Corona RCFE

Type of visit: Case Management - Other

On 7/29/2026 Licensing Program Analysts (LPAs) Mary Rico and Raquel Hernandez conducted an unannounced Health and Safety Check. LPAs met with Administrator Jennifer D. Montgomery and explained the purpose of the visit.. During today’s visit, LPAs reviewed residents’ records, staff records and facility tour. During resident records, LPAs review all twenty-seven (27) residents files. LPAs observed that the facility has four (4) residents with dementia and three (3) residents with schizophrenia per residents Physician Report. LPA Rico reviewed Corona RCFE Dementia Care Plan, the plan indicated the facility will not be accepting residents will hallucinations and paranoia. Therefore, the three (3) residents with schizophrenia must be relocated to another facility. In addition, during facility tour LPA observed residents with dementia and schizophrenia did not have auditory device that will monitor exits and exterior doors. The facility must install an alert system or auditory device to notify staff of residents’ exits. In addition, LPA Rico reviewed (17) staff files. During staff records, LPAs observed four (4) staff did not have their health screening. Based on information gathered, the following are being cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) (LIC809D) was discussed and provided to Administrator Jennifer D. Montgomery. Along with a copy of Appeal Rights. The Administrator Jennifer D. Montgomery refused to sign all documents.the state’s words, verbatim · CDSS document, Jul 29, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(d) · Plan of correction due date: Jul 30, 2026

87705 (d)Care of Persons with Dementia The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter.....This requirement was not met as evidenced by; Based on facility tour, and resident records (4) residents with dementia bedrooms had sliding doors with no alert system.This posed an immediate risk to residents in care.the state’s words, verbatim · CDSS document, Jul 29, 2026

Plan of correction: The Administrator stated they will install an alert system for residents bedrooms and exits. Proof will be sent to LPA Rico. POC due date by 7/30/2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR87208(a) · Plan of correction due date: Jul 30, 2026

87208(a) Plan of Operation..The licensee shall operate the facility in accordance with the terms specified in the plan of operation and may be cited for not doing so pursuant to Health and Safety Code section 1569.49..This requirement was not met as evidenced by; Based on resident records and facility's Plan for Dementia Care the facility. The facility has (3) residents with schschizophrenia, but their dementia care plan indicated they would not accept residents with follow condition. This posed an immediate risk to residents in care.the state’s words, verbatim · CDSS document, Jul 29, 2026

Plan of correction: The Administrator agreed to relocate residents. Proof of relocation will be provided to LPA Rico.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87412(b)(2) · Plan of correction due date: Aug 14, 2026

87412 (b)(2)Personnel Records(2) Health screening documents as specified in Section 87411(f).This requirement was not met as evidenced by; Based on staff records four (4) staff did not have a Health Screening on file. This posed an potential risk to residents in care.the state’s words, verbatim · CDSS document, Jul 29, 2026

Plan of correction: The Administrator stated the four (4) staff will obtain their health screening. A copy of completion will be provided to LPA Rico. POC 8/14/2026.

Allegation investigated: Licensee is not allowing residents in care to choose their own physician.

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to deliver findings on the allegation listed above. LPA met with Administrator Jennifer D. Montgomery and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews and record review. For the allegation, Licensee is not allowing residents in care to choose their own physician. During staff interviews 3 out of the 3 staff stated they allow residents to choose their own physician. During resident interviews 3 out of the 3 residents stated they are allowed to choose their own physician. Based on record review, LPA observed residents had the option to choose their own primary physician or select a physician that is associated with Corona RCFE. Unsubstantiated Based on the evidence found during the investigation, the one (1) allegation listed above is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) was discussed and provided to Administrator Jennifer Montgomery. The Administrator agreed to signed the UNSUBSTANTIATED LIC9099. Based on the evidence gathered during today’s investigation, the one (1) allegation listed above are deemed SUBSTANTIATED. A finding that the complaints are SUBSTANTIATED means that the allegation are valid because of the preponderance of evidence the standard has been met. During today’s visit, one (1) deficiency were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) and LIC9099D was discussed and provided to Administrator Jennifer D. Montgomery, along with a copy of the appeal rights. Administrator Jennifer D. Montgomery refused to sign the SUBSTANTIATED LIC9099.the state’s words, verbatim · CDSS document, Mar 25, 2026 · control 56-AS-20250527170216

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(11) · Plan of correction due date: Apr 3, 2026

87468.1 Personal Rights of Residents in All Facilities (a)(11)To have their visitors, including ombudspersons and advocacy representatives, permitted to visit privately ....and without prior notice, provided that the rights of other residents are not infringed upon. This requirement wasn't met as evidenced by: Based on interviews, which staff denied R1's Physician to enter the facility which poses an immediate health, safety or personal rights risk to persons in carethe state’s words, verbatim · CDSS document, Mar 25, 2026

Plan of correction: The Administrator stated they will read the regulation cited 87468.1(a)(11) and will send a self-verification letter they have read and understood the regulation. POC due date 4/3/2026

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced Case Management Incident visit and conduct a Health and Safety check. LPA met with Administrator Jennifer D Montgomery and explained the reason for the visit. The visit is in response to the death of resident (R1), who passed away on 1/29/2026. During the visit, LPA reviewed R1's file and obtained copies of the following: ID/emergency Information, Admission Agreement, Physician's reports, Medication List, Care Plan and PACE documents. LPA requested a copy of R1’s death certificate when it is made available. An exit interview was conducted, and a copy of this report was provided to Administrator Jennifer Montgomery.the state’s words, verbatim · CDSS document, Feb 5, 2026

Allegation investigated: Staff refused resident re-entry to the facility.

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to investigate and deliver the findings on the allegation listed above. LPA met with Administrator Jennifer Montgomery and explained the purpose of today’s visit. The investigation consisted of staff interviews, resident interviews and record review. For the allegation, Staff refused resident re-entry to the facility. During staff interview 3 out of the 3 staff stated that staff did allow R1 back to the facility. Based on record review, R1 was sent out to the hospital due to an infection. During staff interviews, all staff members stated the facility was waiting for medical confirmation that the infection would not be contagious to other residents or staff. During facility tour, LPA Rico observed R1 back at the facility. In addition, during resident interviews, 3 out of the 3 residents stated staff have allowed them back to the facility. Unsubstantiated Based on the evidence found during the investigation, the one (1) allegation listed above is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) was discussed and provided to Administrator Jennifer Montgomery.the state’s words, verbatim · CDSS document, Jan 28, 2026 · control 56-AS-20250716140942

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Mary Rico conduct an unannounced case management to obtain records from the facility pertaining to Compliant Control Number # 56-AS-20250527170216. LPA Rico met with Administrator Jennifer Montgomery and explained the purpose of the visit. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Jennifer Montgomery.the state’s words, verbatim · CDSS document, Jan 16, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrator Jennifer D. Montgomery and was granted entry to the facility. Licensed capacity is (49) current census (27). LPA was accompanied by Administrator Jennifer Montgomery to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately.LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated office for resident/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for residents. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (5) resident files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed (5) resident medications and (2) hospice files. LPA also reviewed (4) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Jennifer Montgomery.the state’s words, verbatim · CDSS document, Dec 30, 2025

Allegation investigated: Staff refused to accept resident back to the facility.

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to deliver findings on the allegation listed above. LPA met with Administrator Jennifer D. Montgomery and explained the purpose of the visit. The investigation consisted of staff interviews, record review and facility tour. For the allegation, Staff refused to accept resident back to the facility. During staff interview, 3 out of the 4 staff stated the on 2/12/2025 R1 had left the facility and attempted to come back to the facility that same day. The Administrator stated that on 2/12/2025 R1 had signed the self-voluntary moveout form and was no longer a resident. During resident interviews, R1 stated they had no acknowledgement of what document they had signed. R1 informed LPA that on 2/12/2025 they had left the facility for an assessment and indicated facility staff had locked him out when they attempted to returned. Substantiated LPA Rico had obtained facility footage, that demonstrated R1 had left the facility on 2/12/2025 at 10:25am and returned on 2/12/2025 at 11:45am. LPA Rico observed facility had refused to accept resident back to the facility, as resident attempted to gain entry. During facility tour, LPA Rico observed R1 personal belongings had remained inside the facility. In addition, the facility did not provide a 30 day eviction notice to Community Care Licensing and resident did not provide a 30 day notice of move out. Furthermore, the self-voluntary document is not part of Facility Program Designed and is not approved by Community Care Licensing. Based on the evidence gathered during today’s investigation, the one (1) allegation listed above are deemed SUBSTANTIATED. A finding that the complaints are SUBSTANTIATED means that the allegation are valid because the preponderance of evidence the standard has been met. During today’s visit, one (1) deficiency were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) and LIC9099D was discussed and provided to Administrator Jennifer D. Montgomery, along with a copy of the appeal rights. Administrator Jennifer D. Monthgomery refused to signed document.the state’s words, verbatim · CDSS document, Apr 8, 2025 · control 56-AS-20250213114405

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(a)(20) · Plan of correction due date: Apr 9, 2025

To be protected from involuntary transfers, discharges, and evictions.. state.. and relocation protections for residents. For purposes of this paragraph.. means a transfer, discharge, or eviction that is initiated by the licensee, not by the resident. This requirement wasn't met as evidenced by: Based on interviews, facility tour and video footage the Administrator refused to accept resident back to the facility which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 8, 2025

Plan of correction: The Administrator stated they will read the regulation cited 87468.2(A)(20) and will send a self-verification letter they have read and understood the regulation. POC due date 4/9/2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrator Jennifer D. Montgomery and was granted entry to the facility. Licensed capacity is (49) current census (18). LPA was accompanied by Administrator Jennifer Montgomery to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately.LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated office for resident/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for residents. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (10) resident files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed (6) resident medications and (3) hospice files. LPA also reviewed (6) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Jennifer Montgomery.the state’s words, verbatim · CDSS document, Dec 5, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrator Jennifer D. Montgomery and was granted entry to the facility. Licensed capacity is (49) current census (13). LPA was accompanied by Administrator Jennifer D. Montgomery to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated office for client/staff files. The facility is on a 24-hour fire watch until their Fire Clearance has been approved. During today’s visit LPA observed a fire panel install at the facility. Administrator informed LPA, the facility has a schedule appointment with Corona Fire Department on 12/14/2023 for their pending Fire Clearance. Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (13) resident files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed (13) client medications. LPA also reviewed (4) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. LPA Rico informed Administrator that Community Care Licensing Department has not received the following documents: 1. Property Agreement between Property Owner (Landlord) and Licensee (Corona RCFE, LLC) 2. Written Agreement between Vista Cove, INC and Corona RCFE LLC which removes Vista Cove, INC as the Licensee. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Jennifer D. Montgomerythe state’s words, verbatim · CDSS document, Dec 12, 2023

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced case management visit to indicate who is the new Administrator. During today’s visit, LPA obtained documents of the Designated Administrator. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Jennifer D. Montgomery.the state’s words, verbatim · CDSS document, Nov 21, 2023

Type of visit: Office

Licensing Program Analyst (LPA) Mary Rico, Licensing Program Analyst Manger (LPM) Efren Malagon and San Bernardino Regional Manager Leslie Mendiveles conducted a meeting with Administrator Courtney Barreto via Microsoft Office. The additional attendees were Dovy Raskin and Fernando Rodriguez. During today’s meeting, the following matter was discussed: · Compliance with the Fire Marshall · Property Lease Agreement · Bedridden Residents · Beecan Management Agreement During today’ meeting, Administrator agreed to send Community Care Licensing ; Beecan Management Agreement with Corona RCFE LLC, Documentation of removing Vista Cove from License, written update regarding Property Lease Agreement, Copy of Contract with Troy Alarm. LPA Rico emailed a copy of the report for signature and requested the signed copy to be emailed back. The Administrator agreed to provide a signature and mail back to Community Care Licensing.the state’s words, verbatim · CDSS document, Oct 13, 2023