Mona Liza

Allegation investigated: Loss of control of property

On 06/22/2026, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct a complaint visit. LPA Pascua was greeted by Tenant, Rachelle Bradshaw. LPA Pascua identified herself as a representative from Community Care Licensing, explaining that this property was a licensed facility. It was determined at this time that the tenant has resided at the property since June 9, 2026. LPA Pascua attempted to contact the property owner, however, the phone number on file was out of service, and contact could not be established.LPA Pascua toured the property to verify that there were no residents currently receiving care at the location. Additionally, a copy of the rental agreement was reviewed and obtained.Based on the information gathered during the investigation, the facility licensee has lost control of the property. As a result of this investigation, this LPA found the allegations to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegation was valid because the preponderance of the evidence standard had been met. The following deficiencies were cited on the following LIC 9099-D pursuant to Title 22 Rules and Regulations, Division 6 and Health and Safety Codes.An exit interview was conducted and a copy of this report and appeals rights will be certified mailed to the licensee. Substantiatedthe state’s words, verbatim · CDSS document, Jun 22, 2026 · control 27-AS-20260619142753

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.19(a) · Plan of correction due date: Jun 23, 2026

"A license shall be forfeited by operation of law prior to its expiration date when one of the following occurs: (a) The licensee sells or otherwise transfers the facility or facility property, except when change of ownership applies to transferring of stock when the facility is owned by a corporation, and when the transfer of stock does not constitute a majority change in ownership. The sale of a facility shall be subject to the requirements of this chapter. This is not met as evidenced by: Based on observation, interview and record review, the licensee did not ensure that the licensee has control of property. It was learned that the licensee has leased the property out for rent. This poses a potential health, safety and personal rights risks to persons in care.the state’s words, verbatim · CDSS document, Jun 22, 2026

Plan of correction: LPA Pascua was unable to reach Licensee to obtain a Plan of Correction.

Type of visit: Required - 1 Year

Annual Inspection conducted by LPA. Albert Johnson, The facility was toured inside and outside, no resident in care at this time, staff records, medications and training requirements were reviewed. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received a criminal record clearance or exemption. The hot water temperature registered at 110.6 degrees F. The smoke alarms are operational. The facility is clean and there are no health and safety hazards observed. The facility is in compliance with Title 22 regulations. No deficiencies observedthe state’s words, verbatim · CDSS document, Mar 27, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to conduct a case management visit regarding change of ownership. The facility has not submitted the required documentation to change ownership. LPA was told on today's visit that the facility is not going to be sold. LPA toured the facility. During the facility visit LPA observed that there are no residents in care. The Informal meeting was cancelled. Deficiencies were cited on the case management visit on 11/24/2025 will be fixed or replaced by 1/12/2025. Exit interview conducted.the state’s words, verbatim · CDSS document, Dec 23, 2025

Allegation investigated: Staff left residents unsupervised

On 11/24/2025, Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to this facility to conduct a complaint investigation. Based on a facility visit conducted by Ombudsman officials on November 20, 2025, at approximately 12:10 p.m., the facility was found to be without staff present. Ombudsman officials checked the premises and confirmed with R1 that S1 had left to go to the store. The facility was secured by the two Ombudsman officials during their visit. The Department was contacted regarding the situation, and law enforcement was notified; however, law enforcement was redirected to an emergency before a report could be made and subsequently left the scene. S1 returned to the facility at 1:02 p.m. and explained they needed to obtain important items. Substantiated Substantiatedthe state’s words, verbatim · CDSS document, Nov 24, 2025 · control 27-AS-20251120130750

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.321(e) · Plan of correction due date: Nov 25, 2025

HSC 1569.321(e)Basic services requirements: Every facility required to be licensed under this chapter shall provided at least the following basic services: Monitoring the activities of the residents while they are under the supervision of the facility to ensure their general health, safety, and well-being. This requirement was not met as evidence by a facility visit conducted by Ombudsman officials on November 20, 2025, at approximately 12:10 PM., the facility was found to be without staff present. This poses an immediate health and safety risks to resident in care.the state’s words, verbatim · CDSS document, Nov 24, 2025

Plan of correction: The administrator will submit a written plan outlining the supervision of residents in care to ensure their overall health, safety, and well-being are being properly monitored. The written plan to be submitted to the Department by POC due date.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to conduct a case management visit. LPA met with Ruxandra Rios to discuss change of ownership. The facility has not submitted the required documentation to change ownership. LPA provide the facility with information to complete the process to change ownership. LPA toured the facility. During the facility visit LPA observed multiple issues with the facility. S1 does not have a first aid/ CPR card, no health screening and no training. The facility grounds needs attention in the hallway floor transition piece is a trip risk and the roof is leaking in several spots. Medications were pre-poured for R2 for one week. Informal meeting has been scheduled for December 9th at 11:00am. via Microsoft teams to address the above concerns. Deficiencies were cited during today's visit. Exit interview conducted.the state’s words, verbatim · CDSS document, Nov 24, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(5) · Plan of correction due date: Dec 8, 2025

Incidental Medical and Dental Care Services. Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement was not met as evidenced by observation and photos taken, the facility is pre-pouring medication 7 days in advance. This poses a potential health and safety risk to residents.the state’s words, verbatim · CDSS document, Nov 24, 2025

Plan of correction: Per CCL Policy, the facility cannot pre-pour medications for more than 24 hours. The Administrator shall cease from pre-pouring medications over 24 hours. Not withstanding the above statement, the facility shall submit a statement of understanding for regulation, 87465(h)(5). POC shall be submitted by 12/08/25

From the deficiency page — Deficiency type: Type B · Section cited: CCR87303(a)(1) · Plan of correction due date: Dec 8, 2025

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement has not been met as evidenced by: Observation, LPA and staff observedThe facility grounds needs attention in the hallway floor transition piece is a trip risk and the roof is leaking in several spots. This violation posses a potential health and safety risk.the state’s words, verbatim · CDSS document, Nov 24, 2025

Plan of correction: The Licensee will provide the department with photos of the cleared area and/or repair bilsl or plans by close of business on 12/08/25

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to conduct an annual required inspection. LPA was met by Administrator and explained the purpose of the visit. The focus of the concerns at this time is the request for a change of ownership: Control of Property - Licensee will provide a copy of the lease which Licensee reported is current and active Administrator Designee - LIC200 and LIC308 Licensee confirmed the facility is licensed as a sole proprietor Licensee confirmed Liability Insurance Licensee confirmed that the business was sold. The LPA informed the current licensee that he will have to submit. 1. New License Application: The prospective new licensee must submit a new application for a license to the California Department of Social Services (CDSS). Continued 2. Notification of Residents and Licensing Agency: The current licensee must notify both the licensing agency and all residents (or their responsible parties) in writing about the upcoming change of ownership. 60 days prior: For a change of ownership, the notification should be sent at least 60 days before the effective date. 30 days prior: For other changes like licensee, license type, or location, the notification should be sent at least 30 days before the effective date. 3. Continuity of Care: The new owner must ensure a smooth transition for residents, potentially including reviewing and potentially updating admission agreements to reflect the new ownership, but not changing the core terms without consent. 4. Financial and Legal Considerations: Both the seller and buyer need to address insurance policies, potential financing, and other legal aspects of the sale, including compliance with regulations and zoning restrictions, especially in California. 5. Potential Application Fees: There may be application fees associated with the new license application. 6. Application Process: The application process, including the submission of necessary documents and information, may involve the Centralized Applications Bureau (CAB) and can take 90 to 120 days.the state’s words, verbatim · CDSS document, Jun 26, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Albert Johnson arrived on 3/4/2024 unannounced to conduct an annual inspection. LPA met with Administrator Mothanna Saleh. Facility is a 6 bed residential care facility for the elderly (RCFE) with a current census of 4. Facility has 4 bedrooms and 2 bathrooms for resident use. There is a dining area off the kitchen. LPA also conducted the infection control domain tool. LPA and Staff inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards. LPA observed sufficient furniture and lighting throughout the facility. LPA observed sufficient seven day non-perishable and two day perishable food supplies. LPA and Staff measured the hot water temperature in residents bathroom at 114 degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees. Fire extinguisher and Smoke detectors are operational. LPA observed centrally stored medications are kept locked and inaccessible to residents. LPA reviewed and compared resident medication vs. medication logs. LPA, and Staff reviewed 4 resident and 2 staff files. First aid kit was checked and is complete. LPA observed carbon monoxide detectors in the facility. The facility conducts fire/disaster drills with residents on 1/2025. Exit interview conductedthe state’s words, verbatim · CDSS document, Mar 13, 2025

Type of visit: Case Management - Health Checks

On 5/6/2024 LPA Albert Johnson contacted to the facility to complete a health and safety visit. LPA confirmed that staffing is sufficient today and there are no unmet needs for the residents in care. Health and Safety check has concluded for today. The overall safety of the facility including food supply, physical plant and staffing. No deficiencies were cited pursuant to Title 22 rules and regulations, Health and Safety Codes. Exit interview conducted..the state’s words, verbatim · CDSS document, Jun 5, 2024

Type of visit: POC

On 5/6/2024 LPA Albert Johnson made an unannounced POC visit to the facility to verify correction of citations issued during the complaint inspection LPA toured the facility, reviewed document submitted for plans of correction observed that the deficiency cited has been cleared. R1 refused to go to the Optometrist. Deficiency cited under Title 22 Regulations have been cleared. Licensee complied with the terms of the POC by POC due date. Facility was provided POC cleared letter. Exit interview conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, May 6, 2024

Allegation investigated: Staff did not assist resident with scheduling medical appointments

On 3/18/2024, LPA Johnson made an unannounced visit to deliver findings for the above allegations. LPA met with Vicky Santillan Allegation: Staff did not assist resident with scheduling medical appointments. Based on records reviewed the facility did not make appointments for R2 to get an updated physician's report. The department also interviewed R1 and confirmed that the facility has not schedule or assisted to schedule an appointment to have R1's see the optometrist. Continued. Substantiated Allegation: Staff does not provide daily activities for resident. Based on interviews and records reviewed the facility has established a calendar of activities and daily items are listed that the facility has determined to be happening at the time, however the activities happening are alternatives to what is listed. The residents interviewed confirmed that they are not interested in the items listed but would prefer watching television. The residents interviewed confirm that if they had a chose they would not go out. They prefer staying home. Allegation: Staff do not provide clean laundry for resident. Based on interviews with the residents and staff, the facility provide laundry service for all residents, however, R1 does not want anybody touching her items. R1 had a bad experience at another facility and stated that someone would steal clothing when it was wash day. The facility attempted to reassure R1 that this would not happen at this facility. R1 refused to allow staff to wash clothes unless R1 was there to make sure the washed items were not stolen. Although the allegations 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 allegations are Unsubstantiated. As a result, these allegations are SUBSTANTIATED. Citation is issued today under Title 22, Health and Safety Code, Chapter 3.2 and noted on LIC 9099D. Appeal rights provided.the state’s words, verbatim · CDSS document, Mar 18, 2024 · control 27-AS-20240205150133

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(a)(1) · Plan of correction due date: Mar 25, 2024

Incidental Medical and Dental Care:The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement was not met as evidenced bythe state’s words, verbatim · CDSS document, Mar 18, 2024

Plan of correction: Facility will schedule an appointment for resident to be assessed by R2's physician an R1 will have anappointment scheduled for the eye doctor. Facility will provide a written statement to the department indicating the steps the facility will take to ensure the deficiency does not reoccur by POC date 3/25/24

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Albert Johnson arrived on 3/4/2024 unannounced to conduct an annual inspection. LPA met with Administrator Mothanna Saleh. Facility is a 6 bed residential care facility for the elderly (RCFE) with a current census of 5. Facility has 4 bedrooms and 2 bathrooms for resident use. There is a dining area off the kitchen. LPA also conducted the infection control domain tool. LPA and Staff inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards. LPA observed sufficient furniture and lighting throughout the facility. LPA observed sufficient seven day non-perishable and two day perishable food supplies. LPA and Staff measured the hot water temperature in residents bathroom at 112.5 degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees. Fire extinguisher and Smoke detectors are operational. LPA observed centrally stored medications are kept locked and inaccessible to residents. LPA reviewed and compared resident medication vs. medication logs. LPA, and Staff reviewed 5 resident and 2 staff files. First aid kit was checked and is complete. LPA observed carbon monoxide detectors in the facility. The facility conducts fire/disaster drills with residents on 1/2024. Exit interview conductedthe state’s words, verbatim · CDSS document, Mar 4, 2024