Eastvale Manor Assisted Living

Allegation investigated: Due to staff neglect, resident sustained pressure injuries. Staff caused bruises on resident.

Licensing Program Analysts (LPAs) Mary Rico and Sarina Ramirez conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with staff Ruey Nono and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews, and record review. For the allegation, Due to staff neglect, resident sustained pressure injuries. During staff interviews 4 out of the 4 staff stated no resident had sustained pressure injuries due to staff neglect. During record review, LPA observed R1 did not sustain pressure injuries at the facility. For the allegation, Staff caused bruises on resident. During staff interviews, 4 out of the 4 staff stated they did not cause bruises on any resident. In addition, 2 out of the 4 staff stated that R1 had bruises prior to being admitted to the facility. During record review, LPA observed the facility staff had documented R1 bruises during their admission process. Furthermore, outside parties also confirmed R1 already had bruises prior to moving to the facility. Unsubstantiated Based on the evidence found during the investigation, the (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 (LIC9099) was discussed and provided to staff Ruey Nono.the state’s words, verbatim · CDSS document, Oct 29, 2025 · control 56-AS-20250702102709

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Administrator Carmelo Lumbris and was granted entry to the facility. The facility is a (6) bedroom, (3), bathroom home, with a kitchen/dining are , living room, and attached garage. Licensed capacity is (6) current census (4). LPA was accompanied by Administrator Carmelo Lumbris 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, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. 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 (3) resident file for admission agreements, updated physician reports, and needs and services plans. LPA also verified (3) resident's medications. LPA also reviewed (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screening. 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 was conducted, and this report (LIC809) was discussed and provided to Administrator Carmelo Lumbris.the state’s words, verbatim · CDSS document, Oct 27, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Mary Rico and 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 staff Carmelita Cruz and was granted entry to the facility. Licensed capacity is (6) current census (3). LPA was accompanied by staff Carmelita Cruz 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 (2) resident files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed (2) resident medications, LPA also reviewed (2)staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to staff Carmelita Cruz.the state’s words, verbatim · CDSS document, Nov 5, 2024

Type of visit: Required - 1 Year

0945: Licensing Program Analyst (LPA) Amy Goldenberg arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. 1000: Resident Records/Incident Reports/Personal Rights/Residents with Special Needs/Incidental Medial and Dental- LPA began review of resident records. Five (5) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. The facility is meeting documentation requirements. Resident Rights are posted in the facility and a copy is signed on file. 1020: Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. LPAs observe the facility to be clean and in good repair. The home is maintained at a comfortable temperature for the residents. Lighting is sufficient for safety and comfort. Water temperature measured 113 degrees F. Grab bars, non-slip mats are present in the restrooms. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals. All outdoor and indoor passageways are free of obstruction. Night lights and emergency lighting is present. A locked area is provided for medications and sharp objects. There is a telephone working at this location. The LIC 610E, emergency disaster plan is maintained. The facility has a current written definitive plan of operation. Food Service- Food prep areas are clean and organized. Food supply meets the requirement of one week supply of nonperishable and 2 day supply of perishables food on hand. Menu is posted. 1030: Personnel Records/Training/and Staffing- Two (2) records were reviewed. LPA reviewed employee record for first aid certification, finger print clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually, last done so on 10/05/23. The facility is conducting emergency disaster drills, last done on 11/02/23. 1100: Resident and staff interviews were conducted. 1130: LPA began preparation of this report. Based on the information received during this visit today, there are no deficiencies being cited per Title 22, Division 6 of The California Code of Regulations. This report was reviewed with and a copy provided to the facility representative.the state’s words, verbatim · CDSS document, Nov 17, 2023