Fremont Rtrmt Com-Happy Lvng by Cogir/Cogir Fremon

Allegation investigated: Staff are not allowing LTCO into the facility at residents request Facility is not providing adequate care due to insufficient staffing

On 05/08/2026 at 8:55 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct more investigatations and deliver the findings on the above allegations. LPA met with Resident Care Coordinator, Nikka Pauscua and explained the purpose of the visit. Executive Director, Samuel Ogden, gave verbal authorization for Pascua to sign the report. During the course of investigation, LPA interviewed Executive Director, Assistant Executive Director, 8 residents, 11 staff members, and witnesses. LPA obtained and reviewed documents including but not limited to Resident Roster, Staff Schedule, Staff Roster, Digital Visitor Log, physician report, and resident care plan. Continue to LIC9099-C… Unsubstantiated Allegation: Staff are not allowing LTCO into the facility at residents request It was alleged that Staff are not allowing LTCO into the facility at residents request. Interview with S1 and S2 revealed that guests are to show a form of Identification Card to verify who they are when visiting the facility. Once verified and checked into the facility’s kiosk, the guest can enter. Interview with S1 and S2 indicated that Ombudsman representative, Witness 1 (W1), did not properly introduce themselves and their identification card did not clearly show that they are from the Ombudsman. S1 stated that their identification card shows their picture and the logo, “Empowered Aging” without their name included. S1 and S2 stated that front desk staff are trained to not provide anything confidential to guests and that includes the resident roster without verifying that they are authorized to obtain the roster. S1 also added that due to potential scammers, the front desk is trained to be cautious of guests entering and asking for confidential information. A review of the kiosk sign in sheet, the W1 signed in as a Pharmacist under the Ombudsman Services and interview with S1, S2, and W1 verified that W1 was able to conduct their visit that day and obtain the resident roster after verification. Based on the investigation, which included staff interviews and review of available documentation, the allegation that staff are not allowing LTCO into the facility at residents request is unsubstantiated. Although the concern was reported, there is insufficient evidence to confirm the allegation. Therefore, the allegation is deemed unsubstantiated at this time. Allegation: Facility is not providing adequate care due to insufficient staffing It was alleged that Facility is not providing adequate care due to insufficient staffing. On 03/11/2026 and 05/08/2026, LPA interviewed with 7 residents of which 5 of 7 residents reported that there are times when residents would have to wait for assistance for staff to help. However, interviews with S2, S4, S6, S7, and S8 stated that even though there are less staff for the day, staff members will provide care to the residents as soon as possible. On 03/11/2026, R3 stated that R3 needs assistance with showers, dressing, and medication and R3 stated that R3 gets the care R3 needs. Continue to LIC9099-C... Continued from LIC9099-C... On 03/11/2026, R4 stated that the staff members can get busy, but they are overall good to R4 and R5 when available. On 05/08/2026, R1 and R2 stated that there are some staff members that provide better care than others, but R2 will usually get the help they need. On 05/08/2026, R6 stated that the staff assist residents with their personal care needs and the staff members do provide the care R6 needs. Based on the investigation, which included staff and resident interviews, the allegation that facility is not providing adequate care due to insufficient staffing is unsubstantiated. Although the concern was reported, there is insufficient evidence to confirm the allegation. Statements obtained during the investigation were inconsistent, and no corroborating evidence was found to support the allegation. Therefore, the allegation is deemed unsubstantiated at this time. No deficiencies cited. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, May 8, 2026 · control 15-AS-20260122121901

Type of visit: Case Management - Other

On 05/08/2026 at 2:00 PM, Licensing Program Analyst (LPA) conducted a case management in regraded to the complaint number: 15-AS-20260122121901. LPA met with Nikka Pascua, Resident Care Coordinator, and explained the purpose of the visit. Samuel Ogden, Executive Director, gave verbal authorization to sign the report. LPA provided education about facility's collaboration with the ombudsman and provided resources to Pascua to know more about the role of the ombudsman. Resources Provide: PIN 22-32 ASC No deficiency issue on today's date. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, May 8, 2026

Type of visit: Required - 1 Year

On 02/26/2026 at 8:40 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Executive Director, Samuel Ogden and explained the purpose of the visit. Administrator certificate is current. LPA toured the facility inside and out including but not limited to residents' apartments, bathrooms, activity room, beauty salon, garden room, kitchen, common area and courtyard. LPA observe lighting in all rooms is adequate for the comfort and safety of the residents. Hallway temperature was maintained at 72 degrees F. The hot water temperature in a sample of residents shared bathroom were measured at 116.4, 119, 107.6, 107.2, 111.4 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid shower pans. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Carbon monoxide detector was in operating condition during visit. Fire Alarm System inspection was last issued on 09/25/2025. Fire extinguisher was last serviced on 02/02/2026. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 02/26/2026. At 9:32 AM, LPA reviewed 6 residents records. At 12:02 PM, LPA reviewed 7 staff records and 6 of 7 have current first aid training and 7 of 7 associated with the facility. At 1:45 PM, LPA reviewed a sample of resident’s medications. Continue to LIC809-C… Continued from LIC809… Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 03/06/2026: LIC 500 Personnel Report THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 11:19 AM, LPA observed MiraLAX, hydrocortisone cream, eyedrops, unknown pill, and eyedrops in R2’s room. At 11:35 AM, LPA observed Lysol, Comet, Kaboom Oxi Clean, etc. in R6’s room At 2:01 PM, observation revealed that R2 did not have 7 medications not available in the facility. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted with Executive Director. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Feb 26, 2026

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

On 01/26/2026 at 4:45 PM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct a case management visit regarding a death report that was sent to licensing on 08/11/2025. LPA met with Assistant Executive Director, Sarah Husain, and explained the purpose of the visit. While LPA was at the facility for another visit, LPA conducted an interview with S1 regarding R1's care and services that was provided to R1. S1 indicated that R1 passed away in August 2025. LPA obtained the following documents including but not limited to R1's physician report, care plan, medication order, post acute summary report, centrally stored medication and destruction record,resident emergency information, and physician fax report. LPA is requesting for a death certificate from the facility. LPA may return at a later time. No deficiencies cited. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 26, 2026

Allegation investigated: Staff do ensure that facility is maintained free of smoke Staff do not provide a comfortable environment for resident Staff inappropriately spoke to resident Staff do not communicate with resident regarding care

On 09/10/2025 at 9:15AM, Licensing Program Analyst (LPA) P.Manalo arrived unannounced to conduct a complaint investigation and deliver findings on the above allegations. LPA met with Assistant Executive Director, Sarah Husain and explained the purpose of the visit. Executive Director, Salvador Gomez, arrived shortly after. During the course of investigation, LPA interviewed staff and witness. LPA obtained and reviewed independent living resident roster, assisted living resident roster, staff roster, LIC500, independent living Admission Agreement, and visitor log dated 08/27/2025 to 09/10/2025. Based on interview and record review, LPA confirmed R1 lives in the independent living. We have found that the complaint was UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. Exit interview conducted and a copy of this report provided. Unfoundedthe state’s words, verbatim · CDSS document, Sep 10, 2025 · control 15-AS-20250909112710

Type of visit: Case Management - Other

On 07/30/2025 at 1:45 PM Licensing Program Analyst (LPA) P.Manalo conducted an unannounced Case Management visit to follow up on the fire clearance capacity increase and increase of hospice waiver request. LPA met with Executive Director, Sarah Husain and explained the purpose of the visit. Senior Executive Director, Salvador Gomez, arrived shortly after. During the visit, LPA spoke with Senior Executive Director, Salvador Gomez, to obtained more information regarding the fire clearance capacity increase. LPA is requesting for the facility to send in documentation of the fire panel test and an update when the door auto closer is installed. LPA also obtained the hospice waiver letter request from the facility during today's visit. No deficiencies cited. Exit interview conducted and a copy of this report is provided.the state’s words, verbatim · CDSS document, Jul 30, 2025

Type of visit: Required - 1 Year

On 02/25/2025 at 8:35 AM, Licensing Program Analysts (LPAs) P. Manalo and G. Luk arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Senior Executive Director, Salvador Gomez, and explained the purpose of the visit. The facility’s fire clearance was approved for forty (40) non-ambulatory and 3 hospice waiver. LPAs toured the facility with Executive Director inside and out including but not limited to 6 residents' apartments, bathrooms, activity room, beauty salon, garden room, kitchen, common area and courtyard. LPAs observe lighting in all rooms are adequate for the comfort and safety of the residents. Two of Residents' temperature was maintained at 74 and 68 degrees Fahrenheit. The hot water temperature in a sample of residents’ room were measured at 115.9, 118.6, 115.3, 113.6 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid shower pan. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medications, sharps and toxic are locked and inaccessible to residents in care. Smoke detectors was last inspected on 01/10/2025. Carbon monoxide was in operating condition. Fire extinguisher was last serviced on 01/03/2025 all around the facility and in the kitchen. Emergency Disaster Plan was last posted on 02/25/2025. Emergency disaster drill was last conducted on 12/26/2024. Fire Drill was last conducted 01/30/2025. First aid kit was observed to be complete. At 10:08 AM, LPAs reviewed 5 residents records. At 10:38 AM, LPAs reviewed 5 staff records and are associated to the facility. At 1:20 PM, LPAs reviewed a sample of resident’s medications. Continue to LIC809-C... Continue from LIC809... Updated copies of the following documents were requested for facility file and are to be submitted to CCLD by 03/05/2025: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 11:25 AM, LPAs observed during file review that S2 to S5 does not have First Aid Certificate. At 12:00 PM, LPAs observed during file review that staff did not have documentation of training. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted with Administrator. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Feb 25, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Case Management - Incident

On 02/25/2025 at 1:25 PM, Licensing Program Analysts (LPAs) P.Manalo G. Luk arrived unannounced to conduct a case management visit in regards to death report received on 02/24/2025. LPAs met with Senior Executive Director, Salvador Gomez, and explained the purpose of the visit. Unusual Incident Report indicated that R1 was having difficulty breathing and was sent to the hospital on 02/13/2025. Death Report indicated that R1 passed away at the hospital 02/20/2025. LPAs interviewed Senior Executive Director and stated that R1 was in the process of moving to another facility to obtain higher level of care and going into hospice services. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report provided.the state’s words, verbatim · CDSS document, Feb 25, 2025

Type of visit: Case Management - Other

On 01/22/2025 at 1:17 PM Licensing Program Analysts (LPAs) P.Manalo and L. Fontanilla conducted an unannounced Case Management visit. LPAs met with Senior Executive Director, Salvador Gomez, and explained the purpose of the visit. The Case Management visit was conducted due to renovations/upgrades observed at the facility's physical plant. Based on the interview conducted with the Senior Executive Director, he stated that they are doing exterior renovations such as upgrading patios, balconies, and painting exterior walls which began in April of 2024 and will be approximately completed May of 2025. Senior Executive Director stated that this renovation is conducted in phases in which it takes about 3-4 weeks per section of the building. Senior Executive Director does not know whether CCLD was notified of the renovations. LPAs requested to have the following documents such as building permit and plan of the renovations and have the facility sent to CCLD.the state’s words, verbatim · CDSS document, Jan 22, 2025

Allegation investigated: Staff do not answer residents' call buttons in a timely manner Staff do not ensure that residents' dietary needs are being met Staff speaks inappropriately while in the presence of residents

On 11/15/2024 at 2:30PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct investigation and deliver complaint findings for the allegations above. LPA met with Executive Director, Michael Sharkey and explained the purpose the visit. During the investigation, LPA interviewed 5 residents, 4 staff, and witness. LPA reviewed and obtained documents including call button log and staff schedule. Staff do not answer residents' call buttons in a timely manner Interview with staff indicated that call button response time is less than 10 minutes. After reviewing the call button log, AL (Assisted Living) response time average is 10-15 minutes. Interview with residents revealed that staff usually respond to call button in 5-10 minutes. (Continue on LIC9099C...) Unsubstantiated Staff do not ensure that residents' dietary needs are being met Interview with residents revealed that residents did not have issues receiving their meals. Interview with staff indicated that resident's dietary needs are given to kitchen staff and prepared accordingly. Staff have not witness resident's dietary needs not being met. Staff speaks inappropriately while in the presence of residents Interview with residents revealed that staff are nice and friendly. Interview with staff indicated they have not witness a staff spoken inappropriately or used profanity in the presence of residents. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did occur, therefore the allegations are UNSUBSTANTIATED. Exit interview conducted. A copy of this report provided.the state’s words, verbatim · CDSS document, Nov 15, 2024 · control 15-AS-20240506153219

Type of visit: Case Management - Deficiencies

On 11/15/2024 at 5:00PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a case management visit. LPA met with Executive Director, Michael Sharkey. While LPA was at the facility for another visit, LPA observed the following deficiency: At around 3:00PM, LPA was given the resident roster and was informed that facility had 41 residents. After reviewing facility file, LPA observed that facility's fire clearance capacity is 40 residents. Facility is over capacity. Civil penalty of $500 is being assessed. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview conducted. A copy of this report, civil penalty, and appeal rights provided.the state’s words, verbatim · CDSS document, Nov 15, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87204(a) · Plan of correction due date: Nov 18, 2024

Limitations - Capacity and Ambulatory Status. A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons... This requirement is not met as evidence by: Based on observation and record review, licensee did not comply with the section cited above by having over capacity in number of residents which poses an immediate health and safety risk to the persons in care.the state’s words, verbatim · CDSS document, Nov 15, 2024

Plan of correction: Executive Director has agreed to create a plan to address the over capacity issue and submit the written plan to CCLD by POC date. Civil penalty of $500 is being assessed.

Type of visit: Required - 1 Year

On 2/21/2024 at 9:50am, Licensing Program Analysts (LPAs) Carol Fowler and Tonica Syess-Gibson, arrived unannounced to continue the 1-Year Annual Required inspection visit. LPAs met with Michael Sharkey, Administrator, Sarah Husain Business Office Manager and Imelda Macabayah Health and Wellness Director and explained the purpose of the visit. LPAs toured the facility with Health and Wellness Director including but not limited to apartments, bathrooms, kitchen, common area, med tech room, and outside. LPAs toured apartments #102 and #140. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 76 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 112.6 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non slip shower mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 11/17/2023. Emergency disaster plan last updated 8/23/2023. First aid kit was observed to be complete. Fire drill was last conducted on 1/10/2024. Continued on LIC809C. Continued from LIC809. LPAs reviewed ten (10) resident records and one (1) staff record, which were all found to be incomplete. LPAs requested the following documents to be submitted to CCLD by 2/29/2024. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Deficiencies observed by LPAs during record review: At 1:00PM LPA observed staff and residents file incomplete. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. LPAs interviewed three (3) residents. Exit interview conducted. Copy of report, LIC-809 & 809C, LIC-809D (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to staff.the state’s words, verbatim · CDSS document, Feb 21, 2024

Allegation investigated: Staff are not feeding resident

On 11/1/2023 at 11:00am, Licensing Program Analyst (LPA), L. Hall arrived unannounced to conduct the 10-day initial visit and deliver complaint findings for the allegation above. LPA met with Michael Sharkey, Executive Director (ED), and explained the reason for the visit. During the investigation LPA interviewed staff, witness R1, and collected the following documents: admission agreement, assessment (8/25/2023), staff roster, resident roster, physician's report, hospice progress notes and care plan, facility progress notes, and emergency contact information, and R1's service plan. The RP stated that staff is not feeding R1. Based on interviews R1 is able to feed herself. S4 stated dining is open from 7am to 7pm and have an all day menu. Continued on LIC9099C. Unsubstantiated Continued from LIC9099. S4 also stated that R1 is not on a restricted diet but needs the food fine chopped and the caregivers bring R1 her meals and any other food at R1's request. W1 stated during interview that R1 has a friend that was given approval to visit R1 for an hour and feed R1, but R1 is able to feed herself. R1 stated during interview that she was able to feed herself and the staff brings her food. LPA observed during interview with R1 a half eaten banana, an open container of milk, half glass of water, and R1's lunch sitting on the tray at R1's bedside. LPA also observed cookies sitting on R1's night stand. Record review of R1's physician report states R1 is able to feed herself. Based upon the information obtained and the interviews during the investigation. The above allegation is unsubstantiated. A finding that the complaint 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. Exit interview conducted and a copy of report was given.the state’s words, verbatim · CDSS document, Nov 1, 2023 · control 15-AS-20231026113728