Mgb Carmel Manor

Allegation investigated: Staff do not prevent a resident/client from being financially abused.

Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Caregiver Gloria Hughes and explained the purpose of the visit regarding the allegations stated above. First allegation: Staff do not prevent a resident/client from being financially abused. Regarding the allegation stated above, LPA conducted an interview with Staff #1 concerning the alleged allegation “Staff do not prevent a resident from being financially abused” Staff #1 informed LPA that Resident #1 handles and manages their own finances. Staff #1 further explained that the facility does not assist residents with cash management. Staff #1 further indicated that all transactions between R#1 and R#2 take place outside of the facility during the time that both residents are attending InoVage PACE Program. Staff #1 informed LPA that Resident #1 and Resident #2 are good friends however, facility has coached both residents individually concerning Resident #1 loaning Resident #2 money and Resident #2 asking or taking money from Resident #1. Unsubstantiated Based on corroborating evidence LPA has determined that the above allegation is Unsubstantiated, meaning that 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. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Caregiver Gloria Hughes.the state’s words, verbatim · CDSS document, Apr 17, 2026 · control 56-AS-20260415153002

Allegation investigated: Staff did not prevent a resident from hitting another resident

Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Administrator Glenn Bernal and explained the purpose of the visit regarding the allegation stated above. First allegation: Staff did not prevent a resident from hitting another resident. Regarding the allegation, LPA conducted an interview with Staff #1 and Staff #2 LPA went over the alleged allegation with Staff #1 and Staff #2, LPA was informed by S#1 and S#2, that early in the morning (3:00am), staff heard a loud shout that came across the hallway, S#2 informed LPA that S#2 observed R#1 in the wall way across from the bathroom holding their left side of their head. Staff #2 informed that R#1 indicated that Resident #2 had hit Resident #1 with their cane. LPA conducted an interview with Resident #2 LPA went over the alleged allegation with Resident #2 pertaining to Resident #2 hitting Resident #1. Resident #2 informed LPA that resident had woken up to use the bathroom, and while attempting to utilize the bathroom Resident #2 informed LPA that Resident #1 grabbed Resident #2 by the arm. Unsubstantiated Resident #2 further explained to LPA about being legally blind and when Resident #1 grabbed Resident #2 by the arm it startled the resident and that is why resident reacted by hitting Resident #1. Resident #2 informed LPA that it wasn’t an intentional act to hit Resident #1 but a reaction of fear of not knowing who grabbed resident by the arm. Staff #1 and Staff #2 informed LPA that staff immediately assessed Resident #1 and indicated that no manor injuries to Resident #1 were reported. Based on corroborating evidence the department has determined that the above allegations are Unsubstantiated, meaning that 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. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Administrator Glenn Bernal.the state’s words, verbatim · CDSS document, Feb 27, 2026 · control 56-AS-20260225120958

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Administrator Glenn Bernal and was granted entry to the facility. At the time of the visit there was two (2) staff present, two (2) residents present and three (3) residents were attending InnovAge Program. The facility is a six (6) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) facility Licensed capacity is (6) current census (5). LPA was accompanied by Facility Administrator, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be 110 degrees F The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication black cabinet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed five (5) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. First Aid/CPR certificates were verified all certifications were current and valid. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Administrator Glenn Bernal.the state’s words, verbatim · CDSS document, Nov 6, 2025

Allegation investigated: Staff handles resident in a rough manner

LPA Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegation. LPA met with Administrator Glenn Bernal and explained the elements of the complaint. LPA Prieto interviewed resident #1 (R1), R2, R3 and R4. Each stating that staff does not handle them in a rough manner. LPA interviewed caregiver staff #1 (S1) and S2, each stating that they do not handle residents in a rough manner during their care or transfers. Resident in question (R5) was not available for interview during time of investigation. Based on the information obtained there is not enough evidence to support the allegation made in this complaint. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Administrator Bernal and a copy was left with the facility. Unsubstantiatedthe state’s words, verbatim · CDSS document, Sep 12, 2025 · control 56-AS-20221024143427

Allegation investigated: Staff hit resident.

Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility Caregiver Gloria Hughes and explained the purpose of the visit. The investigation consisted of interviews,and observation. First allegation: Staff hit resident. Regarding the first allegation “Staff hit resident” LPA conducted interviews with Resident #1, #2, and #3, and all informed LPA that they have not been hit or mistreated by staff. In addition, R#2 and R#3 informed LPA that they have not witnessed staff hit or mistreat Resident #1. LPA interviewed Staff #1 and Staff #2 regarding the allegation above both S#1 and S#2 denied hitting or mistreating residents. In addition, S#1, and S#2, informed LPA that they have not witnessed other staff hit or mistreat residents in care. Based on corroborating evidence obtained during the course of the investigation, LPA has determined that the above allegation is Unsubstantiated. Unsubstantiated Unsubstantiated: meaning that 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. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Caregiver Gloria Hughes at the end of the visit.the state’s words, verbatim · CDSS document, Dec 16, 2024 · control 56-AS-20241213134701

Allegation investigated: Staff consume liquor while on shift Staff do not have fingerprint clearance Staff lock facility doors to prevent residents from leaving Staff insert suppositories to residents in care Staff did not complete required trainings Staff did not maintain resident records Residents are not provided proper food service Staff did not ensure resident’s diapering needs were met Staff did not provide adequate medication assistance to residents in care

Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility Caregiver Eladia Plenos and explained the purpose of the visit. The investigation consisted of interviews and review of records. First allegation, staff consume liquor while on shift. Regarding the first allegation “Staff consume liquor while on shift” LPA conducted a walkthrough of the facility, LPA inspected kitchen cabinets, appliances, along with kitchen pantry, and liquor was not observed during the inspection. LPA conducted interviews with residents regarding staff consuming liquor while on shift, all residents denied witnessing staff consume liquor while providing care. In addition, residents also denied smelling liquor odor on staff. LPA conducted interviews with staff regarding staff consuming liquor while on shift. All staff denied consuming or storing liquor at the facility. Furthermore, staff also denied witnessing other staff consume liquor while providing care to residents. Second allegation, Staff do not have fingerprint clearance. Unsubstantiated . Regarding the allegation “Staff do not have fingerprint clearance” LPA retrieved a facility roster via Guardian Background System, and observed that Staff #1, Staff#2, and Staff#3, that were currently working at the facility all were eligibly cleared. LPA conducted a file review for Staff 1-3 and discovered that all clearance records were on file. Third allegation, Staff lock facility doors to prevent residents from leaving. Regarding the allegation “Staff lock facility doors to prevent residents from leaving” LPA conducted a walkthrough of the facility and inspected six out of six resident’s bedrooms along with resident’s doorknobs and observed that no laches or childproof locks were in place. In addition, LPA conducted an inspection on all doors along with emergency exists and witnessed that no latches or childproof locks were in place. LPA conducted interviews with residents regarding the allegation “Staff locking facility doors to prevent residents from leaving” all residents denied being locked or prevented from leaving the facility. LPA conducted interviews with staff regarding the alleged allegation, and all denied locking or preventing residents from leaving the facility. Fourth allegation, Staff insert suppositories to residents in care. Regarding the allegation” Staff insert suppositories to residents in care” LPA conducted interviews with staff and all staff denied utilizing or inserting suppositories to residents. In addition, all staff informed LPA that suppositories are not kept or stored at the facility. LPA conducted interviews with residents, and all denied having suppositories inserted by staff. LPA conducted a medication inspection and discovered that no suppositories are being stored. Fifth allegation, Staff did not complete required trainings. Regarding the allegation “Staff did not complete required trainings” LPA conducted a full staff file review and observed that training was completed LPA also observed certificates of completion to be on for all staff. Sixth allegation, Staff did not maintain resident records. Regarding the allegation “Staff did not maintain resident records” LPA conducted a file review of all resident records and discovered that all required documentation for six out of six residents were on file based on Title 22 Residential Care Facility for Elderly (RCFE). Seventh allegation, Residents are not provided proper food service. Regarding the allegation “Residents are not provided proper food service” LPA conducted an inspection on facilities food supply. During the inspection LPA discovered that the facility had adequate amount of food supply to meet resident needs. In addition, LPA observed that all food including canned goods sustained current shelf life. LPA conducted interviews with residents where five out of six residents stated that that the food is okay and have no concerns. Resident#6 stated that the breakfast that is served is good, and that Resident#6 purchases and stores their own lunch and dinner. Eighth allegation, Staff did not ensure resident’s diapering needs were met. Regarding the allegation “Staff did not ensure resident’s diapering needs were met” LPA conducted interviews with residents pertaining to the allegation resident’s diaper needs were not met. Six out of six residents denied the allegation and stated that staff completes their diaper needs and change residents on a timely manner. Ninth allegation, Staff did not provide adequate medication assistance to residents in care, Regarding the alleged allegation. LPA conducted interviews with residents and six out of six residents stated that they receive medication on a timely manner. In addition, all residents stated that medication is always given and not withheld by staff. LPA conducted a file review of residents MAR records and observed that all medication is being distributed and managed correctly by staff. Tenth allegation, Staff threatened residents in care. Regarding the allegation “Staff threatened residents in care” LPA conducted interviews with residents pertaining to the alleged allegation and six out of six residents denied being threatened or mistreated by staff. In addition, all residents denied witnessing staff threat other residents in care. LPA conducted interviews with staff regarding the allegation stated above, all staff denied threatening or mistreating residents in care. In addition, staff also denied witnessing other staff threat or mistreat residents in care. Eleventh allegation, Staff did not ensure sufficient food items were available at the facility for residents in care. Regarding the allegation stated above. LPA conducted an inspection on facilities food supply. During the inspection LPA discovered that the facility had adequate amount of food supply to meet resident needs. LPA conducted interviews with residents and six out of six residents stated that the food provided is fulfilling and have no issues with food or snack supply. Twelfth allegation, Staff yelled at residents in care. Regarding the allegation “Staff yelled at residents in care” LPA conducted interviews with residents pertaining to the allegation stated above and six out of six residents denied being yelled at by staff. In addition, all residents denied witnessing staff yell at residents in care. LPA conducted interviews with staff regarding the allegation stated above, all staff denied yelling at residents in care. In addition, staff also denied witnessing other staff yell at residents in care. Thirteenth allegation, Staff did not assist residents that sustained falls. Regarding the allegation” Staff did not assist residents that sustained falls” LPA conducted interviews with residents, and all denied staff not assisting residents with transfers. All residents also stated that caregivers are very involved with helping residents who are non-ambulatory. Furthermore, during interviews residents denied witnessing residents sustain falls and not being assisted by staff Fourteenth allegation, centrally stored medications are accessible to residents in care. Regarding the allegation “Centrally stored medications are accessible to residents in care” LPA conducted a walkthrough of the facility during the walkthrough LPA discovered a black metal cabined located across bedroom #6 that was locked and secure. LPA checked cabinet to ensure that the cabinet was locked and secured. During the inspection facility staff opened the cabinet with a key (no magnet) and demonstrated to LPA that medication cabinet remains locked and inaccessible to residents in care. Fifteenth allegation, Staff do not have a fire evacuation plan at the facility. Regarding the allegation “Staff do not have a fire evacuation plan at the facility” LPA conducted a walkthrough of the facility and observed proper fire evacuation posters posted around the facility. LPA conducted a record review and observed that the last evacuation was completed in November. LPA observed exit signs throughout the facility. In addition, staff informed LPA that the main entry door is their primary exit in case of a fire. LPA observed that five out of six bedrooms have an exit door. Sixteenth allegation, Staff do not have an infection control plan at the facility. Regarding the allegation “Staff do not have an infection control plan at the facility” LPA conducted a record review and observed that facility had an infection control plan in place that was current. In addition, LPA observed proper postings throughout the facility that indicated the preventions and the spreads of infections and illnesses. Seventeenth allegation, Staff are not following reporting requirements. Regarding the allegation “Staff are not following reporting requirements” LPA conducted interviews with staff who informed LPA that Special Incident Reports, are faxed to CCL office when pertaining to any incident involving the residents in care. Staff in formed LPA that the lates report was faxed a few days ago regarding Upland Police Department conducting a wellness check. Eighteenth allegation, Staff left residents unattended. Regarding the allegation “Staff left residents unattended” LPA conducted interviews with residents regarding the allegation stated above all six residents denied being left alone or unattended at the facility. LPA conducted interviews with regarding the alleged allegation all staff denied leaving residents in care unattended or unsupervised. Based on corroborating evidence obtained during the course of the investigation, LPA has determined that the above allegations are Unsubstantiated. Unsubstantiated; meaning that 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. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Caregiver Eladia Plenos at the end of the visit. Substantiated: A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Title 22 regulations, 87207 False Claims, from division 6, chapter, article 6, is being cited on the attached LIC 9099 D. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided, along with a copy of the appeal rights. to Facility Caregiver Asenath Lainez-Munoz. Third allegation, Staff did not prevent residents from engaging in inappropriate interactions. Regarding the allegation “Staff did not prevent residents from engaging in inappropriate interactions” LPA conducted a resident file review and discovered that Resident #2, Resident #3, Resident #4, and Resident #5, that were listed in the alleged allegation are not residents that have ever lived at the alleged facility. Based on the available information, LPA found the complaint allegation is Unfounded. Unfounded: A find of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis. An exit interview was conducted where this report was discussed, and a copy provided to Facility Caregiver Eladia Plenos.the state’s words, verbatim · CDSS document, Dec 3, 2024 · control 56-AS-20241120095631

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87207 · Plan of correction due date: Dec 13, 2024

87207 False Claims No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement is not met as evidence by: Based on record review, the licensee did not ensure that Staff #1 and Staff #2 had valid First Aid & CPR card, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 3, 2024

Plan of correction: Licensee has agreed to read over False claims regulation and ensure that all staff has a valid CPR & First Aid certification. Licensee with provide LPA with a signed acknowledgement of understanding and provide a copy of all certifications including the signed acknowledgment to LPA Guerrero by POC date 12/13/2024.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Administrator Glenn Bernal and was granted entry to the facility. At the time of the visit there was three (3) staff present, four (4) residents present and two (2) residents were attending InnovAge Program. The facility is a six (6) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) facility Licensed capacity is (6) current census (6). LPA was accompanied by Facility Administrator, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be 113 degrees F The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication black cabinet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed six (6) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Administrator Glenn Bernal.the state’s words, verbatim · CDSS document, Nov 13, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Caregiver Eladia Plenos and was granted entry to the facility. At the time of the visit there was two (2) staff present, and six (6) residents present. The facility is a six (6) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) facility Licensed capacity is (6) current census (6). LPA was accompanied by Facility Caregiver, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be 107.1 degrees F The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication black metal cabinet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed six (6) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Caregiver Eladia Plenos.the state’s words, verbatim · CDSS document, Nov 18, 2023