Emerald Senior Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cassandra Mikkelson arrived unannounced and met with Administrator Natalia Tuleninova to conduct an annual inspection utilizing the inspection tool. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA observed resident rooms, common area bathrooms, common areas, kitchen and perimeter of care home. Facility has a pool located in the back yard of the home. LPA observed pool gate to be locked and inaccessible to residents in care. LPA observed rooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition and properly maintained. LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two day perishable and (7) seven day non-perishable food supply on hand. Smoke detectors and carbon monoxide detectors are operational in the care home. Fire extinguishers and first aid kit are maintained and ready for emergency use. LPA checked medication storage and found medications to be locked away and inaccessible to the residents. LPA reviewed six (6) resident files, two (2) staff files and resident medications. Multiple topics discussed during visit. Facility has a current copy of certificate of liability insurance and LPA obtained a copy. As a result of this visit, no deficiencies were cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Exit interview was conducted with Administrator.the state’s words, verbatim · CDSS document, May 20, 2026

Allegation investigated: Staff did not treat residents with dignity and respect. Staff did not ensure that residents are fed in a timely manner.

On December 1, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to open the complaint the Department received to investigate the allegations cited above. LPA met with Administrator and explained the purpose of the visit. The course of investigation, LPA conducted extensive interviews. The findings are as follow, please continue to LIC 9099-C. Substantiated LIC 9099-C For the allegation of, Staff did not treat residents with dignity and respect, it was revealed that S1 was terminated from the facility due to insubordination and incompetence. Interview conducted with R1 revealed that S1 was “ok” but could be better. R1 emphasized that S1 did not know how to speak gentle to residents in care. Interview conducted with R2 revealed that S1 was a “moody” person and would yell at residents if S1 is feeling overwhelmed. R2 emphasized that S1 would call R2 a liar when R2 complains about not receiving PRN medications. Interview conducted with R3 revealed that S1 was a “terrible, mean lady”. R3 stated R3 has witnessed S1 making another resident pee in their briefs rather than taking the resident to the bathroom, even when the other resident was adamant they did not want to pee in the briefs. R3 stated S1 would talk down to residents in care in a sarcastic way. Based on information obtained, allegation is substantiated. Allegation of, Staff did not ensure that residents are fed in a timely manner, interview conducted with Administrator revealed that breakfast is typically served at 8:30 AM, lunch is at 12 PM and dinner is at 5 PM. Interviews conducted with residents in care revealed that when S1 was working at the facility, breakfast and lunch would be served late. Interview with R1 revealed that S1 would often serve breakfast whenever S1 wants to at approximately 10 AM. R1 does not recall S1 making breakfast on time. R1 stated lunch has often been served at 2 PM. Interview conducted with R2 revealed that S1 often likes to be on the phone and does not get breakfast ready until 9:30 AM, close to 10 AM. R2 does not recalled breakfast being ready on time at 8:30 AM. R2 stated S1 does serve dinner late periodically but often on time. Interview conducted with R3 revealed that S1 does not have a routine and often serves meals late. R3 stated there has been times when R3 goes to the dining table in the morning but there is no breakfast being made yet. Based on the information obtained, 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. The following allegation cited above is substantiated, please see LIC9099-D. Exit interview conducted and a copy of the report and appeal rights was provided.the state’s words, verbatim · CDSS document, Dec 1, 2025 · control 59-AS-20251121125610

From the deficiency page — Deficiency type: Type B · Section cited: CCR 97468.1(a)(1) · Plan of correction due date: Dec 12, 2025

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 is not met as evidenced by: Based on interviews conducted, Licensee did not comply as S1 did not treat residents in care with dignity, which poses an potential risk to residents in care.the state’s words, verbatim · CDSS document, Dec 1, 2025

Plan of correction: Licensee is to conduct an in-service training for all staff on LIC 500 of CCR 87486.1 Personal Rights of Residents in All Facilities Notification of completion is to be submitted to LPA by Friday December 12, 2025.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(b)(1) · Plan of correction due date: Dec 12, 2025

87555 General Food Service Requirements (b) The following food service requirements shall apply: (1) Where all food is provided by the facility arrangements shall be made so that each resident has available at least three meals per day...Not more than fifteen (15) hours shall elapse between the third and first meal. This requirement is not met as evidenced by: Based on interviews conducted, Licensee did not comply as S1 would serve residents in care dinner at approximately 5 PM but breakfast the following morning at approximately 9 to 10 AM exceeding 15 hours, which poses a potential risk for residents in care.the state’s words, verbatim · CDSS document, Dec 1, 2025

Plan of correction: Licensee will adjust meal time to be compliance to Title 22 and post the notification at the facility and provide a copy to LPA by due date of Friday December 12, 2025.

Allegation investigated: Staff do not provide adequate supervision resulting in residents wandering away from facility.

On November 19, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to deliver the finding of the allegation cited above. LPA met with Administrator and explained the purpose of the visit. During the course of the investigation, the department conducted extensive interviews and file reviews for the allegation, Staff do not provide adequate supervision resulting in residents wandering away from facility. Based on file review conducted of Sacramento County Sheriff's Office reports, it revealed that resident (R1) had eloped from the facility on July 20, 2025. Local law enforcement was contacted at approximately 12:04 PM regarding R1 being at caller (C1)'s door, it was reported that staff wearing a scrub appeared at the house at approximately 12:16 PM to retrieve R1 back to the facility. On September 2, 2025 at approximately 12:26 PM there was another call to local law enforcement by caller (C2) regarding R1 being lost at their door. C2 was advised to keep R1 at the location until law enforcement arrives at the scene. It was reported that at approximately 12:38 PM, R1 returned to the facility with a care staff. Please continue on LIC 9099-C. Substantiated LIC 9099-C Interview conducted with witness (W1), it revealed that R1 has eloped from the facility in multiple occasion without staff present but W1 knows R1 belongs to the facility and would assist with walking R1 back to the facility. W1 stated there was a time that R1 wandered to their neighbor's house to ask for a cigarette, after R1 finished the cigarette, R1 allowed the individual to return R1 back to the facility. Interview conducted with witness (W2) revealed that W2 has a ring camera at their front door. W2 has footage of R1 wandering to the door steps. There was an occasion where R1 was not supervised and another occasion where R1 was followed by a staff member. W2 informed LPA local law enforcement has been contacted in a couple of occasion by various bystanders. Based on the information obtained, the allegation is SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. The following allegation cited above is substantiated, but no deficiency will be cited as LPA substantiated the similar allegation for Complaint 59-AS-20250821090941 on November 19, 2025. Exit interview conducted, copy of report and appeal rights was provided.the state’s words, verbatim · CDSS document, Nov 19, 2025 · control 59-AS-20250925141550

Allegation investigated: Staff did not respond to resident's call light in a timely manner

On November 19, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to deliver the finding of the allegation cited above. LPA met with Administrator and explained the purpose of the visit. During the course of the investigation, the department conducted extensive interviews and file reviews. For the allegation of, Staff did not respond to resident's call light in a timely manner, interview conducted with resident (R1) revealed that R1 has requested medication assistance utilizing the call light the morning of August 21, 2025 but received no assistance. R1 stated R1 had to go to the common area looking for staff but they were unavailable. File review of R1's LIC 602 revealed R1 is unable to store and/or administer own medications. Interview conducted with R2 revealed that it takes at least 30 minutes for staff to come to the room to assist with incontinence care. R2 stated usually staff are occupied with other residents in care as multiple residents are incontinence as well. R2 reported R2 is unable to transfer out of bed and does need staff assistance with changing. R2 emphasized that staff are great but "everyone needs help, not just me". File review of R2's LIC 602 revealed no indication of dementia diagnosis, and and is unable to care own toileting needs. Please continue narrative on LIC 9099-C. Substantiated LIC 9099-C Interview conducted with R3 revealed that facility is improving on responding to calls but during the day of LPA's visit, R3 called for assistance but staff was busy changing other residents in care so R3 had to wait for incontinence care. It was reported R3's last changing was the night prior at approximately 9:00 PM and did not receive assistance from staff for a new depend until approximately 3:00 PM. R3 reported that there are usually two caregivers working at the facility, not necessarily are staff ignoring residents' calls, but "they are doing the best they can, we all need help." R3 reported R3 has a prohibited health condition in the buttock area which is critical for incontinence care to be conducted in a timely manner but staff are sometimes not available. File review of R3's LIC 602 revealed no indication of dementia diagnosis,and is unable to care own toileting needs. Interview conducted with R4 revealed that R4 does not recall if staff responds to call lights in a timely manner. Interview conducted with R5 revealed that R5 is fine at the facility and "never needs help". Interview conducted with R6 revealed R6 does not have any information to share with the department at this time. Interview conducted with S1 revealed that residents are to use the call lights for whatever they need. If staff are busy with other residents in care, then staff does inform residents to wait until staff are available. Interview conducted with S2 revealed staff does not neglect residents in care, but there are multiple residents that requires incontinence care in bed and are bed bound so it takes a little longer to complete the task before moving onto the next individual. Based on the information obtained, the allegation is SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. The following allegation cited above is substantiated, please see LIC9099-D. Exit interview conducted and a copy of the report and appeal rights was provided.the state’s words, verbatim · CDSS document, Nov 19, 2025 · control 59-AS-20250821090941

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(a) · Plan of correction due date: Dec 1, 2025

87411 Personnel Requirements - General (a) 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 as evidenced by: Based on interviews conducted, Licensee did not comply as staff are unable to assist residents' needs in a timely manner which poses a potential risk for residents in care.the state’s words, verbatim · CDSS document, Nov 19, 2025

Plan of correction: Licensee will conduct an in-service on how to utilize the call lights appropriately. Additionally, Licensee will conduct an audit on resident's care needs to determine if additional staffing is needed. Notification of completion is to be submitted to LPA by due date. Plan of Correction is due December 1, 2025

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a complaint investigation when LPA observed the following deficiencies. LPA met with Administrator and explained the purpose of the visit. When conducting interviews, LPA was informed that R1 has the tendency of eloping from the facility in multiple occasions since admission. LPA was informed law enforcement was contacted in multiple occasions due to the elopement. LPA further explained that incident reports are to be provided to Licensing within seven days of occurrence. Administrator further stated R1 was admitted to the hospital for evaluation, which Licensee then informed hospital that R1's level of care can no longer be managed at the facility and R1 will not return. LPA and Administrator discussed that residents are to be provided a reassessment and a 30 day eviction letter if wished to no longer retain. When discussing about R2's level of care, LPA was informed that R2 was admitted to the facility with a stage 4 pressure wound, but R2 is no longer at the facility. LPA informed Administrator that facility is not allowed to retain or accept residents with prohibited health conditions without the approval from the Department. As a result of today's visit, deficiencies observed. Please see LIC 809-D. Exit interview and a copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Oct 3, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87616(a) · Plan of correction due date: Oct 4, 2025

87616 Exceptions for Health Conditions (a) As specified in Section 87209, Program Flexibility, the licensee may submit a written exception request if he/she agrees that the resident has a prohibited and/or restrictive health condition ... This requirement is not met as evidenced by: Based on file review and interview, Licensee did not comply as Licensee accepted R2 who has a prohibited health care condition without a exception granted which poses an immediate risk for residents in care.the state’s words, verbatim · CDSS document, Oct 3, 2025

Plan of correction: Licensee was provided CCR 87615 and CCR 87616 to review. Licensee is to submit a statement of understanding of the provided regulations to LPA Yang via email at cassie.yang@dss.ca.gov POC is due Saturday October 4, 2025. Failure to provide LPA the POC by due date may result to $100 civil penalty per day until POC received.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87224(a)(4) · Plan of correction due date: Oct 24, 2025

87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons... Thirty (30) days written notice to the resident is required... (4) If, after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted... This requirement is not met as evidenced by: Based on interview, Licensee did not comply as LPA was informed that Licensee informed hospital R1 cannot be discharged back to the facility due to R1's change of condition. 30 day eviction was not provided, which poses a potential risk for residents in care.the state’s words, verbatim · CDSS document, Oct 3, 2025

Plan of correction: Licensee was provided CCR 87224 to review. Licensee is to submit a statement of understanding of the provided regulation to LPA Yang via email at cassie.yang@dss.ca.gov POC is due Friday October 24, 2025. Failure to provide LPA the POC by due date may result to $100 civil penalty per day until POC received.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1)(D) · Plan of correction due date: Oct 24, 2025

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including... (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence... (D) Any incident which threatens the welfare, safety or health of any resident... This requirement is not met as evidenced by: Based on interview, Licensee did not comply as LPA was informed there was two residents in care that had the tendency of eloping from the facility and R1 was admitted to the hospital for evaluation but an incident report was not submitted, which poses a potential risk for residents in care.the state’s words, verbatim · CDSS document, Oct 3, 2025

Plan of correction: Licensee was provided CCR 87211 to review. Licensee is to submit a statement of understanding of the provided regulations to LPA Yang via email at cassie.yang@dss.ca.gov POC is due Friday October 24, 2025. Failure to provide LPA the POC by due date may result to $100 civil penalty per day until POC received.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a complaint investigation when LPA observed a deficiency. LPA met with staff and explained the purpose of the visit. Administrator arrived to the facility shortly afterwards. Today's inspection, LPA observed two staff working on the floor. LPA was informed that S1 works as on-call since May 2025. Additionally, LPA was informed that S2 has been working as a volunteer for approximately a week now, and comes in as needed. LPA observed S2 assisting residents with incontinence care. File review via Guardian revealed that S1 and S2 does not have a fingerprint association with the facility. File review revealed S1 and S2 are fingerprint cleared at other facilities. LPA provided Administrator LIC9182 for completion. LPA then transfer S1 and S2 to facility roster. A copy of Title 22, California Code of Regulation Section 87355 Criminal Record Clearance was printed and provided to Administrator. As a result of today's visit, deficiencies cited. Please see LIC 809-D. Exit interview and a copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Aug 28, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(g)(2) · Plan of correction due date: Sep 2, 2025

87411 Personnel Requirements - General (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) This requirement is not met as evidenced by: Based on file review, Licensee did not comply as LPA observed S1 and S2 to be working at the facility with no criminal record association to facility roster, which poses a risk for residents in care.the state’s words, verbatim · CDSS document, Aug 28, 2025

Plan of correction: Licensee completed LIC9182 for S1 and S2. LPA will associate S1 and S2 to the facility roster. Licensee is to submit a procedure how facility will ensure all staff working at the facility are associated to facility roster.

Type of visit: Prelicensing

On May 2, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to conduct a pre-licensing inspection utilizing the inspection tool. LPA met with Applicant and Caregiver and explained the purpose of the visit. LPA and Applicant conducted a tour of the interior and exterior of the facility. Areas toured included but not limited to: five residents bedrooms, one staff room, bathrooms, garage, kitchen, backyard and the common areas. LPA observed present of two fire extinguishers recently serviced. LPA observed the required compliance posters in the common area. LPA observed a designated locked space for medications, sharps and toxins. LPA observed facility to have the seven days of non-perishable food supplies present. Washer and dryer was observed to be in the garage, LPA reminded Applicant cleaning supplies are to be inaccessible to residents. LPA observed the resident bedrooms to have the required furnishings. LPA observed a pool in the backyard, pool gate is present with a lock. LPA observed the facility to be clean, sanitary and in good repair. Comp III was conducted with Applicant. Additionally, LPA and Applicant discussed staff training, records, immediate $500 civil penalties. LPA provided facility with a copy of the following: LIC 311F, 1569.625 Staff training; legislative findings; contents, and 1569.69 Employees assisting residents with self-administration of medication; training requirements. Pre-licensing inspection tool completed, the pre-licensing inspection passed. Applicant has satisfied all requirements in accordance to per Title 22, California Code of Regulations. CAB will be notified accordingly of licensure. Exit Interview and copy of report provided to Applicant.the state’s words, verbatim · CDSS document, May 2, 2025