Rb Senior Residences

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jose De La Cruz made an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Administrator Jeremy Bagaoisan. The facility's license shows a maximum capacity of six (6) elderly residents, ages 60 and above, five of whom might be non ambulatory and one bed ridden. Hospice waiver approved for four (4). LPA arrived at 9:15 am, facility looks clean and in good repair. LPA and Administrator toured the facility, the interior and exterior and inspected five residents’ rooms, two bathrooms and the garage. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings and were personalized by the clients. Doors, windows, screens, toilets, and showers were in working order. Extra linen and hygiene supplies were present, as well as Personal Protective Equipment which was stored along with the medication. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days of non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. Toxic chemicals or poisons were locked and not accessible to clients. Medications were labeled, as required, and stored in locked areas. No bodies of water or fireplaces on the premises. Per Administrator, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. First aid kits were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC809] LPA interviewed staff and clients, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited by the California Code of Regulations. An exit interview was conducted with S1, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.the state’s words, verbatim · CDSS document, Dec 10, 2025

Allegation investigated: Staff sexually abused a resident while in care

Licensing Program Analyst (LPA) Manuel Monter conducted an announced investigation visit to deliver the investigation finding and met with Administrator Jeremy Bagaoisan , Via Teams Meeting and explained the purpose of the call. On August 10, 2021, the Department received a complaint allegation that staff (S1) sexually abused a resident (R1) while in care. On August 11, 2021, Licensing Program Analyst (LPA) Laarni Santiago conducted an unannounced visit to open a complaint investigation. During the visit, LPA toured the facility, obtained copies of records, and conducted a health and welfare check among the residents in care. Page 1 Out of 3. Unsubstantiated On August 11, 2021, the Department interviewed resident R1’s Family Member (FM). FM stated, R1 told him/her that S1 would stand behind R1 and would put his/her arms across R1’s breast and whisper things such as, “I want to be alone with you, or I know you like this.” FM stated R1 told him/her that he/she didn’t like the touching and if S1 didn’t stop he/she would inform other staff. FM stated, R1 told him/her that this would make S1 slow down for a while but then a few weeks later S1 would pick back up again. FM stated he/she was informed about the inappropriate touching about one year ago. FM stated he/she could not provide a time frame when R1 informed FM when the inappropriate touching started. FM stated R1 told him/her the last straw was when S1 was changing R1 and S1 took his/her finger and stuck his/her finger inside R1’s private. On October 4, 2021, the Department interviewed Staff S1. S1 stated R1 was confused and disorientated due to his/her neurocognitive disorder. S1 denied the allegations and stated he/she never touched R1 inappropriately. S1 stated when he/she showers R1, he/she would lather R1’s body but this was not done in an inappropriate manner. S1 stated R1 requires two people to shower R1. S1 stated one-time R1 had discharge coming from his/her privates. S1 stated R1’s family member was informed, who contacted R1’s doctor. S1 stated R1’s doctor prescribed a medication to treat the discharge. S1 stated the cream was supposed to be inserted into the privates for 3 days. S1 confirmed he/she was the one who inserted the applicator into R1’s privates. S1 stated nothing sexual or inappropriate occurred as it was part of his/her job. S1 stated he/she would hug R1 from behind to pull R1 up in his/her bed. S1 stated there are times when he/she would pull R1 up from the front by grasping around R1’s body and pulling him/her in the bed and adjusting his/her pillow. S1 also denied ever saying inappropriate comments to R1. The Department interviewed Staff S2. S2 stated he/she did help clean R1. S2 stated it would take two people to pick up R1 to get him/her out of bed and into the shower. S2 stated S1 and him/herself work together when lifting R1 and S1 would have to hug R1 to pick up R1. S2 stated whenever R1 was placed on the toilet or shower, both he/she and S1 worked together to lift R1. S2 stated R1 never told him/her that S1 was ever doing anything inappropriate. S2 stated around May 2021, R1 had discharge coming out of his/her privates. S2 stated a cream medication was prescribed. S2 stated the cream was applied inside R1’s privates for 3 days. S2 stated staff S1 applied this cream medication. S2 stated it didn’t bother him/her that S1 was applying the cream medication. Page 2 Out of 3. On October 4, 2021, the Department interviewed residents R1-R3. Residents R2 and R3 stated no one in the facility ever touched him/her inappropriately. R1 stated S1 would take him/her into the bathroom to prepare him/her for a shower and while giving R1 a shower, S1 would move his/her chest up and down and sometimes just hold them. R1 stated other times when he/she was lying in bed, S1 would stand over and put his/her arms across R1 and rock him/her. R1 stated S1 would tell R1 that he/she wanted to be alone with R1. R1 stated S2 never came to the room to assist S2. R1 stated S1 was always putting his/her hands on her/him in an inappropriate way, such as rocking him/her. R1 stated there wasn’t anyone else in the room when this occurred. R1 stated the worst thing that happened was when S1 was changing his/her diaper, S1 took off his/her gloves and put two fingers insider his/her privates. R1 stated he/she does recall having an infection sometime last year. R1 stated he/she could not recall the name of the medication that was prescribed for the infection or how it was applied. Regarding touching the privates, R1 stated S1 was not applying medication to his/her privates. R1 stated this occurred only 1 time. On October 6, 2021, the Department interviewed Licensee (LN) Azila Ortiz. LN stated R1 has confusion and neurocognitive disorder. LN stated R1 is a two person assist, and both care givers must lift and help R1, and one person cannot do it alone. The Department reviewed R1’s Physician’s report dated December 16, 2019. Based on a review, R1 has increased confusion and a neurocognitive disorder. The Department reviewed R1’s Resident Appraisal, dated December 21, 2020. The appraisal states R1 is confused and hallucinates that people are watching him/her and see people inside his/her room. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegation as UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation did or did not occur. This Report was reviewed with Administrator Jeremy Bagaoisan . LPA Monter informed Administrator Jeremy Bagaoisan that a PDF copy of the signed report by LPA Monter will be emailed to ADM's for his signature and the original returned to LPA Monter. Page 3 Out of 3.the state’s words, verbatim · CDSS document, Nov 21, 2025 · control 08-AS-20210810111930

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Reyner Grangos. Licensee Azila Ortiz arrived during the visit and introduced herself to the LPA. Administrator Jeremy Bagaoisan also arrived during the visit and assisted the LPA. The facility was licensed for a capacity of six (6) non-ambulatory residents, with one bedridden approved in bedroom number four (4). The facility also had an approved hospice waiver for four (4) residents. The LPA, accompanied by caregiver, toured the interior and exterior of the facility, and inspected resident bedrooms. The facility was clean, and sanitary. Pathways were free of obstruction and slip hazards. The exterior perimeter fence was observed to be in disrepair. Resident bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, visitation, meetings, and resident activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents, and medications were labeled and locked. No pools, nor bodies of water were observed on the premises. Per staff, no firearms nor ammunition were kept at the facility. Carbon monoxide detectors, emergency lighting, and fire extinguisher(s) were present and operational. Required licensing postings were observed in visible areas of the facility. The LPA conducted interviews and reviewed staff and resident files. The LPA technical advise and deficiencies discovered during the the review of records were cited in an LIC 809D form, and a Plan of Correction was jointly formulated with Administrator Bagaoisan. An exit interview was conducted with Administrator Bagaoisan, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058), were provided via email. An email read receipt confirms the report was received by the administrator.the state’s words, verbatim · CDSS document, Dec 31, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection Visit. The LPA introduced himself and disclosed the purpose of the visit with Administrator Jeremy Bagaoisan. The facility was licensed for a capacity of six (6) residents, and at the time of the visit, the facility had a census of six (6). Accompanied by Administrator Bagaoisan, the LPA toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Resident bedrooms contained the required furnishings. The facility had sufficient space and equipment to facilitate dining, visitation, meetings, and client activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, and stored in locked areas. No pools, nor bodies of water were observed on the premises. Per staff, no firearms or ammunition were kept at the facility. Carbon monoxide detectors, fire extinguisher(s), and a first aid kit were readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and reviewed multiple staff and resident records/files. Staff files revealed 1st Aid Certificates were not maintained at the facility for Staff #1, #2, and #3. A plan of correction was jointly formulated with Administrator Bagaoisan. An exit interview was conducted with Bagaoisan, to whom a copy of this report, LIC 809D, and the Licensee/Appeal Rights (LIC9058), were provided.the state’s words, verbatim · CDSS document, Dec 18, 2023