitchen. There are sufficient linens/towels/blankets. Inside temperature measured 72*F and hot water measured 120* in the kitchen (temperature controlled by a tankless water heater). Fire extinguisher last serviced 3/20/25. Required postings are in the common area. Outside, there is (1) unlocked exit gate, a fountain, walking trail and covered patio. All doors have exit alarms. There are non-audio cameras in the exterior/interior common areas. The facility has (3) emergency evacuation transport stretchers placed throughout the home. LPA reviewed (2) resident files and (5) staff files. Files were complete and contained current documentation, including required staff training, maintained in a separate training binder. Medications were reviewed for (1) resident. Orders match medications being administered. All documentation is now maintained electronically. There are no citations issued. Exit interview. Copy of report provided to Administrator and Licensee.the state’s words, verbatim · CDSS document, Aug 1, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection related to a recent incident report submitted to the Department. LPA met with Janeyn Kelly, Administrator, and explained the purpose of today's inspection. Also present was Jhamil Espino, Jacob Espino, and Nikolas Martinez, caregivers. LPA observed all (5) residents to be present in their rooms. LPA discussed the incident report when resident (R1) was sent to the emergency room on Sunday, March 9, 2025, around 8:30 am. While providing care, staff observed blood in resident's urine and a red rash to be covering most of resident's body on both sides. Additionally, resident's urine smelled foul. Resident returned the same day, around 5:00 pm with three new prescriptions to treat a urinary tract infection (UTI) and skin rash. There was no definitive diagnosis. Resident went to a follow up appointment with the primary care physician on March 13, 2025, and was told to stop taking the Keflex 500 mg. The Administrator advised family members that a written order is needed to stop any medication. The family members informed the Administrator that a referral was also made to the dermatologist and urologist. As of today, the rash is no longer red, and the resident is not complaining of itchiness, The color of the rash also looks better, there is no blood or unusual odor. Since returning from the emergency room on Sunday evening (5:30 pm), the facility has implemented infection control protocols, including one staff providing care only to (R1) and while wearing PPE (Mask, gown and gloves). No other residents have shown or complained of any rash or itching. (R1) continues to be monitored closely for any changes in condition, including the condition of the rash. LPA spoke briefly to (R1) who indicated they are doing better and don't have any complaints. LPA and Administrator toured the facility and the Administrator pointed out the upgrades made to the back patio area, including a walking path and more space for outdoor activities, such as live musicians. The facility followed appropriate protocols in sending resident out and upon resident's return. There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Mar 13, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection. LPA met with Janelyn Kelly, Administrator, and explained purpose of inspection. Also present were staff, Rebecca Lizama, Jacob Espino, and Licensee, Jhamil Espino. LPA observed (6) residents to be present in their rooms or in the common area during the inspection. Also present was a physical therapist who was working with one resident, and later a hospice nurse. The facility is licensed for (6) residents, (5) of who may be non-ambulatory and (1) may be bedridden. There is (1) resident currently on hospice. LPA and Administrator toured the interior and exterior of the facility including the common areas, (6) private resident rooms, (4) resident bathrooms, kitchen, laundry, and activity area. The staff reside in an adjoining area of the facility, separated by a locked door. LPA observed the facility to be clean, in good repair and odor-free. LPA observed each bathroom to have the necessary grab bars, non-skid flooring, paper towels, trash can with lid and 20-second hand-washing poster. There is sufficient 2+day perishable and 7+day non-perishable supply of food, as well as an emergency supply of food/water and an extra freezer/fridge. Sharps and toxins are locked are in the kitchen. Additional toxins are stored in the locked laundry area. Medications are locked in the medication cart. There is sufficient PPE/incontinent supplies and linens/towels/blankets. The inside temperature measured 72*F and hot water measured 120* in the kitchen (the water heater was adjusted). Facility conducts quarterly emergency drills. Fire extinguisher was last serviced 3/4/24. Required postings are in the common area. There is (1) unlocked outside gate and a covered patio area. LPA reviewed (2) of (6) resident files and found all required documentation. Medications were reviewed for (1) resident and are being given as ordered. Documentation is being done correctly. LPA reviewed (5) staff files. All staff are cleared/associated and have completed current training, including First Aid/CPR certification. RCFE Administrator certificate #6062074740- exp 1/19/26. An updated copy of LIC500 and liability insurance was obtained (exp 10/25/24). There are no citations issued. Exit interview. Copy of report provided to Administrator and Licensee.the state’s words, verbatim · CDSS document, Sep 5, 2024

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection related to a recent incident report submitted to the Department. LPA met with Janeyn Kelly, Administrator, Jhamil Espino and Jacob Espino, caregivers, and explained purpose of inspection. LPA discussed the incident report when resident (R1) was out of the facility from 6/30/24 through 7/5/24, to spend time with relatives. When resident returned to the community on 7/5/24, staff noticed she was limping and had a slightly swollen right ankle. Resident stated her foot was bothering her starting on 7/6/24, after the Administrator asked if it was, but she could not recall how her ankle was injured, due to a diagnosis of Dementia. On 7/6/24, resident's family member visited and the situation was discussed at that time. The family member stated resident sometimes doesn't have good balance. The facility followed up and contacted the Advice Nurse initially, on 7/6/24, and has been applying ice compresses and elevating resident's foot, as recommended. The facility then reached out to the doctor on 7/9/24. LPA observed printed e-mail documentation where the physician recommended an x-ray to rule out a fracture and stated a prescription will be sent for an topical gel. LPA observed (R1) walking in sandals and appeared to not have a limp. Resident's ankle appeared slightly red and did not appear very swollen. Administrator contacted (2) family members during today's inspection and requested they confirm which family member will take (R1) to have an x-ray taken and evaluated soon. Also discussed, as reported, is that (R1) appears to be "pocketing" her medications they were recently found in her room. This was discussed with resident's family member and primary care physician, who indicated medications cannot be crushed at this time. Staff will continue to be present when (R1) takes medications and will try administering one tablet at a time. Administrator will follow up with the Department after an x-ray and evaluation are done. There are no deficiencies issued in this report. Exit interview. Copy of report left at the facility.the state’s words, verbatim · CDSS document, Jul 11, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection related to a recent fire clearance update. LPA met with Janeyn Kelly, Administrator, and explained purpose of inspection. Also present were Jhamil Espino, Licensee, Jacob Espino, caregiver, and Flocerfida Manalac, caregiver. LPA received an updated fire clearance on 12/19/23 from the local fire department permitting residents to have a non-ambulatory status in rooms #1, 2,3, 4, 5 and 6. Additionally, (1) resident that is bedridden can be placed in room #3. LPA and Administrator toured the facility and observed the recent modifications made in room #4 entailing a window being converted to a glass sliding door. (5) resident rooms are occupied and residents' ambulatory status meets the fire clearance. Currently room #2 is vacant but fully furnished. LPA observed all residents to indicate they are doing well. LPA observed the facility to be clean, in good repair and Licensee to be preparing lunch in the kitchen. LPA issued an updated copy of the facility license to reflect the recent changes approved by the local fire department. Administrator provided LPA with an updated copy of the LIC610E (Emergency Disaster Plan for RCFE) which includes the new exit added to room #4. Administrator stated all resident rooms are approved exits also per the fire department. An updated copy of liability insurance was also obtained. There are no deficiencies issued in this report. Exit interview. Copy of report provided to the Administrator.the state’s words, verbatim · CDSS document, Dec 20, 2023