Mrs Scott's Where Heart Is Homes-Carmel by the Sea

Type of visit: Required - 1 Year

On 09/14/2026, Licensing Program Analysts (LPAs) M Vega and H Vang arrived unannounced at the above facility to conduct an Annual Inspection. LPAs introduced self, stated the purpose of the visit, and requested to meet with the Administrator. Facility staff informed LPAs that the Administrator was not present in the facility and was granted entry to the facility. Facility staff contacted Administrator - Phoeun Marez, who arrived a short time later. Facility tour conducted with Administrator - Phoeun Marez. The facility was observed to be at a comfortable temperature, of 72 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPA observed some residents in their rooms awaiting breakfast, others in the dining room during breakfast. Department phone number and infection prevention information signs were posted thought the facility. At the time of inspection there are currently 5 residents at the facility. Fire extinguisher was observed with a service date of 04/09/2026. Water Temperature in Residents’ Restroom measured at 107.2 Degrees F. Residents’ bathroom was observed, hand washing signs posted, trash receptacles did have lids. Medications observed to be locked in a cabinet in the kitchen. Inspecting kitchen LPA observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. An outdoor seating area was observed accessible residents in care. LPA reviewed Staff and Resident files. Resident files observed to have update information. Continuation on LIC 809 C LPAs reviewed medication and there was medication that exceeded the count posted on the bottle, when calculating the pills in the bottles with Medication Administration Record (MAR) and Start dates for medication pill count did not match records kept. The following deficiencies were observed and noted on the attached LIC 809D. All violations that, if not corrected, will have direct and immediate risk to the health, safety or personal rights of clients in care Exit interview conducted and a copy of Facility Report will be provided to Staff for facility record along with LIC 809D and Appeal rights. Administrator - Phoeun Marez granted permission to Staff - Josie Yabud.the state’s words, verbatim · CDSS document, Sep 14, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(c)(2) · Plan of correction due date: Sep 15, 2026

87465(c)(2) Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidenced by: Atrovastatin 10mg, Levothyroxine 75mcg, Trazadone 100mg, Fluticasone Propionate/Salmeterol 250mcg/50 and, Aripiprazole 10mg (Generic for Abilify) were not administered as prescribed by physician for which poses an immediate health and safety risk for the person in care.the state’s words, verbatim · CDSS document, Sep 14, 2026

Plan of correction: Will double check the lable and the pill count, Staff Traiining tomorrow by the end of the day.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87465(c)(3) · Plan of correction due date: Sep 21, 2026

87465(d)(3) The date and time …medication was taken, the dosage taken, and the resident’s response shall be documented and maintained in the resident’s facility record. This requirement was not met as evidenced by: Based on interviews conducted, observation, records reviewed, R1’s medication Quetapine, melatomin, and trazodone, were not signed in some instances, and others signed accidentaly for which poses a potential health and safety risk for the person in care.the state’s words, verbatim · CDSS document, Sep 14, 2026

Plan of correction: Staff training to ensure that staff is signing appropriately.

Allegation investigated: Licensee does not ensure staff has a background clearance to provide care to residents

Licensing Program Analyst (LPA) M Vega conducted an unannounced complaint investigation visit for the purpose of delivering the finding for the above allegations. LPA met with Administrator - Phoeun Marez. During the course of this investigation LPA reviewed facility files relevant to the complaint investigation, as well as conducting interviews. It was determined that the above allegations: Licensee does not ensure staff has a background clearance to provide care to residents is found to be UNFOUNDED. Staff per both visits were documents on staff roster. Interviews do not reveal any other names of workers working in the facility there are not associated to facility. Based on the investigation it has been determined the allegations are UNFOUNDED, meaning that the allegations were false, could not have happened or are without a reasonable basis. The complaint has therefore been dismissed. An exit interview was conducted and a copy of the report provided to Administrator - Phoeun Marez. Unfoundedthe state’s words, verbatim · CDSS document, Dec 18, 2025 · control 24-AS-20251105162206

Type of visit: Required - 1 Year

On 09/19/2025, Licensing Program Analyst (LPA) M Vega arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and requested to meet with the Administrator. Facility staff informed LPA that the Administrator was not present in the facility and was granted entry to the facility. Facility staff contacted Administrator - Phoeun Marez, who arrived a short time later. Facility tour conducted with Administrator - Phoeun Marez. LPA observed signs promoting hand washing, social distancing, and cough/sneeze etiquette throughout facility. LPA toured the facility kitchen. LPA observed an adequate supply of food. LPA observed a 30-day supply of PPE and cleaning supplies. Inspecting kitchen LPA observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. Fire extinguisher was observed with a service date of 06/30/2025. All residents’ bedrooms were observed to be with comfortable temperature. Facility overall temperature was at 75 degrees F. Water Temperature in Restroom 1 measured at 117.5 Degrees F. Residents’ bathroom was observed, hand washing signs posted, trash receptacles did not have lids. Medications observed to be locked in a cabinet in the kitchen. An outdoor seating area was observed accessible residents in care. LPA reviewed Staff and Resident files. Resident files observed to have update information. Continuation on LIC 809C LPA is requesting the following documents be submitted to the Fresno CCL office by 10/03/2024: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC 308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC 500), Register of Facility Clients/Residents for (LIC 9020A) no deficiencies observed and no citations issued. A signed copy of this report was provided to Administrator - Phoeun Marez for facility records.the state’s words, verbatim · CDSS document, Sep 19, 2025

Type of visit: Required - 1 Year

On 09/18/2024, Licensing Program Analyst (LPA) M. Vega arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and requested to meet with the Administrator. Facility staff informed LPA that Director was not present in the facility and was granted entry to the facility. Facility staff contacted Director Grace Petil, who arrived a short time later. Facility tour conducted with Tirso. Pathways in the back of the facility were obstructed. LPA observed signs promoting handwashing, social distancing, and cough/sneeze etiquette throughout facility. LPA toured the facility kitchen. LPA observed an adequate supply of food. LPA observed a 30-day supply of PPE and cleaning supplies. Inspecting kitchen LPA observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. Fire extinguisher was observed with a service date of 08/29/2024 All residents’ bedrooms were observed to be with comfortable temperature. Residents’ bathroom was observed, hand washing signs posted, trash receptacles did not have lids. Medications observed to be locked in a cabinet in the kitchen. Cleaning supplies were observed to be exposed and unlocked in the laundry room and restrooms. An outdoor seating area was observed accessible residents in care. LPA reviewed Staff and Resident files. Resident files observed to have update information. LPA is requesting the following documents be submitted to the Fresno CCL office by 10/03/2024: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC 308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC 500), Register of Facility Clients/Residents for (LIC9020A) Based on observation, Deficiencies were cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809Ds, Technical Violations and Technical Advisories. Exit interview conducted and a plan of correction was reviewed and developed with Director. A copy of this report and appeal rights were discussed and provided to Director Grace Petil, the report was signed and copy of this report was provided to Director for facility records.the state’s words, verbatim · CDSS document, Sep 18, 2024

The state marks this report as 13 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Allegation investigated: Staff are overmedicating a resident while in care Staff are leaving a resident unattended

This is an amended report On 09/24/2024, Licensing Program Analyst (LPA) V Gorban visited facility stated above to deliver findings. LPA met with Administrator Grace Petil, explained the purpose of the visit. LPA toured facility inside and out, observed residents in care and discussed findings to allegation. Allegation: Staff are overmedicationg a resident while in care. During complaint investigation department reviewed facility records, staff training, interviewed staff and Administrator, and observed the staff and residents during facility visits. Records review revealed that medications were provided to residents as prescribed. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Report continues on attached LIC9099-C Unsubstantiated Allegation: Staff are leaving resident unattended. During the facility visits on 7/30/24 and 9/3/24 based on observations, record reviews and interviews revealed that staff were present at the facility. During observations on both visits all residents were in common area with staff present. Records review revealed that facility is staffed and during interview no concerns reported. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Exit interview conducted, report signed and copy of this report provided to administrator for facility records.the state’s words, verbatim · CDSS document, Sep 3, 2024 · control 24-AS-20240509140647

Allegation investigated: Staff did not follow resident's diet Staff did not assist resident in a timely manner Staff took resident's personal items Uncleared staff working at the facility

On 07/30/2024, Licensing Program Analyst (LPA) V Gorban visited facility stated above to deliver findings. LPA met with Administrator Grace Petil, explained the purpose of the visit. LPA toured facility inside and out, observed residents in care and discussed findings to allegation. Allegation: Staff did not assist resident in a timely manner, Staff took resident's personal items, Uncleared staff working at the facility. Staff did not follow resident's diet. During complaint investigation department reviewed facility records, staff training, interviewed staff and Administrator, and observed the staff and residents during facility visits. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Report continues on attached LIC9099-A Unsubstantiated Allegation: Staff did not assist resident with their medication. Based on interviews conducted and records review it was revealed that on multiple occasions, 01/06, 01/07, and 01/08 R1 was not provided medications by staff as ordered. Based on staff interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations being cited on the attached LIC 9099-D. Exit interview conducted, report signed and copy of this report with appeal rights provided to Administrator for facility records.the state’s words, verbatim · CDSS document, Jul 30, 2024 · control 24-AS-20240304102705

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(2) · Plan of correction due date: Aug 2, 2024

87468.1 Personal Rights of Residents in All Facilities (2) To be accorded safe, healthful and comfortable accommodations. This requirement was not observed as evidenced by: Based on witnesses interviews and records review R1 was not provided care to injured right foot. The facility staff failed to offer resident medical evaluation to the injured right foot which poses potential threat to health and safety of the residentts in care.the state’s words, verbatim · CDSS document, Jul 30, 2024

Plan of correction: Administrator and staff will ensure facility staff are following with family and close monitoring residents all day around, keeping family and updating social worker on residents health. Also provide training to LPA by POC due date

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(c)(2) · Plan of correction due date: Aug 2, 2024

87465 Incidental Medical and Dental Care (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement was not observed as evidenced by: Based on witnesses interview and records review R1 did not receive medications as prescribed. Which poses potential threat to health and safety of the residents in care.the state’s words, verbatim · CDSS document, Jul 30, 2024

Plan of correction: Administrator will ensure facility staff are monitoring medications refill and following medications orders. Also provide staff training to LPA by POC due date

Allegation investigated: Staff are unable to effectively communicate with resident.

On 3/07/24, Licensing Program Analyst (LPA) V Gorban visited facility stated above to deliver findings. LPA met with Administrator Grace Petil, explained the purpose of the visit. LPA toured facility inside and out, observed residents in care and discussed findings to allegation. Facility was taken care of 6 residents, two of them was under hospice care. Allegation: Staff are unable to effectively communicate with resident. During complaint investigation department reviewed facility records, staff training, interviewed residents, staff, and Administrator. During resident's stay facility employed interpreter to communicate with resident with communication barrier. 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. Exit interview conducted, report signed and copy of this report provided to Administrator for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 7, 2024 · control 24-AS-20240109112324