La Habra Plaza

Allegation investigated: Staff handle resident in a rough manner Staff are mismanaging medication

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced subsequent complaint visit to deliver findings for the above allegations. LPA was greeted and granted entry by staff at 8:15am. LPA met with Administrator (AD) Gerald Dia and explained the purpose of the visit. LPA reviewed the following documents for Resident #1 (R1): Medical Assessment dated 6/10/2026, Admissions Agreement signed and dated 6/11/2026, Letter of Agreement, Pre-Appraisal, Appraisal Needs and Services Plan, Facility Progress Notes and Medication Administration Records for July and August 2026. Resident #1 (R1) moved into the facility on 6/13/2026 per Admissions Agreement, into a shared room. R1 has a diagnosis of Congestive Heart Failure, Hypertension, Type 2 Diabetes, a history of Cerebral Vascular Accidents and Traumatic Brain Injury. R1 is non-ambulatory and uses a wheelchair; due to partial paralysis on one side of the body, and requires assistance with medications and Activities of Daily Living. (Continued on LIC 9099-C) Unsubstantiated (Continued from LIC 9099) It was alleged that Staff handle resident in a rough manner. On the evening of 7/10/2026 at 9:30pm, Resident #1(R1) repeatedly rang a bell for assistance. Per Progress Notes, Staff #1 (S1) entered R1's room and retrieved a remote control that was out of reach for R1. A second time R1 asked S1 to straighten the bed sheets. Upon S1 leaving the room, R1 slammed the door. A few minutes later, S1 returned to R1's bedroom to inquire what was wrong and if there was anything else needed and R1 began to yell expletives at the staff member. R1 then came towards S1 with the wheelchair, still yelling, and punched R1 in the lower abdomen. LPA obtained photos from the staff member, showing bruising on the lower abdomen. R1 then backed away, grabbed a Gatorade bottle and thew it at the staff member. Per Progress Notes, Staff #2 (S2) was in the bathroom and overheard the exchange. S2 attempted to calm R1. R1 notified the police and four La Habra Police Department (PD) officers arrived at 9:45pm. PD interviewed R1 and the staff. S1 showed PD where R1 had hit the staff member. PD asked staff if S1 needed to be assessed at Emergency Room or wanted to press charges and S1 declined. Officers stated R1 did not want contact with S1 but that the incident was resolved and no further action was needed. LPA requested two of two staff files which include: Personnel Record, Health Screening and Training Documentation. Staff trainings are current and included topics such as: Personal Rights, Medication, Agitation, and Elder Abuse Reporting. There were no employee action forms on file. LPA also interviewed three of four staff members. One staff member had recently began working at the facility and could not confirm nor deny the allegation. Three of four staff members denied the allegation and stated it was the resident who hit the staff member. Staff documented the incident and AD changed the staff schedule so that S1's work duties did not have contact with R1. Per interviews, R1 also apologized to the staff member several weeks later and S1 is now able to assist R1 with any needs. Thus the allegation that Staff handle resident in a rough manner is Unsubstantiated. LPA investigated the allegation that Staff are mismanaging medication. LPA audited R1's medications and obtained Medication Administration Records for July and August 2026. Per review, medications are being given as prescribed. LPA inquired if there were any instances where the wrong medication was provided; which caused R1 to have loose stools. Three of four staff interviewed denied this occurred. In May 2026, the (Continued on LIC 9099-C1) (Continued from LIC 9099-C) Department investigated another resident allegation regarding Staff are not providing residents with their medications as prescribed; which was Unsubstantiated. LPA also interviewed four of four residents, three of four staff and two of two witnesses. One of four residents stated the medication issues were resolved, one of four residents confirmed the allegation and two of four residents denied the allegation. LPA interviewed three of four staff members. Three of four staff members denied the allegation that Staff are mismanaging medication One staff member could not confirm, nor deny the allegation. LPA interviewed two of two witnesses who stated they have not witnessed staff giving residents incorrect medications. LPA observed two of two staff obtained eight hours of medication training from 5/30-6/2/2026 and there were no employee action forms on file. Based on LPA's file review, interviews and observations, the allegations that Staff handle resident in a rough manner and Staff are mismanaging medication are Unsubstantiated. The allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was provided to Administrator (AD) Gerald Dia and a copy of this report and LIC 811s, were provided to the facility.the state’s words, verbatim · CDSS document, Aug 25, 2026 · control 22-AS-20260731160501

Allegation investigated: Facility bathrooms are in disrepair

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to investigate a complaint received in the Regional Office. LPA was greeted and granted entry by staff at 8am. LPA met with Administrator (AD) Gerald Dia and explained the purpose of the visit. During the visit, LPA toured two of two resident bathrooms. Per LPA's observations, one bathroom had a grab bar, located near the toilet, attached to the wall with duct tape. LPA interviewed four of four residents, four of four staff members and one witness. Three of four residents confirmed the bathroom has had duct tape, one resident does not use the bathroom. Four of four staff members acknowledged the grab bar was affixed to the wall with the duct tape and that the owner of the property had not attached the grab bar to the studs in the wall. Based on LPA's observations and interviews, the preponderance of the evidence standard has been met. The allegation that the facility bathrooms are in disrepair is Substantiated. An exit interview was conducted with AD Gerald Dia and a copy of this report, LIC 9099-D and Appeal Rights were provided to the facility. Substantiatedthe state’s words, verbatim · CDSS document, Aug 7, 2026 · control 22-AS-20260731160501

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(e)(4) · Plan of correction due date: Aug 8, 2026

Maintenance and Operation (e) Water supplies and plumbing fixtures shall be maintained as follows: (4) Grab bars shall be maintained for each toilet; bathtub and shower used by residents. This requirement is not met as evidenced by: Based on LPA's observations and interviews, grab bars in one of two bathrooms is secured next to the toilet with duct tape. This poses an immediate health and safety risk for all residents in care.the state’s words, verbatim · CDSS document, Aug 7, 2026

Plan of correction: AD stated this will be repaired today. LPA requested AD email photos of repaired grab bars.

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Gerald Dia and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 3:30PM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 5-bedroom, 2-bathroom, one-story house with a detached garage that is used as an office. There is a back yard with a patio cover for the residents. LPA observed 2 staff and 4 residents present at the facility in addition to AD. Resident Bedrooms: the 4 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the staff bedroom. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 114 degrees F in the resident bathroom. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the laundry room. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees have been paid. At about 1:45PM, LPA reviewed 4 resident files and 3 staff files, interviewed 2 residents and 2 staff, and inspected medications for 4 residents. Facility does not handle resident money. During the inspection, LPA and AD observed the following: based on observation, the front door has an internal chain lock at the very top of the door out of reach of all residents, effectively locking residents inside, and LPA observed the chain lock was used during the inspection; based on observation, the facility was not clean, with stains on the walls, sticky floors, debris on the floor, black staining on kitchen drawers and cabinets, especially in the kitchen; based on records and admission, S2 does not have 8 hours of continuing medication training and S3 does not have 10 hours of initial medication training, and both administer medications; based on documents, the physician's reports for R1 and R2 are on the old form and do not contain required information, including behavioral expressions; and based on documents, R1 does not have an appraisal and R2's appraisal is more than a year old.. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Immediate civil penalties are being assessed. See LIC421IM. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, May 29, 2026

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Gerald Dia and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 8:30AM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 5-bedroom, 2-bathroom, one-story house with a detached garage that is used as an office. There is a back yard with a patio cover for the residents. LPA observed 2 staff and 4 residents present at the facility in addition to AD. Resident Bedrooms: the 4 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the staff bedroom. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested between 110 and 112 degrees F in the 2 resident bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the laundry room. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are not yet due. At about 9:30AM, LPA reviewed 4 resident files and 3 staff files, interviewed 2 residents and 2 staff, and inspected medications for 3 residents. Facility does not handle resident money. During the inspection, LPA and AD observed the following: based on documents, the facility does not have an infection control plan; based on observation, the facility's fire extinguishers have not been inspected in approximately two years; based on observation, the licensee did not ensure two out of two showers had non-slip mats; based on observation, the licensee did not ensure approximately a dozen supplements were inaccessible to residents in the non-lockable staff bedroom and sharp tools were inaccessible in the non-lockable laundry room; based on documents and admission, the licensee did not ensure 2 out of 3 staff had staff files; based on Guardian records, staff Jan Massie is background cleared but is not associated to this facility; and based on documents, the licensee did not ensure 3 out of 3 staff had documented medication training. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, May 12, 2025

The state marks this report as 8 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 7/22/2024, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced visit to the facility for a required annual inspection. LPA was greeted and granted entry by Caregiver, Jan Daniel Massie who was informed of the purpose of the visit. Administrator, Gerald Dia was present and was also informed of LPA's visit. The facility has a fire clearance for six (6) non-ambulatory elderly residents and an approved hospice waiver for six (6). LPA toured the facility with Administrator Dia and observed the facility is made up of a one-story home with four (4) resident bedrooms, two (2) bathrooms, a staff room, kitchen and dining room. During the tour, Administrator Dia tested one (1) of the smoke alarm/carbon monoxide detectors and LPA observed it to be operational. LPA also observed a charged fire extinguisher mounted in the kitchen. Indoor and outdoor passageways were free of obstruction. The facility has outdoor shaded seating for the residents in care. There were no bodies of water observed on the premises. Medications are secured in a locked kitchen cabinet. Resident bedrooms had the required furniture and lighting. The hot water temperature in the resident bathrooms measured at 105- and 109- degrees Fahrenheit. The facility had a 2-day supply of perishable foods and 7-day supply of non-perishable food items. Staff present have a criminal record clearance and valid first aid/CPR certification. During the visit, LPA requested to review resident files and Administrator Dia reported some files were incomplete. Upon review, LPA observed the files for Resident 1, Resident 2, and Resident 3 only contained signed admission agreements and there were no records for Resident 4. Resident 5 and Resident 6 had complete records on file. During the facility's file review, LPA noted the facility is not current with their annual fees. As a result the facility will be cited pursuant to California Code of Regulations, Title 22. An exit interview was conducted where this report was reviewed and provided to Administrator Dia along with LIC9099-D, Confidential Names List (LIC811), and Appeal Rights.the state’s words, verbatim · CDSS document, Jul 22, 2024