Meadow Creek Senior Living

Allegation investigated: Staff do not treat resident with dignity and respect.

Licensing Program Analyst (LPA) Christi Coppo arrived at this facility unannounced, to open an investigation into the above allegation. LPA met with licensee Kelly Muelrath. Licensee had to leave but was available by phone while LPA delivered findings. Caregiver given permission to sign report. Complaint alleges staff do not treat resident with dignity and respect. Complainant states that resident R2 feels fearful of staff (S1) only at night during their bedtime routine as S1 becomes very controlling and angry when residents don't do exactly what S1 says. Complainant states no physical abuse was reported by R2. During investigation, LPA conducted interviews and made observations. Facility has five [5] residents in care. LPA interviewed four [4] out of five [5] residents:R1, R2, R3, and R4. Two [2] out of [4] residents report that S1 has yelled at them. R2 reports that S1 jerks residents by the wrist. However, when asked if Continued on 9099C... Unsubstantiated Continued from 9099... S1 has ever jerked them by the wrist, R2 reports that is something they do not remember.. During investigation, LPA interviewed five [5] out of seven [7] staff. None of the staff interviewed report having witnessed S1 be rough or yell at residents. None of the staff interviewed reported receiving reports from residents of S1 yelling or being rough with them. During investigation, LPA interviewed five [5] witnesses. All witnesses report being present at the facility at least one time per week, with one witness reporting as much as every other day. Four [4] out of five [5] witnesses report never having observed S1 or any staff yell or be rough with any residents, including their loved one. One [1] witness (W1) reports that it was reported to them that a staff person did yell at a resident, but W1 told LPA that the resident did not give the name of the specific staff person, no name was reported to W1. So, although the allegation 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.the state’s words, verbatim · CDSS document, Feb 24, 2026 · control 21-AS-20260220104445

Allegation investigated: Uncleared staff member providing care and supervision to residents in care

Licensing Program Analyst (LPA) Shannan Hansen was at facility conducting annual inspection and delivered complaint investigation findings regarding the above allegation. LPA met with Licensee/Administrator Kelly Muelrath. During investigation LPA made 2 visits (10/16/25 &11/20/25), conducted 8 interviews with staff and outside parties, made observations and reviewed records. Uncleared staff member providing care and supervision to residents in care- Complainant alleges there is a staff member working at the facility without background clearance. Background clearance record review of I1 revealed they were not cleared to work at a facility. Interview with Administrator on 10/16/2025 confirmed individual (I1) had been working at facility since August 2025 while working on getting background clearance. Continue on LIC9099-C Substantiated Continued from LIC9099 Follow up interview with licensee revealed I1 ceased working 10/16/2025 and obtained different employment. There was sufficient information obtained that supported a violation had occurred. Based on interviews and record/document reviews obtained during the investigation the allegation Uncleared staff member providing care and supervision to residents in care is Substantiated, meaning the preponderance of evidence standard has been met, therefore the above allegation is Substantiated. **$500.00 civil penalty assessed for uncleared adult I1 working in facility The following deficiencies were observed (see LIC 9099D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided. Continued from LIC9099A Four staff interviews were conducted. S2 indicated sometimes residents have bad days or are confused due to their dementia or have behaviors but all staff try to help the residents through these times. Outside parties (I2 & I3) who visit R1 at the facility at all different hours indicated there is no supporting information that could raise any concerns regarding or about the care residents are receiving at this facility. Law Enforcement report indicated did not believe anyone at the facility was in immediate danger or was being denied care or was neglected in any way. Case Closed. There was no information obtained that supported a violation had occurred. Based on interviews conducted, observations, and Law Enforcement report obtained during the investigation, the allegation staff speaks inappropriately and aggressively to residents in care or treats the elders in the home badly is Unsubstantiated, meaning that 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.the state’s words, verbatim · CDSS document, Nov 20, 2025 · control 21-AS-20251013161836

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Nov 21, 2025

87355 Criminal Record Clearance (e)All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility (2) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidence by: Based on LPA record review from DOJ and interview with Licensee I1 was not background cleared prior to working at facility as required. LPA confirmed start date 8/2025. This is an immediate risk to the Health & Safety of residents in care.the state’s words, verbatim · CDSS document, Nov 20, 2025

Plan of correction: Licensee/Administrator to submit self-certification of understanding of regulation. 87355(e)(1) & 87355(e)(2), and submit to CCL by POC due date 11/21/2025 to clear citation. ***Civil Penalties assessed in the amount of $500.

Type of visit: Required - 1 Year

At approximately 8:45 AM Licensing Program Analyst (LPA) Shannan Hansen arrived unannounced to conduct an annual inspection of this licensed senior care facility. LPA met with Licensee/Administrator Kelly Muelrath. The facility is single story, with 3 bedrooms and 2 bathrooms. Facility has a fire clearance for 6 non-ambulatory residents and Hospice waiver for 3. There are currently 6 residents in care, of which 3 have diagnoses of dementia and 2 are receiving hospice. At approximately 8:55 AM LPA toured the building and grounds with Licensee/Administrator which were found to be at a comfortable temperature, clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity space & activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerator and freezers were clean, and food was stored properly. Toxins are stored in locked closet across from laundry room & in locked cabinets under kitchen-sink. Water temperature measured between 107.6 degrees F & 107.9 degrees F, within regulations of 105 degrees F and 120 degrees F at faucets accessible to residents. Bathrooms were equipped with necessary grab bars, and slip-resistant mats and shower chairs in both shower floors as required by Title 22 regulations. Fire extinguishers were last charged 1/8/2025. There are 7 hardwired combination smoke /carbine monoxide detectors last inspected 10/7/2025 along with 2 additional carbon monoxide detectors found to be operational. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure. At approximately 9:45 AM, LPA reviewed 5 resident records and found all residents have current physician's reports & care plans. All resident records contained current and signed admission agreements and contained physician's medication orders for each resident, as well as all required documentation. Continue on LIC809 Continued from LIC809 At approximately 11:35 AM, LPA reviewed 5 staff records. All records contained documentation of completed training as required. Evidence of current first aid and CPR training were present. All staff records reviewed had required criminal record clearance and associated. At approximately 12:20 PM the Medications of 2 out of 2 residents were found to be given according to physicians’ directions on 11/20/2025. Centrally Stored Medication Record (CSMR) of 2 out of 2 residents were found to be complete and accurate. At approximately 12:50PM, LPA reviewed the facility emergency disaster plan with staff. Facility has a generator to supply power during an emergency outage. The plan outlines evacuation routes, which are shown on facility sketch and has alternative meeting locations. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducts and documents disaster drills quarterly & in different shifts with the last being 10/7/2025. Administrator Certificate’s for Kelly Muelrath # 7031393740 Exp. 9/26/2027. Facility activities include weekly musical performances, yoga instructor for “chair yoga”, and art therapist as well as options of nightly games. While conducting annual inspection LPA observed ukulele player performing sing a longs with residents and staff who were all engaged. The back porch of the house is shaded and provides a safe and secure area for residents to spend time outside. There were no deficiencies cited at this time. LPA Hansen is requesting Licensee to update the following documents and submit to CCL by 12/15/2025: LIC 308 Designated (if changes) LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan (if changed) LIC 9020 Register of Facility Resident’s Copy of Administrator Certificate Copy of Certificate of Liability Insurance (when receive)the state’s words, verbatim · CDSS document, Nov 20, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Shannan Hansen arrived to conduct an annual unannounced inspection of this licensed senior care facility at approximately 8:45AM. LPA met with Licensee/Administrator Kelly Muelrath. The facility is a single story 3 bedroom, 2 bathrooms with currently 6 residents of which 3 have diagnoses of dementia and 2 are receiving hospice care. Facility has been cleared for hospice waiver of 2. At approximately 8:45AM LPA toured the building and grounds with Licensee/Administrator which were found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity space & activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerator and freezers were clean, and food was stored properly. Toxins are stored in locked closet across from laundry room & in locked cabinets under kitchen-sink. Water temperature measured 107.9 degrees F & 117.3 degrees F, within regulations of 105- and 120-degrees F at faucets accessible to residents. Fire extinguishers were last charged 1/8/2025. There are 7 hardwired combination smoke /carbine monoxide detectors last inspected 1/8/2025 along with 2 additional carbon monoxide detectors found to be operational. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure. At approximately 9:30 AM, LPA reviewed 5 resident records and found all residents have current physician's reports & care plans. All resident records contained current and signed admission agreements and contained physician's medication orders for each resident. At approximately 11:20 AM, LPA reviewed 6 staff records. All records contained documentation of completed training as required. Evidence of current first aid and CPR training were present. At approximately 11:00 AM the Medications of 2 out of 2 residents were found to be given according to physicians’ directions on 1/30/2025 at 11:05 AM. Centrally Stored Medication Record (CSMR) of 2 out of 2 residents were found to be complete and accurate. Continue on LIC809-C Continued from LIC908 At approximately 12:50PM, LPA reviewed the facility emergency disaster plan with staff. Facility has a generator to supply power during an outage. The plan outlines evacuation routes, which are shown on facility sketch and has alternative meeting locations. Facility does not handle resident cash. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducts and documents disaster drills monthly & in different shifts with the last being 1/1/2025. Administrator Certificate’s for Kelly Muelrath # 6067128740 Exp. 9/26/2025. Facility activities include weekly musical performances, yoga instructor for “chair yoga”, and art therapist as well as options of nightly games. While conducting annual inspection LPA observed ukulele player performing sing a longs with residents and staff who were all engaged. The back porch of the house is shaded and provides a safe and secure area for residents to spend time outside. There were no deficiencies cited at this time. LPA Hansen is requesting Licensee to update the following documents and submit to CCL by 2/14/2025: LIC 308 Designated (if changes) LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan (if changed) LIC 9020 Register of Facility Resident’s Copy of Administrator Certificate Copy of Certificate of Liability Insurancethe state’s words, verbatim · CDSS document, Jan 30, 2025

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Shannan Hansen made an unannounced post-licensing inspection of this licensed senior care facility at approximately 8:30AM. LPA met with Administrator Kelly Muelrath. The facility currently has 2 residents, one with dementia diagnosis, none receiving hospice services. At approximately 8:45AM LPA toured the building and grounds which were found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity space & activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerator and freezers were clean, and food was stored properly. Toxins are stored in locked closet across from laundry room & in locked cabinets under kitchen-sink. Water temperature measured 112.8 degrees F & 114.9 degrees F, within regulations of 105 and 120 degrees F at faucets accessible to residents. Fire extinguishers were last inspected 1/26/2024 & charged. 6 smoke detectors were found to be in working order, 2 carbon monoxide detectors were present and operational. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure. At approximately 10:15 AM, LPA reviewed 2 resident records and found 2 of 2 residents have current physician's reports & care plans. 2 of 2 resident records contained current and signed admission agreements and medication records are thorough and contained physician's orders for each resident. At approximately 11:20 PM, LPA reviewed 5 staff records. All records contained documentation of completed training as required. Evidence of current first aid and CPR training were present. At approximately 12:50PM, LPA reviewed the facility emergency disaster plan with staff. Facility has a generator to supply power during an outage. The plan outlines evacuation routes, which are shown on facility sketch and has alternative meeting locations. Continued on LIC809-C Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducts and documents disaster drills quarterly & in different shifts with the last being 2/2024. Administrator Certificate’s for Kelly Muelrath # 6067128740 Exp. 9/26/2025. The back porch of the house is shaded and provides a safe and secure area for residents to spend time outside. There were no deficiencies cited at this time. LPA Hansen is requesting Licensee to update and submit the following documents by 4/30/2024 to CCL: LIC 308 Designated LIC 500 Personnel Summary LIC 9020 Register of Facility Resident’s Proof of Liability Insurancethe state’s words, verbatim · CDSS document, Apr 4, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Hansen conducted a pre-licensing inspection and met with Administrator Kelly Muelrath. Fire clearance has been approved for 6 non-ambulatory residents by Marin County Fire Department. LPA will conduct a component III orientation with Administrator Kelly Muelrath. Facility has a dementia care program and a request for hospice waiver for 2. LPA toured facility and observed: Facility is a one floor residence in good repair and at a comfortable temperature. Hot water temperature checked 115.5 degrees F to 115.7 degrees F in 2 out of 2 resident's bathrooms as required by Title 22 Regulations and Fire Extinguisher is fully charged. Smoke and Carbon Monoxide detectors present and in working condition. The facility has a phone line designated for resident’s use. There is an ample supply of personal hygiene products, bedding and linens, utensils, dishes, and cook ware. Personnel and residents' records will be stored in locked front hallway cabinet. Centrally stored medications will be kept in locked kitchen cabinet. Facility plans on having awake staff. The facility has three resident’s bedrooms and two bathrooms. Facility has a kitchen, laundry room, living room area, office, dining room. Facility plans on having several different activities available for residents as desired. There is outdoor deck space for activities and visiting. Resident's & Personnel records, medication, first aid supplies, and toxins will be locked. Postings noted to be current and in compliance with guidelines. Locked box for sharps in kitchen and cleaning/laundry supplies in locked cabinet in laundry room. First aid kit was observed. Emergency supplies and PPE located in kitchen cabinet and container to be stored. All exits have egress alarms. Infection Control Plan has been submitted. Inspection conducted and report generated in office and signature obtained off site. Licensee does not anticipate opening prior to January 7, 2024. Facility is cleared for licensure. No deficiencies cited during this inspection.the state’s words, verbatim · CDSS document, Nov 21, 2023