Jan-Roy Place of Fresno 2

Type of visit: Required - 1 Year

On 09/4/26, Licensing Program Analysts (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit and request to meet with Administrator. LPA was greeted by staff Florita Gabriel. Care Coordinator (S1) Anamarie Gregorio was called and shortly during visit. Administrator Joycelyn Hopper was called, stated unavailable to attend meeting, and authorized Care coordinator to sign and receive the report. LPA toured facility with S1. Five resident were present upon arrival. XX1 left to day program during inspection. The facility was observed to be at a comfortable temperature at 75 degree F, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. A non-audio surveillance camera was observed in dining room. Fire extinguisher was observed with a service date of 11/24/25. Temperature maintained for refrigerator at 42 degrees F and freezer at -2 degrees F. 2 day perishable food and 7 day non-perishable food were observed. Cleaning supplies observed locked under kitchen sink. All bedrooms were observed to have required furnishings and with adequate lighting. Bathrooms toured and observed with securely fastened grab bars and non-skid mat. Hot temperature tested to be maintained at 111.7 degree F. Outside of facility toured and observed to be free of debris. Adequate outdoor seating is available for residents. Side gate observed self-closing. Carbon monoxide and smoke detectors were tested and observed to be operational. Medications observed locked in hall closet. MARs were reviewed and medications were checked. Half of the residents’ and a sample of staff files were reviewed to have all required documents. A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6 see attached 809D. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 09/10/26. Forms requested: Lic 308, Lic 500, Lic 610E, and current liability insurance. A copy of this report and appeal rights were provided to the S1, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Sep 4, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(6) · Plan of correction due date: Sep 7, 2026

87465 (h)(6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: This requirement is not met as evidenced by: Based on interview conducted, observation, and records reviewed, R1’s current Escitalopram medication filled on 08/5/26 was not recorded in Centrally Stored Medication (Lic 622) record, poses/posed a potential health and safety and personal rights risk to the resident in care.the state’s words, verbatim · CDSS document, Sep 4, 2026

Plan of correction: Staff recorded medication into Lic 622 during visit. POC cleared.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Katie Brown is conducting a Case Management in conjunction with a complaint visit. LPA met with and explained the reason for the Case Management with Resident Care Coordinator (RCC) Ana Marie Gregorio. RCC informed Administrator, Joycelyn Hopper of the visit. Complaint control Number 24-AS-20260707123850 During the course of the complaint investigation noted above, LPA discovered the following deficiencies. 1. A record review and medication audit was conducted in conjunction with a complaint for Resident (R1). The record review revealed that the order, according to the prescription label has not been followed. This has resulted in the medication not being given as ordered. 2. During resident record reviews, LPA noted that R2's Physician Report is dated 12/16/2021. In this report, R2's Physician has checked MCI. R2 needs to have a reappraisal and Physician Report updated. Deficiencies are being cited in accordance with California Code of Regulations on the attached LIC 9099-D. An exit interview was conducted and Plan of Correction was developed. A copy of this report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Jul 13, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87463(a) · Plan of correction due date: Aug 3, 2026

87463 Reappraisals (a) The pre-admission appraisal…. as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate… This requirement was not met as evidenced by: Licensee did not ensure R2's Physician Report was updated as required. R2's Physician report dated 12/16/21 states R2 has MCI. R2 has not had a Reappraisal or Physician Report updated since 12/16/2021. This poses a potential health & safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 13, 2026

Plan of correction: RCC has agreed to obtain an updated and accurate Physicians Report for R2. The Physician's Report will be submitted to CCL by POC date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(4) · Plan of correction due date: Jul 14, 2026

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care.... (4) licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Licensee did not ensure R1 was assisted self-administered medications as needed. Review of MAR and PRN Logs reveal between 7/1-7/13/26 R1 was given MAPAP 500 mg at 8am & 12pm daily. The medication label and MAR read the MAPAP can be taken every 6 hours but was given after 4 hours. This poses an immediate health & safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 13, 2026

Plan of correction: RCC immediately removed the MAR and PRN logs. A revised PRN log was placed. Staff were inserviced during the visit. DEFICIENCY CLEARED DURING THE VISIT.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Licensee, Joycelyn Hopper, Continual Administrator's Certification expires 05/31/2026. There are currently 2 residents who reside at this home and there is 0 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable. Smoke alarms were tested and are operational. The home has a carbon monoxide detector. Water temperature was tested at 119 degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. LPA reviewed the facility Infection Control Plan, Emergency Disaster Plan, Fire drills, Plan of Operation, both resident files, and two staff files. LPA observed the facility fire extinguisher is not within the safety regulation period. Resident 1 and resident 2's needs and service's plan has not been updated as annually as required. The facilities Emergency Disaster Plan and Infection control plan has not been marked as reviewed annually as required. The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22. LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing. Exit interview conducted with Licensee, Joycelyn Hoppe, and copy of report left at facilitythe state’s words, verbatim · CDSS document, Nov 24, 2025

The state marks this report as 9 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Allegation investigated: Staff did not ensure proper supervision was provided to resident in care.

An unannounced Complaint visit was conducted by Licensing Program Analyst (LPA) K. McClurg. LPA met with CareGiver (CG) Augusto Arroyo. LPA greeted CG, introduced self, stated purpose of visit, provided business card, & was allowed entry. LPA was joined during visit by Care Coordinator (CC) Ana Marie Gregorio. Incident regarding Former Client (FC) discussed. It was confirmed that an incident occurred where FC was dropped off at health services location. FC wandered away from area unobserved. Fresno PD contacted. FC located in another part of town. Client was known to occasionally wander & it was indicated they were not to leave the facility unassisted. When client was located, they were observed to be confused & disoriented. No known physical injuries as a result of this incident. The Department has investigated the above allegation & determined it to be SUBSTANTIATED. DEFICIENCY ISSUED. Exit interview conducted with CC. Report provided. Substantiatedthe state’s words, verbatim · CDSS document, Jun 24, 2025 · control 24-AS-20250311155806

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(2) · Plan of correction due date: Jun 25, 2025

Incidental Medical and Dental Care. The licensee shall provide assistance in meeting necessary medical and dental needs. Client with tendency to wander was dropped off unassisted @ care services location. C1 did wander away & Fresno PD were contacted. C1 located in another part of town. This violation poses an immediate risk.the state’s words, verbatim · CDSS document, Jun 24, 2025

Plan of correction: CC agreed to submit a plan of facility protocol for accompanying clients & providing assistance for medical & dental needs. Plan should include training & date training will be conducted. To be submitted to LPA by due date. Failure to submit timely may result in Civil Penalties.

Allegation investigated: Staff did not ensure that medications were inaccessible to clients. Staff did not seek medical attention for client in a timely manner

An unannounced Complaint visit was conducted by Licensing Program Analyst (LPA) K. McClurg. LPA met with CareGiver (CG) Augusto Arroyo. LPA greeted CG, introduced self, stated purpose of visit, provided business card, & was allowed entry. LPA was joined during visit by Care Coordinator (CC) Ana Marie Gregorio. Previous incident was reviewed with CC during this visit. Emergency services not contacted directly after discovery of medication with C1. See below. Facility personnel found Client 1 (C1) with medications belonging to an unknown person. Could not determine where medication had been obtained. Rx: Amlodipine 10mg. Medications removed from Client 1 & secured. Personnel could not determine if C1 had taken any of medication. Medications origin unknown as name on prescription did not belong to any facility staff, current clients, or former clients. However due to the fact that during this visit medications to be were observed to be unlocked, the allegation has been Substantiated. The above allegations were investigated by the Department & determined to be SUBSTANTIATED. DEFICIENCIES ISSUED. Exit interview conducted with CC. Copy of report provided. Substantiatedthe state’s words, verbatim · CDSS document, Jun 24, 2025 · control 24-AS-20250615224327

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(2) · Plan of correction due date: Jun 25, 2025

Incidental Medical and Dental Care. Centrally stored medicines shall be kept in a safe & locked place not accessible to persons other than employees... C1 observed to be in possession of medication belonging to persons unknown. Origin unknown. However medications observed to be unlocked & accessible during this visit. This violation poses an immediate risk to clients.the state’s words, verbatim · CDSS document, Jun 24, 2025

Plan of correction: CC agreed to submit updated facility policy with subsequent plan when policy will be updated, including specific date for facility staff training. Copy of plan to be submitted to LPA by due date. Failure to submit on time may result in Civil Penalty

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(g) · Plan of correction due date: Jun 25, 2025

Incidental Medical and Dental Care. The licensee shall immediately telephone 911 if an injury or other circumstance has resulted in an...threat to a resident’s health... Facility did not contact &/or notify emergency services, medical personal, or poison control after finding C1 in possession of Rx & unknown if C1 had taken any of Rx. This violation poses an immediate risk to residents.the state’s words, verbatim · CDSS document, Jun 24, 2025

Plan of correction: CC agreed to submit updated facility policy with subsequent plan when policy will be updated, including specific date for facility staff training. Copy of plan to be submitted to LPA by due date. Failure to submit on time may result in Civil Penalty

Type of visit: Required - 1 Year

An Annual visit was conducted by Licensing Program Analyst (LPA) K. McClurg. Physical Plant toured. Kitchen appeared to be clean & organized. Knives & cleaning products in separate locked areas making inaccessible to residents. Sufficient supply of perishable & nonperishable food on the premises. Dining & living room sufficiently furnished. Furnishings appeared to be in good repair. Sufficient lighting. Resident bedrooms appeared to be sufficiently furnished with items in good repair & adequate lighting. Linens on beds & additional supplies available as needed. Resident bathroom appeared & smelled to be clean with no unpleasant odors. Fixtures operational. Grab Interior passageways & exits observed to be clear with no obstructions, including exit door in each resident bedroom. Smoke & carbon dioxide detectors operational Medications observed to be inaccessible to clients & organized. Medication Administration Records (MARs) & Centrally Stored Medication & Destruction Records (CSMDRs) documentation completed & maintained. Resident files maintained. Staff files maintained. Exit interview conduced with AA. Report provided.the state’s words, verbatim · CDSS document, Oct 31, 2024

Type of visit: Required - 1 Year

An unannounced Annual visit was conducted on the date & time indicated above by Licensing Program Analyst (LPA) K. McClurg. LPA met with CareGiver (CG) Augusto Arroyo. LPA introduced self & was allowed entry into facility. CG called Assistant Administrator (AA) Kirgil Roy Mendoza. LPA spoke with AA over phone explaining purpose of visit. AA unable to join LPA facility, therefore CG was verbally authorized to sign for receipt of report. AA was able to join LPA @ facility @ later end of visit. Facility toured. Kitchen observed to be relatively clean, with sufficient amount of plates, glasses, utensils, etc. Refrigerator & Freezer @ appropriate temperatures, & observed to be relatively clean. Garage toured. Freezer in garage @ appropriate temperatures, & observed to be relatively clean. Small refrigerator in garage observed containing medications that were accessible with no lock on appliance, & garage is accessible as door from kitchen to garage is able to be locked/unlocked from inside facility. Small refrigerator with medications moved to locked room @ time of visit. Resident rooms toured. West bedroom @ front of facility had lamp with no lampshade & a chest of drawers was missing a bottom drawer & in further disrepair. Bathroom had grab bars in toilet & shower/tub areas. Outside toured. Lawn mower observed accessible. Mower removed @ time of visit. Interior & exterior passageways observed to be clear with no obstructions. Facilty appeared to be relatively clean with no unpleasant odors. Fire extinguisher service date: 6/19/23. Deficiencies issued. Type A citations (2) were corrected @ time of visit. LPA contacted AA regarding citations & created plans of correction. AA stated that they would join LPA @ the facility shortly. AA arrived @ facility towards end of visit. Exit interview conducted with AA. Report provided.the state’s words, verbatim · CDSS document, Dec 27, 2023