The Good Nests II

Allegation investigated: Licensee did not ensure facility equipment was maintained in good repair Licensee did not ensure hazardous items were inaccessible to residents

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced initial complaint investigation visit regarding the above allegations. LPA Gonzalez was greeted by Administrator Tiffany Montoya and the purpose of the visit was explained. The investigation consisted of the following: LPA Gonzalez requested and obtained copies of Personnel Roster, Resident Roster, toured the facility physical plant, interviewed staff #1-2 (S1- S2) and interviewed residents #1-4 (R1-R4). R4 was interviewed and R4 could not answer LPA’s questions due to cognitive impairment. continued on LIC 9099C Unsubstantiated The investigation revealed the following: Regarding the allegation "Licensee did not ensure facility equipment was maintained in good repair”: it was reported that a broken chair was removed from the TV room and later put back in the room. Metal ramps are not secured to the ground and are unsafe for residents in care. A grab bar in the shower was loose. The sliding glass door gets jammed if closed all the way. Interviews with 3 out of 3 residents revealed residents stated no concerns with broken chairs in TV room, metal ramps on stairs, loose grab bars in the shower, or jammed sliding glass door. R1 stated staff address issues immediately and has no concern about safety. R3 stated they use a walker and feel safe using the portable metal ramps and staff will assist when needed. LPA observed sufficient seating in TV room for residents in care and chairs were in good repair. LPA observed a broken chair in the garage. Interviews with staff revealed S1 stated they were unsure how a resident broke two (2) wooden chairs and the chairs were immediately removed and put in the garage and were replaced with other chairs that were not broken. S1 stated the chair would be thrown away on trash day, the other chair was already disposed of. LPA and staff tested all ramps by walking up and down the ramps. Ramps were sturdy and not wobbly. All ramps had secured grabs bars on the walls adjacent to ramps as support for residents that may have poor balance. LPA and S1 checked grab bars in showers of the two (2) bathrooms by tugging and pushing down on grab bars. LPA observed metal grab bars to be securely bolted to the wall and did not move. LPA observed sliding glass door to open and close completely and smoothly with no jamming. Regarding the allegation " Licensee did not ensure hazardous items were inaccessible to residents”: it was reported that due to the broken lock on the laundry room cabinet, residents may have access to hazardous items which could pose a danger when not in a locked storage and are left unattended if outside the locked storage. Interviews with staff revealed detergents and cleaning supplies are kept in a locked cabinet in the garage, inaccessible to residents in care. LPA observed door to garage was labeled “RESTRICTED AREA. AUTHORIZED PERSONNEL ONLY” and the cabinet door above the laundry area has a lock making detergents and cleansers inaccessible to residents in care. S1 and S2 stated cabinet door is locked at all times. Based on interviews and observation, although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to Administrator Tiffany Montoya.the state’s words, verbatim · CDSS document, Feb 2, 2026 · control 28-AS-20260126152616

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an announced visit to the facility for the purpose of a Pre-licensing inspection. LPA met with Applicant Tiffany Montoya. The facility has an approved fire clearance to be licensed to serve six (6) non-ambulatory residents age range 60 and over of which one (1) may be bedridden. Bedroom #2 with direct exiting to the exterior shall house the bedridden resident. The facility is a single-story home located in a residential area of Glendora. The home consists of kitchen, dining area, living room, den, three (3) bedrooms, two (2) bathrooms, backyard and garage with laundry area. LPA and Applicant toured the physical plant interior and exterior. The Pre-Licensing Inspection CARE Tool was used, and the following was observed: Infection Control: Facility has an Infection Control Plan in place. Physical Plant and Environmental Safety: Appliances such as a microwave and stove were observed to be clean and operating properly. Freezer of adequate size maintained and refrigerator of adequate size observed to be clean and operating properly. Kitchen area was observed to be clean and free of litter, rodents, vermin and insects. Containers storing waste were observed in good repair, free of leaks. continued on LIC 809C continued from LIC 809 (page 2) Sharps secured in a locked kitchen cabinet, inaccessible to residents. Disinfectants, cleaning solutions, and poisonous substances stored in areas separate from food supplies. Telephone service on the premises A comfortable, appropriately furnished living room and en, available to all residents for their relaxation and for entertaining friends and relatives, was observed with games and magazines. Dining area was clean with sufficient seating. Fireplace in the living room had screened covering. Combination smoke/carbon monoxide detectors located throughout the facility are interconnected, were tested and are operable. Laundry room observed in the garage included a locked cabinet for detergents. Washing machine and dryer were observed to be in good repair. Two (2) fire extinguishers observed and charged. Resident bedrooms all have required furniture which includes, for each resident; a bed, a chair, nightstand, and lights sufficient for reading. Bed linens were clean and in good repair. There is closet space for clothing and other belongings. Extra linens and towels observed in hall closet. Water temperature was tested and measured at 133°F, which is above the required 105°-120°F in both bathrooms. Applicant adjusted at time of visit. Grab bars were observed in showers and by toilets in bathrooms used by residents. Slip-resistant flooring was observed in shower floors. Residents Rights: Personal Rights are posted in common area. Centrally stored medication will be located in a locked kitchen cabinet, inaccessible to residents in care. The first-aid kit and manual were observed and kept in the kitchen. Outdoor activity area that is easily accessible to residents, protected from traffic, and adequate shady area was observed. Doors, exits, hallways, and passageways were clear and free of obstruction. No pools or large bodies of water were observed. Continued LIC809C page 3 Disaster Preparedness: Facility has Emergency Disaster Plan LIC 610 in place. Applicant will add an addition temporary location, outside the immediate area where facility is located. The Pre-licensing inspection is completed. Comp III was waived, applicant completed Comp III at the Riverside RO June 2025. Exit interview was conducted with applicant Tiffany Montoya and a copy of this report was provided. Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.the state’s words, verbatim · CDSS document, Nov 24, 2025