Mom's Retreat Board and Care Home

Allegation investigated: Staff are not communicating with resident's authorized representative

On September 2, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to initiate the investigation into the allegation listed above and to deliver the complaint findings. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Gabriela Garcia was notified via telephone and later arrived to assist with the inspection. On today's visit, LPA conducted a tour of the physical plant of the facility. LPA observed the facility to be free of any hazards. LPA additionally conducted four staff interviews, six resident interviews, reviewed and obtained pertinent documents for this complaint. Regarding the allegations that, staff are not communicating with resident's authorized representative, the following has been concluded: LPA reviewed the facility's resident rosters for June, July, and August 2026. LPA observed that the individual mentioned in this complaint was not a resident at the facility during this times and there is no evidence to support that the individual ever resided at the facility. CONTINUED ON LIC9099-C Unfounded Four out of four staff interviews conducted also confirmed that the individual has not been a resident at the facility and has not been associated to the facility in anyway. LPA conducted six resident interviews. Three residents were unable to be qualified for an interview. However, the three other residents confirmed that the individual mentioned in the complaint has not been a resident of the facility. Based on the evidence gathered during this investigation, the complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without reasonable basis. An exit interview was conducted with Administrator Gabriela Garcia and a copy of the report was provided at time of visit.the state’s words, verbatim · CDSS document, Sep 2, 2026 · control 22-AS-20260826151831

Type of visit: Required - 1 Year

On July 6, 2026, Licensing Program Analysts (LPAs) Brandon Lopez and Tran Nguyen made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPAs were greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Gabriela Garcia was notified via telephone and later arrived to assist with the inspection. LPAs observed that Gabriela Garcia has a valid administrator certificate which expires on May 29, 2027. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for four. The facility is a single story home with four resident bedrooms, two of which are shared, two shared resident bathrooms, a living room, a dining room, a kitchen, a laundry room, and an attached one car garage. LPAs, accompanied by the AD, conducted a tour of the interior portion of the facility. On today's visit, LPAs observed six residents in care and two care giving staff present. LPAs observed residents relaxing in their respective bedrooms and in the living room. LPAs observed the See Something, Say Something poster (PUB 475) mounted on the wall in the living room. LPAs inspected the four resident bedrooms and they were observed to be free of hazards. LPAs observed residents bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPAs observed resident beds had clean linens and blankets. LPAs observed additional linens to be stored in a hallway closet. LPAs inspected the two resident bathrooms. Resident bathrooms were clean. Resident bathrooms were equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 106.5 and 107.6 degrees Fahrenheit. LPAs observed the kitchen has a two day perishable and a seven day nonperishable food supply on hand. LPAs observed kitchen appliances to be clean and operational. CONTINUED ON LIC809-C LPAs observed kitchen knives and sharps to be stocked in a locked kitchen cabinet. LPAs observed the facility has a three day emergency food and water supply stored in the kitchen. LPAs observed fire extinguishers to be mounted in the kitchen and in the resident hallway. Fire extinguishers were observed to be charged and up to date on service. LPAs tested the wired smoke detectors and individual carbon monoxide detector which tested operational. LPAs observed the facility conducted their last emergency disaster drill on April 23, 2026. LPAs observed the centrally stored medication to be kept in a locked cabinet in the laundry room. LPAs observed the facility has a first aid kit stored in the laundry room and it had all the required components. LPAs observed chemicals and toxins to be stored in a separate locked cabinet in the laundry room. LPAs observed the garage door to be kept locked and inaccessible to residents in care. LPAs observed the garage to be used for storage. LPAs, accompanied by the AD, conducted a tour of the exterior portion of the facility. The exterior portion was observed to be free of hazards and obstructions. LPAs observed a shaded outdoor seating area with furniture for resident use. LPAs observed the perimeter gates on the north side and south side of the facility to be self latching and can be opened in an evacuation. There are no bodies of water on the premises. LPAs reviewed all six resident files. All the required documentation were present and current in the resident files reviewed. LPAs reviewed residents' medication and medication records. LPAs reviewed three staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, no deficiencies are being cited per the Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator Gabriela Garcia and a copy of the report was provided at time of visit.the state’s words, verbatim · CDSS document, Jul 6, 2026

Allegation investigated: Staff abandoned resident Staff did not seek timely medical attention Staff did not ensure medication was dispensed as prescribed

On September 5, 2025, Licensing Program Analysts (LPAs) Brandon Lopez and Garlli Tat made an unannounced visit to the facility to initiate the investigation into the allegations listed above and to deliver findings. LPAs were greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Gabriela Garcia was notified via telephone and later arrived to assist with the inspection. On today's visit, LPAs conducted a tour of the physical plant, conducted four staff interviews and conducted six resident interviews. LPAs additionally reviewed and collected pertinent documents such as the resident rosters. Regarding the allegations that, staff abandoned resident, staff did not seek timely medical attention, and staff did not ensure medication was dispensed as prescribed, the following has been concluded: LPAs reviewed the resident roster dated July 5, 2025. CONTINUED ON LIC9099-C Unfounded LPA observed the individual was not a resident at the facility at this time and that the residents listed on the roster have not changed since that date. Four out of four staff interviews conducted also confirmed that the individual has not been a resident at the facility and has not been associated to the facility in anyway. Six out of six resident interviews also confirmed that this individual has not been a resident at the facility. Based on the evidence gathered during this investigation, the complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without reasonable basis. An exit interview was conducted with Administrator Gabriela Garcia and a copy of the report was provided.the state’s words, verbatim · CDSS document, Sep 5, 2025 · control 22-AS-20250829150212

Allegation investigated: Facility refused to accept resident after a hospital visit.

On May 30, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to follow up on the investigation into the above allegation and to deliver findings. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Gabriela Garcia was notified via telephone and later arrived to assist with the inspection. The initial complaint investigation visit was conducted on May 20, 2025. During the initial visit, LPA conducted a tour of the physical plant, conducted four staff interviews and conducted six resident interviews. LPA additionally reviewed and collected pertinent documents such as the resident rosters. Regarding the allegation that, facility refused to accept resident after a hospital visit, the following has been concluded: LPA reviewed the resident roster dated May 1, 2025. LPA observed the individual was not a resident at the facility at this time. CONTINUED ON 9099-C Unfounded LPA reviewed the resident roster dated May 15, 2025, and observed the individual was also not a resident at the facility at this time. Four out of four staff interviews conducted also confirmed that the individual has not been a resident at the facility and has not been associated to the facility in anyway. Six out of six resident interviews also confirmed that this individual has not been a resident at the facility. Based on the evidence gathered during this investigation, the complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without reasonable basis. An exit interview was conducted with Administrator Gabriela Garcia and a copy of the report was provided.the state’s words, verbatim · CDSS document, May 30, 2025 · control 22-AS-20250513174825

Type of visit: Required - 1 Year

On May 20, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Designees Gabriela Garcia and Julian Garcia were notified via telephone and later arrived to assist with the inspection. LPA observed that Denise Gilroy has a valid administrator certificate which expires on June 9, 2026. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for four. The facility is a single story home with four resident bedrooms, two of which are shared, two shared resident bathrooms, a living room, a dining room, a kitchen, a laundry room, and an attached one car garage. LPA, accompanied by the Designees, conducted a tour of the interior portion of the facility. On today's visit, LPA observed six residents in care and two care giving staff present. LPA observed residents relaxing in their respective bedrooms and in the living room. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall in the living room. LPA inspected the four resident bedrooms and they were observed to be free of hazards. LPA observed residents bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds had clean linens and blankets. LPA observed additional linens to be stored in a hallway closet. LPA inspected the two resident bathrooms. Resident bathrooms were clean. Resident bathrooms were equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured 112.2 degrees Fahrenheit. LPA observed the kitchen has a two day perishable and a seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. CONTINUED ON 809-C LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. LPA observed the facility has a three day emergency food and water supply stored in the kitchen. LPA observed fire extinguishers to be mounted in the kitchen and in the resident hallway. Fire extinguishers were observed to be charged and up to date on service. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on January 5, 2025. LPA observed the centrally stored medication to be kept in a locked cabinet in the laundry room. LPA observed the facility has a First Aid Kit stored in the laundry room and it had all the required components. LPA observed chemicals and toxins to be stored in a separate locked cabinet in the laundry room. LPA observed the garage door to be kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage. LPA, accompanied by the Designees, conducted a tour of the exterior portion of the facility. The exterior portion was observed to be free of hazards and obstructions. LPA observed a shaded outdoor seating area with furniture for resident use. LPA observed the perimeter gates on the north side and south side of the facility to be self latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all six resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed residents' medication and medication records. LPA reviewed five staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, no deficiencies are being cited per the Title 22 of the California Code of Regulations. An exit interview was conducted with Designees Gabriela Garcia and Julian Garcia. A copy of the report was provided.the state’s words, verbatim · CDSS document, May 20, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Lydia Martinez made an unannounced visit to the facility to conduct a Required - 1 year inspection. LPA was allowed entry into the home by Staff Alejandra Barrera and Sebastian Sanabria. Administrator (AD) Gabriela Garcia arrived shortly after. AD Garcia has a Certificate which expires on 05/29/2025. There were 6 Residents present during today's visit. LPA, along with AD Garcia toured the physical plant. LPA observed the facility to be clean and in good repair. The home is maintained at a comfortable temperature. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each Resident comfortably. Bathrooms were checked, toilets/water faucets worked properly and shower was free of mold/mildew. Hot water temperature was within regulatory requirements. Bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. Kitchen is clean and organized. Perishable and non-perishable food supply was checked and adequately stocked. LPA observed sharps and cleaning supplies locked in a kitchen cabinet and in the garage. Smoke detectors and carbon monoxide detector tested operational; Fire extinguisher was fully charged and mounted. No bodies of water were observed outside. Walkways around the home were clear of hazards. Exit gates are unlocked and self-latching. Backyard has a covered patio, patio furniture for outdoor activities and sufficient seating for Residents and visitors. Last Emergency/Fire Drill was conducted 3 weeks ago but not documented. LPA observed emergency supplies including food and water. LPA reviewed 6 Resident files and 2 staff files. Resident files contained required documentation such as health assessments and admission agreements. Staff files contained required documentation including fingerprint clearance and required training. Medication was observed to be in a centrally stored location and medication reviewed appeared to have been dispensed accurately. Based on observations made during today’s visit, no deficiencies are being cited. This report was discussed with Administrator and a copy was sent to email on file.the state’s words, verbatim · CDSS document, Sep 27, 2024