Concord Estates Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA's) Abdoulaye Zerbo and Tremayne Barra conducted an unannounced visit for a required annual inspection. The LPA's were greeted by Caregiver Mega Siby, notified her of the purpose for the visit and was allowed to enter the facility to conduct the inspection. The Administrator Heather Ramirez, joined the visit at a later time. Facility Overview: The facility is a single story building with six (6) residents bedrooms, 1 staff room, three(3) bathrooms, a living room, a kitchen area and garage. There is no gated pool and there are no firearms on the premises. Infection Control: LPA's observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in the kitchen area inaccessible to residents. The smoke detector and carbon monoxide detector were operational. LPA's observed fire extinguishers to be in compliance with the department requirements and with an expiration date of January 20, 2026. Water temperature tested within regulation at 108.2. Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate with expiration date of February 13, 2026 and a CPR certification with the expiration date of January 29th, 2026 Record Review and Resident/Staff Files: LPA's reviewed files for three(3) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Four (4) residents' files were reviewed and contained all required documentation. LPA's observed first aid kit to be locked and stored in the living room area. The staff and residents files were kept in a locked cabinet next to the hallway. Health-Related Services/Incidental Medical Services: All residents' medications were securely locked in a cabinet and located in the living room. LPA's reviewed medications for five residents, confirming that all medications were listed and accounted for. Disaster Preparedness: LPA's reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 01-03-2026, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed, and a copy was provided to Caregiver Mega Siby.the state’s words, verbatim · CDSS document, Jan 20, 2026

Allegation investigated: Staff did not provide care that met resident's needs

Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced visit to the facility to deliver the finding of the above allegation. LPA met with Staff, Sammi Vasquez, and the licensee Heather Ramirez over the phone who was informed of the purpose of the visit. LPA conducted interviews and records review. It was alleged “Staff did not provide care that met resident's needs”. It was alleged staff did not get Resident #1 (R1) out of bed even when the resident requested it. It was alleged R1 was given a Hoyer lift by their medical provider, however this lift was never used by staff. Interview with R1 was unable to be conducted as R1 has since passed away. Interview with (1) resident who resided at the home with R1 revealed they did not recall R1. Unsubstantiated LPA conducted (2) staff interviews with staff who cared for R1. (2) of (2) staff revealed R1 was bedridden and unable to turn or reposition themselves in bed, and was turned every (2) hours. They revealed staff made attempts to get R1 out of bed but R1 was unable to tolerate it. (1) of (2) staff revealed a Hoyer lift was not used on R1 as R1 would yell out in pain due to a sore on their body. Admission agreement and Hospice visit notes for R1 revealed R1 resided at the facility from 11/21/2022 to 12/24/2022. R1’s Hospice Care Plan from 11/21/2022 revealed R1 had a pressure injury on their bottom and was bedbound. Hospice equipment list revealed a Hoyer lift was ordered 10/31/2022, prior to R1 being placed at the facility when they were deemed non-ambulatory. The facility’s internal “Two-hour Turn Log to Prevent Skin Breakdown” was documented every (2) hours for the resident during R1 stay at the facility. Therefore, the allegation that R1 was not provided with the opportunity to be out of bed is unsubstantiated at this time. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided. Staff interview revealed R1 arrived at the facility with (2) medication patches on their body from their previous placement. It was revealed R1’s legal representative and a representative from R1’s hospice agency were also present for the incident. Interview with R1’s legal representative confirmed they witnessed R1 arrive to the facility with (2) medication patches on their body. R1’s medication’s list revealed one medication patch for M1 was prescribed every 72 hours. Hospice visit notes for R1 revealed they resided at the facility from 11/21/2022 to 12/24/2022. The visit notes did not reveal any medication errors for R1’s patch. Therefore, the allegation that staff did not administer R1’s medication patches as prescribed is unfounded at this time. It was alleged “Staff do not follow physician's order”. It was alleged R1’s speech pathologist ordered to not thicken R1’s liquids and that facility staff did not comply. Additional information for the speech pathologist was not available and review of R1’s hospice care plan did not reveal an assigned speech pathologist. Interview with R1 was unable to be conducted as R1 has since passed away. LPA conducted (2) interviews with staff who cared for R1. (1) of (2) staff did not recall a speech pathologist being assigned to R1, and they recalled having physician’s orders to thicken R1 liquids as R1 had difficulty swallowing. Medications list for R1 revealed fluid thickener was ordered by R1’s physician and started on 10/5/2022. Instructions on the medication list stated to thicken liquids to a nectar thick consistency. Therefore, the allegation that staff were not following R1’s physician orders is unfounded. This agency has investigated the complaints and have found that the complaints are unfounded, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. An exit interview was conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 28, 2025 · control 18-AS-20240202140052

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit for a required annual inspection. The LPA was greeted by Administrator Heather Ramirez, notified her of the purpose for the visit and was allowed to enter the facility to conduct the inspection. Facility Overview: The facility is a single story building with five (5) residents bedrooms, three(3) bathrooms, a living room and a kitchen area. There is no gated pool and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in the kitchen area inaccessible to residents. The smoke detector and carbon monoxide detector were operational. LPA observed fire extinguishers to be in compliance with the department requirements and with an expiration date of September 12, 2025. During the visit, LPA could not measure the water temperature due to power outage Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate with expiration date of February 13, 2026 and a CPR certification with the expiration date of January 20th, 2026 Record Review and Resident/Staff Files: LPA reviewed files for three(3) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Five (5) residents' files were reviewed and contained all required documentation. LPA observed first aid kit to be locked and stored in the living room area. The staff and residents files were kept in a locked cabinet next to the hallway. Health-Related Services/Incidental Medical Services: All residents' medications were securely locked in a cabinet and located in the living room. LPA reviewed medications for five residents, confirming that all medications were listed and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 10-04-2024, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed, and a copy was provided to administrator Heather Ramirez.the state’s words, verbatim · CDSS document, Jan 8, 2025

Type of visit: Required - 1 Year

On 1/25/2024, Licensing Program Analyst (LPA) Chinwe Nwogene arrived unannounced at the facility to conduct an annual inspection. LPA Nwogene was greeted and granted entry by Caregiver, Mia Ibarra who was informed of the purpose of the visit. LPA also met with Licensee, Heather Ramirez who was informed of the purpose of visit. At the time of visit there was two #2 staff and five #5 residents present. LPA toured the facility inside and out with Caregivers, Samantha Vasquez and Mia Ibarra, and Heather Ramirez. Tour included: Kitchen: LPA toured the kitchen and observed the kitchen to be clean. Food is stored in a safe and healthful manner. Utensils and dishware are sufficient for the capacity. The refrigerator and stove are in working order. Trash cans has tight-fitting lid. Fridge, freezer, and all need appliances were present and shown to be in working condition and clean. During LPA’s tour of the kitchen, LPA observed the knives and other sharps in the kitchen drawer not locked, accessible to clients. LPA asked Mia and Samantha to lock the drawer but was told they couldn’t find the key and the knives are not usually locked. Heather arrived and immediately locked the drawer (Citation will be issued). Dining and Livingroom; LPA toured the dinning and Livingroom area. LPA observed area to be clean and furnitures in good condition. Temperature was 72 degrees Fahrenheit. Hallway: LPA toured the hallway and observed hallway to be clean with no pathway obstruction. LPA inspected the fire extinguisher and found it to be in compliance and record to be up to date. Carbon monoxide & smoke detector were tested and functioning properly. LPA observed additional linens and hygiene items. Medication: Medications were labeled and stored in separate bins inside of a locked medication cart and are distributed according to physician orders. The first aid kit was complete. Bathroom: LPA toured three #3 resident bathrooms and observed bathrooms to be clean and equipped with grab bar and non-slip mat. There is also a good number of personal toiletries available for the residents in care. The hot water measured at 113 degrees Fahrenheit. Bedroom: LPA toured six #6 out of #6 resident bedrooms and observed bedrooms to be clean and furnished according to regulation, which includes proper furniture, dressers, chairs, and lighting. Night lights were maintained throughout the facility. Garage: LPA tour the garage and observed garage to be clean. Laundry: Washing machine and dryer are all in good repair and sufficient for the census. Cleaning supplies are stored away in the laundry room. During LPA’s toured of the laundry room, LPA observed laundry room to be open and cleaning solutions not locked up in the laundry room making it accessible to clients (Citation will be issued). Backyard: LPA toured the backyard and observed backyard to be clean and furnitures in good condition. The backyard was free from obstruction and the side gate remain unlocked. No bodies of water were observed. Food Services: There are seven days non-perishable and two days of perishable food supply present, and all food was properly stored and available to residents. Fridge and Freezer are large enough to accommodate required perishable foods. Records: All required postings, including COVID’s postings, were posted near the entryway and throughout the facility. The administrator certificate expires on 2/12/2024. Three #3 residents file were reviewed. LPA requested for three staff files for review but was informed by Heather that staff files are not available at the facility (Citation will be issued). Interview: Two staff and three residents were interviewed. Therefore, based on the observations made during today’s visit, three #3 deficiencies will be cited per Title 22, Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted, and this reported was provided along with appeal rights to Heather Ramirez.the state’s words, verbatim · CDSS document, Jan 25, 2024