Long Life Living Inc. II

Allegation investigated: Lack of staff supervision resulting in resident sustaining a fracture while in care Staff did not address resident's fall risk

At approximately 8:55AM, Licensing Program Analyst arrived unannounced at the facility met with Administrator, Justine Herrera. The purpose of the visit was to close a complaint investigation regarding the above allegations. Complaint investigation was opened in error under the wrong facility number, as the resident indicated in the complaint report does not reside at this facility address. Based on record review and observations made, these allegations are Unfounded. A finding of Unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents. Unfoundedthe state’s words, verbatim · CDSS document, Jun 9, 2026 · control 21-AS-20260601221435

Type of visit: Required - 1 Year

At approximately 12:55PM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a 1-Year Required Visit and met with Administrator, Justine Herrera. Facility serves residents with dementia and has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and total capacity for 6 non-ambulatory residents of which 1 may be bedridden. Facility has an approved hospice waiver for 4 individuals. Upon arrival, LPA was informed that there were 6 Residents in care and 2 staff members on-site. At approximately 1:10AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPA conducted a walk-though of the facility with Administrator and observed the following: Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility is a 1 story building with 6 Resident bedrooms, 3 bathrooms, and common spaces. Facility had emergency lighting. Facility had an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for Residents. Mattress pads were in place or available for Resident use. Toxins were observed to be stored inaccessible to Residents. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit. Fire extinguishers were last inspected July 2025. Smoke detectors and carbon monoxide detectors were tested and operational. Facility's last emergency/disaster drill was conducted June 2025. LPA reviewed staff files, resident files and resident medication. All files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid and CPR certification. Medication was observed to be centrally stored and secure. Administrator's Certificate for Justine Herrera (7027363740) was current with an expiration date of 10/23/2027. Continued on LIC809 Continued from LIC809 LPA requested the following documents to update facility file: Designation of Facility Responsibility (LIC308) Emergency Disaster Plan (LIC610E) Updated Personnel Report (LIC500) Updated Liability Insurance Active and Current Administrator Certificate Documents to be submitted to Community Care Licensing (CCL) by due date of 10/04/2025. No Deficiencies Cited during Visit. Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Sep 4, 2025

Type of visit: Required - 1 Year

At approximately 9:15AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a 1-Year Required Visit and met with Staff Member, Yazmin Ovilla. Adminstrator, Justine Herrera, arrived during visit at approximately 9:30AM. Facility serves residents with dementia and has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance for 5 non-ambulatory and 1 bedridden resident for a total capacity of 6 residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were 6 Residents in care and 2 staff members on-site. At approximately 9:30AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 9:45AM, LPA conducted a walk-though of the facility with Administrator. LPA observed the following: The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a 1 story building with 6 Resident bedrooms, 2 bathrooms, and common spaces. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for Residents. Mattress pads were in place or available for Resident use. Toxins were observed to be stored inaccessible to Residents. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit. Fire extinguishers were last inspected August 2024. Smoke detectors and carbon monoxide detectors were tested and operational. The last facility disaster drill was conducted in August 2024. At approximately 10:00AM, LPA reviewed staff files, resident files and resident medication. All files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid and CPR certification. Medication was observed to be centrally stored and secure. Administrator's Certificate for Justine Herrera (7027363740) was current with an expiration date of 10/23/2024. Continued on LIC809C Continued from LIC809 PA requested the following documents to update facility file: Designation of Facility Responsibility (LIC 308) Emergency Disaster Plan (LIC 610D) Updated Personnel Report (LIC 500) Register of Clients/Residents (LIC 9020) Updated Liability Insurance Active and Current Administrator Certificate Documents to be submitted to Community Care Licensing (CCL) by due date of 10/19/2024. No Deficiencies Cited during Visit. Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Sep 19, 2024