Park Place Camarillo

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a post-licensing visit. Upon arrival, the LPA met with the receptionist then met with Executive Director (ED) Gloria Morales shortly after. The reason for the visit was explained. Entrance interview conducted. The LPA, along with the ED, conducted a physical plant tour starting at 11:14AM. The physical plant areas were inspected inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. The following was observed: BEDROOMS: The facility consists of 107 total bedrooms, of which LPA observed ten (10) random resident bedrooms; three (3) in the Meadows (Memory Care) and seven (7) in Assisted Living. All resident rooms observed were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. One (1) resident room (Resident #1's room) observed in the Memory Care unit is a bedridden room and the magnet latching mechanism was observed broken off from the wall. ED indicated this was broken over the weekend and is scheduled to be repaired today once parts are obtained. RESTROOMS: Each resident room contains its own private restroom. Resident restrooms observed contained sufficient grab bars and slip-resistant surfaces. The LPA observed that the restroom belonging to Resident #2 (R2) had broken and possibly water damaged tiles surrounding the toilet area. Water temperature was tested in seven (7) resident restrooms and measured between 107.1 and 135.5 degrees Fahrenheit, with six (6) of the seven (7) rooms measuring above the required range. Report Continued on LIC 809-C COMMON AREAS: Consisting of the lobby, library, activity room, dining room, bistro, and theater room in the Assisted Living side and activity room and dining room in the Meadows side. The LPA observed common areas to be clean and properly furnished at the time of the visit. A janitor's closet was observed to have a broken doorknob and the door closing mechanism was taped open during the visit, rendering the door unable to be closed. ED stated the key broke off in the door lock recently. The temperature was maintained at a comfortable level throughout the building. Cleaning supplies and disinfectants are stored locked per regulation. The LPA observed cameras in the common areas. The LPA observed the required postings in the common area. OUTDOOR SPACE: The LPA observed the building and grounds in both Assisted Living and Memory Care. Multiple seating areas were observed with tables and chairs and shaded seating areas for resident use. During today’s visit, the LPA inspected the two (2) side delayed egress doors located in the Meadows; both delayed egress units were functional at the time of the visit. In the Memory Care unit outdoor area, the storage shed that houses the facility's trash was observed to be broken and overflowing with trash. RECORD REVIEW: LPA reviewed 5 (five) staff and five (5) resident records for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisals, and admission agreements. Staff records reviewed contained all required documentation. LPA noted that the designated Administrator is no longer present in the facility and the ED has assumed the role approximately two (2) months ago, however, documentation was not received by the Department. All five (5) of five (5) resident files reviewed contained all documents, however, none of the reappraisals reviewed contained required signatures from the resident or resident’s responsible party. MEDICATION REVIEW: Not observed during today's visit. KITCHEN: Not observed during today's visit. INFECTION CONTROL/EMERGENCY DISASTER PLAN: Not observed during today's visit. INTERVIEWS: Not conducted during today's visit. The following deficiencies were observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 29, 2026

The state marks this report as 8 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Type of visit: Office

Facility Type: Residential Care Facility for the Elderly Application Type: Change of Ownership Capacity: 130 Census (if any clients in care): 54 COMP II Participants: HEIDI CHARETTE, JANETTA CHERNEGA Interview Method: Telephone interview On August 03, 2026, 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 the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restricted/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Aug 3, 2026

Allegation investigated: Facility does not have a working telephone

Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced initial complaint visit regarding the above noted allegation. LPA met with Administrator Heidi Charette. Entrance interview conducted. During today’s visit, LPA interviewed Administrator at 12:53PM, staff at 01:35PM, and a telephonic interview with staff at 02:00PM. LPA obtained copies of pertinent documents. Prior to conducting today's visit, the LPA had called the facility on various occasions and made observations. The following was then determined: Interviews revealed that following the recent change of ownership, the licensee decided to upgrade the facility's phone system. Technicians were on site on 06/04/2026 and 06/05/2026 to work on the upgrade and reprogram the extensions. Interviews revealed that it is possible that during the service, the phones may Report continued on LIC 9099-C Unsubstantiated have been down for a brief period of time. Interview with staff revealed that the families have alternate ways to contact the facility such as calling a resident on their personal cell phone or sending a text message to staff. No one informed the facility that they had attempted to contact a resident and they were unable to reach anyone. Residents can use either the facility phone to call out or they can ask staff to assist them in making a call. No residents reported ever not being able to make or receive telephone calls. LPA also called the facility on various occasions during the time the complaint was received and today's visit. On one of the LPA's telephone calls, there was a recording prompting the LPA to choose an extension. The other three (3) telephone calls the LPA made were answered by the receptionist. Administrator indicated that a receptionist is present at the front desk seven (7) days a week from 09:00AM to 05:30PM. After hours, calls are automatically redirected to the memory care unit where staff are always present and able to answer the phone. The information obtained during the investigation did not include sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time. No citations issued. Exit interview was conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Jun 8, 2026 · control 29-AS-20260604123240

Type of visit: Prelicensing

Licensing Program Analysts (LPAs) Valeria Conway and Kelly Dulek conducted an announced pre-licensing visit to the facility noted above at 09:40AM. This is a change of ownership application. LPAs met with Applicants Janetta Chernega, Stuart Montalvo and Steve Kregel. An approved fire clearance was granted on 05/14/2026 clearing for a total capacity of one hundred thirty (130) residents of which one hundred ten (110) are for non-ambulatory residents and twenty (20) are for residents who are bedridden. All rooms are approved for non-ambulatory/bedridden residents. There is a pending hospice waiver for ten (10). Facility Layout: The facility is a one-story building with one hundred seven (107) units. There is a secured memory care unit with approved delayed egress doors. There are twenty-three (23) resident rooms in the Memory Care Unit and eighty-four (84) rooms in Assisted Living. LPAs inspected ten (10) randomly selected resident bedrooms. Bedrooms are equipped with clean mattresses, pillows, bedding and have sufficient lighting. There is a sufficient supply of linens, including blankets, bath towels, and wash cloths. The facility has the following amenities and common areas: office spaces, beauty salon, the bistro, lobby, activity room, dining rooms, courtyards, theater, and library. Common Spaces: Regarding the signal system, staff utilize walkie-talkies to communicate accordingly and all residents have pull cords in their rooms. There are cameras observed in the common areas and exterior perimeter. The community’s smoke detectors and carbon monoxide detectors are hard wired and were inspected by Ventura County Fire Protection on 12/24/2025 with no violations observed. LPAs observed fire extinguishers throughout the facility to be fully charged and last serviced on 04/09/2026. There is a functioning telephone on the premises. The emergency exiting plans/sketch are posted in the hallways. LPAs observed other required postings throughout the community. Report Continued on LIC 809-C Bathrooms: Bathrooms were equipped with grab bars near the toilet and shower/tub, and slip-resistant surfaces were observed in the shower/tub. During today's visit, water temperature was tested in resident bathrooms, and all measured within the required range of 105 to 120 degrees F. Grounds: LPAs observed appropriate outdoor furniture with a covered shaded area for residents. There was an enclosed courtyard for residents whom reside in the memory care unit. Passageways were free and clear from obstruction. Kitchen: The community had a sufficient supply of perishable and nonperishable food at the time of the visit. Appliances in the kitchen were clean and appeared functional. Snacks and beverages are available for residents in the Bistro. Food is prepared in the main kitchen by Assisted Living and is delivered to the Memory Care dining room. Records: Beginning at 12:31PM, LPAs reviewed five (5) resident files and five (5) personnel files for required documents. Both resident and staff files were observed to be incomplete. During today's visit, a designee was present auditing all resident records. Management stated that all staff and resident files will be audited to ensure complete records are maintained. Medications: There is a medication room in the assisted living section. Medications appeared to be documented on the centrally stored medication record and were present in the facility for self-administration. During today's visit, a designee was present auditing medications. Management stated that all medications and medication records will be audited to ensure compliance. Physical plant is not consistent with the submitted facility sketch/floor plan as there are twenty four (24) bedrooms in memory care on the sketch, however there are twenty three (23) rooms present bedroom in memory care and eighty-six (86) bedrooms in assisted living on the submitted sketch that were not observed during the physical plant inspection. LPAs informed applicants to send the updated sketch to Centralized Application Bureau (CAB). Comp III conducted with Applicant. This report will be sent to CAB. You will be notified by the CAB Analyst when your license has been approved.the state’s words, verbatim · CDSS document, May 20, 2026