Majestic Residential Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with Administrator Kemi Osilesi and explained the reason for the visit. At approx 12:35 p.m. LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. LPA inspected the kitchen/food service area. LPA observed Knives and other sharp objects were stored in a locked drawer to the left of the dishwasher. Cleaning supplies were stored underneath the sink and were inaccessible to residents in care. Kitchen appliances were observed to be in operable condition. The facility maintained a sufficient supply of perishable and non-perishable food, which was properly stored. Medications were stored in a cabinet inaccessible to residents in care. Common area furniture was observed to be in good condition. Two (2) residents were observed watching television in the living room while staff served lunch. Multiple board games and activities were stored on a bookshelf in the living room. A sufficient supply of clean linens and towels was stored in the hallway near Room #3. PPE and toiletries were stored in a closet near Room #1 and were inaccessible to residents in care.The facility maintained a comfortable temperature of 72 degrees Fahrenheit. Smoke detectors and carbon monoxide detectors were operational at the time of the visit. Fire extinguishers were fully charged and had a purchase date of July 2026. Five (5) resident bedrooms were observed and were appropriately furnished with clean linens, adequate furnishings, and sufficient lighting. Resident restrooms were clean, sanitary, and operational. Restrooms were equipped with grab bars and non-skid surfaces and were sufficiently stocked with necessary supplies and paper towels. Hot water temperatures in each restroom measured between 105 and 120 degrees Fahrenheit. A staff room near the entryway was observed to be empty and inaccessible to residents in care at the time of the visit. Office area was located next to the dining area. LPA observed facility files stored inaccessible to residents in care. All exits have functioning auditory devices and were operational at the time of the visit. LPA observed required postings on bulletin board by entry way, on bulletin board by garage as well as throughout the home. An attached garage was observed and was inaccessible to residents in care. The garage contained an additional refrigerator for properly storing perishable food, a laundry area, furniture, medical equipment, PPE, incontinence supplies, and other facility-use items. Several emergency bins were adequately stocked and ready for use during an emergency. Portable power stations and solar panels were also available for emergency use. The backyard included a covered outdoor area with appropriate furniture. Two (2) self-latching gates were observed, and the passageways were clear of obstructions. No bodies of water were observed at the time of the visit. Records review, five (5) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. Six (6) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were observed to be in order at this time . Medication review, medications for all residents were observed. All medications were stored properly and were appropriately documented on their respective centrally stored medication and destruction record sheets. No deficiencies were observed during medication review. Infection control / Emergency Disaster plan: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills are conducted quarterly; the facility’s last emergency disaster drill was conducted in August. The facility’s emergency disaster plan is up to date and is adequate. Both the infection control plan and the emergency disaster plan are reviewed/updated annually by the facility’s administrator. Smoke detectors and carbon monoxide detectors were tested, all alarms were functional at the time of the visit. During today’s visit LPA obtained a copy of the facility’s LIC 500, resident roster and limited liability insurance. Exit interview conducted and copy of the report issued to Administrator.the state’s words, verbatim · CDSS document, Sep 3, 2026

Allegation investigated: Staff did not provide adequate supervision to resident in care resulting in a fracture Staff mismanaged resident's medication Staff did not provide a proper rate increase notice to resident or resident's authorized representative Staff did not provide resident records to resident's authorized representative

Licensing Program Analyst (LPA) Brian Balisi conducted a subsequent complaint visit to deliver final findings for the above allegation. During today’s visit, LPA met with Kemi Osilesi and explained the reason for the visit. On 03/18/2025, the Woodland Hills Adult and Senior Care Regional Office (RO) received a complaint alleging Resident #1 (R1) fell and sustained a fractured femur due to lack of supervision of the facility staff. The case was referred to Community Care Licensing Division (CCLD) Investigations Branch (IB) and assigned to Investigator Douglas Real. On 03/19/2025, from 03:07pm to 5:00pm, Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced complaint visit for the allegation listed above. Upon arrival LPA Balisi met with staff and explained the reason for the visit, Administrator Kemi Osilesi arrived shortly after. Continued on 9099-C Unsubstantiated Continued from 9099 At approximately 03:10pm the LPA conducted a physical plant tour, interviewed staff and reviewed and obtained copies of pertinent documentation relevant to the investigation. The LPA determined further investigation was needed prior to issuing findings. On 04/01/2025, at approximately 10:30am, Investigator Real conducted interviews with R1’s resident representative; on 04/17/2025, from approximately 11:30am to 2:00pm, with R1, staff, and residents; on 06/13/2025, at approximately 12:25pm, with the Administrator; on 06/17/2025, at approximately 12:30pm, with the overnight staff; and on 07/01/2025, at approximately 12:50pm, with R1’s resident representative. In addition, Investigator Real reviewed Los Robles Regional Medical Center medical records and facility file documents related to the investigation. According to the facility file documents reviewed, R1 was admitted to the facility on 06/15/2024. R1 had a history of falls and was considered a fall risk. R1’s Appraisal Needs and Services Plan, updated 12/27/2024, noted confusion and agitation at night, with R1 attempting to walk without supervision. The plan noted safety measures were put in place and staff encouraged R1 to use the call button at night. A review of the Unusual Incident/Injury Report related to R1’s fall on 02/07/2025 revealed the overnight staff checked on R1 at 12:26am and at that time R1 was in bed. At 12:40am the staff heard the safety mat alarm and saw R1 on the floor in R1’s room with leg pain. R1 did not request assistance prior to getting out of bed. The Administrator was notified and 911 was called. Paramedics transported R1 to the hospital. A review of the Los Robles Regional Medical Center medical records revealed R1 was admitted to the hospital on 02/07/2025 with a diagnosis of femur fracture. Surgical procedure was performed to repair the fracture. R1 was discharged from the hospital on 02/14/2025. The Department’s investigation revealed the facility provided a sufficient level of care and supervision for R1. R1, who suffered from dementia, did not have 24/7, one on one supervision. R1 wore a call button alarm that R1 could use to contact facility employees when R1 wanted to get out of bed and was consistently reminded by staff to use the alarm so that staff could assist R1 out of bed. Continued from 9099-C In addition, floor alarm mats were placed on the floor around R1’s bed at night to alert the night staff if R1 got out of bed without contacting them for help. The overnight staff spent the night in a chair outside R1’s room, which allowed them to respond in a prompt manner to incidents or accidents that might occur in the residents’ rooms. The staff working on the night of R1’s fall properly responded as well as assessed R1 after the fall and 911 was called when R1 reported pain. Interviews were conducted with R1’s resident representatives, R1, facility residents and staff. The information obtained during the Department’s investigation did not sufficiently support the allegation. While R1 did sustain a fall which resulted in a fracture, the investigation did not provide sufficient evidence to substantiate neglect/lack of supervision. Therefore, the allegation is deemed Unsubstantiated at this time. It was reported that “Staff mismanaged resident’s medication” as it was alleged that the Administrator was administering medications that were discontinued. Interviews and record reviews revealed that on 02/07/2025, R1 was admitted to Los Robles Regional Medical Center. The discharge orders directed to stop administering the medication Amlodipine Besylate (NORVASC 5 mg) daily and to consider resuming blood pressure medication only if systolic blood pressure exceeded 160–170 mmHg. On 02/24/2025, R1 was admitted to Kaiser for hypertension and mild chronic kidney disease. The Primary Care Physician (PCP) ordered R1 to start Amlodipine for blood pressure control. On 02/25/2025, during a scheduled visit at the Kaiser Geriatric Clinic, R1 was discharged with instructions to stop taking Amlodipine. Between 02/26 - 03/06/2025, R1’s blood pressure readings were as follows: 149/88, 164/88, 172/80, 167/81, 157/83, 149/89, 164/89, 156/90, and 168/90. On 03/06/2025, the facility administrator notified R1’s PCP of these readings. The PCP recommended restarting Amlodipine. According to the administrator’s interview, the facility requested the POA to order and provide the medication, as has been done in the past. The POA declined to order Amlodipine, citing the 02/07/2025 recommendation from Los Robles advising against its use. As a result, R1 did not receive Amlodipine from March 6 until March 11, 2025, when R1 relocated from the facility. Medication Administration Records (MARs) confirm that R1 was not administered Amlodipine from February 7 through March 11, 2025. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation 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 above allegation “Staff mismanaged resident’s medication” is deemed Unsubstantiated at this time. Continued from 9099-C It was reported that "Staff did not provide a proper rate increase notice to resident or resident's authorized representative" as it was alleged that the Administrator informed the POA of R1 of a $500 rent increase without giving at least 30 days’ notice. Interviews and records review revealed that R1 was admitted to the facility on 06/15/2024, with a monthly rent of $4,000. On 12/27/2024, a notice of a $500 rent increase, effective April 2025, was provided to R1’s Power of Attorney (POA) at that time. Following the death of the POA on 01/16/2025, a family member was designated as the new POA. On 02/28/2025, the new POA was informed of the upcoming rent increase. On 03/07/2025, the facility provided the new POA with an updated Admission Agreement reflecting the increased monthly rent of $4,500. However, the updated agreement was never signed, and the rent increase was not implemented. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation 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 above allegation “Staff did not provide a proper rate increase notice to resident or resident's authorized representative” is deemed Unsubstantiated at this time. It was reported that “Staff did not provide resident records to resident’s authorized representative” as it was alleged that Administrator did not provide requested medical records in a timely manner. Interviews conducted and records reviewed revealed on 03/11/2025, upon R1’s discharge from the facility, a family member / responsible party of R1 was provided facility records. LPA’s records review revealed all relevant records were given to the family member / responsible party of R1. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation 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 above allegation “Staff did not provide resident records to resident’s authorized representative” is deemed Unsubstantiated at this time. Exit interview conducted, copy of this report issued.the state’s words, verbatim · CDSS document, Aug 21, 2025 · control 29-AS-20250318122806

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with Administrator Kemi Osilesi and explained the reason for the visit. The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. The LPA inspected the kitchen/food service area at approx. 10:30 a.m. LPA observed (2) resident resting in the living room. Knives and sharp objects are stored in a locked drawer to the left of the dishwasher. Cleaning supplies were observed kept underneath the sink inaccessible to residents in care. Kitchen appliances were observed to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food properly stored at this time. At the time of the visit, the common area furniture's were observed to be in good condition. LPA observed multiple board games and activities stored on a book shelf in the living room. A sufficient supply of clean linen and towels were observed stored in the hallways next to Room #3. A sufficient supply of PPE and toiletries were observed stored inaccessible to residents in care in a closet next to room #1. The facility maintained a comfortable temperature of 72 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. LPA observed fire extinguishers to be fully charged and last purchased in 08/12/2025 LPA observed four (4) resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured in each restroom between 105 - 120 degrees Fahrenheit. At approx. 11:15 am, LPA observed staff conducting exercises with (2) residents. The staff room located to the right of the entry way was observed to be inaccessible to residents in care and empty during the time of the visit. Office area was located to the right of entry way. All exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings throughout the common areas. There is an attached garage observed inaccessible to residents in care. LPA observed garage to store an additional fridge and extra perishable food. LPA also observed laundry area, along with additional furniture and medical equipment for facility use. Extra PPE supplies were observed stored in this area as well. The backyard has a covered outdoor area equipped with furniture including a table and chairs for resident use. The LPA observed two (2) self-latching gate with clear passageways clear of obstruction. There were no bodies of water noted at the time of the visit. Records review, five (5) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. Five (5) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were observed to be in order at this time. Last emergency disaster drill was conducted on 08/15/2025. Medications review, all medications reviewed including PRNs were labeled, stored and inaccessible to residents in care. Medications were observed to be administered as prescribed at this time. Infection control: Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. At this time, the staff will continue to keep up signs that promotes good hand hygiene and symptoms of a communicable disease. The facility has an adequate supply of Personal Protection Equipment (PPE), and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of an infectious disease. The facility’s policies and procedures as it pertains to infection control are adequate. The LPA obtained the following documents at the time of visit: LIC500 Personnel Report, LIC9020 Client Roster, and a copy of the facility’s liability insurance. Interviews were conducted during the visit. Exit interview conducted and a copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 21, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with Administrator Kemi Osilesi and explained the reason for the visit. The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. The LPA inspected the kitchen/food service area at approx. 10:05 a.m. The LPA observed resident watching television in the living room. Knives and sharp objects are stored in a locked drawer to the left of the dishwasher. Cleaning supplies were observed kept underneath the sink inaccessible to residents in care. Kitchen appliances were observed to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food properly stored at this time. At the time of the visit, the common area furniture's were observed to be in good condition. LPA observed multiple board games and activities stored on a book shelf in the living room. A sufficient supply of clean linen and towels were observed stored in the hallways next to Room #3. A sufficient supply of PPE and toiletries were observed stored inaccessible to residents in care in a closet next to room #1. The facility maintained a comfortable temperature of 72 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. LPA observed fire extinguishers to be fully charged and last purchased in August 23rd, 2024. LPA observed four (4) resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured in each restroom between 105 - 120 degrees Fahrenheit. Continued from 9099 At approx. 10:35am, LPA observed staff mopping floors. The staff room located to the right of the entry way was observed to be inaccessible to residents in care and empty during the time of the visit. Office was located to the right of entry way. All exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings throughout the common areas. There is an attached garage observed inaccessible to residents in care. LPA observed garage to store an additional fridge to store extra perishable food. LPA also observed laundry area, along with additional furniture and medical equipment for facility use. The backyard has a covered outdoor area equipped with furniture including a table and chairs for resident use. The LPA observed two (2) self-latching gate with clear passageways clear of obstruction. There were no bodies of water noted at the time of the visit. Records review began at approx. 10:45am, five (5) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. All files were observed to be in order at this time. Three (3) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. At approx 1:30p.m, LPA observed Staff #1 (S1) to have criminal background clearance, but they were not associated to this facility. Last emergency disaster drill was conducted on August 15, 2024. Medications review began at approx. 1:00 p.m. All medications including PRNs were labeled, stored and inaccessible to residents in care. Medications were observed to be administered as prescribed at this time. Infection control: Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. At this time, the staff will continue to keep up signs that promotes good hand hygiene and symptoms of a communicable disease. The facility has an adequate supply of Personal Protection Equipment (PPE), and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of an infectious disease. The facility’s policies and procedures as it pertains to infection control are adequate. Continued from 809-C The LPA obtained the following documents at the time of visit: LIC500 Personnel Report, LIC9020 Client Roster, a copy of the emergency disaster plan, and a copy of the facility’s liability insurance. Interviews were conducted during the visit. Pursuant to Title 22 of the California Code of Regulations Division 6, Chapter 8, the following deficiencies were cited (refer to LIC 809-D). Civil Penalties assessed in the amount of $500. Failure to correct the deficiencies may result in additional civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 3, 2024