Crest Home for the Elderly

Type of visit: Case Management - Deficiencies

On 06/19/2026 Licensing Program Analyst (LPA) Raquel Hernandez conducted an unanounced visit to the facility in regards to complaint 56-AS-20260618130650. LPA met with Administrator Deborah Davis. Upon visit, LPA observed Staff #1 (S1) does not have an active association to the facility. LPA advised to submit proper documentation (LIC9182) to ensure S1 is associated to the facility. A deficiency and immediate $500 civil penalty will be assessed. A copy of this report was given and discussed with Administrator Deborah Davis. Along with a copy of appeal rights.the state’s words, verbatim · CDSS document, Jun 19, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(4) · Plan of correction due date: Jun 22, 2026

(e) All individuals subject to a criminal record review pursuant to...(4) Request and be approved for a transfer of a criminal record exemption, as specified in Section 87356(r), unless, upon request for a transfer, the Department permits the individual to be employed, reside or be present at the facility. Based on observation and record review, the licensee did not comply with section cited above not ensuring S1 had an active association/transer to facility, which poses an immediate health, safety, and or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 19, 2026

Plan of correction: Licensee stated to submit LIC9182 to licensing department by POC due date.

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPAs) E. Conchas and A. Martinez conducted an unannounced health and safety visit at the facility. LPAs met with House Manager Florence Nahin (S1) and Licensee Ghislaine "Gigi" Ramasar, informing them of the purpose of the visit. LPAs observed two (2) staff during the initial entrance of the facility, three (3) residents in the activity room coloring, and two (2) other residents passing by. LPAs requested copies of the current resident and staff rosters, reviewed resident and staff files, gathered documents, and conducted a tour of the facility. S1 stated Resident 1 (R1) is currently in the hospital and Resident 2 (R2) moved out about 2 months ago. LPAs requested copies of R1's file. During facility tour, the indoor room temperature was observed to be 74 degrees Fahrenheit, and the facility has sufficient food supply for residents in care. LPAs observed the following issues, citing one (1) Type B deficiency: Water temperatures in two (2) restrooms measured above 125 degrees Fahrenheit. Licensee was notified and a warning sign was promptly posted. LPAs observed the backyard to have hazardous debris and furniture (e.g., mattress, desk, window, chairs, mirror) in the back yard/back patio area, as well as debris underneath the walkway ramp. LPAs observed exposed electrical wires extending from a green box located at the back of the building affixed to the outside wall next to the kitchen window, and LPAs observed exposed broken lumber on both sides of railing at the end/top of ramp rail. An exit interview was concluded where this report was discussed along with the deficiency and a copy provided to Gigi Ramasar at the conclusion of the visit.the state’s words, verbatim · CDSS document, Apr 7, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: May 7, 2026

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times...maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Based on LPAs observation, the back yard/back patio areas containing hazardous debris around and underneath ramp walkway, broken/unused furntiure, broken lumber, and exposed electrical wires which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 7, 2026

Plan of correction: Licensee agrees to remove all hazardous debris and unsued furniture from the back areas of facility. Licensee will send photographic proof of correction to LPA via email by POC due date.

Allegation investigated: Staff pushed a resident resulting in an injury Staff engaged in a verbal altercation with a resident

On 02/20/2026 Licensing Program Analyst (LPA) Renese Howell-Small conducted an unannounced visit to the facility to deliver findings for the above allegations. LPA met with Administrator, Melisande Sevilla , introduced self and stated the purpose of the visit. It is alleged that staff pushed a resident resulting in an injury. LPA conducted interviews with current residents and staff. Resident 1 (R1) was discharged from the facility on 08/14/2024 and was not available to be interviewed. LPA interviewed residents and residents denied witnessing the allegation. LPA interviewed staff and staff denied the allegation. Based on interviews conducted with residents and staff, and a review of facility records, the allegation is UNSUBSTANTIATED. It is alleged that staff engaged in a verbal altercation with resident.Residents interviewed denied witnessing a verbal altercation between staff and resident. LPA conducted interviews with residents and staff. Residents stated that staff are nice and treat them well. Unsubstantiated LPA interviewed staff and staff denied the allegation. Based on interviews conducted with residents and staff, the allegation is UNSUBSTANTIATED. An UNSUBSTANTIATED complaint is defined as the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted where this report LIC9099 and LIC9099C were discussed and copy provided to Administrator, Melisande Sevilla.the state’s words, verbatim · CDSS document, Feb 20, 2026 · control 56-AS-20240703091417

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Raquel Hernandez made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrator Ghislane Ramasar and was granted entry to the facility. Licensed capacity is (29) current census (24). LPA was accompanied by Administrator Ghislane Ramasar 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 slip-resistant mat going into bathroom shower but not slip-resistant mat inside of shower floor. Technical violation will be given. 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 clients 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. LPA observed facility emergency exit gate to be locked. Deficiency will be issued. 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. LPA observed kitchen refrigerator to be locked. Deficiency will be issued. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (8) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA reviewed (8) resident medications. **Continuation on LIC809C** LPA observed for Resident #2 (R2) and Resident #7 (R7) PRN administration was not properly documented in Medication Administration Record (MAR) with date, time, dosage taken, and resident's response. Deficiency will be issued. Additionally, LPA also reviewed (6) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. No issues were observed. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) and (LIC809D) was discussed and provided to Administrator Ghislane Ramasar. Along with copy of appeal rights.the state’s words, verbatim · CDSS document, Nov 25, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced facility visit to conduct a Case Mangement Incident Visit. LPA met with Administrator Gigi and Oscar Ramasar and explained the purpose of today's visit. The visit is in response to an incident that may have occurred with Staff #1 (S1) and Client #1 (C1). During today's visit, LPA Hernandez conducted resident and staff interviews and LPA requested resident roster and staff roster, and staff phone numbers. 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 Gigi and Oscar Ramasar.the state’s words, verbatim · CDSS document, Aug 21, 2025

Allegation investigated: Staffs do not ensure residents medications are secured and locked. Staff do not ensure that residents are taking medication as prescribed.

Licensing Program Analyst (LPA) Raquel Hernandez conducted an unnannounced visit for the purpose to deliver findings on the allegations listed above. LPA met with Administrator Janette Racelis and explained the purpose of the visit. The investigation consisted of staff interviews, facility tour, and resident interviews. For the allegation, Staffs do not ensure residents medications are secured and locked. LPA Hernandez observed medication room to be locked and secured. LPA Hernandez spoke with Staff #2 (S2) who stated residents are asked to come to medication room and facility staff will pass out resident’s medications accordingly. LPA conducted (4) resident interviews. 4 out of the 4 residents indicated medication room is kept secured and locked at all times. Unsubstantiated For the allegation, Staffs do not ensure that residents are taking medications as prescribed. LPA Hernandez conducted (4) resident interviews. 4 out of the 4 residents stated facility staff ensure their medications are taken as prescribed. LPA conducted (2) staff interviews. 2 out of the 2 facility staff stated all resident’s medications are taken as prescribed, however, if a resident declines it is then documented as a medication refusal. Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. 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 Janette Racelis.the state’s words, verbatim · CDSS document, Jul 17, 2025 · control 56-AS-20240725085934

Allegation investigated: Resident sustained injury while in care Facility fire alarm is covered up to prevent residents from pulling it Resident hygiene needs are not met Staff does not ensure that residents have incontinence supplies Residents are not provided a variety of quality foods of a sufficient quantity Resident files are incomplete Resident medications are mismanaged Facility Medication records (MAR) are inaccurate Administrator is not at the facility a sufficient amount of time

Licensing Program Analyst (LPA) Magda Malcore conducted an unannouced complaint visit to the facility. LPA met with Licensee Ghislaine (Gigi) Ramasar and informed the purpose of the visit. The investigation consisted of LPA observations, pertinenant record review, interviews with staff and residents. Regarding the allegation, resident sustained injury while in care, the Licensee, four (4) staff, and six (6) residents interviewed deny the allegation that resident sustained injuries while in care. Regarding the allegation, facility fire alarm is covered up to prevent residents from pulling it, LPA observed the facility's pull alarm plastic cover can be lifted and the alarm can be pulled. The cover is not taped or bolted down to prevent from opening. Regarding the allegation, resident hygiene needs are not met, LPA observed a sufficient supply of tooth paste, soaps, shampoo, lotion, stored at the facility. Unsubstantiated The Licensee, four (4) staff, and six (6) residents reveal not enough evidence to corroborate the allegation. Regarding the allegation, staff does not ensure that resident have incontinence supplies, LPA observed a sufficient amount of incontinence supplies stored at the facility. Interviews with the Licensee, four (4) staff and six (6) resident reveal not enough evidence to corroborate the allegation. Regarding the allegation,residents are not provided a variety of quality foods of a sufficient quantity, LPA observed a sufficient supply of nonperishable foods and perishable foods stored at the facility; which included fruits and vegetables. Interviews with the Licensee, four (4) staff and six (6) residents reveal not enough evidence to corroborate the allegation. Regarding the allegation, resident files are incomplete, LPA pertinent record review, interviews with the Licensee and four (4) staff reveal not enough evidence to corroborate the allegation. Regarding the allegation, resident medications are mismanaged, LPA pertinent record review, interviews with the Licensee, four (4) staff and six (6) residents reveal not enough evidence to corroborate the allegation. Regarding the allegation, facility medication records (MAR) are inaccurate, LPA pertinent record review, interviews with the Licensee, and four (4) staff reveal not enough evidence to corroborate the allegation. Regarding the allegation, Administrator is not at the facility a sufficient amount of time, interviews with the Licensee, four (4) staff and six (6) residents reveal not enough evidence to corroborate the allegation. Based investigation findings, the allegations are Unsubstantiated. Unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted with this report was discussed and a copy provided with appeal rights to the Licensee at the conclusion of the visit.the state’s words, verbatim · CDSS document, May 15, 2025 · control 18-AS-20220323122333

Type of visit: Case Management - Other

On 04/29/2025 Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit regarding complaint 56-AS-20240122114325. LPA Hernandez met with Staff Florence Nahin and explained the purpose of the visit. LPA Hernandez amended LIC9099 report in order to include all three allegations onto the LIC9099. Previously, only two allegations were added onto LIC9099. Report now includes all three allegations.the state’s words, verbatim · CDSS document, Apr 29, 2025

Allegation investigated: Staff denied residents access to their rooms Staff yelled at the residents while in care Facility has inadequate staffing Staff do not seek timely medical attention for the residents Staff do not meet a resident's diabetic needs

Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced complaint visit to the facility for the above allegations. After introducing self, LPA met with Administrator Oscar Ramasar and Ghislaine (Gigi) Ramasar, and discussed the purpose of the visit. Regarding the allegation, staff denied residents access to their rooms, interviews with the Administrator, four (4) staff, and five (5) residents reveal not enough evidence to corroborate the allegation. Regarding the allegation, staff yelled at the residents while in care, interviews with the Administrator, four (4) staff, and five (5) residents reveal not enough evidence to corroborate the allegation. Unsubstantiated Regarding the allegation, facility has inadequate staffing, interviews with the Administrator, four (4) staff and five (5) residents reveals not enough evidence to corroborate the allegation. Regarding the allegation, staff do not seek timely medical attention for the residents, interviews with the Administrator, four (4) staff and five (5) resident reveals not enough evidence to corroborate the allegation. Regarding the allegation, staff do not meet a resident's diabetic needs, interviews with the Administrator, four (4) staff and five (5) resident reveals not enough evidence to corroborate the allegation. Based on LPA record reviewed and interviews the allegations are Unsubstantiated. Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and a copy of this report was provided with appeal rights to the Licensee at the conclusion of the visit.the state’s words, verbatim · CDSS document, Apr 28, 2025 · control 18-AS-20220330102307

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87219(b) · Plan of correction due date: May 5, 2025

87219(b)Residents served shall be encouraged to contribute to the planning, preparation, conduct, clean-up and critique of the planned activities. This requirement is not met at evidenced by: The Licensee did not comply with the section cited above by four (4) out of five (5) residents interviews reveals they were not aware of staff planned activities which poses a potential health, safety, and personal rights risk to persons in carethe state’s words, verbatim · CDSS document, Apr 28, 2025

Plan of correction: The Licensee/Administrator shall shall review the regulation cited and provide a statement of understanding to the licensing agency by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87219(e) · Plan of correction due date: May 5, 2025

87219(e)In facilities licensed for sixteen (16) to forty-nine (49) persons, one staff member, designated by the administrator, shall have primary responsibility for the organization, conduct and evaluation of planned activities. This person shall have had at least six (6) months experience in providing planned activities or have completed or be enrolled in an appropriate education or training program. This requirement is not met at evidenced by: The Licensee did not comply with the section cited above by not having a dedicated staff with required training and/or experience to plan and conduct resident activities which poses a potential healh, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 28, 2025

Plan of correction: The Licensee shall review the regulation cited and submit a statement of understanding to the licensing agency by POC due date.

Allegation investigated: Staff neglect led to the death of multiple residents. Staff did not prevent resident from sustaining a pressure injury.

Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Florence Nahin and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews and document review. For the allegation, Staff neglect led to the death of multiple residents and Staff did not prevent resident from sustaining a pressure injury. LPA Hernandez conducted five (5) resident interviews. 5 out of the 5 residents stated facility staff help assist residents with all medical needs. Additionally, Resident #1 (R1) who allegedly had a pressure injury was in fact not a wound but a rash. Staff #1 and Staff #2 stated the resident refuses to take showers which contribute to the rash. For additional former residents Resident #6 and Resident #7 were treated accordingly for their pneumonia and flu-like symptoms. LPA Hernandez observed documents containing doctor visits and notes for all three residents. Unsubstantiated Based on the evidence gathered during the investigation, the allegation listed above is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. 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 House Manager Florence Nahin.the state’s words, verbatim · CDSS document, Apr 11, 2025 · control 56-AS-20230104144903

Allegation investigated: Residents in care engaged in inappropriate interactions. Staff did not follow proper reporting requirements.

Licensing Program Analyst (LPA) Raquel Hernandez conducted an unnannounced visit for the purpose to deliver findings on the allegation listed above. LPA met with House Manager Florence Nahin and explained the purpose of the visit. The investigation consisted of staff interviews and resident interviews. For the allegation, Residents in care engaged in inappropriate interactions. LPA Hernandez conducted (6) resident interviews. 4 out of the 6 residents stated residents in care do not engage in inappropriate interactions at the facility. Additionally, LPA Hernandez conducted (3) staff interviews. 3 out of the 3 staff stated no inappropriate interactions with residents in care occur at the facility. Unsubstantiated For the allegation, Staff did not follow proper reporting requirements. LPA Hernandez verified facility administrator did report and submit Special Incident Report (SIR) to licensing department. Additionally, LPA Hernandez observed facility administrators contacted law enforcement. Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. During today’s visit, pertaining to these allegations, 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 House Manager Florence Nahin.the state’s words, verbatim · CDSS document, Apr 11, 2025 · control 56-AS-20230803151014

Allegation investigated: Staff are not adequately supervising resident(s) resulting in resident(s) wandering from the facility while in care.

Licensing Program Analyst (LPA) Raquel Hernandez conducted an unnannounced visit for the purpose to deliver findings on the allegation listed above. LPA met with House Manager Florence Nahin and explained the purpose of the visit. The investigation consisted of staff interviews and resident interviews For the allegation, Staff are not adequately supervising resident(s) resulting in resident(s) wandering from the facility while in care. LPA Hernandez spoke with Administrator Ghislaine Ramasar regarding former resident. Administrator Ghislaine stated former resident did leave the facility without staff knowing. Additionally, former resident was found three hours after they went missing. Substantiated Based on observations, interviews, and record review, the allegations are SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. During today’s visit, a deficiency was cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report LIC9099, LIC9099C and LIC9099D were discussed and provided to House Manager Florence Nahin and discussed over the phone with licensee Ghislaine Ramasar and Oscar Ramasar along with a copy of the appeal rights. For the allegation, Licensee is not ensuring that a complete record is being maintained for a resident in care. LPA Hernandez reviewed and received resident file for former resident. Additionally, LPA Hernandez spoke with Administrator Ghislaine Ramasar who stated residents records are completed and kept in a secure and locked space. For the allegation, Staff do not seek assistance for resident(s) in care in a timely manner. LPA Hernandez conducted (6) resident interviews. 5 out of the 6 residents stated facility staff do help them in a timely manner. LPA Hernandez conducted (4) staff interviews. 4 out of the 4 staff stated facility staff do help residents in a timely manner. For the allegation, Facility is unkept. LPA Hernandez conducted (6) resident interviews. 6 out of the 6 residents stated the facility is kept clean. Additionally, LPA Hernandez conducted (4) staff interviews. 4 out of the 4 staff stated the facility is cleaned everyday and it is always kept clean. Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. During today’s visit, no deficiencies pertaining to these allegations, 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 House Manager Florence Nahin.the state’s words, verbatim · CDSS document, Apr 11, 2025 · control 56-AS-20231113111520

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.312(e) · Plan of correction due date: Apr 14, 2025

1569.312 Basic Service Requirements (e) Monitoring the activities of the residents while they are under the supervision of the facility to ensure their general health, saftey, and well-being. Based on interviews, licensee failed to meet this requirement by not ensuring staff were properly supervising residents, which poses an immediate health, saftey or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 11, 2025

Plan of correction: Licensee stated to submit proof of staff training on supervision rules to LPA Hernandez by Plan of Correction (POC) due date.

Allegation investigated: Staff handled resident in a rough manner. Resident sustained bruising while in care. Resident was financially abused while in care.

Licensing Program Analyst (LPA) Raquel Hernandez conducted an unnannounced visit for the purpose to deliver findings on the allegation listed above. LPA met with House Manager Florence Nahin and explained the purpose of the visit. The investigation consisted of staff interviews and resident interviews For the allegation, Staff handled resident in a rough manner. LPA Hernandez conducted (3) resident interviews. 3 out of the 3 residents stated they have not witnessed facility staff handle any of the residents in care in a rough manner. Additionally, LPA Hernandez conducted (3) staff interviews. 3 out of the 3 staff stated they have not handled any residents in care in a rough manner. Unsubstantiated For the allegation, Resident sustained bruising while in care. LPA Hernandez conducted (3) resident interviews. 3 out of the 3 residents stated they have not sustained any bruising by facility staff while in care nor have witnessed any residents in care sustain bruising from facility staff. Additionally, LPA Hernandez conducted (3) staff interviews. 3 out of the 3 staff stated residents do not sustain bruising while in care from facility staff but at times can have behaviors that cause them to hit things or objects. For the allegation, Resident was financially abused while in care LPA Hernandez conducted (3) resident interviews. 3 out of the 3 residents stated the facility is not financially abusing them. Administrator Ghislaine and Oscar Ramasar stated residents get their funds monthly from conservators which is then documented. Administrators stated money for (4) residents are kept in office for management and safeguarding purposes and the rest are given to residents in care. Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. During today’s visit, no deficiencies pertaining to these allegations, 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 House Manager Florence Nahin.the state’s words, verbatim · CDSS document, Apr 11, 2025 · control 56-AS-20240122114325

Allegation investigated: Facility is financially abusing resident in care.

Licensing Program Analyst (LPA) Raquel Hernandez conducted an unnannounced visit for the purpose to deliver findings on the allegation listed above. LPA met with House Manager Florence Nahin and explained the purpose of the visit. The investigation consisted of staff interviews and resident interviews. For the allegation, Facility staff is financially abusing residents in care. LPA Hernandez conducted (3) resident interviews. 2 out of the 3 residents stated the facility is not financially abusing them and have not witnessed the facility abusing other residents in care. 1 out of the 3 residents stated the facility has been financially abusing them. LPA Hernandez conducted (2) staff interviews. 2 out of the 2 staff stated the facility is not financially abusing residents in care. Unsubstantiated Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. 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 House Manager Florence Nahin.the state’s words, verbatim · CDSS document, Jan 17, 2025 · control 56-AS-20241125112929

Allegation investigated: Facility staff is forcing residents to take medications. Facility staff is opening resident's mail without permission.

Licensing Program Analyst (LPA) Raquel Hernandez conducted an unnannounced visit for the purpose to deliver findings on the allegation listed above. LPA met with House Manager Florence Nahin and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews and facility tour. For the allegation, Facility staff is forcing residents to take medications. LPA Hernandez conducted (6) resident interviews. (4) out of the (6) residents stated staff does not force them to take their medications and have not witnessed any staff forcing other residents to take their medication. (2) out of the (6) staff stated staff does force them to take their medications. LPA Hernandez conducted (4) staff interviews. (4) out of the (4) staff stated they do not force residents to take their medications and have not witnessed any staff forcing residents to take their medications. Unsubstantiated For the allegation, Facility staff is opening resident's mail without permission. LPA Hernandez conducted (6) resident interviews. (6) out of the (6) residents stated staff does not open their mail without their permission. LPA Hernandez conducted (4) staff interviews. (4) out of the (4) staff stated they do not open resident's mail without their permission and have not witnessed any staff opening resident's mail without their permission. Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. 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 House Manager Florence Nahin.the state’s words, verbatim · CDSS document, Dec 26, 2024 · control 56-AS-20241220111135

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Raquel Hernandez made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrators Oscar & Ghislane Ramasar and was granted entry to the facility. Licensed capacity is (29) current census (28). LPA was accompanied by Administrator Oscar and Ghislane Ramasar 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 clients 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 (6) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA reviewed (6) resident medications. **Continuation on LIC809C** LPA observed Resident #1 (R1), Resident #2 (R2), Resident#3 (R3), Resident #4 (R4) medications were transferred from original received medication packet to a separate container. Deficiency will be issued. Additionally, LPA also reviewed (3) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. No issues were observed. Based on the observations made during today’s visit, a deficiency was cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) and (LIC809D) was discussed and provided to Administrator Oscar & Ghislane Ramasar.the state’s words, verbatim · CDSS document, Nov 6, 2024

Allegation investigated: Staff did not properly supervise resident, resulting in resident wandering away.

Licensing Program Analysts (LPAs) Raquel Hernandez and Mary Rico conducted an unnannounced visit for the purpose of investigating the above allegation. LPAs met with House Manager Florence Nahin and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews and facility tour. For the allegation, Staff did not properly supervise resident, resulting in resident wandering away. LPA Hernandez conducted (4) resident interviews and (4) staff interviews. During resident interview R1 admitted to leaving the facility without care and supervision. Additionally, 3 out of the 4 staff admitted R1 left without care and supervision. Substantiated During record review, LPAs Hernandez and Rico observed R1's physician report and it states R1 has confusion and wandering behavior that requires 24 hour care and supervision. Based on observations, interviews, and record review, the allegations are SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. During today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report LIC9099, LIC9099C and LIC9099D were discussed and provided to House Manager Florence Nahin and discussed over the phone with licensee Ghislaine Ramasar and Oscar Ramasar along with a copy of the appeal rights.the state’s words, verbatim · CDSS document, Oct 18, 2024 · control 56-AS-20241015113034

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.312(e) · Plan of correction due date: Oct 21, 2024

1569.312 Basic Service Requirements (e) Monitoring the activities of the residents while they are under the supervision of the facility to ensure their general health, saftey, and well-being. Based on interviews, licensee failed to meet this requirement by not ensuring staff were properly supervising residents, which poses an immediate health, saftey or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Oct 18, 2024

Plan of correction: Licensee stated to submit proof of staff training on supervision rules to LPA Hernandez by Plan of Correction (POC) due date 10/21/2024.

Allegation investigated: Staff are mismanaging residents medication

Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegation. LPA Prieto met with licensees Oscar and Gigi Ramasar and explained the elements of the complaint. Regarding the allegation that staff are mismanaging residents medication; LPA interviewed resident #1 (R1), R2, R3, R4, R5, and R6, all stated that their medications are being dispensed as prescribed in the presence of staff and at their appropriate times. An audit was conducted of the facility medication room and resident files that reveal medications are dispense appropriately. LPA observed staff training files and are current. All medications are locked in their med tech cart, in a locked med room. ***continued on LIC 9099C*** Unsubstantiated Based on the information obtained there is not enough evidence that staff are mismanaging residents medication. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and licensee Oscar Ramasar and a copy was left with the facility. .the state’s words, verbatim · CDSS document, Jul 3, 2024 · control 56-AS-20240626154350

Allegation investigated: Staff did not contact authorized representative of resident injury.

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with caregiver Florence Nahin explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews document reviews, and facility tour. For the allegation, Staff did not contact authorized representative of resident injury. LPA Rico conducted four (4) staff interviews, 4 out of the 4 staff stated they are responsible to contact authorized representative regarding any incidents that occurs. 2 out 4 of the staff stated that R1 did not have an injury but had reoccurring wound care on (L) knee from the clinic since 2020 and the authorized representative was informed. Unsubstantiated During record review, LPA received R1 documents that indicated R1 was receiving wound care in 2020 through 2022. In addition, R1 Physician Report from 2022 also indicated R1 was receiving wound treatment (L) knee. During interview with resident. R1 stated they did not have an injury but recalls receiving wound care on their (L) knee. Based on the evidence found during the investigation, the one (1) allegation listed above are 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 was discussed and provided to Administrator Ghislaine Ramasar along with a copy of the appeal rights.the state’s words, verbatim · CDSS document, May 22, 2024 · control 18-AS-20220411110422

Allegation investigated: Resident sustained injury in care. Staff did not contact authorized representative of resident injury.

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Administrator Ghislaine Ramasar and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews, document reviews, and facility tour. For the allegation, Resident sustained injury in care. LPA Rico conducted four (4) staff interviews. 4 out of 4 staff informed LPA that R1 did not sustained an injury while in care. 2 out of the 4 staff informed LPA R1 is independent but would refuse to change their clothes for a week. Due to resident's refusals R1 abdomen skin became irriated. In addition, R1 confirmed they would refuse to change their clothes. R1 also indicated they were receiving treatment for their abdomen skin but did not have an injury. Unsubstantiated During record review, R1 Physician Report from 2022 indicated resident had a history of skin condition. In addition, on residents’ observation reports also indicated resident was receiving treatment in 2022. For the allegation, Staff did not contact authorized representative of resident injury. During staff interview 2 out of the 4 staff indicated R1 authorized representative was informed regarding skin condition. During resident interview, R1 informed LPA that their representative was aware of her condition but no injury occurred. During record review, LPA Rico received facility confirmation letter that was sent to authorized representative. Based on the evidence found during the investigation, the two (2) allegations listed above are 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 was discussed and provided to Administrator along Ghislaine Ramasar with a copy of the appeal rights.the state’s words, verbatim · CDSS document, May 22, 2024 · control 18-AS-20220411144445

Type of visit: Required - 1 Year

09020; Licensing Program Analysts (LPAs) Amy Goldenberg and Bianca Wolcott conducted an unannounced visit to the facility for the purpose of a required annual. LPAs rang the bell and were granted entry by LVN Ravinder Ahuja. LPAs discussed the purpose of the visit. LPAs were later met by Licensee Ghislaine Ramasar. LPAs toured the facility inside and out. The facility has no bodies of water or firearms. The facility has charged fire extinguishers, operating smoke alarms, and carbon monoxide detectors. All indoor and outdoor passageways were kept free of obstruction. Cleaning supplies, medications, and sharps were locked and kept inaccessible to the clients. All client bedrooms had sufficient lighting. The facility had a supply of additional linen and extra hygiene items for the clients. In terms of the food supply, the facility had a sufficient amount of nonperishable and perishable food items. LPA measured the hot water temperatures in three resident bathrooms ranging 105-112 degrees F. LPAs reviewed staff and client files. Client files had appropriate documentation including an admission's agreement. Staff files had appropriate documentation including current first aid/CPR certification and a health screening report. LPAs learned that E1's criminal record clearance has not been associated tho this facility number. LPAs reviewed medications. Medications appeared to be dispensed appropriately according to the physician's orders. Centrally stored medication logs are maintained. This reports was reviewed with and a copy was provided to the facility representative. Refer to LIC809D for deficiencies cited. Appeal rights were discussed and provided to Ghislaine Ramasar.the state’s words, verbatim · CDSS document, Nov 2, 2023