House of Hope

Allegation investigated: Staff do not notify the residents' responsible party of a change of condition. Staff do not assist residents' with ADL's Staff did not allow a resident to eat food. Staff do not conduct group acitivites for residents'

On 04/30/26, Licensing Programming Analyst (LPA) Jewel Baptiste conducted a subsequent complaint visit to the facility. Upon arrival, LPA met with Direct Support Professional (DSP)Veronia Navarro, who contacted Viviana Renaga (Administrator) and explained the purpose of the visit. At 9:35 a.m., Viviana Renaga (Administrator) arrived and assisted with the visit. During the previous visit on 4/07/2026, LPA obtained the resident roster, staff roster, activities calendar, two (2) physician reports for R1, Photo of R1 hospice contact information, R1 identification and emergency information, R1 needs and service plan, R1 admission agreement, R1 preplacement appraisal, R1 hospice physician’s orders, R1 Responsible party confirmation, Staff notes, Incident report dated 4/01/2026, Healing care hospice sign in sheet, and hospice visit documentation. LPA also reviewed the food supply with DSP Silvia. LPA interviewed the administrator and three (3) staff members, who shall be referred to as Staff #2 through Staff #4 (S2-S4). LPA also interviewed a total of 5 residents who shall be referred to as resident#2 through resident #6 (R2-R6). Report continued on 9099c Unsubstantiated Prior to the visit, LPA interviewed Resident #1(R1) and staff#1(S1). LPA interviewed two family members of R1, a Hospice Nurse, a Cal Aim placement coordinator, and a Family friend of R1, who shall be referred to as W1 through W5. The investigation reveals the following: Regarding "Staff do not notify the residents' responsible party of a change of condition," it is alleged that the facility failed to inform R1’s responsible party when R1 fainted. According to the Administrator, R1 fainted twice: the first time, R1 was admitted to the facility, and the family was updated; the second incident sent R1 to the hospital. Both times, R1’s family was notified. W1 stated that R1 fainted about 3-4 times and that each time they were under the impression that the family knew. R1’s responsible party believes that R1 doesn’t faint but gets long-winded whenever moving a certain distance. Staff interviewed stated that it was 2-3 times R1 had fainted, and each time Hospice and family were notified. They further stated that there was never any change in R1's condition. The investigation reveals the following: Regarding "Staff do not assist residents with ADLs," it is alleged that the facility does not assist R1 with baths when hospice is not present. LPA interviewed the Administrator, who stated that the facility provides R1 with a bath as needed and that hospice comes twice a week to provide a bath. All staff interviewed stated they have always assisted R1 with ADL’s, including bathing as needed. All residents stated the facility provides them with a proper bath and brief changes. W1 stated that whenever they are at the facility, R1 is always clean. The investigation reveals the following: Regarding “Staff did not allow a resident to eat food," it is alleged that S1 did not allow R1 to eat the ice cream provided by W2. LPA interviewed the Administrator, who stated that they are unaware of the incident. All staff interviewed denied the allegation, stating that they had never withheld food from the residents. 5 out of 6 Residents denied the allegation. S1 denied the incident ever happened. R1 stated they do not remember the incident. Report continued on 9099c The investigation reveals the following: Regarding “Staff do not conduct group activities for residents'., it is alleged that facilities do not provide activities for the residents. The administrator and staff stated that they provide residents with activities such as puzzles, cards, dancing, music, the lottery, and spa treatments. 3 out of 6 residents stated the facility provides activities. 1 out of 6 residents stated there were no activities. 1 out of 6 residents stated there were activities but chose not to participate. 1 out of 6 residents is unsure if they did activities. LPA received/reviewed the activities calendar provided by the facility. Based on LPA's interviews, investigation revealed: Although the allegations 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 with Administrator/ A Copy of the Report Issued. Prior to the visit, LPA interviewed Resident #1(R1) and staff#1(S1). LPA interviewed two family members of R1, a Hospice Nurse, a Cal Aim placement coordinator, and a Family friend of R1, who shall be referred to as W1 through W5. The investigation reveals the following: Regarding " Staff do not provide residents with adequate food service," it is alleged that R1 has lost significant weight over the past three months. The Administrator and staff stated that all residents eat 3 times a day with snacks in between. All 5 residents confirmed that they were provided with adequate food. LPA received pictures of R1's food from the administrator and family members. The food described in the photo was a sandwich and a bowl of shredded chicken. LPA reviewed R1’s physician’s report and confirmed R1 is on a puree texture, No Added Salt (NAS), and Consistent Carbohydrate (CCHO) diet. The food R1 was receiving did not align with the diet that was ordered by the physician. The investigation reveals the following: Regarding " Staff refused to accept the resident back to the facility," it is alleged that the facility refused to accept the resident back from the hospital. The Administrator stated they did not take the resident back because the resident requires blood sugar checks, and the facility is not equipped to manage their medication. The Administrator did not consult with Licensing nor follow the process for a resident needing a higher level of care. Based on LPA observations, interviews, and file review, the preponderance-of-the-evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, is being cited on the attached LIC9099D. Exit Interview Conducted with Administrator/ Appeal Rights Provided / A Copy of the Report Issued.the state’s words, verbatim · CDSS document, Apr 30, 2026 · control 28-AS-20260403133657

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(b)(7) · Plan of correction due date: May 21, 2026

87555 General Food Service Requirements (b) The following food service requirements shall apply:(7) Modified diets prescribed by a resident's physician as a medical necessity shall be provided. This requirement was not met as evidence by: Based on observation, photos and file review the facility was not providing R1 with a puree diet, which poses an potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 30, 2026

Plan of correction: The facility agrees to provide staff traing on regulation 87555 and a copy of the training records will be sent to LPA by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.682(i)(1) · Plan of correction due date: May 21, 2026

(i) Nothing in Section 87224 precludes the licensee from initiating the urgent relocation to a licensed health facility of a terminally ill resident receiving hospice services when the resident's condition has changed and a joint determination has been made by the Department, the resident or resident's health care surrogate decision maker, the resident's hospice agency, a physician, and the licensee, that the resident's continued retention in the facility poses a health and safety risk to the resident or any other facility resident. (1) The licensee shall follow the procedures specified in Section 87637(b)(2) to reduce the risk of This requirement was not met as evidence by:the state’s words, verbatim · CDSS document, Apr 30, 2026

Plan of correction: Based on interviews the facility did not take pick up R1 and followed the process of a resident needing a higher level of care, which poses an potential health, safety or personal rights risk to persons in care. The facility agreed to construct a plan of action outlining what they wil do when ever they are faced with this situation. The plan will be sent to the LPA by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced annual inspection visit on 12/08/2025 and was greeted by Caregiver Silvia Heredia. LPA Ramirez identified herself and explained the purpose of the visit. The facility is located on a residential street and is a single-story 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 three (3) 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 shower. LPA Ramirez observed no-slip coating in showers. LPA Ramirez observed seated shower chairs in bathrooms. During resident record, LPA Ramirez discovered that the facility currently has three (3) hospice residents. The facility license is approved for two (2) hospice residents only. LPA Ramirez will issue a Type B deficiency based on this record review. 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. 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 pantry. During record review, LPA Ramirez did not observe quarterly emergency drills. According to Administrator Reynaga, the emergency drill logs were temporarily boxed up due to cosmetic renovations in the facility. LPA Ramirez will issue a Type B deficiency based on this record review. 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. Knives, sharps or other items that could pose a danger to residents with dementia, were observed to be inaccessible. Auditory devices were observed to be in working order. Health Related Services/Incidental Medical Services: The medications are centrally stored in the medication closet and in bubble packs and/or original containers. LPA Ramirez observed Centrally Stored Medication and Destruction Record. The facility provides incidental medical services. Staffing: Administrator Certificate for Viviana Reynaga is currently pending renewal and expired on 10/19/2025. 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 two (2) out of the two (2) personnel record reviewed. LPA Ramirez observed TB testing results, Health screening, fingerprint clearance and job application for two (2) out of the two (2) personnel record reviewed. Infection Control: Staff 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 five (5) residents over the age of 59 years old of which four (4) may be non-ambulatory and one (1) bedridden. This facility may retain no more than two (2) hospice residents. Resident Records/Incident Reports: LPA reviewed resident records for five (5) residents in care. Resident records 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. During resident record review, LPA Ramirez did not observe a medical assessment for R5. LPA Ramirez will issue a Type B deficiency based on this record review. Three (3) deficiencies were observed and cited during this complaint investigation. Exit interview was conducted. A copy of this report, 809-D and appeals rights was emailed due to printer out of ink.the state’s words, verbatim · CDSS document, Dec 8, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Daniel Konishi conducted a required unannounced annual inspection using the Inspection Tool. LPA met with the Administrator, Viviana Reynaga and the purpose of the visit was discussed and assisted in the tour of the facility. The following (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Resident Rights/Information, Planned Activities, Food Service, Health Related Services, Incident Medical and Dental, Disaster Preparedness, and Emergency Intervention. Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. LPA observed that the facility has an infection control plan in place. Physical Plant/Environment Safety: LPA conducted a tour of the facility and observed the following: The facility is part of a single-story home located in a residential area and contains the following: living room, dining room, kitchen with refrigerator, oven, stove, dishwasher, sink/faucet, (3) resident rooms, (2) bathroom for residents, toilet and washbasin. A back yard with shaded area and seating for resident use. There’s a laundry area; with washer and dryer. All passageways, walkways, driveway, steps and patio are free from obstructions. The front, back and side areas of the house are free of hazards. Hallway linen closet: Contained plenty of linens, towels, and hygiene products. Beds have the required furniture including bedframes, dressers, lamps, night stands, and sofas. Beds have the required linen and the linen is in good condition. Fire extinguisher was observed in the dining room last reviewed 02/07/2024. Physical Plant/Environment Safety [Cont.]: Carbon monoxide detectors are tested and in working condition. Cleaning supplies are kept locked in the hallway away from food supplies. Sharps are kept locked in a kitchen drawer. Shared resident bathrooms were observed to be clean and contained soap and paper towels. Water temperature in this bathroom#1 was measured at 132.5 degrees F and Bathroom #2 was measured at 132.6 degrees F which is in not between the required 105 – 120 degrees Regulations. Operational Requirements: Fire clearance was approved by LA County Fire Department for four (4) non-ambulatory and 1 bedridden. Approved Hospice Wavier for 2. Liability Insurance is confirmed and currently on file. Resident Rights/Information: Residential Care Facility for the Elderly Complaint Poster (PUB 475) posted on the wall. Residents’ Personal Rights posted on the wall. Facility provides internet access for residents. Staffing: A total of three (3) full-time staff members provides care and supervision to the residents. Personnel Records/Staff Training: Administrator’s certificate is active and effective through 02/14/2025. Four (4) staff files were reviewed for criminal background clearance and training. Personnel records have health/TB screenings, employee rights, certifications, and 1st Aid/CPR training. Based on record review, LPA observed Staff #1 (S1) to Staff # 3 (S3) does not have valid 1st Aid Training in file. Planned Activities: Facility has sufficient space to accommodate indoor and outdoor activities that are easily accessible. Incident Medical and Dental: Residents are assisted with self-administration of prescription and non-prescription medications. Four (4) centrally stored resident medication records were reviewed. Centrally stored medications are kept in a safe and locked place not accessible to residents in care. Medications are given according to Physician directions. All residents have a Needs and Services Plan, and COVID-19 vaccination cards on file. Staff training was on file. Resident Records/Incident Reports: Four (4) resident files were reviewed containing admission agreements, Identification and Emergency Information, Physician's Report, medical/functional assessments, Appraisal/Needs and Services Plans, TB clearance, Pre-placement Appraisal, personal rights, and medication records. However, based on record review, LPA observed Resident # 2 (R2) negative TB test results not in file. Disaster Preparedness, and Emergency Intervention: A posted Emergency Disaster Plan LIC 610D containing emergency evacuation information was observed. An emergency drill was conducted in 07/07/2024. No manual restraints or seclusion are used with residents in care. Residents with Special Health Needs: The facility is free from odors of incontinence. Currently, one (1) resident is on hospice care and one (1) resident is on home health. Bed rails for mobility assistance were observed in some resident beds but no physician order R2's files. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC809-D. Exit Interview conducted and a copy of the report with appeal rights were provided to the Administrator Viviana Reynaga.the state’s words, verbatim · CDSS document, Dec 5, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angelica Rea conducted an unannounced visit for the purpose of conducting the Required annual inspection. On today's visit LPA met with Administrator, Viviana Reynaga assisted with the visit. LPA Rea discussed infection control practices with Ms. Reynaga, toured the facility inside and out, reviewed food supply, reviewed staff files, and reviewed resident medications. Bedrooms have the required furniture including bedframes, dressers, lamps and chairs. Beds have the required linen and the linen is in good condition. Passageways and exits are free of obstruction. The front and backyard are well maintained. The resident bathroom is clean and have the required grab bars in the shower and near the toilet for non-ambulatory residents. Showers also have non-skid materials. The hot water temperature measured at 110.6 degrees F. The facility temperature at the time the visit was comfortable. There is sufficient lighting throughout the facility. There are smoke detectors/carbon monoxide detectors located throughout the facility, tested and operating. Sufficient PPE supplies observed. Per California Code of Regulations, Title 22, and California Health and Safety Code, no deficiencies cited. Exit interview held and a copy of the report provided to Ms. Reynaga.the state’s words, verbatim · CDSS document, Feb 7, 2024