Omnicare III

Allegation investigated: Staff do not ensure a comfortable temperature for residents is maintained Staff do not treat resident with dignity

Licensing Program Analyst (LPA) Zabel Chochian conducted an unannounced subsequent complaint visit to this facility today to deliver investigation finding. LPA met with staff and introduced self. Staff contacted Laila Kulungu, Assistant Administrator and reason for the visit was explained. Investigation finding was discussed and staff was designated to sign the report. On 03/10/2026, the Department received the above listed allegations. On 03/18/2026, LPA Chochian conducted complaint visit. Beginning at approximately 12:15PM, LPA and staff toured the facility common areas and resident rooms. Facility temperature observed at 72 degrees Fahrenheit (F) and outside temperature was approximately 93 degrees F. At approximately 12:45PM LPA reviewed facility records including but not limited to resident files. Between 1:15PM-2:45PM, LPA interviewed the Administrator, staff, and other potential witnesses. LPA attempted to interview residents. All residents currently have cognitive issues however two (2) out of the four residents were able to converse with LPA and expressed being happy with the facility and staff. No issues were reported about the facility being cold. (Continue to LIC9099c) Unsubstantiated Following is a summary of the allegations and finding: Regarding allegation “Staff do not ensure a comfortable temperature for residents is maintained”. Information was received that resident #1 was observed to be cold, and staff did not ensure resident was appropriately covered. During the initial visit LPA attempted to interview resident #1 however resident was unable to answer questions. Other residents and families were interviewed during the initial visit and reported no issues and shared that they are very satisfied with the care staff. No issues were reported about the facility temperature. Facility temperature was observed to be 72 degrees during the visit on 03/18/2026. Staff reported that resident #1 is often cold especially after showers, therefore staff provide a blanket for resident #1 when in the common area. Staff reported that each resident has a blanket and the facility also has extra blankets. LPA observed sufficient supply of blankets at the facility for residents use. LPA attempted to reach the reporting party on 3/18/2026, 4/23/2026 and 5/12/2026. Based on the above information gathered although the allegations may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the allegations “Staff do not ensure a comfortable temperature for residents is maintained” is deemed unsubstantiated at this time. Regarding allegation “Staff do not treat resident with dignity”. Information was received that staff said “don’t pay attention to what residents say because they have dementia”. Staff interviewed denied the allegation and reported that residents are all treated with dignity and respect. Staff explained that resident do have cognitive issues and repeat things and staff do acknowledge that and redirect and ensure residents health and safety is not compromised in any way. Interview was attempted with all residents. Two out of the four residents were able to communicate and shared no concerns about the treatment of staff. Both residents interviewed reported that they are pleased with the staff at the facility and are treated well. Residents’ responsible persons interviewed expressed being very satisfied with the care and staff. No issues were reported. LPA attempted to reach the reporting party on 3/18/2026, 4/23/2026 and 5/12/2026. Based on the above information gathered although the allegation may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the allegation “Staff do not treat resident with dignity” is deemed unsubstantiated at this time. Exit interview conducted and copy of report issued.the state’s words, verbatim · CDSS document, May 17, 2026 · control 29-AS-20260310103157

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility to conduct a required annual inspection. Upon arrival LPA was greeted by staff and entrance interview and introductions conducted. Assistant Administrator Laila Kulungu was contacted and arrived to the facility. At approximately 110:15a.m., LPA and staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: Fire extinguisher located in the kitchen was observed fully charge with receipt dated 10/2025. There is a functioning telephone on the premises. Emergency exiting plans/sketch are posted. Emergency telephone numbers are posted in the main hallway area wall. Other required postings are also posted on the main hallway area wall. KITCHEN: Kitchen knives are stored in a locked kitchen drawer. The supply of dishes, utensils, pots, pans, and drink ware is adequate. The supply of nonperishable food is adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen, and house cleaning supplies are stored and locked under the sink cabinet area. BEDROOMS: The facility has six (6) private residents’ bedrooms, and one (1) staff’ bedroom. All bedrooms observed with required furniture and clean linen. Lighting in the rooms appeared sufficient. BATHROOMS: There are three (3) bathrooms. Hot water temperature was tested in all restrooms and recorded between 109-118 degrees Fahrenheit. COMMON AREAS: The common areas were appropriately furnished, and the lighting was adequate. Entertainment equipment, books and/or activity supplies observed for residents use. There was sufficient space to accommodate both indoor and outdoor activities. Alarms on all exterior doors were engaged at the time of visit and functional. Garage was observed locked and contained extra food, PPE supplies, cleaning supplies, and water supply. Laundry room observed with supplies and chemicals locked in the cabinets. LPA reviewed the facility emergency disaster and infection control plan with Ms. Kulungu. (Continue to LIC809c) INFECTION CONTROL: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills are conducted quarterly as is required. Earthquake and fire drill conducted on 10/1/2025. Smoke/carbon monoxide detectors were tested at 11:15am and observed operable. OUTDOOR: The exterior passageways were clean and clear of any obstructions. There is a covered patio with furniture for residents use. LPA met with all five residents, one family member and two staff. Resident #1 was observed seat belted in a wheelchair. Interview with staff revealed that the family installed the seat belt to prevent resident #1 from falling forward. LPA informed staff that postural devises cannot be used to restrain resident, cannot be used to prevent falls; can only be used to assist in mobility. RECORD REVIEW: Records review began at 11:30a.m.-1p.m.. LPA observed all five (5) resident records for documents including, but not limited to: needs and service appraisals, medical records, admissions agreement, and consent forms. LPA observed three (3) personnel records for documents including, but not limited to: health assessments, criminal record clearances, first aid/CPR training, and required training. Resident and Personnel files reviewed were in order and had no missing documents. MEDICATIONS: Medications are stored inaccessible in locked cabinets in the hallway/office area. Beginning at 1:30p.m.-2:30p.m., LPA reviewed five (5) residents medication and medication records. Medications were observed to be properly documented on the centrally stored medications. One out five residents medications reviewed did not have a prescription for over the counter medication (advil/cough syrup). Pursuant to Title 22, CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Administrator was informed that failure to correct deficiencies may result in civil penalties. Exit interview conducted, report issued, and appeal rights provided.the state’s words, verbatim · CDSS document, Dec 15, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility to conduct a required annual inspection. Upon arrival LPA was greeted by staff and entrance interview and introductions conducted. Administrator Laila Kulungu was contacted and arrived to the facility. The LPA and administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: Kitchen knives are stored in a locked kitchen drawer. The supply of dishes, utensils, pots, pans, and drink ware is adequate. The temperatures for the refrigerator and freezer could not be verified as neither have a thermometer. The supply of nonperishable food is adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen, and house cleaning supplies are stored and locked under the sink cabinet area. BEDROOMS: The facility has six (6) private residents’ bedrooms, and one (1) staff’ bedroom. All bedrooms observed with required furniture and clean linen. Lighting in the rooms appeared insufficient - lamps used in residents bedrooms did not provide sufficient lighting. BATHROOMS: There are three (3) bathrooms. One is a private bathroom located in bedroom #1. Two (2) bathrooms are located in the hallways and are for residents' and staff use. Hot water temperature was tested in all restrooms and recorded between 114-117 degrees fahrenheit. COMMON AREAS: The common areas were appropriately furnished, and the lighting was adequate. Entertainment equipment, books and/or activity supplies observed for residents use. There was sufficient space to accommodate both indoor and outdoor activities. There is a fireplace in the living room observed with cover. Alarms on all exterior doors were engaged at the time of visit and functional. Garage was observed locked and contained extra food, PPE supplies, cleaning supplies, and water supply. Laundry room observed with supplies and chemicals locked in the cabinets. Medications observed locked in the cabinet in the hallway; each resident medications stored in separate boxes. The exterior passageways were clean and clear of any obstructions. There is a covered patio with furniture for residents use. Interviews conducted with two staff and three residents. Due to time technical difficulties and time constraints annual inspection will continue on another date for records review. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Dec 23, 2024

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 6 COMP II Participants: Name - Oyewole Joseph Jose CEO/ Verona Isambi Administrator Interview Method: Telephone interview On December 13, 2023, Applicant/Administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of the following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-Licensing Readinessthe state’s words, verbatim · CDSS document, Dec 13, 2023