Crystal Creek Senior Living

Allegation investigated: Licensee does not ensure staff have a Tuberculosis clearance

On 8-27-2026 at 12:30pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open and investigate the allegation noted above. LPA met with Director of Nursing Jennifer Almendarez and explained the purpose of the visit. Director of Nursing departed and LPA met with staff5 (S5) during the remainder of today's visit. Administrator Angela Ringu was not present during today's visit. During today's investigation, LPA requested various staffing files for March 2026 and additional employment information for August 2026 including employee separations. Additionally, LPA conducted interviews with one staff member. Allegation: Licensee does not ensure staff have tuberculosis clearance. It was alleged that a staff identified as a caregiver did not receive a Tuberculosis (TB) clearance after being hired five months ago. LPA reviewed new hire staff files for March 2026 and recent staff files of those who ended employment in August 2026. LPA also conducted interview with S1. Based on these file reviews and interview, it was revealed that all staff hired received TB testing and health screen clearance performed by an appropriately skilled professional. It was further revealed through interview that housekeeping staff, but no caregivers resigned during the week of {Cont. on 9099C} Unfounded 8/17/2026. As a result, there is not a preponderance of evidence to conclude staff did not have tuberculosis clearance, therefore, this allegation is UNFOUNDED. A finding of unfounded means the allegation is false, could not have happened, and/or is without a reasonable basis. An exit interview was conducted with S5 and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 27, 2026 · control 27-AS-20260825135528

Type of visit: Required - 1 Year

On 8-11-2026 at 1:35pm, Licensing Program Analyst (LPA) Michael Bilger arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the administrator Angela Ringu and explained the purpose of the visit. LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room area, living area, common TV area, and outside of the facility to ensure compliance with Title 22 regulations. Facility is an residential care facility for the elderly (RCFE) with a current census of 72. LPA also conducted the inspection using the CARE tool. The facility has an approved infection control plan in place. Water temperature reads 105*F to 120*F in the bathroom and room temperature reads 73*F. LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguisher was checked 4-16-26. Facility has an emergency food and water kit. All toxins and other dangerous items including sharp objects were locked and inaccessible to residents in care. Medication storage area was observed to be locked and inaccessible to residents in care. First aid kit was observed to have adequate supplies and accessible to staff. {Cont. on 809C} During this inspection 5 resident files and 5 staffing files were reviewed for regulatory compliance. All files contained required contents including staff training requirements. All staff noted on LIC 500 contained criminal background clearances. LPA completed 4 resident interviews and 4 staff interviews. Resident files reviewed contained all required contents including updated admission agreements, medical assessments, and updated appraisal forms as required. Facility’s liability insurance is current and up to date per regulatory requirements. Facility does not contain any bodies of water. LPA observed personal rights and complaint information posted. Facility has appropriate internet access available for resident use. LPA observed facility’s activity calendar and sufficient equipment and supplies to meet activity program needs of residents in care. LPA reviewed facility’s disaster plan to ensure regulatory compliance. Facility conducts monthly fire drills. LPA requested an updated copy of LIC 308 and LIC 500. Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a report was given to Administrator.the state’s words, verbatim · CDSS document, Aug 11, 2026

Allegation investigated: Staff did not prevent residents from engaging in inappropriate sexual behaviors Staff are not checking on residents regularly Staff are not following acceptance and retention limitations procedures Staff are not meeting residents needs Staff failed to observe changes in resident

On 7-7-2026 at 11:00am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to continue investigation, deliver and discuss findings for the allegations noted above. LPA met with Administrator Angela Ringu and explained the purpose of the visit. During this investigation, LPA conducted interviews with five staff members and seven residents in care. LPA also reviewed facility file documentation including care notes, observation notes for various residents in care, needs and service plan, and physician’s reports pertaining to resident1 (R1) and R2. LPA also reviewed additional documentation including incident reports, death report, death certificate and activities calendar. LPA also conducted a facility observation as part of this investigation. Allegation: Staff did not prevent residents from engaging in inappropriate sexual behaviors. LPA conducted interviews and record reviews as noted above. Based on these interviews and record reviews it was revealed that R2 has engaged in sexual relationships with at least one resident in care. Although these events occurred, it was further revealed that these encounters were consensual. {Cont. on 9099C} Unsubstantiated Additionally, care notes reviewed revealed multiple attempts by staff to redirect these encounters for purposes of promoting safety, privacy, and resident rights. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. Allegation: Staff are not checking on residents regularly. LPA conducted interviews, record reviews, and observation as noted above. Based on the evidence reviewed, it was revealed that staff conduct regular rounds for residents in care to ensure safety. Additionally, record reviews and interviews revealed that various residents require frequent checks, which were observed and noted on needs and services plans and observation notes. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. Allegation: Staff are not following acceptance and retention procedures. LPA conducted interviews and record reviews as noted above. Based on evidence reviewed, it was revealed that facility currently provides care for multiple residents under the age of 60. It was further revealed that facility has adequately been able to meet the needs of these residents including physical, social, and mental health needs. LPA observed activities and care provided to identified residents under the age of 60. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. Allegation: Staff are not meeting resident needs. LPA conducted interviews and record reviews as noted above. This allegation stated that resident1 (R1) was found with a leg laceration on 5-5-2026 without proper treatment applied. Based on interviews and record reviews, it was revealed that R1 experienced a leg laceration which staff attended to via first aid. Additionally, it was revealed that staff called 911 personnel who attended to the laceration and transported R1 to the hospital. On 5-6-2026, it was revealed that R1 passed away at the hospital. Additional care notes reviewed indicate staff’s involvement in care planning including appointments and communication with dialysis center for R1. Additional notes indicate staff’s attempts to redirect R1 to his special diet and informing R1’s physician regarding R1’s refusal to comply with diet restrictions. Additionally, LPA observed staff meeting the general needs of residents in care. As a result, there is not a preponderance of evidence to conclude staff are not meeting resident needs, therefore, this allegation is UNSUBSTANTIATED. {Cont. on 9099C} Allegation: Staff failed to observe changes in resident. LPA conducted interviews and record reviews as noted above. This allegation states that R1 was found deceased in facility after experiencing an injury. Based on evidence reviewed including interviews and record reviews, it was revealed that on 5-5-2026, R1 experienced a leg laceration which was tended to by facility staff. R1 was then sent to a local hospital for additional treatment. On 5-6-2026, facility staff learned that R1 passed away at the hospital with a stated cause of cardiac arrest. A review of death certificate states place of death at local hospital with immediate cause of death to be acute respiratory failure and secondary causes including cardiac arrest and end stage renal failure. Care notes reviewed indicate staff had been engaging in regular observation of R1’s diet non-compliance, behaviors, and medication. It was further revealed that facility staff have arranged for R1’s follow-up doctor appointments and required dialysis treatment. Care notes and interviews also revealed that facility staff offered consultations to R1 regarding diet restrictions. An observation conducted by LPA revealed staff observing and addressing various resident needs. As a result of the evidence reviewed, there is not a preponderance of evidence to suggest staff failed to observe changes in a resident, therefore, this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means 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 with Administrator and a copy of this report was provided. Appeal rights provided.the state’s words, verbatim · CDSS document, Jul 7, 2026 · control 27-AS-20260519094937

Allegation investigated: Staff do not respond to communication from resident's doctors in a timely manner Staff cancel resident's medical appointments without explanation Staff are not assisting resident with obtaining medical care

On 7-7-2026 at 10:00am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver and discuss findings for the allegations noted above. LPA met with Administrator Angela Ringu and explained the purpose of the visit. During this investigation, LPA conducted staff interview and record reviews including physician’s report, needs and services plan, care notes and appointment calendar all pertaining to resident1 (R1). Allegation: Staff do not respond to communication from resident’s doctor’s in a timely manner. LPA conducted interview and record reviews as noted above. Based on evidence reviewed, it was revealed that R1 previously had multiple interventions with medical personnel including dialysis and psychological services. Additionally, the evidence revealed that staff engaged in communication with outside medical personnel including physicians regarding diet restrictions, medication changes, behaviors, and doctor appointments. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. {Cont.on 9099C} Unsubstantiated Allegation: Staff cancel resident’s medical appointments without explanation. LPA conducted interview and record reviews as noted above. Based on the evidence reviewed it was revealed that R1 previously had regular scheduled appointments for dialysis throughout the months of March, April, and May of 2026. Additional medical appointments were also noted for lab work, physical therapy, heart check-ups, and other physician appointments. Records reviewed and interviews revealed no evidence of staff-initiated cancellations of appointments. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. Allegation: Staff are not assisting resident with obtaining medical care. LPA conducted interview and record reviews as noted above. Based on the evidence reviewed, it was revealed that R1 previously required medical attention regarding diet restrictions, medication changes, behaviors, and dialysis. Further evidence revealed that staff have been providing on-going interactions regarding the above including arranging medical appointments for consultation. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means 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 with Administrator and a copy of this report was provided. Appeal rights provided.the state’s words, verbatim · CDSS document, Jul 7, 2026 · control 27-AS-20260504140507

Allegation investigated: Staff do not keep facility clean and sanitary

On 6-4-2026 at 10:15am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open and investigate the complaint allegation noted above. LPA met with Administrator Angela Ringu and explained the purpose of the visit. During this investigation, LPA conducted a facility observation including a tour of common areas, various resident rooms, dining room, kitchen area, activities room, and outside of facility. LPA also reviewed facility housekeeping schedule and conducted interviews with two residents in care, and two staff members. Based on observation, interviews, and record reviews, it was revealed facility is maintaining a generally clean, safe, and sanitary environment at this time. Observation did not reveal any excessive unsanitary or malodorous environments. Observation revealed housekeeping on duty and performing general housekeeping duties. Room #11 was observed to contain clutter, however, interviews revealed resident1 (R1) prefers this environment while exercising his resident rights. Housekeeping scheduled reviewed indicates consistent schedule of cleaning for all rooms within facility. As a result of this investigation, there is not a preponderance of evidence to conclude facility does not maintain a clean and sanitary environment, therefore, this allegation is UNSUBSTANTIATED. (cont. on 9099C) Unsubstantiated A findings of unsubstantiated means 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 with Administrator and a copy of this report was provided. LIC 811 and appeal rights provided.the state’s words, verbatim · CDSS document, Jun 4, 2026 · control 27-AS-20260528084535

Allegation investigated: Staff discouraged resident from using call light.

On 5-27-2026 at 1:30pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open a complaint investigation regarding the allegation noted above. LPA met with Administrator Angela Ringu and explained the purpose of the visit. During this investigation, LPA conducted interviews with three residents and four staff members in care, and conducted facility observation. Allegation: Staff discouraged resident from using call light. LPA conducted interviews and observation noted above. Based on interviews and observation, it was determined that no corroborated statements exist to support the allegation noted above. Interviews further revealed an encouragement for residents to use call button for help, with no expression of discouragement or fear to do so. Observation conducted revealed staff consistently answer call buttons without negative statements such as discouragement to use call buttons. As a result, the preponderance of evidence standard is not met, and this allegations is UNSUBSTANTIATED. A finding of unsubstantiated means 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 with Administrator and a copy of this report was provided. Appeal rights provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, May 27, 2026 · control 27-AS-20260521165659

Allegation investigated: Staff are rude to residents

On 5-20-2025 at 10:15am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to continue investigation and deliver findings for the allegation noted above. LPA met with business offfice manager Maria Posadas and explained the purpose of the visit.Adminstrator Angela Ringu was made aware of LPA's visit and purpose. During today's visit, LPA conducted interviews with four additional staff members. The full investigation consisted of six resident interviews and five staff interviews. Additionally, LPA conducted a facility observation, and reviewed staff file for staff8 (S8). Allegation: Staff are rude to residents. LPA conducted interviews and observation as noted above. Interviews conducted revealed that staff member engaged in dialogue interpreted as rude by residents and staff in at least two instances. Interviews revealed multiple coroborated statements consistent with the description of the dialogue expressed and interpreted as rude with such statements as "You need to get up!" and "Next time you need to remember why you rang the call button", and "You're lying." As a result, there is preponderance of evidence to conclude staff are rude towards residents in care, therefore, this allegation is SUBSTANTIATED {Cont. on 9099C} Substantiated Citation is issued under Title 22, Division 6 and noted on LIC 9099D. An exit interview was conducted with business office manager and a copy of this report was provided. Appeal rights provided. LIC 811 provided. A finding of unsubstantiated means 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 with business office manager and a copy of this report was provided. Appeal rights provided.the state’s words, verbatim · CDSS document, May 20, 2026 · control 27-AS-20260430085520

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Jun 3, 2026

87468.1 Personal Rights of Residents in All Facilities. (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1)To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by: Based on interviews conducted, licensee did not ensure the requirement above in that a staff member engaged in rudeness towards various residents in care. This posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, May 20, 2026

Plan of correction: Licensee to ensure completed staff training on resident rights including but not limited to: Staff relations with residents, dignity, approach towards residents in care. Proof of completed training to be sent to LPA by POC due date.

Allegation investigated: Staff are not allowing a resident to attend religious meetings.

On 5-5-2026 at 10:15am, Licensing Program Analyst (LPA) arrived unannounced to deliver and discuss findings for the allegation noted above. LPA met with Director of Wellness Jennifer Almendarez and explained the purpose of the visit. During this investigation, LPA conducted interviews with two staff members and one resident in care. Additionally, LPA reviewed needs and service plan, admissions agreement, physician’s report, facility care notes, and facility’s internal complaint documentation pertaining to resident1 (R1) Allegation: Staff are not allowing a resident to attend religious meetings. Based on interviews and record reviews, on or about 3-29-2026, R1 entered the activity room to watch a religious services program, but was told he was unable to at that moment as it would interfere with other residents wishing to also utilize the television and participate in other activities. On this date, R1 was allowed to watch his religious program in the activities room as an exception. {Cont. on 9099C} Unsubstantiated Interviews conducted and documentation reviewed further revealed that facility has purchased R1 a television for this room to accommodate his religious services program. During an interview with R1, LPA observed R1’s television to be functioning properly for purposes of watching his religious program. Additionally, it was revealed that R1 continues to have access to his cell phone which can provide his religious program. Interviews and documentation review did not reveal corroborated evidence that facility staff were disallowing R1 to attend his religious program. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means 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 with Director Of Welness and a copy of this report was provided. Appeal rights provided.the state’s words, verbatim · CDSS document, May 5, 2026 · control 27-AS-20260330153304

Allegation investigated: Staff do not ensure resident's dietary needs are met

On 5-5-2026 at 11:30am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver and discuss findings for the allegations noted above. LPA met with Director of Wellness Jennifer Almendarez and explained the purpose of the visit. During this investigation, LPA conducted interviews with four residents and four staff members. Additionally, LPA reviewed needs and service plan, physician’s report, care notes, weight record, and incident report pertaining to resident1 (R1). LPA also reviewed facility house rules and menus. Allegation: Staff do not ensure resident’s dietary needs are met. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews, it was revealed that facility staff have offered food items to various residents counter to their dietary needs. It was further revealed through observation that facility staff offers residents in care the same food items while in the dining room. {Cont. on 9099C} Substantiated Additional staff interview regarding dietary needs also confirmed staff is not consistently adhering to dietary needs. As a result, the preponderance of evidence is met and this allegation is SUBSTANTIATED. Citation is issued under Title 22, Division 6 and noted on LIC 9099D. An exit interview was conducted with Director of Wellness and a copy of this report was provided. LIC 811 and Appeal rights provided. Further interviews conducted revealed that although residents may engage in some form of inappropriate interactions within dining room and other areas within the facility, facility staff are available to redirect and prevent further escalations. Additionally, interviews conducted did not reveal any corroborated statements from staff not preventing inappropriate interactions between residents. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. Allegation: Staff speak to a resident inappropriately. LPA conducted interviews and observations as noted above. Based on interviews conducted, there were no corroborated statements to support the allegation of staff speaking inappropriately to a resident in care. Additionally, LPA did not observe staff speaking in an inappropriate manner to any residents in care. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means 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 with Director of Wellness and a copy of this report was provided. Appeal rights provided.the state’s words, verbatim · CDSS document, May 5, 2026 · control 27-AS-20260403081111

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(b)(7) · Plan of correction due date: May 15, 2026

87555 General Food Service Requirements. (b) The following food service requirements shall apply: (7) Modified diets prescribed by a resident's physician as a medical necessity shall be provided. This requirement was not met as evidenced by: Based on interviews conducted, staff are not consistently adhering to various resident dietary needs including diabetic and low salt diets. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, May 5, 2026

Plan of correction: Licensee to ensure completed staff training on dietary needs and how these needs pertain to various diet restrictions for residents’ in care. Proof of completed training to submitted to LPA by POC due date.

Allegation investigated: Staff do not respond to resident’s call button. Staff cancels resident’s scheduled appointments.

On 5-5-2026 at 1:30pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver and discuss findings for the allegations noted above. LPA met with Director Wellness Jennifer Almendarez and explained the purpose of the visit. During this investigation, LPA conducted facility observations on 4-22-2026 and 5-5-2026. Additionally, LPA conducted interviews with five staff members and six residents in care. LPA also reviewed facility file documentation including resident appointment calendars Allegation: Staff do not respond to resident’s call button. LPA conducted facility observations and interviews as noted above. During observations conducted, LPA observed staff attending to resident needs and answering call lights within an average time frame of 5-10 minutes. Interviews conducted revealed that 10-15 minutes are the facility’s expectation standards. Further interviews revealed no corroborated statements from staff not responding to resident call buttons. {Cont. on 9099C} Unsubstantiated This allegation also states management staff have told care staff to not answer a particular call button when pressed. Interviews conducted also did not reveal corroborating evidence of such occurrence. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. Allegation: Staff cancels resident’s scheduled appointments. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews, it was revealed that facility staff maintain appointment calendars for resident appointments. Interviews revealed no corroborated statements of staff initiating cancellations of residents’ appointments. Appointment calendars reviewed did not indicate appointment cancellations. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means 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 with Director of Wellness and a copy of this report was provided. Appeal rights provided.the state’s words, verbatim · CDSS document, May 5, 2026 · control 27-AS-20260414134148

Allegation investigated: Staff did not ensure that insulin administration to residents was performed by an appropriately skilled professional

On 4-22-2026 at 10:15am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver findings for the allegation noted above. LPA met with Health and Wellness Director Jennifer Almendarez and explained the purpose of the visit. During this investigation, LPA conducted interviews with five staff members and reviewed facility file documentation including medication logs for January and February of 2026, and facility’s medication policy. Allegation: Staff did not ensure that insulin administration to residents was performed by an appropriately skilled professional. LPA conducted interviews and record reviews as noted above. Based on these interviews and record reviews, it was revealed that at the time of review, a total of 15 residents received insulin via flex pen. Interviews also revealed that five of these residents were unable to determine what the dosage should be and required assistance as a result. A review of facility’s medication policy states in part: "Properly trained med techs may physically assist a resident with setting the dial of an insulin multi-dose pen according to physician's orders. If resident is unable to determine what the dosage should be, med techs cannot assist with setting the dial..." {Cont. on 9099C} Substantiated Interviews conducted revealed corroborated statements that med techs assisted these five residents with their insulin flex pens by turning the dial for appropriate dosage on various dates and times between January and February of 2026. A review of medication log sheets indicated these residents were assisted with their insulin flex pens with confirmation via med tech initials present on these log sheets. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED. Citation is issued under Title 22, Division 6, and noted on LIC 9099D. An exit interview was conducted with Health and Wellness Director and a copy of this report was provided. Appeal rights and LIC 811 provided.the state’s words, verbatim · CDSS document, Apr 22, 2026 · control 27-AS-20260206104333

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(4) · Plan of correction due date: Apr 23, 2026

87465 Incidental medical and Dental Care. (a) A plan for incidental medical and dental care shall be developed by each facility… (4) The licensee shall assist residents with self administered medications as needed. This requirement was not met as evidenced by: Based on interviews and record reviews, Licensee did not ensure that an appropriately skilled professional assisted residents as needed with self-administering insulin flex pen injections. This posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 22, 2026

Plan of correction: Licensee will ensure completed staff training on proper assistance with medications with topics to include but not be limited to: Diabetes, injections, use of insulin flex pen, and general medication assistance with self-administration of medication in addition to facility’s written medication policy. Training date to be submitted to LPA by POC due date. Proof of completed training to be submitted to LPA by 5/6/2026

Allegation investigated: Staff did not maintain the resident's room in a sanitary condition. Staff did not ensure that the resident was regularly observed for changes in condition.

Licensing Program Analyst (LPA) Kesha Lewis and Melina Oropeza arrived unannounced to deliver findings for the above allegations. LPA met with Angela and explained the purpose of the visit. Based on multiple interview with the resident (R1) and observations of R1'S room and records reviewed. the ficility did have care notes for R1 that covered time period, LPA did not obersrve R1'S room to be unsanitary. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 24, 2026 · control 27-AS-20260116125404

Allegation investigated: Staff do not assist resident with adequate supervision, resulting in resident unclothed in facility and/or smoking inside of facility. Resident Rights are violated; Staff inappropriately speaks to resident, humiliate resident and/or interact inaapropriately. Staff do not maintain a comfortable temperature in the facility for residents in care. Staff do not distribute residents' medications as prescribed. Staff confined resident to room. Staff do not safeguard resident's mail Staff do not serve residents food of good quality Staff do not have medication training

Licensing Program Analyst (LPA) Kesha Lewis and Melina Oropeza arrived unannounced to deliver findings for the above allegations. LPA met with Angela and explained the purpose of the visit. Allegation 1: Staff do not assist resident with adequate supervision, resulting in resident unclothed in facility and/or smoking inside of facility is UNSUBSTANTIATED, based on interviews and observations no residents were unclothed. Allegation 2: Resident Rights are violated; Staff inappropriately speaks to resident, humiliate resident and/or interact inaapropriately. Baed on obersvation over mulitlple visit LPA never heard or saw any staff interact inaapropriately with residents. Allegation 3: Staff do not maintain a comfortable temperature in the facility for residents in care this alleagaton is UNSUBSTANTIATED based on interviews and abservations no resdients stated there were uncomfterbale with the tempiture and over muliple visits the LPA observed the facility to be with in the required tempature range. Unsubstantiated Allegation 4: Staff do not distribute residents' medications as prescribed is UNSUBSTANTIATED, based on records reviewed R1 received all medication that was prescribed to them. Allegation 5: Staff confined resident to room is UNSUBSTANTIATED, based on interview with reporting party. They stated on multiple occasions they leave the facility to go to the taco truck and based on observation when LPA arrived at the facility R1 was outside in the parking lot with other residents. Allegation 6: Staff do not safeguard resident's mail is UNSUBSTANTIATED, based on interviews with staff there is only one person that handles mail for the facility and they pass the mail out to the residents. Allegation 7: Staff do not serve residents food of good quality is UNSUBSTANTIATED, based on observations and records reviewed the facility is providing food that is within regulation. Allegation 8: Staff do not have medication training is UNSUBSTANTIATED, based on records review all staff that handle medication has the required training. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 24, 2026 · control 27-AS-20260128081241

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87464(f)(1) · Plan of correction due date: Mar 25, 2026

87464(f)(1) Basic Services: Basic services shall at a minimum include: Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidence by: based on interviews and file review. the Licensee did not ensure staff were responding to residents call buttons timely and providing care in a timely manner. This posed a potential health and safety risk.the state’s words, verbatim · CDSS document, Mar 24, 2026

Plan of correction: The facility has already updated there call button system and each resident now has a pendent they wear and additionial training has been compleated and the time is now able to be seen.

Type of visit: Case Management - Incident

On 2-11-2026 at 1:00pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management visit regarding a self reported incident. LPA met with Administrator Angela Ringu and explained the purpose of the visit. LPA requested facility file documentation from Licensee including: recent incident reports, physician's report, admissions agreement, needs and service plan, behavior assessments for last previous three months, medication logs for last previous three months, and emergency and ID information all pertaining to resident1 (R1). LPA also requested staff file documentation including LIC 501, training records, administrator certificate, mandated reporter form, staff reprimand documentation, and employment application pertaining to staff1 (S1). Additionally, LPA requested any law enforcement contact information related to the incident in question. All documentation to be sent to LPA and Licensing Program Manager by end of day 2-12-2026 via email. LPA provided contact emails to Administrator and Licensee. Additional time is necessary for the Department to conduct this case management investigation. LPA will return at a later time for completion. An exit interview was conducted with Administrator and a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 11, 2026

Allegation investigated: Staff do not ensure residents have adequate hygiene supplies.

On 01/21/26, Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to deliver findings for the above allegations. LPA identified herself upon arrival, stated the purpose of the visit. LPA met with Angela Ringu and a brief interview followed. LPA toured the facility. LPA learned the facility will be installing shower Despensers and updating the facility’s admissions agreement starting March 1st. Based on interviews and document review the facility did not provide body soap to residents therefore the allegation Staff do not ensure residents have adequate hygiene supplies is SUBSTANTIATED. The Department has determined, based on the preponderance of the evidence obtained during this investigation, that the allegation is substantiated. The following deficiency is cited per California Code of Regulations, TITLE 22. Exit interview was conducted with facility staff. Appeal Rights were issued, and a copy of this report was given. Substantiatedthe state’s words, verbatim · CDSS document, Jan 21, 2026 · control 27-AS-20251210083346

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87307(a)(3) · Plan of correction due date: Jan 28, 2026

87307 Personal Accommodations and Services (a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply: (3) Equipment and supplies necessary for personal care and maintenance of adequate hygiene practice shall be readily available to each resident. The resident may provide the following items; however, if the resident is unable or chooses not to provide them, the licensee shall assure provision of: Based on interviews and document review the facility did not provide body soap to residents per the admissions agreement. This poses a potential risk for residents in care.the state’s words, verbatim · CDSS document, Jan 21, 2026

Plan of correction: Facility will be installing shower Despensers and updating the facility’s admissions agreement starting March 1st or sooner. Licensee will send updated admissions agreement to LPA Lewis once it has been drafted.

Allegation investigated: Staff did not prevent residents from fighting.

On 01/21/26, Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to open an investigation for the above allegations. LPA identified herself upon arrival, stated the purpose of the visit. LPA met with Angela Riungu. Based on documents received and interviews conducted R1 has not been in any physical altercations while in the facility and staff do not keep R2's Cigarettes. Therefore, the allegation Staff did not prevent residents from fighting is UNSUBSTANTIATED. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jan 21, 2026 · control 27-AS-20251209104837

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Kesha Lewis arrived unannounced to conduct a case management visit on incident reports received. LPA met with Angela and explained the purpose of the visit. The incident reports received dated October 29th, 2025, regarding a resident being burned. LPA asked for documents including care plans, physician report for resident R1. Based on interviews with staff and observation of R1'S room The facility did not take measures to prevent an injury from happening. The following deficiency is cited per California Code of Regulations, TITLE 22. Exit interview and copy of the report and appeal rights given.the state’s words, verbatim · CDSS document, Jan 21, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87307(e)(1) · Plan of correction due date: Jan 30, 2026

87307 Personal Accommodations and Services (e) The licensee shall supervise residents as needed and as determined by the resident's appraisal pursuant to Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, when residents are in proximity to or when there is use of the following items: (1) Ranges, ovens, heaters, fireplaces, wood stoves, inserts, and other heating devices. Based on interviews and observation of R1's heater it has no safety measures in place. This poses a potential safety risk to residents in care.the state’s words, verbatim · CDSS document, Jan 21, 2026

Plan of correction: Licensee will buy residents a new cool touch heater and send proof to LPA Lewis by COB on POC date. Licensee will also conduct checks on R1 for safety.

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Kesha Lewis arrived unannounced to conduct a case management visit on incident reports received. LPA met with Angela and explained the purpose of the visit. The incident reports received were dated for the month of December 8th, 2025, regarding resident Elopement from the facility on 12/06/2025. LPA asked for documents including care plans, physician report for resident R1 also a staff schedule for the month of December 2025. Facility is conducting 30-minute checks on R1 at this time as well as trying to find placement in a different facility for R1. Based on R1'S documentation they cannot leave the facility unassisted therefore a citation will be issued during this visit see 809D page.... Exit interview and copy of the report and appeal rights given.the state’s words, verbatim · CDSS document, Dec 15, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87411(a) · Plan of correction due date: Dec 16, 2025

87411(a) Personnel Requirements - General. Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement is not met by: Based on interviews and record review, the Licensee did not ensure adequate supervision of residents in care. Resident R1 AWOL'd from the facility on 12/06/2025. This poses an immediate health and safety risk to the resident in care.the state’s words, verbatim · CDSS document, Dec 15, 2025

Plan of correction: The Licensee/Administrator shall conduct an in-service training with staff to go over what and how staff shall ensure that residents do not AWOL. Administrator shall submit the in-service training materials and plan of correction on how facility will ensure residents do not AWOL and sent a signature sheet of all staff who attended to LPA by POC date.

Allegation investigated: Staff did not follow resident's medication orders.

On 12/10/25, Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to open an investigation for the above allegations. LPA identified herself upon arrival, stated the purpose of the visit. LPA met with Angela Ringu. Based on documents recieved and reviewed the allegation Staff did not follow resident's medication orders is UNSUBSTAITIATED. Both R1 and R2 do not take blood pressure medication.A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Dec 10, 2025 · control 27-AS-20251209104837

Allegation investigated: Staff did not ensure they had adequate planned activties for residents.

On 12/09/25, Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to open an investigation into the above allegation. LPA identified herself upon arrival, stated the purpose of the visit. LPA met with Angela Ringu and a brief interview followed. LPA requested a copy of the facilities activities Calander for November and December, and the LPA requested the name of contract for the activity’s director. Based on documents reviewed there is an activity's director on staff and both months of November and December have different activities for the residents to participate in. Therefore, the allegation is UNFOUNDED. This agency has investigated the complaint allegation(s). This agency has found that the complaint was UNFOUNDED, meaning that the allegation(s) were false, could not have happened and/or was without a reasonable basis. This agency has therefore dismissed the complaint. There were no deficiencies observed or cited during today’s complaint visit. Exit Interview. Unfoundedthe state’s words, verbatim · CDSS document, Dec 9, 2025 · control 27-AS-20251205111053

Allegation investigated: Staff are denying residents medical treatment.

On 12/09/25, Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to continue an investigation for the above allegations. LPA identified herself upon arrival, stated the purpose of the visit. LPA met with Angela Ringu and a brief interview followed. Based on interviews with staff and residents along with documents reviewed. LPA could not find evidence that the above allegation. R1 was able to be seen by a doctor as they wished, alson with 4 out of 4 residents interviewed felt they could be seen by the doctor as they wished. A review of R1'S medication was done, and all was found to be accounted for. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Dec 9, 2025 · control 27-AS-20251118125214

Allegation investigated: Staff interfered with resident’s ability to engage in religious activities. Staff threatened resident. Staff transported resident in an unsafe manner. Staff did not safeguard resident’s medication.

On 12/02/25, Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to deliver findings about the above allegations. LPA identified herself upon arrival, stated the purpose of the visit. Based on interviews with staff and residents along with the reporting party and documents reviewed. LPA could not find evidence that the above allegation. Two of the interviewees stated that the facility purchased items for R1 to engage in their religious activities, there is also no person that can corroborate R1 was transported in an unsafe manner or threatened. A review of R1'S medication was done, and all was found to be accounted for. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Dec 2, 2025 · control 27-AS-20251105095151

Allegation investigated: Staff do not ensure a safe environment for residents in care.

On 12/02/25, Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to deliver findings about the above allegations. LPA identified herself upon arrival, stated the purpose of the visit, Based on interviews with staff and residents along with the reporting party. LPA could not find evidence that the above allegation of Staff do not ensure a safe environment for residents in care. was true, therefore the allegation is UNSUBSTANTIATED. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Dec 2, 2025 · control 27-AS-20251016152255

Allegation investigated: Staff do not assist resident with arranging transportation to attend church Staff do not allow resident access to personal belonging. Staff do not safeguard resident's mail. Staff do not allow resident to travel into the community.

On 12/02/25, Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to deliver findings about the above allegations. LPA identified herself upon arrival, stated the purpose of the visit. Based on interviews with staff and residents along with the reporting party and documents reviewed. LPA could not find evidence that the above allegation. Interviews with state that when available the facility van was used to transport R1 and when it was not the staff offered to call uber or a cab for R1 this was confirmed their interviews. Based on LPA'S observation R1 had all their belongs and they were available to R1. Mail at the facility is called and passed out by one staff member only. Based on records reviewed R1 cannot leave the facility unassisted. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Dec 2, 2025 · control 27-AS-20251010151501

Allegation investigated: Staff not abiding by contract.

On 11/12/25, Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to Amed the report for the above allegations and met with Deanna Posada. LPA identified herself upon arrival, stated the purpose of the visit. LPA met with Angela Ringu and a brief interview followed. LPA requested copies of the R1'S admissions agreement, LPA also interviewed and R1. Based on documents reviewed and interview with staff the above allegation is UNFOUNDED. The facility has no intention of moving R1 into a shared room, R1 has lived at the facility for 11 years in a private room and has not waived their right to a private room. The department has determined that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview and copy of report given. Unfoundedthe state’s words, verbatim · CDSS document, Oct 29, 2025 · control 27-AS-20251021094041

Allegation investigated: Facility does not have an administrator

Licensing Program Analyst (LPA) Kesha Lewis and Licensing Program Manager (LPM) Liza King arrived unannounced to conduct a complaint investigation and follow up incidents that the department has become aware of which need additional follow up. LPM and LPA met with Angela Riungu and explained the purpose of the visit. According to interview and records review, previous Admin last day 07/31/25, current Admin start date date 08/11/25 however documents were not receieved in the RO by the licensee to appoint the individual. Admin Cert 7028459740 exp 07/25/26 and meets all educational experience. On todays date documents were requested to incl. o A letter from the licensee and/or Board appointing the individual as the Administrator o LIC308 o Copy of current Admin Cert o Any documentation that meets the education and/or experience requirements, if applicable o LIC 200 signed by the licensee or designee o LIC 500 to indicate the days/hours the administrator is in the facility o LIC 501 so that we can determine if the admin meets the education/ experience requirement. Cont. Substantiated LPM verified fingerprint clearance and association which show effective 08/16/2025. Based on documentation and interviews it was determined the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations is being cited on the attached LIC 9099D. Appeal Rights have been provided and an exit interview with Angela was conducted to discuss these finding.the state’s words, verbatim · CDSS document, Sep 19, 2025 · control 27-AS-20250808081449

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87205(a) · Plan of correction due date: Sep 22, 2025

87205 Accountability of Licensee Governing Body (a) The licensee, whether an individual or other entity, shall exercise general supervision over the affairs of the licensed facility and establish policies concerning its operation in conformance with these regulations and the welfare of the individuals it serves. This regulation was not met as evidenced by: The licensee failied to provide the requested documentation to the department to verify qualifications and assign the prospective Administrator. Date of hire: 08/11/25 This poses a potential risk to cllients in care.the state’s words, verbatim · CDSS document, Sep 19, 2025

Plan of correction: Documents will be submitted via email by POC date.

Allegation investigated: Facility failed to providfe residents comfortable temperature

On 08/13/25, Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to open an investigation into the above allegations. LPA identified herself upon arrival, stated the purpose of the visit, and asked to meet with the Designated Facility Administrator/Executive Director (ED). LPA met with Angela Riungu and a brief interview followed. LPA requested a copy of log showing when the power went out and for how long it was documented that the power was out for 10 minutes and the generators came on a few minutes after. The investigation revealed the preponderance of evidence standards have not been met; therefore, the above allegation is found to be UNSUBSTANTIATED. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Aug 13, 2025 · control 27-AS-20250811094532

Type of visit: Prelicensing

On 7/01/2025, Licensing Program Analyst (LPA), Kesha Lewis arrived announced to conduct an inspection to the above facility for purpose of a pre-licensing evaluation. This pre-licensing is for Change of Ownership (CHOW). LPA met with PUNNI,MANISHA, and explained the purpose of the visit. LPA, Kesha Lewis inspected the physical plant of the facility to ensure compliance of Title 22 regulation. LPA observed 8 random resident units, the activity room, dining room, kitchen, laundry, and outdoor areas. Facility has a 80-resident capacity for Assisted Living residents, 78 of which can be non ambulatory and 2 Bedridden residents. Facility is a one-story building located in a residential neighborhood. Outdoor passageways, walkways, driveways, and steps are free from obstructions. LPA did not observe hazards, such as ladders, gardening tools and/or motorized equipment in the front, back and/or side areas of the facility. LPA did not observe bodies of water at this time. Bedrooms Residents: LPA inspected 8 resident units. 78 unit is fire cleared for non-ambulatory residents. The resident apartments/units are spacious and will easily accommodate the residents furnishings. The inspected resident units were observed to be furnished with adequate storage for resident belongings. Bathroom: Each resident unit contain private bathroom. All bathrooms inspected have working toilets,wash basins and showers. There are grab rails next to both the toilets and the showers as well as nonskid flooring. Toxins and Chemicals: Toxins and chemicals for cleaning are properly stored, locked, and inaccessible to residents in care. Water temperature: Water temperature in a randomly selected bathroom (in a resident units) were measured at 112 and 119 degrees F. COMP III completed. Activities: Facility employs an activity director. LPA observed activity calendar for residents use. LPA observed an activity area in the facility. Doors leading to the outside have auditory devices to monitor exits.the state’s words, verbatim · CDSS document, Jul 1, 2025

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Change in Ownership (CHOW) Capacity: 80 Census (if any clients in care): 67 COMP II Participants: Toby Tilford, Applicant Manisha Punni, Administrator Interview Method: Virtual interview (Microsoft Teams) On June 12, 2025, Applicant and Administrator participated in COMP II. Identification of the Applicant and Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant and Administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant and Administrator’s understanding of following areas: 1. Facility Operation: License Type, Client/Resident Populations, and Program. 2. Admission Policies 3. Staffing Requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General Provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing Readinessthe state’s words, verbatim · CDSS document, Jun 12, 2025