Fountain of Youth Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to conduct an Annual Required Evaluation. LPA was greeted and granted entry by the House Manager at 12:30pm. LPA met with Moe Jerrar, Administrator (AD) and explained the purpose of the visit. The facility is a single story, six bedroom, three bathroom residence with an approved fire clearance for six non-ambulatory residents in which one can be bedridden in Room #3. The facility has an approved hospice waiver for six residents. Currently there are six residents in care in which there are no residents receiving hospice services. At time of entry LPA observed two residents having lunch. During the visit LPA toured the kitchen and observed the facility had two days of perishable items and seven days of non perishable items on hand. LPA observed food pantry items were not expired and there was plenty of fresh fruit and vegetables. A knives drawer was not locked and a deficiency will be given. Chemicals and cleaning supplies were secured underneath the kitchen sink. Kitchen appliances were in working order and clean. LPA tested the carbon monoxide and smoke detectors and both detectors were operational. The fire extinguisher was charged and inspected on April 29, 2026. The facility's last fire drill was conducted on November 25, 2025. A fire drill will be scheduled with care staff for Sunday, August 16, 2026. LPA measured the hot water temperatures in three of three resident bathrooms. The hot water temperatures ranged between 105.6 to 116.6 degrees Fahrenheit. (Continued on LIC 809-C) (Continued from LIC 809) LPA toured the exterior of the property and observed a shaded seating area and the live-in staff lives in the permitted Additional Dwelling Unit (ADU). A landscaper was outdoors clearing foliage and there is ample space for outdoor activities. The outside gates are open and have latches. Video cameras oversee the perimeter of the property and do not include audio. LPA observed the medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed. The First Aid Kit is on site but Administrator ordered an additional First Aid Kitwith a book. LPA observed the See Something, Say Something (PUB 475) and Long Term Care Ombudsman posters posted along with Personal Rights, Theft and Loss and Client Rosters posted in prominent areas. LPA reviewed two of two staff training and fingerprint records and conducted a complete review of resident records. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has an administrator certificate which expired on July 21, 2026 but AD has submitted all continuing education units and is on the pending renewal list. LPA reminded AD that the licensing fees are due on August 29, 2026. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Moe Jerrar, Administrator and a copy of this report was given to the facility along with a copy of the LIC 858, LIC 859; LIC 809-D, LIC9102-TV and Appeal Rights.the state’s words, verbatim · CDSS document, Aug 13, 2026

The state marks this report as 9 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On September 23, 2025, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, staff on duty contacted the House Manager (HM) Brianna Bernal about the visit. For this visit, there are two staff members on duty, both of which are background cleared and associated. HM later arrived to assist with the inspection. The PUB475 ‘See Something, Say Something’ poster was observed to be located by the front entrance. LPA observed the Administrator's Certificate for Moe Jerrar, which expires on July 20, 2026. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, five of which may be non-ambulatory, one of which may be bedridden, and six of which may be on hospice. LPA toured the interior and exterior portions of the facility with HM. For this visit, there are a total of four non-ambulatory and one ambulatory residents in care, none of which is on hospice, and one is bedridden. The facility is a single-story home. There are a total of six bedrooms, five of which are private resident rooms, and one serves as staff quarters. LPA toured each bedroom with the HM and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. LPA observed the staff quarters to be kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of three bathrooms. Continued on LIC 809-C. Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 105.2 and 109.5 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in the kitchen and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the living room. Fire extinguishers were dated and tagged on April 29, 2025. LPA observed the emergency disaster and evacuation plan, which is posted by the front entrance. Facility had back-up emergency food and water supply, located in the pantry. LPA observed that the First Aid kit had all the required components. Medications and toxins were also observed to be locked in a cabinet in the kitchen, inaccessible to residents in care. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards or obstructions. There are two self-latching gates in the backyard that can be opened in case of an emergency. No bodies of water were observed. Five client records and three staff records were reviewed during this visit. Based on today's observations, there are four deficiencies being cited per Title 22 of the California Code of Regulations. A Technical Violation (TV) and a Technical Advisory (TA) were also cited. An exit interview was conducted with Brianna Bernal. This report was reviewed with the administrator and a copy was provided at the end of the visit. Appeal Right were reviewed.the state’s words, verbatim · CDSS document, Sep 23, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Lydia Martinez made an unannounced visit for the purpose of conducting an Annual Required inspection. LPA met with House Manager Brianna Bernal and purpose of visit was shared. Licensee/Administrator was not available. Facility is a 6-bedroom, 3-bathroom, 1-story house with an outside shed on the side of the kitchen that is used for storage. There is also a shed on the other side of the facility with staff's personal belongings, table, and a bed. Facility has a working telephone land line. There were 6 Residents of which one is receiving Hospice Care and three staff present during the visit. LPA observed the facility to be clean and in good repair. The home is maintained at a comfortable temperature. Lighting is sufficient for safety and comfort. Backyard has a covered patio for outdoor activities and sufficient seating for residents and visitors. Bedrooms were observed to be spacious and easily accommodate furnishings such as lamps, chair, dresser and a bed. Bathrooms were observed to be clean and have a supply of soap and paper towels. Hot water temperature was within regulatory requirements. Linen and hygiene supplies were stocked. Emergency Phone Numbers and Exit Plan were reviewed. Food prep area is clean and organized. Food supply meets the requirement of one (1) week supply of non-perishable and two (2) day supply of perishables. Smoke detectors and carbon monoxide detectors were found to be operational. Fire Extinguishers were charged and mounted. Stove burners, dishwasher, microwave, washer, and dryer are operational. Chemicals and sharps are made inaccessible to the residents. Medication was observed locked in a kitchen cabinet. Medications reviewed appear to have been dispensed accurately. LPA reviewed 6 resident files and 4 staff files. LPA interviewed residents and staff. LPA confirmed Administrator's certificate expired on 07/20/2024. Administrator Moe Jerrar has submitted documentation to renew Certificate. Based on observations made during today's visit, the following deficiencies are being cited. Advisory Note was also issued. An exit interview was conducted with House Manager and a copy of this report was sent to email on file.the state’s words, verbatim · CDSS document, Aug 15, 2024

Allegation investigated: Staff are mean to the resident Unqualified staff are performing blood glucose testing

Licensing Program Analyst (LPA) Ruth Martinez made an unannounced visit to conduct the initial visit to begin the investigation into the allegations listed above. LPA met with Brianna Bernal, Assistant Administrator and explained the nature of the visit. Based on the information obtained during this investigation the department has concluded the investigation into the above mentioned allegations. Findings are based upon this investigation which included interviews conducted, tour of the physical plant of the facility and copies of pertinent documents obtained. It is alleged facility staff are mean to residents. Interviews with four of six residents indicated that staff treat them well and are very courteous towards the residents. Resident indicated that they had no complaints Continued on LIC9099-C Unsubstantiated of the care and treatment they received at the facility. Residents indicated that if anything they give the staff a hard time. Residents indicated that they do not have any complaints of the care or treatment they receive at the facility. Interview with 2 of 2 staff revealed that they have never witnessed any of the staff treating the resident mean and/or received any complaints from their peers about seeing staff treating the residents bad. It is alleged that unqualified staff are performing blood glucose testing. Based on records review there is only one out of six resident that has a primary diagnosis of insulin dependent diabetes. Interview with resident R1 stated that R1 performs their own insulin injections and R1 indicated they don’t like that they must do injections, but they know they need it. R1 stated that they know that staff are not allowed to do the injections for them. Records review revealed that R1 has a Free style Libre 3 sensor on R1’s shoulder which gives an automatic glucose reading without requiring glucose testing to be done by a glucose meter. Interview with staff S1 indicated that the glucose reader is placed by R1’s daughter every two weeks. Interview with R1 revealed that R1 indicated that staff do not do any of the diabetes related task for R1 and R1 does their own injections. R1 indicated that staff hand R1 the insulin and stay in the room till R1 has completed the injection. Based on the information mentioned above, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated. An exit interview was conducted with the facility representative and a copy of this LIC9099 report was left at facility.the state’s words, verbatim · CDSS document, Jul 8, 2024 · control 22-AS-20240703160942