Concord Royale

Type of visit: Required - 1 Year

On 05/06/2026 at 8:30AM, Licensing Program Analyst (LPA) Andrew Christy arrived unannounced to conduct the 1-Year Annual Required inspection. LPA met with Executive Director, Connie Kuhlmann, and explained the purpose of the visit. The facility currently houses 93 residents with a max capacity of 160 residents. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. No bodies of water were observed. A comfortable indoor temperature is maintained at 70.0 degrees Fahrenheit. The hot water temperature in the residents’ shared bathroom was measured at 118.1 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 05/15/2025. At 10:30AM, LPA reviewed five (5) resident files and five (5) staff files, all found to be complete. The emergency disaster plan was last reviewed 04/02/2026. Quarterly emergency drills were last conducted 04/29/2026. A review of resident medications and the Medication Administration Record (MAR) found no outstanding errors. No deficiencies cited during visit. Exit interview conducted and a copy of this report was provided to the executive director.the state’s words, verbatim · CDSS document, May 6, 2026

Type of visit: Case Management - Incident

On this day, August 27, 2025, at 1:00 p.m., Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct a case management in response to the Death Report (LIC624A) for resident (R1) received by Community Care Licensing Regional Office on August 25, 2025. LPA met with Executive Director (ED) Connie Kuhlmann, and informed the reason for visit. LIC624A indicated that on August 21, 2025, at approximately 1:00 pm, R1 was watching movie in the front room when R1 appeared to be in a panic attack, screaming and tried to move R1's wheelchair. The staff wheeled R1 to the medication room to be assessed. R1 became unconscious and 9-11 was immediately called. CPR was performed and R1 was pronounced dead at 4:00 pm. Police officers arrived and notified staff that the Coroners Office released the body. LPA reviewed R1's file and obtained copies of including but not limited to the following: LIC601 Identification and Emergency Information; LIC602A Physician's Report, LIC625 Appraisal/Needs and Services Plan. LPA conducted interviews. No deficiency cited during today's visit. Exit interview conducted and copy of this report provided.the state’s words, verbatim · CDSS document, Aug 27, 2025

Type of visit: Required - 1 Year

On 05/21/2025 at 9:45 AM, Licensing Program Analysts (LPAs) P. Manalo and K. Nguyen arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Executive Director, Connie Kuhlmann and explained the purpose of the visit. The facility’s fire clearance was approved for 160 residents all may be non-ambulatory and 15 hospice and total care waivers. LPAs toured the facility inside and out including but not limited to 7 residents' apartments, bathrooms, multiple activity rooms, kitchen, and dining hall. There are no bodies of water observed. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained between 72 to 74 degrees F all around the facility. The hot water temperature in sample of residents’ shared bathroom were measured at 116.9, 114, 112.7, 109, 108.8 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid shower pan. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 05/15/2025. Emergency Disaster Plan was last posted on 03/05/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 04/25/2025. At 11:52 AM, LPAs reviewed 7 residents records. At 12:20 PM, LPAs reviewed 6 staff records and 5 of 6 have current first aid training and 6 of 6 associated to the facility. At 2:30 PM, LPAs reviewed two sample of resident’s medications. Continue LIC809-C... Continue from LIC809... Updated copies of the following documents were requested for facility file and are to be submitted to CCLD by 05/29/2025: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance THE FOLLOWING DEFICIENCY WAS OBSERVED DURING VISIT: At 11:15 AM, LPAs observed freezer burn in the freezer. Interview with kitchen staff stated that the freezer door was not capable of closing all the way. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiency by POC date may result in additional Civil Penalties. Exit interview conducted with Executive Director. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, May 21, 2025

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Case Management - Incident

LPA K. Nguyen conducted an unannounced case management visit due to an unusual incident report (UIR) to CCLD received on 1/8/25. LPA met with Executive Director (ED), Connie Kuhlmann and explain the purpose of the visit. LPA interview S1 regarding the unusual incident report received on 1/8/25 regrading R1 got admitted to the hospital due to R1 have no urine output. S1 stated that when R1 was admitted to the facility R1 had this problem before. We have caregiver check on R1 twice a day and develop a routine for R1. Any unusually that R1 have with R1 catheter or urine coloration need to informed med-tech right away and sent them to the emergency right away. S1 spoke with R1 daughter and confirmed that R1 is doing okay, but R1 is still weak and is still recovering. LPA reviewed R1 physician report and needs/ service plan showed that R1 have a second diagnosed with urinary retention requiring foley catheter. S1 will update R1 needs and service plan when R1 return to the facility. No deficiency issue on today date. Exit interview conducted and copy of this report provided to ED, Connie Kuhlmann.the state’s words, verbatim · CDSS document, Jan 16, 2025

Allegation investigated: Facility staff did not maintain passageway(s) free from obstruction

On 12/12/2024 at 9:50 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct the initial visit and deliver findings for the above allegation. LPA met with Executive Director (ED) and explained the purpose of the visit. LPA informed ED of the allegation and ED immediatly stated that "Yes there were exits blocked". ED stated that they were blocked for gardening and are now clear. LPA toured facility and observed that all exits are now clear. Based on LPAs interview conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D. Substantiatedthe state’s words, verbatim · CDSS document, Dec 12, 2024 · control 15-AS-20241205132733

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87203 · Plan of correction due date: Dec 12, 2024

All facilities shall be maintained... with the regulations adopted by the State Fire Marshal for the protection of life ... and panic. This requirement is not met as evidenced by Based on interview Facility did not comply with the regulation above by having exits blocked with benches to prevent residents going outside during landscaping which posed an immediate safety risk to residents in care.the state’s words, verbatim · CDSS document, Dec 12, 2024

Plan of correction: Executive Director has removed the obstructions and agrees to no longer block doors with objects. POC cleared.

Type of visit: Required - 1 Year

On 5/03/24 at 1:00 PM, Licensing Program Analyst (LPA) Greg Clark arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Maria Salgado, Administrator and explained the purpose of the visit. LPA toured the facility including but not limited to residents’ apartments, bathrooms, multiple activity rooms, kitchen, common area and courtyard. There are no bodies of water observed. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 70 degrees F. The hot water temperature in a residents’ bathroom was measured at 114.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medications, sharps and toxic are locked and inaccessible to residents in care. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 5/17/23. Emergency Disaster Plan was last posted on 3/1/24. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 4/30/24. LPA reviewed 5 residents records and 5 staff records, and all were complete. LPA also reviewed a sample of resident’s medications. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided via email due to printer being out of ink..the state’s words, verbatim · CDSS document, May 3, 2024