Norris Senior Home

Allegation investigated: Staff neglect led to a resident developing pressure injuries while in care. Staff left a resident in a soiled diaper for a long period of time. Staff did not respond to a resident's call button. Staff are not bathing a resident in care. Staff did not serve an adequate amount of food portions to a resident in care.

On 06/17/2026, Licensing Program Analysts (LPA) Arielle Pascua arrived unannounced to this facility to conduct a complaint visit. LPAs met with Facility Staff, Rosana Geronimo and explained the purpose of the visit. LPA Pascua asked for Staff Geronimo to call the Facility Designated Administrator (FDA), Nazarina Vega to inform them that CCL was present. Shortly after, FDA Vega he purpose of the visit was to deliver complaint findings for the allegations above. Current census was 5. A brief interview with Staff Geronimo was conducted. Allegation: Staff neglect led to resident developing pressure injuries while in care. It was alleged that staff neglect let to resident developing pressure injuries while in care. During the course of this investigation the department conducted interviews and reviewed facility records. Based on interviews conducted, it was determined that a resident was observed to have a pressure injury upon admission in or around January 2026. Unsubstantiated Facility staff notified the home health agency and coordinated with the Home Health Nurse to assist with the treatment and management of the pressure injury while the resident remained in care at the facility.A review of facility records indicated that the resident was provided with a pressure-relieving mattress through home health services to help prevent further skin breakdown and reduce the risk of future pressure injuries. Documentation further showed that the pressure injury was subsequently assessed and determined to be healed by a licensed healthcare professional.Based on the information gathered, there is not sufficient evidence to show that staff neglected the resident which lead to pressure injuries. Allegation: Staff left a resident in a soiled diaper for a long period of time. It was alleged that staff left a resident in a soiled diaper for a longer period of time. During the course of this investigation, the department conducted interviews and reviewed facility records. Based on interviews conducted with five residents, one out of five residents stated that facility staff had left them in a soiled brief for an extended period of time. The remaining four out of five residents stated that facility staff did not leave them in a soiled brief. Interviews were also conducted with four staff members. All four staff members denied leaving residents in a soiled brief for an extended period of time. A review of facility records revealed that one of the five residents consistently declined incontinence care, stating that they were "dry" and did not require changing at the time of staff intervention. Documentation further indicated that facility staff provided ongoing reminders and education to the resident regarding the importance of routine changes and incontinence care.Based on the information gathered, there are inconsistent statements that indicate that the staff left the resident in a soiled diaper for a long period of time. Allegation: Staff do not respond to a resident’s call button. It was alleged that staff do not respond to a resident’s call button. During the course of this investigation, interviews with 5 residents and 4 staff members were conducted. 1 out 5 residents state that the facility staff do not respond to the resident’s call button. 4 out 5 residents deny that the facility staff do not respond to their call buttons. 4 out 5 residents state that they are able to obtain help from the facility staff within 5-10 minutes. Interviews with 4 staff members were conducted. 4 out 4 staff members deny that they do not respond to a resident’s call button. Based on the information gathered, there is not sufficient evidence to prove that staff do not respond to a resident’s call button. Allegation: Staff are not bathing a resident in care. It was alleged that staff are not bathing a resident in care. During the course of this investigation, the department conducted interviews and reviewed facility records. Based on interviews conducted with five residents, one out of five residents stated that facility staff do not respond to their call button in a timely manner. The remaining four out of five residents denied experiencing issues with staff responding to their call buttons. Four out of five residents further stated that they are typically able to obtain assistance from facility staff within approximately 5 to 10 minutes of activating their call button. Interviews were also conducted with four staff members. All four staff members denied failing to respond to resident call buttons and stated that resident requests for assistance are addressed as promptly as possible. Based on the information gathered, there are inconsistent statements that indicate that the staff are not bathing a resident in care. Allegation: Staff did not serve an adequate amount of food portions to a resident in care. It was alleged that the facility staff did not serve an adequate amount of food portion to a resident in care. During the course of the investigation, the department conducted interviews and reviewed facility records. Based on interviews conducted with five residents, one out of five residents expressed dissatisfaction with the facility's food service. The remaining four out of five residents stated that they had no concerns regarding food quality, portion sizes, or meal service. Interviews were also conducted with four staff members. All four staff members denied failing to provide residents with adequate food portions and stated that meals are served in accordance with residents' dietary needs and facility standards. A review of facility records indicated that the residents interviewed had not documented any concerns regarding food portions, meal quality, or food service at the time of review. Based on the information gathered, there is not sufficient amount of evidence to prove that the facility staff did not serve an adequate amount of food portions to a resident in care. As a result of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. There were no deficiencies observed or cited at this time. An exit interview was conducted, a copy of the 9099 and 9099-C was provided to the facility.the state’s words, verbatim · CDSS document, Jun 18, 2026 · control 27-AS-20260317161456

Type of visit: Case Management - Deficiencies

On 3/20/26 Licensing Program Analyst (LPA) Kevin Gould conducted an unannounced Case Management - deficiencies inspection to address deficiencies observed during an unrelated complaint inspection. LPA inspected the food supply and observed several medications requiring refrigeration stored in the facility frigid, unsecured from residents in care. LPA observed prescriptions medications stored in packaging from the pharmacy in the door of the fridge. LPA informed the licensee that all medications are required to be secured from residents and a lock box or separate fridge with a lock is required. LPA also observed several cans of expired food items and items in the fridge that are passed the best by date. Advisory note provided. Per California Code of Regulations, Title 22, the following deficiencies are cited. Exit interview conducted and a copy of this report and appeal rights were left at the facility.the state’s words, verbatim · CDSS document, Mar 20, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(2) · Plan of correction due date: Mar 16, 2026

Incidental Medical and Dental Care: Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not met as evidenced by LPA observations of medications stored in the fridge door with no lock box which poses a potential health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Mar 20, 2026

Plan of correction: LIcensee has agreed to obtain a lock box or lockable fridge.

Type of visit: Required - 1 Year

On November 04, 2025, at 9:00 AM, Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual required inspection. LPA Martinez met with Nazarina Vega and explained the purpose of today's visit. The facility Administrator holds current certificate and expires on August 07, 2025. The facility is licensed for six non-ambulatory clients. There are currently four residents who reside at this facility. The facility has an approved hospice waiver for five. Zero out of the five hospice placements are occupied. The LPA Martinez toured the facility with Rona Geronimo, 2025, at 2:00 PM. LPA Martinez reviewed four resident files; six staff files; and two medication files. Facility staff files were complete. Four out of four resident files were missing reappraisals. Resident 1's (R1) medication order, medication bottle label, and Medication Administration Record (MAR) have different dispense instructions for Famotidine 40 MG. Medication order states, "take 1 tablet by mouth daily at bed time." The MAR states, "take 1 tablet daily." The medication bottle label states, "take 1 tablet by mouth 2 times a day." R1's Ferosul 325 MG bottle label states, "take 1 tablet by mouth every other day or as directed." However, the bottle was altered to state, "everyday" with a black marker. The facility is not following R3's melatonin 10 MG medication order. R3' MAR indicates that care staff have been administering one 10 MG tablet daily. However, the Melatonin tablet being administered daily is 5 MG. In addition, the MAR does not indicate that two 5 MG tablets are being administered daily. Continued.. R3's MAR states, "Buspirone 10 MG- 1.5 tablet 3 times daily." The Buspirone medication bottle label states, "15 MG- take 1 tablet by mouth 3 times a day." The medication order states, "15- MG take 1 tablet by mouth 3 times a day." R3's MAR states, "Calcium Citrate 1 tablet daily." The Calcium Citrate bottle has a label, and the dosage is 700 MG. The Calcium Citrate medication order states, "250 MG- take 1 tablet by mouth daily. Facility fire extinguisher was last inspected on July 25, 2025. The facility smoke and carbon detectors were in good repair. The exterior emergency exit gate was in good repair. The facility has a first aid kit. The facility has a locked closet for medication storage. Resident bedrooms, common areas, kitchen, bathrooms, and laundry room were furnished and sanitary. The facility has a public telephone located at the kitchen. The facility has an adequate food supply. The facility water temperature measured at 105 degrees and the facility temperature measured at 72 degrees. The exterior of the home is clear of debris, and the resident patio is furnished and in good repair. The facility shed is used as storage room. The facility does not have interior or exterior cameras. The facility sketch is current. Bedroom one is occupied by one resident Bedroom two not occupied. Bedroom 3 is occupied by one resident. Bedroom 4 is a staff room. Bedroom 5 is occupied by two residents. LPA Martinez will continue to follow up facility resident bedroom layout and fire clearance request. As a result of this annual inspection visit, the following deficiencies were cited, per California Code of Regulations, Title 22 and Health and Safety Code: 87465(e)(2) Incidental Medical and Dental Care; 87465(a)(6) Incidental Medical and Dental Care; 87465(h)(4) Incidental Medical and Dental Care; 87465(a)(4) Incidental Medical and Dental Care; and 87463(a) Reappraisals. An exit interview was conducted, and a copy of the 809 report, 809D-Page, and appeals right were given to the facility at the end of this visit.the state’s words, verbatim · CDSS document, Nov 4, 2025

From the deficiency page — Deficiency type: Type B · Plan of correction due date: Nov 18, 2025

87463(a) Reappraisals: The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first...This requirement was not met as evidence by: based on observation file review, and interview, 4 out of 4 residents did not have an updated reappraisal. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 4, 2025

From the deficiency page — Deficiency type: Type B · Plan of correction due date: Nov 18, 2025

87465(h)(4) Incidental Medical and Dental Care: The following requirements shall apply to medications which are centrally stored:All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label. This requirement was not met as evidence by: based on file review/observation, the licensee did not ensure R3 Ferosul 325 MG med-bottle label was correct. R3's Med- bottle was altered. This posed a potential health and safety risk to R3.the state’s words, verbatim · CDSS document, Nov 4, 2025

Plan of correction: Facility staff agrees to email training documents and medication audit findings and pictures of new medication bottle label to LPA Martinez by POC Date: 11/18/2025 by 5:00 PM.

From the deficiency page — Deficiency type: Type B · Plan of correction due date: Nov 18, 2025

87465(a)(4) Incidental Medical and Dental Care: The licensee shall assist residents with self-administered medications as needed.The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidence by: based on observation file review, the licensee did not ensure facility staff assisted R1 and R3 with medications . This posed a potential health and safety risk to R1the state’s words, verbatim · CDSS document, Nov 4, 2025

Plan of correction: Facility staff agrees to email training documents and medication audit findings to LPA Martinez by POC Date: 11/18/2025 by 5:00 PM.

From the deficiency page — Deficiency type: Type B · Plan of correction due date: Nov 18, 2025

87465(e)(2) Incidental Medical and Dental Care: For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank... and a label on the medication...The exact dosage. Based on file review and observation, the Licensee did not ensure R1 and R3's written orders and medication lables contained the correct medication order information. This posed a potential health and safety risk to R1 and R3.the state’s words, verbatim · CDSS document, Nov 4, 2025

Plan of correction: Facility staff agrees to email training documents and medication audit findings to LPA Martinez by POC Date: 11/18/2025 by 5:00 PM.

From the deficiency page — Deficiency type: Type B · Plan of correction due date: Nov 18, 2025

87465(a)(6) Incidental Medical and Dental Care:A plan for incidental medical and dental care shall be developed by each facility:When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirment was not met as evidence by: based on observation and file reivew, the licensee did not ensure dosages of medications on MARs were maintained. This posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 4, 2025

Plan of correction: Facility staff agrees to email training documents and medication audit findings to LPA Martinez by POC Date: 11/18/2025 by 5:00 PM.

Type of visit: Case Management - Other

On 5/28/25 Licensing Program Analyst (LPA) Holly Williams conducted a case management inspection to address the shed that is not permitted and was being lived in, the staff room, and decrease in capacity. LPA met with facility designated administrator (FDA) Nazarina Vega and together discussed the report. LPA arrived at Norris Senior Care to follow up on the deficiencies that were cited from a prior annual visit conducted on 11/6/2024. This visit was to follow up on the shed in the back yard where the employee's were living. FDA agreed that they would reduce their capacity from 6 residents to 5 residents and make one room a staff room. The staff bedroom is room 4, bedroom 5 houses 2 clients, and bedrooms 1,2,3 are single client rooms. This was all approved by a new fire clearance granted on the date 5/22/2025. LPA toured the facility and in the shed out in the backyard was a fold up bed, lamp, clothes, dresser, plastic forks, food storage containers, snacks, hair spray, and a portable toilet. LPA stated that these things were not in the shed last time LPA was there on 2/13/2025 and the FDA stated that they obtained the all of the a fore mentioned items from the garage. LPA asked S1 why all the items were in the shed and S1 stated that there old from a long time ago. LPA informed FDA that they cannot use the shed outside as a staff room and the shed should only be used as storage. LPA asked the FDA to remove all of the items from the shed. LPA explained to the FDA that if they do have someone sleeping in the shed that the department could assess penalties. No deficiencies cited at this time. Exit interview conducted and a copy of this report and appeal rights was left at the facility.the state’s words, verbatim · CDSS document, May 28, 2025

Type of visit: POC

Licensing Program Analyst (LPA) Holly Williams arrived at Norris Senior Home 342700194 for a plan of correction visit. LPA Williams stated the purpose of the visit. A brief interview was conducted with the facility staff person at this time. This LPA requested that the facility staff person go ahead and contact the facility licensee. Von Vega came to the house and met with LPA Williams. The purpose of this visit was to follow up on the deficiencies that were cited from a prior annual visit conducted on 11/6/2024. This visit was to follow up on the shed in the back yard where the employee's are living. In an interview on 11/6/24, Von Vega said they would move the bed out and would try to get the shed permitted. On 2/13/2025 in an interview, Vega stated that they were waiting for the fire clearance and that is the reason the shed has not been permitted. Vega informed LPA Williams to wait for the permit before the fire clearance which they did not get. LPA Williams informed Von Vega on 11/6/2024 that they could not have anyone sleeping out in the shed and the furniture would have to be moved out. When LPA arrived on 2/13/25 the furniture is still in the shed and employee's are still sleeping in the shed. LPA Williams learned that a resident room is now used as a staff room. If the resident room will be used as a staff room a request will need to made to the Department. LPA Williams informed Vega that Vega is required to submit a new LIC200, new facility sketch, and a new fire clearance. In an interview, Vega stated that they are waiting for a contractor to come out to turn the garage into a living room for staff. LPA Williams informed Vega that they have to write a letter to the Department about the new construction and it has to be labeled staff room on the facility sketch and obtain a permit and new fire clearance. This facility is being cited per 22 CCR sections 87305(a). An exit interview was held with Vega. Appeal rights and a copy of this report were left with Vega.the state’s words, verbatim · CDSS document, Feb 13, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87305(a) · Plan of correction due date: Feb 15, 2025

Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: Based on observation, the licensee did not obtain a building permit and has staff living in shed in backyard which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 13, 2025

Plan of correction: Licensee agrees to provide a plan agreeing to not let anyone sleep in the shed and additional plans moving forward by POC due date. Holly.williams@dss.ca.gov

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Holly Williams and Licensing Program Manager Czarrina Camilon-Lee arrived unannounced to conduct an annual inspection. LPM Camilon-Lee and LPA Williams met with facility administrator Nazarina Vega explained the purpose of the visit. LPM Camilon-Lee LPA Williams reviewed five resident files (R1-R5) and three staff files (S1, S2, S4). LPM Camilon-Lee and Williams toured the facility with Caregiver Nolan Geronimo and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. Door to outside in the double client room when opened had a cable cord that was exposed and is a fall hazard. The facility temperature was 72 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 137 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. LPM Camilon-Lee and LPA Williams observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and working carbon monoxide/smoke detectors. LPM Camilon-Lee and LPA Williams observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPM Camilon-Lee and LPA Williams observed a locked cabinet for the storage of medication. LPA Williams observed a residents medication unlocked in the kitchen. LPAs Moleski and Williams observed locked cabinets for the storage of cleaning solutions and knives. LPA Williams when in the unlocked garage observed poisons and laundry detergents out for residents to access. LPA Williams observed in the backyard a shed that is not permitted, contained a bed, and staff is sleeping in the shed. LPA Williams LPM Camilon-Lee and LPA Williams interviewed three residents. This facility is being cited per 22 CCR Section 87303(e)(1), 87305(a), 87309(a)(1) . An exit interview was held with Nazerina Vega. Appeal rights and a copy of this report were handed to Nazerina Vega.the state’s words, verbatim · CDSS document, Nov 6, 2024

The state marks this report as 7 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) Jamie Ivey Canady made an unannounced visit to this facility to conduct an annual inspection. LPA met with Nazarina Vera and stated the purpose of today’s visit. LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations. Administrator certificate 6027605740 expired on 8/7/2023. Administrator applied for new certificate 7/1/2023. The facility is licensed for six non-ambulatory residents. There are currently 6 residents who reside at this facility, and the facility has an approved hospice waiver for 6. LPA Ivey Canady toured the facility with Nazarina Vera. LPA requested and reviewed 2 staff and 2 personnel files during today's visit. The facility has submitted a Covid-19 mitigation plan and Infection Control plan. The facility has one main screening entry point, and conducts daily staff, visitors, and resident screening checks. The fire extinguisher 7/2024, smoke detectors, and carbon detectors are in good repair. The facility has a first aid kit and medications are stored in a locked cabinet. The facility has an adequate supply of food, and the kitchen was sanitary. The resident bedrooms were furnished and in good repair. The exterior of the facility is clear of debris, and the emergency exit gate is in good repair. The facility is in compliance with California Code of Regulations, Title 22 and Health and Safety Code, there were no deficiencies cited at this time. An exit interview was held, and a copy of this report was emailed to administrator due to printer malfunction.the state’s words, verbatim · CDSS document, Oct 17, 2023