Gold Medal Estates

Allegation investigated: Staff lock resident(s) in their room while in care. Licensee does not ensure that resident(s) have access to an emergency call system while in care. Staff do not ensure that resident(s) are provided activities while in care. Staff emotionally abused resident(s) in care. Food services are inadequate. Staff do not accord privacy to resident(s) in care. Staff do not accord dignity to resident(s) in care.

Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced complaint visit to investigate the above allegations. LPA met with Administrator/Licensee Toni Santos and explained the purpose for todays visit. The investigation consisted of the following: LPA obtained copies of food menu, activity calendar, R1's Physician Report, toured facility, inspected food supply, activities, incontinence care products, resident bedroom doors, tested resident call buttons, conducted interviews with 3 Staff (S1-S3), 1 Resident (R1) and 3 Family/POA’s for R1, R3 and R4. LPA attempted interviews with residents R2-R6, however, due to cognitive impairment these were not successful interviews. (Continued on LIC9099-C) Unsubstantiated The Investigation Revealed the Following: Allegation: Staff lock resident(s) in their room while care. It is alleged that R1 and R2 are locked in their room at night. LPA interviewed 3 staff and each denied the allegation, they stated that the door does not have a lock but a hook that is able to be opened from both the inside and outside of the bedroom door that both R1 and R1 reside in. LPA inspected door and there was a hook on both sides of the door, staff demonstrated door to LPA and how it is easily opened from both sides at any time. LPA also had R1 demonstrate how they would be able to open the door in the case the hook is latched and R1 was able to successfully able to open the door with ease. Staff also stated that the door is never locked, the only time the latch is used Is when the residents need privacy to change clothing or their diapers as the door sometimes opens on its own without latch, staff stated they do not use latch to close the door at night. LPA interviewed family/Power of Attorney (POA) for R1, R3 & R4, each denied the allegation, stated they have never observed residents being locked in their rooms & have never had this concern. Allegation: Licensee does not ensure that resident(s) have access to an emergency call system while in care. It is alleged that there is no way for residents to call staff in event of an emergency during night hours. LPA toured facility and observed residents call buttons, R1 was wearing their call button and this was tested during visit and was observed to be operable. LPA interviewed 3 staff and each denied the allegation and stated that each residents room has an Audio Only Nanny speaker that will notify staff if someone is calling for help and each resident has a call button that they either wear as a necklace or have near their bedside for easy access. LPAs interviews with family/POA for R3 and R4 and denied the allegation and stated that they have seen the call buttons and speaker in the residents rooms but have not had to use them. Allegation: Staff do not ensure that resident(s) are provided activities while in care. It is alleged that activities are not provided for the residents to engage in. LPA toured facility and observed supplies such as card games, puzzles, bingo, magazines and art supplies and observed Residents painting, and R1 doing exercises with physical therapist. Interview with R1 revealed that they have participated in some of the activities at the facility and enjoy bingo, listening to music and doing artwork. LPA interviewed 3 staff, and each denied the allegation and stated that activities are provided for the residents, however, it varies as some residents sometimes prefer not to participate, other activities will be offered but due to their cognitive disabilities they sometimes decline the activities. LPA interviews with family/POA for R3 and R4 and denied the allegation and stated that they have visited the facility and can confirm that activities are provided to the residents, interview with POA for R1 stated that although they cannot visit often due to distance they are provided with updates and photos of what R1 did for the day and the activities they participated in. (Continued on LIC9099-C) Allegation: Staff emotionally abused resident(s) in care. It is alleged that staff play loud music to avoid having to respond to residents. LPA interviewed 3 staff and each denied the allegation, both S1 an S2 stated that R1 enjoys listening to music and has asked to have music played louder so they can hear better but this was per the request of the resident and not to emotionally abuse residents. LPA interviewed R1 and they confirmed they enjoy listening to music and it has never been played too loud. LPA interviewed the family/POA for R1, R3 and R4 and each denied the allegation and stated they have never observed music being played too loud at the facility before, interview with POA for R1 stated that R1’s family member mentioned that one day the music was played loudly when they arrived but when the staff was asked to turn it down they did so immediately. Allegation: Food services are inadequate. It is alleged that R1 is being provided with foods that they are unable to eat due to not having ability to chew solid foods properly. LPA interviewed 3 staff and each denied the allegation, interview with S2 revealed that all residents are on a soft food diet and facility ensures that this is being met by thinly slicing all meals and avoiding any hard foods. LPA interviewed R1 and they denied the allegation and stated the food is not hard to chew and they enjoy the food at the facility. LPA interviewed the family/POA for R1, R3 and R4 and each denied the allegation and stated they have not had any concerns of the food at the facility and staff accommodate their family with foods they prefer. LPA checked food supply and there was sufficient amount of food at the facility to meet the needs of the residents. Per R1's Physician Report there is no special diet. Allegation: Staff do not accord privacy to resident(s) in care. It is alleged that staff put a commode next to R1 and R2’s beds so if they need to urinate at night, they must do it in front of each other with no privacy. LPA toured room and observed commode in R1’s closet, along with sufficient supply of incontinence care products. LPA interviewed R1 and resident stated that they were using the commode because they were having difficulty making it to the restroom on time, however, they now prefer to use their incontinence diaper when they need to use the restroom in the late-night hours. LPA interviewed 3 staff and each denied the allegation and stated that the commode’s are only used if needed in the late-night hours, residents are assisted and encouraged to use the restroom, however, there may be times when the resident cant make it to the restroom and that is when the commode is used. S1 and S2 stated that R1’s POA was the one who requested for the commode to be in R1’s room in the case of emergency and interview with R1’s POA they confirmed this to be true. Interviews with family/POA for R3 and R4 denied the allegation and stated they have not seen any of the residents use a commode during visits and have seen staff assist residents to the restroom. (Continued on LIC9099-C) Allegation: Staff do not accord dignity to resident(s) in care. It is alleged that staff at the facility are unprofessional and intimidating towards residents. LPA interviewed 3 staff and each denied the allegation and stated they have never acted unprofessional or intimidating towards residents and have never seen another staff be this way towards residents. LPA interviewed R1 and R1 denied the allegation and stated that all staff have been friendly and respectful. LPAs interviews with family/POA for R1, R3 and R4 and denied the allegation and stated that all staff have been great with the residents and have never witnessed staff act unprofessional or intimidating towards residents. Interview with family of R4 stated that although some may appear to be intimidating they have never witnessed staff to be anything other than kind, professional, caring and helpful towards the residents in care. Based on statements/interviews conducted with staff/residents/POA’s/Family of Residents, review of R1's file and LPA’s observations, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview held, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 6, 2026 · control 28-AS-20260203153623

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kimberly Ramirez and Associate Governmental Program Analyst (AGPA) Krissia Gerard conducted an unannounced required annual inspection visit on 10/16/2025 and was greeted by Caregiver Arianna Palacio. LPA Ramirez explained the purpose of the visit. Alternate Administrator Vicki Serna arrived shortly after to assist with tour. The facility is located on a residential street and is a single store dwelling. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Physical Plant and Environment safety: Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to residents, were observed to be inaccessible to residents. LPA Ramirez observed carbon monoxide detectors and smoke alarms in hallways. LPA Ramirez inspected five (5) resident rooms. All resident bedrooms contained required furniture, linens and lighting. Water temperatures in all grooming and bathing areas were measured to be with 105 – 120 degrees F. LPA Ramirez observed grab bars near toilets and inside showers. LPA Ramirez observed no-slip mat in showers. Bathrooms were observed to be wheelchair accessible. Food Service: LPA Ramirez observed sufficient supply of nonperishables for one week and perishable foods for a minimum of two days in the facility kitchen area. Soaps, detergents, and cleaning compounds were observed to be stored away from food supplies. Freezers and refrigerators were observed to be clean and within temperatures of 0-degree F (-17.7 degree C), and refrigerators with maximum temperature of 40-degree F. (4 degree C). Planned Activities: LPA Ramirez observed board games, magazines, and other activities for residents. Residents Rights-Information: LPA Ramirez observed the following postings in common areas throughout the facility: Complaint Poster (PUB 475), personal rights, and nondiscrimination notice. LPA Ramirez observed facility land line. See 809-C Disaster Preparedness: The facility has the Emergency Disaster Plan (LIC610D/9 pages) in place. Last documented emergency drills were conducted on 09/11/2025 at 9:20am. LPA Ramirez observed facility sketches with exits and emergency exits routes throughout various locations of the facility. LPA Ramirez observed emergency food supply located in garage. Residents with Special Needs: No large bodies of water were observed LPA Ramirez observed signs posted indicating “No smoking - Oxygen in Use” in various locations of the facility. LPA Ramirez observed several oxygen tanks in resident rooms secured in stands. Auditory devices were observed to be in working order. Health Related Services/Incidental Medical Services: The medications are centrally stored and in bubble packs and/or original containers. The facility uses the Medication Administration Record (MAR) log to document medications given. The facility provides incidental medical services. Staffing: Administrator Certificate for Toni Santos expires 07/20/2026. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. Personnel Records Training: Staff files are maintained at the facility. LPA Ramirez observed required annual training, CPR and First Aid for three (3) out of the three (3) personnel records reviewed. LPA Ramirez observed TB testing results, Health screening, fingerprint clearance and job application for three (3) out of the three (3) personnel records reviewed. Infection Control: There are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has an Infection Control Plan in place. Operational Requirements: The fire clearance is approved for six (6) non-ambulatory of which one (1) may be bedridden. Bedridden musted be in bedroom#4. This facility may retain no more than six (6) hospice residents. There were three (3) resident under hospice care during inspection. Resident Records/Incident Reports: LPA reviewed Resident files for five (5) residents in care. Resident files are maintained at the facility. Admission Agreement, Physician's Report (including T.B and Ambulatory Status), Consent for Medical Treatment, Preplacement Appraisal Information, Resident Pre-Appraisal, Care Plan/Appraisal/Needs and Services Plan, Resident Rights were observed. No deficiencies were observed during visit. One (1) Technical Advisory was observed and discussed with staff. Exit interview conducted. A copy of this report, LIC 9102, and appeals rights were provided.the state’s words, verbatim · CDSS document, Oct 16, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA was met by Caregiver Priscilla Santos and explained the purpose of the visit. House manager Victoria Santos and Licensee Eduardo Medal arrived shortly. Facility is licensed to serve residents over 60 years old six (6) can be non-ambulatory, of which one (1) may be bedridden in room #4. Approved hospice waiver for six (6). During today’s visit it was observed facility had one (1) staff S5 member who has yet to be fingerprinted civil penalties assessed. The facility is a single-story building located in a residential area five (5) resident bedrooms, three (3) resident bathrooms, living room, kitchen, dining area, laundry/medication room, front yard backyard with gated pool, pool house and ADU. LPA obtained city permits for ADU however it was observed during tour of facility that ADU was occupied by someone not associated with facility with no fingerprint clearance civil penalties assessed. LPA toured the facility and observed the following: Each client bedroom has the required furniture and bedding. There is extra clean linen and towels in a hallway closet. Auditory devices were observed at entrances/exits and operating properly. Smoke detectors/carbon monoxide were observed in each room and throughout the facility and are properly operating. The facility has one (1) fully charged fire extinguisher which is kept in the kitchen. Cleaning supplies and toxic substances were observed to be inaccessible to clients in laundry room. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. Sharps are locked and placed in cabinet in kitchen. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. LPA observed scissors in drawer unlocked in bathroom #1 and no grip bars in bathroom #1-2 deficiency cited. There is a pool surrounded with a locked safety fence. There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction. Four (4) Staff files were reviewed and included Criminal clearance record, CPR/training, and health screening with TB. Four (4) Client files were reviewed and included physicians report, TB clearance. Fire/earthquake drill was last conducted August 4th, 2024. Infectious control plan was reviewed. The medications are centrally stored and locked in laundry room. The facility uses the Medication Administration Record (MAR) log to document medications given. LPA reviewed medications for Four (4) clients, and they are being administered as prescribed by the physician. Deficiencies have been noted on LIC 809D under Title 22 Regulations. Exit interview was conducted and a copy of this report, LIC 809D and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 13, 2024

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) V. Maldonado made an unannounced subsequent visit to the facility for the purpose of concluding the required Annual inspection. LPA Maldonado met with Care Manager, Victoria Serna, and explained the purpose for the visit. Today's visit consisted of the following: Review of (4) resident's medications. Interviews conducted with (2) staff Interviews attempted with (5) residents. LPA was unable to interview some residents due to them sleeping during the visit. Per California Code of Regulations, Title 22, no deficiencies were observed during today's visit. An exit interview was conducted with Care Manager, Victoria Serna, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 31, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) V. Maldonado made an unannounced visit at the facility for the purpose of conducting the required annual inspection, using the Compliance and Regulatory Enforcement (CARE) Tool, to evaluate the facility. LPA Maldonado met with Care Manger, Victoria Serna, and explained the purpose for the visit. During today's visit, LPA Maldonado conducted a tour of the physical plant with Licensees, observed the facility food supplies, reviewed (4) resident files, and attempted to review (4) staff files. The facility is a single-story home, operating as an Residential Care Facility for the Elderly. It is licensed to serve (6) older adults, ages 60 and over. There is a fire clearance approved for (6) non-ambulatory residents, of which (1) may be bedridden, in room#4, only. There is a hospice waiver approved for (2). Currently, there is (1) resident on hospice. All resident bedrooms were inspected and had the required furniture, storage space, and lighting. Bathrooms were equipped with a toilet, wash basin, and showers. They were observed to have the required grab bars and non-skid mats. The water was tested and measured at 114*F in bathroom (BR)# 1, the water in BR#2 had a trickle of water coming out of the faucet when opened- in disrepair, and water in BR#3 did not have hot water. LPA and house manager left the hot water running for about 10 minutes, and the water did not turn hot. The food supplies was observed and had the required 2-day perishables and 7-day non-perishables. Fire extinguishers were observed throughout the premises, with current inspections and were fully charged. Walkways and ramps were observed to be free of debris and obstructions/hazards. Sharps were observed stored in the kitchen, inaccessible to residents in care. Toxins and cleaning supplies were observed stored in the laundry room and underneath the kitchen sink, locked and inaccessible to residents in care. Centrally stored medications were also observed stored inaccessible to residents. Auditory devices were observed at entrances/exits and operating properly. Sufficient linens, towels, and personal hygiene supplies were available. (Report Continued on LIC809-C...) The facility has an approved mitigation plan on file and a current infection control plan submitted to the department. Smoke/carbon monoxide detectors were observed in each room. The last fire drill was conducted on 8/30/23. Resident files were reviewed for required documentation, and observed to be complete. (3) of (4) staff files were reviewed and had the required documents. (1) staff file was unavailable to review at the facility during the time of the visit. At 2:05PM, LPA observed Staff#1's (S1) bed inside the kitchen area, separated by curtains. Per S1, S1 is a live-in staff and that is their room. Due to time constraints, LPA was unable to conclude the required Annual Inspection. The following domains are pending completion: Incidental Medical and Dental. Staff and Resident interviews are also pending to be conducted. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies were observed and will be cited on the LIC809-D. An exit interview conducted with Care Manager and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Oct 23, 2023