Harborview Senior Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA Domingo was welcomed by, identified herself to, and discussed the purpose of the visit with Genoveva Guerrero, Manager. The facility serves thirty (30) elderly residents; ages 60 years and above; all of whom may be non-ambulatory and five (5) of which may be bedridden. there were a total of twenty five (25) clients in care, and per medical records, all were ambulatory. LPA, accompanied by the house manager, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Call box was available in each resident unit and were tested for functionality. Resident's room temperatures were within a comfortable range. The facility’s ambient internal temperature was 70 F. Hot water temperature at taps accessible to clients were all compliant: Kitchen sink was 115 F, Bathroom #1 sink was 115 F, and Bathroom #2 sink was 118 F. Refrigerator temperature was 34 F and freezer temperature was -0 F. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. [CONTINUED ON LIC 809C] [CONTINUED FROM LIC 809] The fountain structure is not accessible to residents or visitors without staff accompaniment and there is a locked fenced area around the structure. Per the licensee's staff, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. The last disaster drill was conducted in 2/2/26. LPAs interviewed multiple staff and clients. LPA reviewed multiple staff and client records/files. The interviews did not raise any significant licensing concerns. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. The reviewed files contained required documents. Confidential records were stored in locked areas. Licensee's staff also presented proof of current/active business liability insurance and surety bond. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Genoveva Guerrero, Manager to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Mar 12, 2026

Allegation investigated: Neglect/Lack of Supervision resulting in serious bodily injury.

On 02/21/2026, LPA Janet Ngallo conducted a subsequesnt visit to deliver findings regarding the above-mentioned allegation. LPA spoke with Medical Technician Gloria Castro and explained the purpose of the visit. Regarding the allegation Neglect/Lack of Supervision resulting in serious bodily injury, during a visit a resident (R1) was found to have "severe swelling" to elbow and bruising on upper arm and was "experiencing severe pain when touched or moved". During the investigation, staff members were interviewed, and records were reviewed. (Cont. on LIC 9099-C) Unsubstantiated (Cont. from LIC 9099) According to the interviews with facility staff, hospice care staff, and family member, R1 is bedridden and hardly moves while in bed. R1 has never attempted to climb out of bed without assistance and R1 has never been found on the floor after an unwitnessed fall. Hospice nurse, H3 stated he/she does not believe R1 suffered a fall. There is no evidence or witnesses to corroborate the allegation of Neglect/Lack of Care and Supervision resulting in R1 sustaining a fractured left arm. Based on interviews and records review, the department has determined that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Medical Technician Gloria Castro, whose signature below confirms receipt of these rights. (Cont. from LIC 9099) On the evening of 1/13/2025, S2 heard R1 in the room screaming when a caregiver was attempting to change R1s clothing for bed. S2 went to check and noticed R1 had bruising from the left shoulder to the elbow and R1s elbow was swollen. S2 notified hospice of R1s condition. The hospice representative told S2 there was no on-call nurse available to visit R1 and that R1 had a scheduled visit with a hospice nurse on 1/14/2025. The nurse visited R1 on 1/14/2025 and had R1 transported to the hospital to be evaluated. Hospice was notified immediately when R1 expressed pain in R1s left arm and again when bruising and swelling was noticed. Facility staff were directed by Hospice staff to give R1 the prescribed pain medication and did not send a nurse to the facility as requested to evaluate R1. There was the delay as R1 had advised they were expressing pain. Although the facility did contact the hospice agency, the hospice agency advised they can’t come out until the next day and left R1 without medical care after expressing pain. It was not until the hospice agency came and then advised the facility to send R1 to the hospital. The facility should have sought further medical treatment since the resident was expressing pain. At the time of the complaint visit the licensee was informed that the incident is currently under review and a future civil penalty may apply based on Health and Safety Code § 1569.49. Based on interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8, is being cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Medical Technician Gloria Castro, whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Feb 21, 2026 · control 08-AS-20250116150125

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(1) · Plan of correction due date: Feb 22, 2026

(a) A plan for incidental medical and dental care shall be developed... (1)for medical and dental care appropriate to the conditions and needs of residents. This was not met as evidenced by: Based on interviews and records review, the facility did not meet the needs of R1 as there was a delay in sending R1 to get further medical treatment when R1 was expressing pain, which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Feb 21, 2026

Plan of correction: Staff will provide proof of scheduled incidental medical care in-service training with all staff within 24 hours to LPA via email. Training will be completed and submitted to LPA with sign-in sheet and training topic clearly noted via email by 02/24/2026.

Allegation investigated: Resident was sexually abused while in care Resident sustained unexplained injury while in care.

On 12/09/2025 at 3:00PM, Licensing Program Analysts (LPAs) J. Clancy-Czuleger meet virtually via Teams to deliver findings for the above allegations. LPA explained the purpose of the visit with Administrator Genoveva Guerrero. During the course of investigation, the Department conducted interviews with staff, the resident and Witnesses. On the allegation: Resident was sexually abused while in care. interviews were conducted with R1, staff member S1, and witness W1. Although R1 has a diagnosis of dementia, she was alert, able to answer questions, and able to engage in conversation. S1 reported that R1 underwent colon surgery due to colon cancer, and the procedure was successful. R1 returned to the facility with a colostomy bag on 3/19/2023, Continued on 9099C... Unsubstantiated ...Continued from 9099 and staff from St. Paul’s PACE provided nursing support to monitor her condition. According to S1, R1 disliked the colostomy bag and would occasionally pull on the tubing, causing leaks and soiling her clothing and bedding. R1 was no longer able to use the toilet independently and began wearing adult diapers (Depends) to prevent accidents. Shortly after R1 began using Depends, staff observed a rash developing around her vaginal area. During the interview, R1 did not report any concerns regarding staff or her own well-being. Facility staff and PACE nursing staff continued to monitor her condition. Based on the information available, there is insufficient evidence to conclude that the blisters or rash in R1’s vaginal area were the result of sexual abuse. On the allegation: Resident sustained unexplained injury while in care. Interviews and documentation indicate that the blisters observed on R1 were identified by facility staff and promptly reported to the PACE nursing team and W2. Following recent surgery, R1 returned to the facility with a new colostomy bag. According to S1, R1 often expressed discomfort with the colostomy bag and would occasionally pull on the tubing, causing leaks that contributed to skin irritation and the development of blisters. Facility staff and PACE nursing staff monitored R1’s condition. Based on the information obtained, there is insufficient evidence to conclude that R1’s injuries were the result of abuse or neglect. Therefore, the allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided via email.the state’s words, verbatim · CDSS document, Dec 9, 2025 · control 08-AS-20230428094732

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Janet Ngallo conducted an unannounced Case Management Visit. LPA was greeted by and met with Compliance Staff Gladys Vincent, to discuss the purpose of the visit. Facility Manager Genoveva Guerrero later joined the visit. Today's visit is in response to the self-reported death of Resident 1 (R1). R1 passed away on 11/17/2025. LPA conducted a wellness check at the facility and collected records for review; no health or safety issues were identified. No deficiencies were cited or observed on this date. An exit interview was conducted with Facility Manager Genoveva Guerrero who was provided with a copy of this report and Appeal Rights (LIC9056 03/22). Their signature confirms receipt of these documents.the state’s words, verbatim · CDSS document, Dec 3, 2025

Allegation investigated: Staff did not provide adequate supervision resulting in a resident's elopement and injury Staff did not provide resident’s records to resident’s authorized representative

On 9/26/2025, LPA Grace Donato conducted a telephone interview to the facility to deliver findings. LPA spoke with Genoveva Guerrero and explained the purpose of the call. Regarding the allegation of Staff did not provide adequate supervision resulting in a resident's elopement and injury, Reporting party (RP) stated that a resident (R1) was admitted 4-5 days prior to the incident and when admitted the facility was aware of R1’s history of dementia and his/her tendencies to flee. On 2/6/24, R1 exited through a staff door and no other details are known such as how far R1 went, how long R1 was missing, and who found R1. All that is known is that R1 managed to get on top of some rocks, fell and fractured R1s left wrist. During the course of the investigation, staff members were interviewed, photos obtained, and records were reviewed. page 1 of 3 Unsubstantiated S1 and S2 stated R1 was a very complicated resident. S1 stated R1 always said he/she had to leave the facility to go with R1s son and when staff would try and redirect R1, R1 would become upset and hit staff with a cane and say mean things to them in Spanish. S2 stated staff had to rotate constantly when dealing with R1 because they noticed R1 would become a bit calmer when R1 would see a new face and didn’t like dealing with the same staff member the whole day. On 02/06/2024, S1 was working his/her shift as a MedTech and preparing medications to pass out when S1 saw R1 walking toward the front door. S1 told R1 to not go outside, and R1 proceeded to walk out the front door acting like R1 didn’t hear what S1 said. S1 went after R1 but before doing so S1 needed to secure the medication cart and lock it before going outside. S1 said when R1 finally went out the front door, S1 told R1 to come inside, and R1 turned around and began swinging his/her cane toward S1. S1 said as R1 was swinging the cane facing S1, R1 was also walking backwards and suddenly R1 tripped over R1s own feet and fell to the floor landing on his/her left arm. S1 said she did a head-to-toe assessment on R1 and also called for help over the radio. S1 said R1 said he/she had no pain on his/her body or legs. S1 mentioned that S2 arrived and they helped R1 up onto a patio chair and that’s when R1 started complaining of wrist pain and S1 called S4 to come. S1 told me once S4 came, S4 decided to call 911 to get R1’s injuries further checked out and medics arrived and transported R1 to the hospital where R1 was later diagnosed with a fractured left wrist. S3 and S5, stated the complaint received about R1 eloping outside the facility is false. S5 stated the facility has a secure perimeter and staff knew R1’s whereabouts the whole time leading up to his/her fall. S3 added there are no rocks large enough to climb on facility grounds and there were no rocks near where R1 had a fall. Based on photos obtained, the facility has a facility fence preventing residents to go out of the facility without assistance. There were no rock formations that would make the residents climb and cause injury. Based on records review, according to resident appraisal dated 2/1/2024, R1 is able to ambulate with the help of a cane. page 2 of 3 For the allegation of Staff did not provide resident’s records to resident’s authorized representative, RP stated that a family member (F1) has requested information from the facility administrator and believes they are withholding information. In addition, F1 requested to view camera footage but was told that the cameras were not operational and is not being given full disclosure of the incident or full access to R1’s files. According to S3, on the day of R1s accident as well as the times F1 went to the facility, F1 asked how the incident occurred and each time F1 was told how R1 fell, and staff never avoided telling F1 anything. S3 stated no information was withheld from F1 and they had no reason to lie to F1 or not tell him/her what occurred. S3 said F1 asked for video surveillance of the incident, and they told him/her they didn’t have any footage of the fall because their cameras don’t record and are only live cameras. S3 said F1 never came to the facility asking for R1s admission agreement and if F1 did, they would have no problem giving it. S3 said a copy was provided to F1 at the beginning. S1 also added that days after the incident F1 came to the facility to collect R1s belongings and F1 had asked for a copy of R1s contract. S1 said at the time S3 and S4 were not at the facility and advised F1 that S1 couldn’t get a copy at the moment but if F1 came back when the managers were present, they will gladly provide that to F1. S1 said he/she even mentioned emailing or giving S4 a call regarding the contract and maybe S4 would be able to email it over. There were several attempts to contact RP and F1 but never received a response. Based on interviews, records review and observations, the department has determined that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Report is reviewed and a copy is provided. page 3 of 3the state’s words, verbatim · CDSS document, Sep 26, 2025 · control 08-AS-20240621145032

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced case management visit to follow-up on consultation provided during a required annual inspection on May 15, 2024. After identifying himself and explaining the reason for the visit, LPA was allowed into the facility. LPA met with Gladys Vincent, Compliance Analyst. During the visit, LPA toured the facility, inside and out, reviewed records and interacted with residents in care. No deficiencies were cited. An exit interview was conducted with Ms. Vincent. A copy of this report and Licensee Rights (LIC 9058/16) were provided to Ms. Vincent, and her signature on this form confirms receipt of the documents.the state’s words, verbatim · CDSS document, May 31, 2024

Type of visit: Required - 1 Year

Daniel Pena, Licensing Program Analyst (LPA) conducted an unannounced annual one year required inspection. LPA was greeted by Office Assistant, Gladys Vincent. LPA later met with Jeffery Settineri, Administrator and Genoveva Guerrero, Facility Manager. LPA introduced himself, explained the purpose of the inspection, and was allowed entry into the facility. Facility census was twenty-five (25) residents. The facility serves thirty (30) elderly residents; ages 60 years and above; all of whom may be non-ambulatory and five (5) of which may be bedridden. A tour of the facility was conducted inside and out. LPA, accompanied by Mr. Settineri and Ms. Guerrero, conducted a general overall inspection, which included, but was not limited to the following: physical plant, food service, facility administration, medication management, resident and staff records, resident rights, and activities. During today's inspection LPA observed the following: All indoor and outdoor passageways were free from obstructions. All bodies of water were observed to be in compliance with Title 22 regulations. Per Mr. Settineri, there are no firearms or other dangerous weapons stored in the facility. Facility layout is consistent with the Fire Clearance. LPA toured a sample of resident rooms and all had a bed, night stand, dressers, chairs and sufficient lighting available for residents. Licensee provided each resident with clean linen in good repair. All resident rooms had an operating signal system and individual pendants for resident use. The hot water temperature used by residents of the facility were measured to be within Title 22 regulation requirements. The facility had multiple functioning carbon monoxide detectors that met statutory requirements. The facility also had operating smoke detectors that met statutory regulations along with several operable fire extinguishers. The facility was stocked with a two day supply of perishable and seven day supply of nonperishable food items. The kitchen and dining areas were clean, in good repair, and there were no observable expired food items. Per Ms. Guerrero, the last fire drill was conducted on May 14, 2024. LPA was able to verify that physical medications in bubble packs and medication containers were being administered by physician's orders. LPA reviewed staff records and verified that all staff reviewed have the required Personnel Record, Criminal Record Clearance, TB clearance, Health Screening Report, and required training in their file. LPA reviewed resident records and verified that a current Physicians Report, Identification and Emergency Information, Admission Agreement, and Centrally Stored Medication and Destruction Record were in each resident's file. LPA conducted a sample of staff interviews which did not raise licensing concerns. Based on today's inspection, no deficiencies were observed. An exit interview was conducted, and a copy of this report was provided to Administrator Settineri. Administrator Settineri was provided a copy of their Licensee/Appeal Rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights.the state’s words, verbatim · CDSS document, May 15, 2024

Allegation investigated: Lack of supervision resulting in resident on resident abuse

Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced visit to conclude a complaint investigation and deliver findings regarding the above-mentioned allegation. LPA was met by Genoveva Guerrero, Manager, and was granted entry into the facility. LPA met with Ms. Guerrero and discussed the purpose of the visit. On 5/16/23, the Department received this complaint alleging, lack of supervision resulted in resident-on-resident abuse. Investigation consisted of interviews with pertinent residents, staff, and outside sources, record review, and LPA observations. Per an outside source, during the evening of 5/12/23, Resident 1 (R1) and other residents were in the dining room eating dinner. Resident 3 (R3) left the table to get a drink but was coming right back. Resident 2 (R2) came up and pulled out the chair where R3 had been sitting. R1 told R2 someone was sitting in that chair. R2 got mad and wouldn't go find another despite there were many open ones available. R1 stood up to get staff and R2 grabbed R1’s arm. R1 pulled away and had taken three steps when R2 hit R1 on the back with an open hand. Unsubstantiated Staff 1 (S1) arrived at the area and separated R1 and R2 and documented the event on an Incident Report. R1 complained of pain the next day but it subsided later that evening. Staff interviews indicated R1 received a fingerprint size bruise on their shoulder. The residents and others in the area were contacted for their observation. Most of the residents contacted had Dementia diagnoses and were unable to provide statements. R1 provided their account which is consistent with the allegation reported to CCLD. R2 provided a statement saying they were sorry for striking R1. R3 was interviewed and said they did not see the incident. When asked, R3 said they never witnessed any resident strike another resident during the time they lived at the facility. LPA contacted an outside agency regarding the incident. LPA asked the outside source if they observed concerns with a lack of supervision at the facility. The outside source reviewed their records and found no complaints or related visits regarding a lack of supervision. Records were reviewed, including staffing schedules. LPA found no evidence of staff shortages. Per Staff 2’s (S2) interview and staffing level record review, there were three staff working on the day of the incident. S2 said the shift was fully staffed. S2 conducted a post-action review of the incident and did not identify lack of supervision as a contributing factor. Per S2, S1 was in the dining area at the time of the incident. S2 said the altercation happened quick but S1 was able to respond and address it immediately. LPA asked S2 about the Incident Report submitted to CCLD. The report referenced counseling was provided. S2 said the term counseling referred to communication/training regarding R2’s updated care plan was disseminated to all staff. S2 said R2’s care plan was modified in response to R2’s change in behavior. LPA interviewed S1. S1 said they were in the area when the incident occurred. S1 witnessed R2 squeeze the area of R1’s arm. S1 observed no immediate markings but said a bruise appeared on R1, 2-3 days later. S1 was in the kitchen when they heard R1 yell. S1 responded to the scene immediately and redirected the two residents. S1 said they asked residents in the area what they observed but none of the residents reported seeing anything. S1 said neither resident required one-on-one supervision or had a history of aggressive behavior. S1 prepared the LIC624 report documenting the incident. The Department has investigated the allegation that lack of supervision resulted in resident-on-resident abuse. Based upon interviews with residents, staff, and outside sources, no corroboration or information was obtained to support the allegation. No evidence was obtained to prove the incident occurred due to a lapse in supervision by staff. The Preponderance of Evidence standard was not met. Therefore, the allegation is Unsubstantiated. An exit interview was conducted with Ms. Guerrero and a copy of this report was provided to Ms. Guerrero whose signature below confirms receipt of copies of this report and Licensee Rights (LIC 9058).the state’s words, verbatim · CDSS document, Apr 4, 2024 · control 08-AS-20230516113325

Allegation investigated: Licensee did not provide copy of admission agreement Licensee did not safeguard residents' belongings Licensee did not report resident's change in condition to responsible party

Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced facility visit to conclude a complaint investigation regarding the above-mentioned allegations. LPA identified himself and discussed the purpose of the visit and complaint conclusion with Genoveva Guerrero, Manager. On 5/25/2023, the Adult and Senior Care Regional Office received a complaint alleging; the licensee did not provide a resident’s representative with a copy of the admission agreement, did not safeguard a resident’s personal belongings and did not report a change in the resident’s condition to the representative. The Department’s investigation consisted of observations, interviews with pertinent staff and outside sources and facility record reviews. It was alleged, Resident 1's (R1) representative was not given a copy of the Admission Agreement. Record review show the representative signed all required pages of the agreement. Staff interviews indicate that the representative refused a copy on the day they signed the agreement. An outside source Unsubstantiated denied the representative refused to accept a copy. LPA confirmed with the outside source that the representative did receive a copy of the agreement but did not recall the date. As to the allegation the facility did not safeguard a resident’s belongings, LPA found insufficient evidence to prove this claim. LPA obtained a copy of R1’s LIC621 Resident Personal Property and Valuables. The document contained no entries. Per staff interviews, R1 had no personal property when they moved in. An interview with staff indicated that a relative of R1 took with them a bracelet on the day R1 moved into the facility. Staff interviews and records refute that R1 had property when they were admitted to the facility. Outside sources said they did not contact law enforcement to report a theft of R1’s property. Additionally, it was stated R1’s representative was not notified when R1 experienced a change in condition. Following two choking incidents which occurred in May 2023, an outside source claimed that the resident at times refused to attend medical appointments and would not go. The source stated that the resident also refused to be transported to the hospital following one of the choking incidents. The source stated that R1 would sign refusals of treatment but did not have the cognitive capacity. A review of R1’s records revealed appraisals and needs and services plans showing R1’s representative was notified when care plan changes were made. The Department has investigated the above-mentioned allegations and obtained insufficient evidence to corroborate them. The Preponderance of Evidence standard was not met. Therefore, the allegations are Unsubstantiated. An exit interview was conducted with Ms. Guerrero and a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to Ms. Guerrero and her signature on said documents confirms receipt of receiving them.the state’s words, verbatim · CDSS document, Apr 4, 2024 · control 08-AS-20230525113628

Allegation investigated: Medications were not given as prescribed.

Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to deliver investigation findings. LPA was granted entry into the facility and met with Jeffrey Settineri, Administrator, to whom she disclosed the reason for the visit. Community Care Licensing (CCL) has investigated the above-listed complaint allegation. The investigation consisted of a tour of the facility and interviews of facility residents and staff. It was alleged that on 4/27/2023, Resident 1 (R1) [LIC 811 Confidential Names List was provided to identify the resident and staff] was not given his/her evening medications. Interviews conducted during the investigation yielded that R1 was not administered two prescribed medications on the evening of 4/27/2023. There was no reason for the medications being missed, other than that staff did not administer the medications. Substantiated Accordingly, the allegation is substantiated. This finding means that the preponderance of the evidence standard has been met and the allegation is valid. The deficiency is cited in accordance with California Code of Regulations, Title 22, Division 6, Chapter 8 and noted on the attached LIC 9099-D. An exit interview was conducted with Jeffrey Settineri, Administrator, and copies of this report and Licensee/Appeal Rights (LIC 9058) were provided at the conclusion of the visit. Administrator's signature below serves as acknowledgment of receipt of copies of the report and rights. It was also reported that, on the same date, R3, who receives meal service and feeding in their room, was not served his/her dinner meal. Evidence obtained during the investigation did not yield evidence to corroborate either of the allegations listed above. Based on the foregoing, the allegations are unsubstantiated. This finding means that although the allegations may have happened or may be valid, there is not a preponderance of evidence to prove that the alleged violations occurred. An exit interview was conducted with Jeffrey Settineri, Administrator, and copies of this report and Licensee/Appeal Rights (LIC 9058) were provided at the conclusion of the visit. Administrator's signature on this report acknowledges receipt of copies of the rights and report.the state’s words, verbatim · CDSS document, Mar 28, 2024 · control 08-AS-20230501103744

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(c)(2) · Plan of correction due date: Apr 11, 2024

Incidental Medical and Dental Care. Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidenced by: Based on interviews, the licensee did not ensure that medication was administered according to physician’s directions to 1 of 26 residents (R1), which posed a potential health risk to persons in care.the state’s words, verbatim · CDSS document, Mar 28, 2024

Plan of correction: Administrator provided proof of medication training attended by staff in October 2023 and on January 19, 2024. Deficiency will be cleared during today's visit.