Green Merrylands Murrieta Home

Type of visit: Case Management - Deficiencies

On July 7, 2026, Licensing Program Analyst (LPA), Ivashia Wright, arrived at the facility unannounced to conduct a Case Management - Deficiencies Inspection. LPA met with Caregiver, Nidya Reynoso, explained the purpose of the visit, and inspected the facility. LPA told caregiver Nidya a deficiency is being issued to the facility due to LPA observing an incomplete Medical Assessment (602A) in R1's files dated 8/21/2025. LPA observed pages 2-9 of the (602A) were blank. LPA had observed the incomplete (602A) during a complaint investigation with complaint number 18-AS-20260701094201. Based on the information above deficiencies will be cited per Title 22, California Code of Regulations, Division 6, Chapters 8. An exit interview was conducted and a copy of this report was discussed and provided to Nidya Reynoso.the state’s words, verbatim · CDSS document, Jul 6, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87458(c)(1) · Plan of correction due date: Jul 13, 2026

87458(c)(1) Medical Assessment. A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: (A)Communicable tuberculosis. (B)Infectious diseases. (C)Contagious diseases. (D)Other medical conditions. This requirement was not met as evidenced by: Based on record review R1s 602A dated 8/21/2025 was incomplete and pages were blank listing no diagnosis or diagnoses.the state’s words, verbatim · CDSS document, Jul 6, 2026

Plan of correction: Licensee shall have the physician's report completed in its entirety, Licensee shall submit proof of correction no later than the end of POC date.

Allegation investigated: Licensee did not ensure water was accessible to residents in care.

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted a subsequent complaint visit to deliver final findings for the above allegation. During today’s visit, LPA met with Caregiver Osvaldo Nunez and explained the reason for the visit. It was alleged that Licensee did not ensure water was accessible to residents in care. Concerns were raised that the water the facility was shut off and residents were unable to have personal hygiene. LPA interviewed the licensee and residents, and the information obtained revealed that the facility’s water service was shut off on December 3, 2025, due to non-payment. Further information obtained revealed that residents were unable to access running water for basic hygiene needs, including showering and brushing teeth. Continued .... Substantiated Although bottled water and alternative beverages were provided, the lack of running water posed a health and safety concern. Based on interviews conducted, and records reviewed, there is sufficient evidence to support the allegation that Licensee did not ensure water was accessible to residents in care 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. An exit interview was conducted where a copy of this report, along with a copy of LIC9099C, LIC9099D, and Appeal Rights were provided to Caregiver Osvaldo Nunez.the state’s words, verbatim · CDSS document, Dec 23, 2025 · control 18-AS-20251204141830

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.686(a)(5) · Plan of correction due date: Jan 22, 2026

1569.686 Licensee notification of specified events; department initiation of compliance plan, noncompliance conference, or other appropriate action; penalties; exception (a) A licensee shall notify the department, the State Long-Term Care Ombudsman, all residents, and, if applicable, their legal representatives, in writing, within two business days, and shall notify all applicants for potential residence, and, if applicable, their legal representatives, prior to admission, of any of the following events, or knowledge of the event: (5) A utility company has sent a notice of intent to terminate electricity, gas, or water service on the property within not more than 15 days of the notice. This requirement is not met as evidenced by: Based on LPA Abdoulaye's observation, interview and record review, the licensee did not comply with the section cited above, resulting in the water being shut off, which posed an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 23, 2025

Plan of correction: Licensee set up a payment plan with the water company and water was restored on 12-04-25.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit for a required annual inspection. The LPA was greeted by Caregiver Karim Ibarra Morales , notified them of the purpose for the visit and was allowed to enter the facility to conduct the inspection. Facility Overview: The facility is a single- story building with 4 residents bedrooms, 1 staff bedroom, 3 bathrooms, a kitchen, a laundry room and a garage. There is no gated pool and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department's requirements. Physical Plant: The physical plant, including floors, windows, and doors, was not well maintained. LPA observed two exterior window screens and one door screen to have tears. Citation will be issued. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in the kitchen and inaccessible to residents in care. The smoke detectors and carbon monoxide detectors were operable. LPA observed fire extinguisher not to be in compliance with the department's requirements. The last serviced date was 06-10-24. Citation will be issued. The water temperature tested within regulations measuring 108.5 F. Care & Supervision/Administration: Adequate staff were present to supervise residents during the visit. The Administrator holds a current Administrator's certificate with the expiration date of 05-02-2026 and a CPR certification with the expiration date of 11-25-2025. Record Review and Resident/Staff Files: LPA reviewed files for 2 staff members, confirming criminal clearance, updated training, and health screening. 2 residents' files were reviewed and contained all required documentation. LPA observed first kit to be available for the clients in care. The residents and staff files were kept locked and inaccessible to unauthorized individuals. Health-Related Services/Incidental Medical Services: All residents' medications were securely locked upstairs in the medication room. LPA reviewed medication for 2 residents confirming that all medication were listed and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last emergency drill conducted on 11-05-2025, which met the department's requirements. All facility exits were clear of obstructions. Deficiencies were cited during the visit. An exit interview was conducted, during which this report, the 809-D and the appeal rights were reviewed, and a copy was provided to Caregiver Karim Ibarra Morales.the state’s words, verbatim · CDSS document, Nov 25, 2025

Allegation investigated: Staff are not able to communicate effectively with residents in care

Licensing Program Analyst (LPA), Armando Perez, conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegation. LPA Perez met with Caregiver Osvaldo Nunez, where the LPA explained the purpose of the visit and the elements of the allegation. LPA contacted Administrator Brandon Marquez by telephone and was notified of the purpose of the visit.The investigation consisted of interviews with staff and witnesses and file reviews. On February 13, 2025, Community Care Licensing Division (CCLD) received a complaint alleging that staff are not able to communicate effectively with residents in care. It was alleged that Staff 1 (S1) lacked the ability to communicate effectively in a language understood by the residents. The allegation raised concerns about S1’s ability to provide essential services and respond appropriately in emergency situations. Interview with Administrator, Sandy Zhao revealed that S1 was not fluent in English, however, they reported S1 could comprehend and communicate in order to provide care and supervision. Continued on LIC 9099-C. Substantiated Additionally, Sandy corroborated that S1 was encouraged to use translator tools when they needed to understand more complex conversations. Information obtained from resident interviews revealed that 2 out of 5 individuals experienced difficulty communicating with S1. Residents reported that S1 was unable to communicate effectively, noting that their requests were often misunderstood or disregarded. Interview with Additional Witness 1 (AW1), it was reported they observed S1 unable to communicate with the residents in care throughout their visit. AW1 further stated that during the exit interview, S1 relied on a translator device and did not verbally acknowledge AW1 to confirm their understanding of the information provided. AW1 further noted that, based on the interaction, it was unclear whether S1 would be capable of effectively communicating and responding properly in the event of an emergency. LPA was unable to interview S1 due to their resignation in February 2025 and their inability to contact them. Through file reviews, information obtained revealed that the Plan of Operation includes a Job Description stating that staff must be able to interact professionally and respectfully with residents, visitors, licensing agents, and other community agencies. Based on interviews and record reviews, the allegation that staff are not able to communicate effectively with residents in care 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. This poses a health and safety and or personal rights risk to residents in care. The facility will be cited. An exit interview was conducted. A copy of this report was provided to facility representative Osvaldo Nunez, along with a copy of the LIC9099-C, LIC9099D, and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Oct 10, 2025 · control 18-AS-20250213102134

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(d)(3) · Plan of correction due date: Oct 31, 2025

87411(d)(3)Personnel Requirements(d)All personnel shall be given on the job training…for the job assigned and as evidenced by safe and effective job performance:(3)Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents. This requirement is not met as evidenced by: Based on records and interviews, Licensee did not ensure that 1 of 6 staff (S1) had the skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents.the state’s words, verbatim · CDSS document, Oct 10, 2025

Plan of correction: The licensee confirmed S1 resigned. To prevent recurrence of deficiency, the facility will implement staff training focused on residents' personal rights and the facility's emergency procedures policy. Licensee will email proof of the training conducted with all employees by POC due date. This posed a potential health, safety, and personal rights risk to residents in care.

Allegation investigated: Staff do not have running water for the residents Facility is experiencing financial distress

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced subsequent complaint investigation visit regarding the above allegations. LPA Flores met with Oswaldo Nunez and explained the reason for the visit. The investigation consisted of the following: On 11/17/22 LPA Arreola conducted an initial investigation visit. On 9/25/25 LPA Flores contacted the administrator and requested copies of bank statements for June through December of 2022, utility bill for July 2022, pertaining documents for resident #1. On 9/30/25 LPA Flores conducted a visit interviewed 4 residents, 1 staff, and conducted a tour of the facility. The investigation revealed the following: Regarding allegation: Staff do not have running water for the residents. It is alleged resident was not able to flush toilet as there was no water at the facility. Interviews conducted with residents revealed there is running water, utilities, and meals are served to them at the facility. (CONTINUED ON LIC 9099C) Unsubstantiated Interviews conducted with staff revealed there are water services and utilities at the facility. Interview conducted with administrator/licensee revealed the facility has not had water services cut out and bills have been paid timely. There have been no interruptions in water services. On 11/26/22 LPA Arreola contacted Eastern Municipal Water District who stated the account was current and services were running at the facility. During today’s visit LPA observed running water in the bathrooms and kitchen. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. Regarding allegation: Facility is experiencing financial distress. It is alleged the facility was unable to cover their bills. Interviews conducted with residents revealed meals have been provided 3 times a day, water, and electricity are available. Interviews conducted with staff revealed facility licensee/administrator ensures all utilities are available, food supplies are provided once a month for the month, and payroll is cover. LPA Flores reviewed the status of the licensee’s incorporation in the California Secretary of State website, it revealed that the licensee’s facility incorporation was suspended on 12/28/21 and back to active on 4/18/23. Per the licensee, the facility did not provide care to residents in 2021 due to COVID mandates and only provided services to resident #1 for two to three weeks during 2022. LPA reviewed bank statements provided, expenses and balance was observed between June 2022 to December of 2022. Based on the preponderance of evidence it cannot be established that they were in financial distress. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was conducted with Oswaldo Nunez and a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 30, 2025 · control 18-AS-20221114152101

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced case management visit regarding deficiencies observed during a complaint investigation visit. LPA met with Oswald Nunez and explained the reason for the visit. On 9/30/25 during a complaint investigation visit. LPA reviewed food supplies and observed 9 cans of mixed vegetables, 9 cans of peaches, 1 box of oatmeal, 3 boxes of pancake mix, 1 box of cereal, 1 bag of cereal, 2 jars of jelly, 1 jar of peanut butter, 2 bags of bread, 1 bag of tortillas, empty gallon of milk, less than 1 pound of grapes, about 6 strawberries, 3 eggs, 4 tomatoes, 1 pepper, 1 bag of string beans, 2 bags of potato tatters, 1 bag with some chicken 1 bag of vegetables, 1 frozen chicken. Per Title 22 Regulations facility should have at least 2 days of perishables and 7 days of non-perishables which include a variety of foods. Currently the facility has 4 residents. Therefore, the facility does not meet this requirement. Deficiency noted on LIC 809D per Title 22 Regulations. Exit interview was conducted with Oswaldo Nunez and a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 30, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 8755(b)(26) · Plan of correction due date: Oct 1, 2025

87555 General Food ServiceRequirement: (b) The following food service requirements shall apply:(26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not met as evidence by: Based on observation licensee did not ensure there was 7 days of non-perishables and 2 days of perishable food supplies which poses an immediate risk to the health, safety, personal rights of the persons in care.the state’s words, verbatim · CDSS document, Sep 30, 2025

Plan of correction: Administrator will provide food supplies for at least 2 days of perishables and 7 days of non-perishables and submit pictures and receipts to the department by 9/30/25.

Type of visit: Case Management - Deficiencies

This Case management– Deficiencies inspection is being conducted by Licensing Program Analyst (LPA) Abdoulaye Zerbo on 07-14-25 for the purpose of issuing citations for deficiencies observed during the investigation into Complaint Control No. 18-AS-20250711151040. LPA met with Caregiver Titus Irungu and explained purpose of the visit. During the visit, no records of Resident 1(R1) were present at the facility for LPA to review. Based on observations, and interviews , deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809-D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative Titus Irunguthe state’s words, verbatim · CDSS document, Jul 14, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(d) · Plan of correction due date: Jul 25, 2025

87506 Resident Records (d) All resident records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements: Based observation and interview , the licensee did not comply with the section cited above. The administrator told LPA on the phone that the R1's binder was taken by the paramedics because the facility did not have time to make copies for themthe state’s words, verbatim · CDSS document, Jul 14, 2025

Plan of correction: Licensee agreed to obtained copies of R1's records and provided copies to LPA by POC due date

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Abdoulaye Zerbo, Andrei Castillo, and Ferrer Sabarias conducted an unannounced visit for a required annual inspection. The LPAs were greeted by the caregiver Titus Irungu, notified him of the purpose for the visit and were allowed to enter the facility to conduct the inspection. Facility Overview: The facility is a single story building with 4 residents bedrooms, 1 staff bedroom, 3 bathrooms and a garage. There is no gated pool and there are no firearms on the premises. Infection Control: LPAs observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in a kitchen cabinet and inaccessible to residents. The smoke detector and carbon monoxide detector were operational. LPAs observed fire extinguishers to be in compliance with the department requirements and with an expiration date of 06/10/2025. LPAs observed the hot water temperature to meet requirements at 115.5°F. Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Continued on LIC809-C..... Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate with expiration date of May 22nd, 2026 and a CPR certification with the expiration date of 10-5-25 Record Review and Resident/Staff Files: LPAs reviewed files for four(4) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Four (4) residents' files were reviewed and contained all required documentation. LPAs observed Staff and resident files, to be stored in a locked cabinet in the staff room. The first aid kit was stored in a cabinet in the pantry next to the living room. Health-Related Services/Incidental Medical Services: All residents' medications were securely locked in a cabinet and located in the kitchen area. LPAs reviewed medications for four residents, confirming that all medications were listed and accounted for. Disaster Preparedness: LPAs reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 09-01-2024, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed, and a copy was provided to Verona Gitauthe state’s words, verbatim · CDSS document, Nov 4, 2024

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced visit to continue the required annual. LPA was granted entry and met with Staff, Maritza Alfaro Mendoza, who was informed of the purpose of the visit. At the time of the visit there was (2) staff and (1) clients present. Food Service: LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. Health Related Services/ Incidental Medical Services: Resident Medication was reviewed during the visit. All medication for (1) resident had required labeling and was accounted for. Disaster preparedness: LPA reviewed the facility's emergency and disaster plan. The last fire drill was conducted 10/11/2023. An exit interview was conducted where this report where reviewed and provided to Staff, Maritza Alfaro Mendoza.the state’s words, verbatim · CDSS document, Nov 2, 2023

The state marks this report as 6 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: POC

Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced visit to the home in order to verify clearance of plans of correction created with Licensee, Sandy Zhao from visit on 10/5/2023. LPA met with staff Maritza Alfaro Mendoza. The following Plan of Correction (POC)s were cleared at the time of the visit: The licensee was cited on 10/5/2023 for 87307(d)(4) Personal Accommodations and Services. Based on observation the licensee did not maintain measures of safety with ramp that lead to back yard that was falling apart. The plan of correction was to repair the ramp. During today's visit. LPA observed the wooden ramp was replaced with a cement ramp and was in good repair. The LPA provided a clearance letter for this deficiency during the visit. 87307(a)(2)(C) Maintenance and Operation. Based on observation the licensee was utilizing a room as a staff room which is used as a passage way to a bathroom and license resident room. The POC was to remove the items from the room and cease the use as a staff sleeping quarter. During today's visit. LPA found that the bed had been removed from the room and was no longer used as a sleeping quarter. The LPA provided a clearance letter for this deficiency during the visit. The licensee was cited on 10/5/2023 for 87465(i) Incidental Medical and Dental. Based on observation the facility has medication that were not destroyed for a prior residents. The POC was to destroy the medication and provide proof of the record. During today's visit the LPA received destruction records for the medications. Clearance letter was provided during the visit. The following deficiency were not cleared during the time of the visit: The licensee was cited on 10/5/2023 for 87412(f) Personnel Records. Based on record review and interview, the licensee did not have records for the LPA to review for (1) staff member and no staff training on site. The POC was to send the complete record for house manager, send LPA all staff training, and send LPA all staff COR training. Licensee agreed to send file for house manager by the POC due date. During the visit, LPA observed the staff files still did not have CPR or staff training. The LPA was able to review this information for (3) staff members during the time of the visit as Administrator faxed the records. There are still staff who have incomplete records at the facility. Therefore, the POC was not cleared at the time of the visit. Civil penalties will be assessed in the amount of $100 per day for 21 days. The licensee was cited on 10/5/2023 for 87309(a) Storage Space. Based on observation the laundry detergent was left unlocked with (1) dementia resident in care. The POC was to send LPA proof of in-service conducted with staff on locking chemicals. LPA did observe the laundry room door was replaced with a locked door knob, however in-service was not provided during the time of the visit. Civil penalties will be assessed in the amount of $100 per day for 27 days. An exit interview was conducted with licensee over the phone where this report along with civil penalty assessment pages, and appeal rights were reviewed and provided to them. Licensee was advised that civil penalties will continue to accrue until corrections are received by the LPA.the state’s words, verbatim · CDSS document, Nov 2, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced annual required visit on 10/4/2023. LPA was granted entry and met with staff, Dennise Gutierrez, who was informed of the purpose of the visit. At the time of the visit there was (1) staff and (1) clients present. The facility is a one story home with (6) bedrooms and (3) bathrooms with attached garage. No pools or firearms are being kept at the facility. The residents served are elderly ages 60 and over. The facility is approved for a capacity of (6) non-ambulatory residents of which (1) may be bedridden. LPA conducted a tour of the interior and exterior, reviewed facility documents and conducted a staff and resident interviews. LPA observed the following: Infection Control: The LPA observed hand washing stations in the facility stocked with supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. The facility has an infection control plan, however the licensee and staff were unable to show these documents in a timely manner. Physical Plant: Physical plant, floors, windows, and doors were observed to be clean. Facility is in need of repair, with broken ramp. The smoke detector and carbon monoxide was operational, and the hot water temperature 105.8F. LPA observed unlocked chemicals in the laundry room, this will be cited. LPA observed staff belongings in an unapproved room which is used as a passage way to a restroom. Facility will be cited for this. Care & Supervision/Administration: The licensee has a staff schedule, however the licensee was unable to provide this to the LPA in a timely manner. Facility sketch, exit routes, personal rights, complaint information and emergency phone numbers were found posted in the facility. The listed administrator, possesses a current administrator's certificate. Record Review and Resident/Staff Files: LPA reviewed (3) staff files and training. (1) staff does not have CPR on file. Staff training was not provided to the LPA during the time of the visit. (1) staff is currently residing in the home and does not have a staff file at the facility. Two (1) resident file was reviewed, and possessed all required paperwork. The facility will be cited for incomplete staff files. Health Related Services/ Incidental Medical Services: All client medication was kept locked in facility pantry. The LPA observed medication for Resident #E1 (R1) whom no longer resides at the facility. LPA observed undestroyed controlled medication for the resident is being stored at the facility. Facility will be cited for this. Due to time constraints, the annual will be continued on a later date. Observations were documented and will be addressed during the annual continuation. An exit interview was conducted where a copy of this report, 809-D pages and appeal rights were reviewed and provided to staff, Dennise Gutierrez.the state’s words, verbatim · CDSS document, Oct 5, 2023