Perris Oases

Type of visit: Required - 1 Year

On 2/24/26, Licensing Program Analysts (LPAs) Kyle Wellington and Jacqueline Shaw-Ross made an unannounced visit to the facility to conduct an annual inspection. LPAs were greeted at the door by the Administrator, Maria Plascencia, who was informed of the purpose of the visit. LPAs observed six (6) staff and thirteen (13) residents present at the facility. The census at the facility is fifteen (15) residents. LPAs received a roster for staff and residents from the Admin. LPAs toured the inside and outside of the facility with the Admin. LPAs conducted an observation, interview and record review at the facility for the inspection. Facility Overview: The facility is a one story building with nine (9) resident bedrooms, six (6) bathrooms, kitchen, living room, dining room, office, and laundry room. There are no pools, bodies of water or firearms at the facility. The facility has a fire clearance to serve fifteen (15) non-ambulatory residents. The facility has an approved hospice waiver for nine (9) residents. Infection Control: LPAs observed soap dispensers in the bathrooms and hand sanitizers in the facility. Cleaning supplies were locked in a cabinet in the hall and available for regular facility maintenance. LPAs reviewed the facility’s infection control plan which met the department’s requirements. Physical Plant: LPAs observed the inside and outside of the facility to be clean, safe and well-kept. The floors, windows and doors were clean and well maintained. The halls were free of obstruction and had night lights. The common areas’ fixtures and furniture were in good repair. The residents’ bedrooms were neat, tidy and had the required bedding, furniture and lighting. Bathrooms were clean, orderly and contained handrails and non-slip mats in the shower. The hot water temperature in the bathroom was measured at 107.2 F. Additional clean linens and towels were available in a hall closet. The laundry equipment was in good working condition. Laundry supplies were kept in a locked cabinet in the hall inaccessible to residents. The four (4) fire extinguishers were charged and tested on 1/1/26 within the last year. The facility has a fire & life safety clearance from Cal Fire Riverside conducted on 2/10/26. Smoke and Carbon Monoxide detectors are hard wired and operational. The front yard was clean, free of hazards and contained outdoor furniture and shaded area for the residents. Kitchen/Food Service: LPAs observed the kitchen to be clean, organized, and well maintained. The kitchen had the ability to prepare and store food in a safe and clean environment. Kitchen equipment was in good working condition and functional. Dishes and silverware were clean and in good condition. The refrigerator/freezer was clean, stocked and at the required temperatures. Food in the refrigerator and pantry/cabinets were stored properly and was not expired. The facility has met the department’s requirement to have at least a two day supply of perishable foods and a seven day supply of non perishable foods. All sharp and dangerous objects were kept in a locked cabinet inaccessible to residents. Cleaning supplies were kept in a locked cabinet under the sink inaccessible to residents. Care & Supervision: LPAs observed the facility had sufficient staff present to supervise the residents. Administration: LPAs observed emergency exit plans, facility sketch, emergency phone numbers, Ombudsman information and complaint procedures were posted near the front door. Admin holds a current Administrator Certificate expiring on 11/26 and a CPR Certification expiring on 11/26. Admin has a criminal record clearance. Record Review and Resident/Staff Files: LPAs compared the staff present at the facility and on the staff roster to the Guardian staff roster for criminal record clearance. LPAs reviewed the records of two (2) staff files and three (3) residents’ files. The files contained all the required documentation and paperwork. The staff files possessed a criminal record clearance, and the required training and CPR Certifications were up to date. The residents’ files contained a current physician’s report and signed admission agreement. The staff and residents’ files were kept in a locked cabinet and inaccessible to unauthorized individuals. Health Related Services/Incidental Medical Services: LPAs observed all residents’ medications were locked in a closet located in the kitchen inaccessible to residents. LPAs reviewed and compared two (2) resident’s medication to the facility’s medication log to make sure all medication was accounted for and was being dispensed according to their physician’s orders. First Aid kits contained all the required items and were kept in a locked cabinet. Disaster Preparedness: LPAs reviewed the facility’s emergency and disaster plan. The plan was current and up to date. LPAs observed all facility exits were clear of obstructions and had required signage. No deficiencies were cited during this visit. Exit interview was conducted with the Admin and a copy of this report was given to the Admin.the state’s words, verbatim · CDSS document, Feb 24, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit for a required annual inspection. The LPA was greeted by the Administrator Maria Plascencia, notified her of the purpose for the visit and was allowed to enter the facility to conduct the inspection. Facility Overview: The facility is a single story building with nine (9) residents bedrooms, four(4) bathrooms, a dinning room, a family room, an office and a kitchen area. There is no gated pool and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in the kitchen under the sink and inaccessible to residents. The smoke detector and carbon monoxide detector were tested by the fire department on 12-14-2024. LPA observed fire extinguishers to be in compliance with the department requirements and with an expiration date of December 12, 2025. The water temperature was tested within regulations measuring at 113.9 F Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate with expiration date of November 10, 2025 and a CPR certification with the expiration date of November, 2026 Continued 809-C...... Record Review and Resident/Staff Files: LPA reviewed files for three(3) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Four (4) residents' files were reviewed and contained all required documentation. LPA observed first kit to be locked and inaccessible to the residents in care. The residents and staff files were kept in a locked cabinet in the office and inaccessible to unauthorized individuals Health-Related Services/Incidental Medical Services: All residents' medications were securely locked in a cabinet and located in the kitchen area. LPA reviewed medications for six residents, confirming that all medications were listed and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 1-30-2025, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed, and a copy was provided to Administrator Maria Plascencia.the state’s words, verbatim · CDSS document, Feb 18, 2025

Type of visit: Required - 1 Year

On 2/7/2024, Licensing Program Analyst (LPA) Janette Romero arrived unannounced to the facility to conduct a required annual visit. LPA me with Administrator, Maria Plascencia who was informed of the purpose of the visit. LPA toured the facility's interior and exterior with Administrator Plascencia, conducted staff and resident interviews and reviewed random staff and resident files. The facility has a fire clearance for 15 non-ambulatory residents and a hospice waiver for six (6). Staff present have a criminal record clearance on file and are associated with the facility. Resident files had the required documentation. During the tour, LPA observed the facility to be clean with no indoor or outdoor passageway obstructions. LPA observed the Administrator test the fire alarm system and carbon monoxide detectors, and found them to be operational. LPA observed charged fire extinguishers mounted throughout the facility. LPA toured the kitchen and observed food is stored in a safe and healthful manner. The facility had more than a 2-day supply of perishable food and 7-day supply of non-perishable food items. LPA observed emergency food and water, and Personal Protective Equipment stored in hallway cabinets. Medications are secured in medication carts, only accessible to authorized personnel such as medication technicians. Cleaning solutions and disinfectants are secured in a hallway cabinet. The facility has additional towels and linens available for the residents in care, and a fireplace with the appropriate barrier to make it inaccessible for residents. LPA did not observe bodies of water. During today's visit, LPA did not issue any deficiencies. An exit interview was conducted where a copy of this report was reviewed and provided to Administrator Plascencia.the state’s words, verbatim · CDSS document, Feb 7, 2024

Allegation investigated: Staff neglected resident over time resulting in multiple falls with injuries Staff are not properly trained Staff are not properly feeding resident while in care

Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced visit to deliver findings for the allegations listed above. LPA was granted entry and met with Administrator Maria Plascencia who was advised of the purpose of today's visit. Below is a summary of the findings of the investigation: Regarding the allegation "Staff neglected resident over time resulting in multiple falls with injuries", the Department conducted interviews and reviewed hospital records for Resident 1 (R1). Facility and hospital records revealed R1 sustained falls on 01/07/2019, 02/12/2019, 06/06/2019, 06/10/2019, 06/11/2019, and on 07/26/2020. The fall on 07/26/2020 resulted in inpatient hospitalization at Riverside University Health System on 07/26/2020 with an admissions diagnosis of hematoma of scalp, brain concussion without loss of consciousness, fracture of fourth cervical vertebra, and C4 cervical fracture. Emergency department notes revealed R1 had a fall 30 minutes prior to arrival at the emergency department due to an attempt to put on slippers, R1 slipped and fell. Unsubstantiated Record review of the facility daily notes revealed on 01/07/2019, R1 experienced an unwitnessed fall and no injuries were noted. On 02/12/2019, R1 fell and was subsequently taken by ambulance to the hospital. The hospital's emergency department (ED) records dated 02/12/2019 revealed R1 was brought in by ambulance after a fall at home due to R1 picking up an orange peel, lost balance, and fell. ED records revealed R1 sustained a contusion to the right orbit. On 06/06/2019, R1 fell and hit their head, and was taken to the hospital. Hospital ED records dated 06/06/2019 revealed R1 slipped on the bed and hit their head on the floor. ED records revealed R1 was diagnosed with right lateral frontal scalp hematoma swelling. On 06/10/2019, R1 fell and facility notes read “R1 falling by bed and nightstand – was not hurt”. On 06/11/2019, facility notes read “last night R1 slipped off bed, R1 don’t want anybody to know”. On 07/26/2020, R1 fell and was transported by ambulance to Riverside University Health System sustaining a cervical fracture. Interviews with facility staff revealed R1 would often refuse any assistance, despite having poor balance and prone to falls, and would attempt to do tasks by themselves without requesting assistance. As R1's health declined and R1 had multiple falls, the facility worked with R1's family to formulate a verbal care plan to ensure facility staff were providing as much care and supervision as possible for R1. The formulated care plan included: staff checking on R1 every 2 hours, switching R1's bed to a hospital bed with bed rails per Physician Orders, and encouraging staff to walk beside R1 when they ambulated. Interview with R1’s responsible party (RP) on 09/17/2020 revealed they were notified of R1’s falls and RP worked with the facility to discuss plans to address safety concerns after each fall. RP stated bedrails were placed on R1’s bed and was informed staff will check on R1 more often. Interview with Staff One (S1) revealed staff always had to watch over R1 but after R1 returned from the hospital from their last fall in July 2020 they were informed to check on R1 every two hours and to watch R1 closely. S1 stated R1 received the hospital bed with the bed rails around August 2020 or September 2020. Interviews with staff revealed they were aware of the verbal care plan and implemented staff checks on R1 every two hours, offered more assistance to R1, and monitored R1 as they moved around at the facility. Staff were aware that R1 needed a hospital bed with bedrails. Interview with relevant residents revealed staff provide care and supervision and assist when requested. It was revealed that R1 will try to get out of their wheelchair on their own and staff will assist even when R1 does not request assistance. Through the Department’s investigation it is unclear if R1's fall was as a result of neglect, or an accident aided by R1's decline in health and unwillingness to request or accept facility staff assistance. Therefore, based on the Department’s investigation the allegation "Staff neglected resident over time resulting in multiple falls with injuries" has been deemed UNSUBSTANTIATED at this time. Regarding the allegation “Staff are not properly trained” LPA conducted interviews with staff and residents and conducted record review in relation to the allegation. Information received from interviews and record review reveal facility holds quarterly training every year with documentation of training from 2020. In-House training sign-in sheets from 2020 was provided to LPA but not the certificates of completion for staff in attendance due to record retention time frame. It was also confirmed Staff who completed the training in 2020 no longer work at the facility. In-house training sign-in sheet and training certificates from 2023 were provided to LPA for record review. LPA conducted interviews with Resident Two (R2) who stated Staff Two (S2) had “saved their life” due to observing changes in R2’s physical behavior were different and immediately contacted emergency services. Therefore, based on LPA’s information obtained from interviews and record review the allegation has been deemed UNSUBSTANTIATED at this time. Regarding the allegation “Staff are not properly feeding resident while in care” LPA conducted interviews with staff and residents and conducted record review in relation to the allegation. LPA conducted interviews with R1 inquiring about the quality and quantity of food R1 receives. R1 stated the facility always provide meals and snacks to R1 and R1 has never had any issues with not being properly fed. LPA’s interview with Administrator Plascencia revealed that the facility hired a cook to come every day to prepare the residents’ breakfast, lunch, and dinner to ensure residents are properly fed. LPA’s record review of the menu corroborated with the lunch the residents were served during LPA’s visit. During the facility tour, LPA observed the facility had the required amount of perishable and non-perishable food available per Title 22 regulations. Therefore, based on LPA’s information obtained from interviews, record review, and observation, the allegation has been deemed UNSUBSTANTIATED at this time. A finding that the complaint is UNSUBSTANTIATED means 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 at this time. An exit interview was conducted and a copy of this report was provided to Administrator Plascencia along with LIC811-Confidential Names.the state’s words, verbatim · CDSS document, Jan 23, 2024 · control 18-AS-20200903144018