Respit Manor

Allegation investigated: Staff did not issue responsible party a refund.

On August 12, 2026, at 8:00 AM Licensing Program Analyst (LPA) Edward Kim conducted an unannounced initial complaint visit and delivered findings at the facility. LPA Kim met with Administrator (ADMIN) Mark Mendez and explained the purpose of the visit. During today's visit, LPA Kim conducted a physical tour of the facility. LPA Kim reviewed and obtained copies of resident roster and staff roster. LPA conducted interviews with three staff and one witness. The investigation revealed the following: Continued on LIC9099C Unfounded Allegation: Staff did not issue responsible party a refund. It is alleged the facility did not reimburse resident #1’s (R1) responsible person a refund after R1 passed away. Based on interviews conducted, three staff and one witness denied the allegation. All three staff stated that R1 has never resided at the facility. S1 stated R1 has never lived at this facility location. Witness #1 (W1) confirmed this stating that R1 has never lived at this facility location. Based on record review, resident roster has never had R1 residing at this facility. Based on observations made and records reviewed, LPA has determined that the investigation, through record review and interviews, the preponderance of evidence standard has not been met. Therefore, the allegation Staff did not issue responsible party a refund is deemed UNFOUNDED. We have found that the above allegation is unfounded, meaning that the allegation is false, could not have happened and/or is without a reasonable basis. An exit interview was conducted and a copy of this report was provided to Administrator Mark Mendez.the state’s words, verbatim · CDSS document, Aug 12, 2026 · control 22-AS-20260804095800

Allegation investigated: Facility does not have sufficient staffing. Residents needs are not being met.

On May 26, 2026, Licensing Program Analyst (LPA) Eboni Bentley arrived at the facility unannounced to for a subsequent complaint investigation into the above allegations. LPA was greeted and granted entry after stating the purpose of the visit to staff. Licensee/Administrator (LI) Mark Mendez was contacted by telephone and arrived shortly to assist with the visit. During the visit LPA conducted a tour of the facility with staff and reviewed copies of facility documents including: Resident Roster, Staff Roster, Employee Contact Information, Staff Schedule, Resident Emergency Contact Forms, Physician’s Reports, Admission Agreements, and Service Plans. The investigation revealed the following: CONTINUE TO LIC9099-C....... Unsubstantiated Regarding the allegation, Facility does not have sufficient staffing, it was reported that staff quit due to not being paid in a timely manner, resulting in the facility not having staff present to care for residents. During the visits, LPA observed six residents present and two staff on duty. Interviews were conducted with residents and staff. Four out of four residents denied the allegation, stating staff have always been present to care for them and they do not believe the facility has ever been short staffed. LPA was unable to take statements for the remaining two residents due to their medical condition. Two out of two staff denied the allegation. One staff stated they only heard rumors of former staff not being paid but did not have any firsthand information. Another staff stated they recall some staff calling off around November and December 2025, and added there was always sufficient staff present as the other staff worked together to ensure two staff were always working at the facility during the day and one staff there at night, to provide care for residents. Both staff stated they have had no interruption in pay and are paid timely. During an interview, the Licensee admitted paying staff late, resulting in at least two staff quitting, however, they stated there were no gaps in staffing as other staff stepped up to cover the abandoned shifts. A record review of the staff schedule for November 2025 through February 2026, indicates two staff were scheduled everyday from 7am-7pm and one staff scheduled overnight from 7pm-7am. Due to conflicting information obtained, the allegation: Facility does not have sufficient staffing is deemed unsubstantiated. Regarding the allegation, Residents’ needs are not being met, it is alleged that there were insufficient staff present at the facility, resulting in residents having to wait a long time to receive care. Four out of four residents denied the allegation, stating staff have always been present to care for them and they respond right away. LPA was unable to take statements for the remaining two residents due to their medical condition. All residents successfully interviewed stated they have no issues or concerns with the care being provided now nor in the past. Two out of two staff denied the allegation, stating residents needs are being met as all staff work hard all the time to ensure good care is being provided. There is always someone at the facility available to assist residents with whatever they need. Based on the review of the staff schedule, between November 2025 through February 2026, there were always two staff present for the morning/afternoon shift and one staff present for the evening/overnight shift. None of the evidence gathered supports the allegation, therefore the allegation is deemed unsubstantiated. CONTINUE TO LIC9099-C....... Based on observations made, interviews which were conducted, and records reviewed, the Department is unable to ascertain if the above allegations occurred as reported. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, the allegations are deemed UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was provided to Licensee/Administrator (LI) Mark Mendez at the end of the visit.the state’s words, verbatim · CDSS document, May 26, 2026 · control 22-AS-20260122102955

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) made an unannounced visit for the purposes of conducting an annual inspection. Upon arrival LPA was greeted and granted entry to the facility by facility staff. LPA explained the purpose of the visit. Administrator (AD) Mark Mendez was notified via telephone, and arrived shortly after to assist with the annual inspection. LPA Vanegas observed AD has a valid Administrator certificate. LPA began a tour of the facility and observed the following. The facility is a one storied home with five bedrooms that are all utilized by residents in care. three bathrooms utilized by residents in care, staff, and visitors, and an attached two car garage. LPA observed kitchen to be clean and free any mildew and debris. LPA observed a two day supply on non-perishable food, and a seven day supply of non-perishable food on hand. LPA observed a dishwasher, microwave, gas stove, refrigerator, washer, and dryer to be in good condition and operational. LPA Vanegas observed all fire extinguishers to be up to date and fully charged. LPA observed all smoke detectors and carbon monoxide detectors to be in good condition and operational. LPA observed all resident rooms to be clean, and free of any hazards. LPA Observed all rooms to have required furnishings such as a bed, chest drawers. a reading lamp, and enough storage space to store personal belongings. LPA observed facility bathrooms to have operational water faucets, and toilets. Bathrooms had required furnishings such as grab bars, a shower chair, and slip resistant floor matts. Hot water temperature tested between 112.2 and 114.3 degrees. CONTINUED ON LIC809-C LPA observed the outside of the facility to be clean and free of any hazards. LPA observed side doors to be self latching and unlocked. LPA Observed there to be an outdoor shaded sitting area, and enough space to participate in outdoor activities upon resident request. LPA observed all smoke detectors and carbon monoxide detectors to be in good condition and operational. LPA observed fire extinguishers to be fully charged and recently purchased with a receipt attached to it. LPA reviewed two staff files, and five resident files. Resident files had all required documents, however two of two staff did not have their physical exams available for review. A deficiency will be issued on today's date. Staff training was up to date and documented. LPA reviewed medication administration record and medications with facility staff; per LPA review mediations are stored away and inaccessible to residents in care. Per LPA review medications are being administered per physicians orders. Based on observations made during today's inspection deficiencies will be issued on today's date An exit interview was conducted and a copy of this report was provided to facility staff.the state’s words, verbatim · CDSS document, Feb 5, 2026

Allegation investigated: Facility is not providing food of good quality

On January 28, 2026, Licensing Program Analyst (LPA) Eboni Bentley arrived at the facility unannounced to initiate the complaint investigation into the above allegation. LPA was greeted and granted entry after stating the purpose of the visit to staff. Licensee/Administrator (LI) Mark Mendez was contacted by telephone and arrived shortly to assist with the visit. Regarding allegation: Facility is not providing food of good quality It is alleged that the facility is obtaining food items that are close to the expiration dates, from food banks, and serving expired food to residents. During the visit LPA conducted a tour of the facility with staff and Licensee and immediately noticed a sour smell near the two refrigerators in the kitche, being used for residents in care. CONTINUE TO LIC809-C...... Substantiated LI confirmed the sour smell. LPA and LI opened refrigerator #1 and observed an open, half used bag of brownish colored broccoli emitting the sour smell. Expired yogurt cups and molded tomatoes were also observed in refrigerator #1. Additionally, 15 expired cans were observed, stored in the garage. LI stated they sometimes bring food items from nearby food banks and provide these items to both residents and staff. LI stated food items were brought from the food banks one week ago. Based on LPA’s observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. A deficiency is being cited on the attached LIC9099D. An exit interview was conducted with Licensee Mark Mendez, and a copy of this report and appeal rights provided at exit.the state’s words, verbatim · CDSS document, Jan 28, 2026 · control 22-AS-20260122102955

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(b)(8) · Plan of correction due date: Feb 5, 2026

(b) The following food service requirements shall apply: (8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. This requirement is not met as evidenced by: Based on LPA observation, 15 expired cans of food in the garage and 5 molded vegeteble item were found in the kitchen refridgerator, which poses a potential health and safety risk to persons in care. LI admitted food items were brought from food banks and provided to residents in care.the state’s words, verbatim · CDSS document, Jan 28, 2026

Plan of correction: Licensee and staff discarded the expired food items during visit. Licensee stated they will train staff on CCR 87555 and facilty food storage procedures, and will submit proof to CCLD by POC due date of 2/5/2026.

Type of visit: Case Management - Other

On January 28, 2026, Licensing Program Analyst (LPA) Eboni Bentley conducted a case management deficiency visit unrelated to allegations for complaint #22-AS-20260122102955. A record review revealed, S1 is not associated with the facility. Licensee Mark Mendez stated, S1 began working at the facility as a caregiver on December 2, 2025 and is currently providing care to residents, six days per week. During today's visit, LPA observed S1 working at the facility and providing care to residents. A deficiency was cited by Title 22 Division 8 Chapter 6. CIVIL PENALTY ASSESSED. An exit interview was conducted, and a copy of this report, LIC809-D, LIC421BG, and appeal rights were provided to Licensee Mark Mendez.the state’s words, verbatim · CDSS document, Jan 28, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(3) · Plan of correction due date: Jan 29, 2026

87355 (e)(3) All individuals subject to a criminal record review... shall prior to working, residing or volunteering in a licensed facility: (3)Request a transfer of a criminal record clearance... This requirement is not met as evidenced by: Based on observation, interview, and record review, the licensee did not comply with the section cited above. LPA reviewed S1’s record that they are not associated with the facility. This poses an immediate health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 28, 2026

Plan of correction: The Licensee stated they will associate S1 to the facility and submit proof to CCLD via email by POC due date of 1/29/2026.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced case management visit to deliver an amended report in conjunction to complaint: 22-AS-20251024105308. LPA Rodriguez explained reason for visit and was greeted and granted entry by staff on duty. During the visit, staff on duty contacted facility administrator (AD) Mark Mendez about visit. AD Mendez was unable to be present, however provide consent for staff on duty (S1) Michael Abada to receive and sign report. For this visit, there are 2 staff members on duty, and a total of 6 residents, of which 1 is on hospice. For today's visit no deficiencies were issued. No citations were issued. An exit interview was conducted with S1 Abada. A copy of this report and amended report dated for 11/6/2025, was explained and provided.the state’s words, verbatim · CDSS document, Nov 6, 2025

Allegation investigated: Staff did not provide a refund upon resident’s death

Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced 10-day visit to the facility for the complaint and to deliver the findings. LPA Rodriguez explained the purpose of today's visit, was greeted, and granted entry by staff on duty, who contacted facility administrator (AD) Mark Mendez. At 11:00AM, AD Mendez arrived and met with LPA. During the investigation, LPA Rodriguez toured the physical plant of the facility, conducted interviews, and requested copies of pertinent records reviewed. It was alleged that staff did not provide a refund upon resident’s death. 1 out of 1 staff (S1) interview corroborated with the allegation by providing direct admission that facility has not paid resident (R1) family with the money owed due to unforeseen circumstances, however disclosed plans on issuing a check on 10/29/25. Substantiated Based on LPA’s interviews which were conducted, review of documents obtained, and observations, the preponderance of evidence standard has been met, therefore the allegation is SUBSTANTIATED. An exit interview was conducted with AD Mendez. A copy of this report was explained, and appeal rights were provided during the visit.the state’s words, verbatim · CDSS document, Oct 28, 2025 · control 22-AS-20251024105308

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.657(a)(5)(A) · Plan of correction due date: Oct 29, 2025

Health and Safety Code section 1569.657 provides: (a) …The notice shall include… (5) Refund conditions. (A) ...Will be returned in the event of a resident’s death… This requirement is not met as evidence by: Based on LPAs review of documents, interviews and observations, facility administrator provided direct admission that the refund was not issued. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Oct 28, 2025

Plan of correction: As a plan of correction (POC) facility is to issue the refund to R1's family in the amount of $1,122.54 by 10/29/25. Facility is to provide proof to assigned LPA on 10/29/25.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to amend findings delivered on July 18 2025. LPA was greeted and granted entry by Michael Abada, Administrator Designee (AD). Administrator Mark Mendez was contacted regarding the purpose of the visit. LPA explained to Administrator Mendez that the findings in the report remain the same and that the amendment was to comply with Department report requirements. An exit interview was given with Michael Abada, Administrator Designee and a copy of the amended findings and this report was given to the facility.the state’s words, verbatim · CDSS document, Jul 29, 2025

Allegation investigated: Staff inappropriately fondled resident

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility regarding a complaint received in our Regional Office on March 18, 2025. LPA was greeted and granted entry by staff and met with Administrator (AD) Mark Mendez. On March 19, 2025 LPA toured the facility and conducted a health and safety check on five residents LPA obtained the following from resident files: Emergency ID Facesheet, Needs and Appraisal Services, and Physician's Reports. LPA also obtained handwritten Unusual Incident Report from March 14, 2025 and staff clearance information. An incident report was filed with the Department on March 14, 2025 from AD Mendez which reported an incident on 03-13-25 at around 6 PM in which staff stated (staff) was cleaning resident 1 (R1) under breast as there are rashes present, staff was wiping (with) wipes while R1 and staff was having a conversation. At (Continued on LIC 9099) ****This is an amended report.**** Unsubstantiated (Continued from LIC 9099) around 8 PM night staff called Administrator and reported that R1 was touched inappropriately by staff while being cared for. On March 18, 2025, four days later, the RO received a complaint alleging Staff inappropriately fondled resident.. The Department conducted joint visits with the Orange County Sheriff (OCS) Investigator regarding the complaint. On March 28, 2025, the an interview was conducted with R1 at R1's new place of residence. R1’s file was reviewed. On April 24, 2025, the Department spoke to Staff #1 (S1) and obtained a statement. S1 stated to investigators that R1’s top was taken off, and S1 applied powder to a rash underneath the resident’s breasts. Caregiver said they wore gloves, and first asked the resident permission to apply the powder. The resident gave permission, and S1 applied the powder. The Department reviewed hospice records in which notes on March 11, 2025 that R1 had a slow decline In the last 2 months and was able to verbalize their needs. R1 remained bed bound and had a rash to Bilateral breasts that is being treated with nystatin powder TID (three times per day) that has been effective. On July 18, 2025, LPA Ruppert interviewed Staff #2 (S2), who had worked with Staff #1 on the day the incident occurred. S2 stated they had been surprised at the allegation since R1 had been treated with Nystatin powder for several weeks by S1. S2 had also interacted with R1 on the date of the incident and the resident did not share any concerns with S2. LPA also interviewed two of two residents who resided at the facility at the time of the incident. Resident #2 (R2) stated they have, "...never been inappropriately touched. These people are gifts. They care, are attentive and responsive." R2 could not recall the caregiver in question but has had no issues with staff. LPA interviewed Resident #3 (R3) and asked if R3 remembered anything about Staff #1 (S1). R3 nodded yes when LPA stated the staff member's name. When asked if R3 had ever been inappropriately touched by staff members or S1, R3 shook head with a "No." LPA inquired about R3's stay at the facility and if R3 liked the food and was assisted when needed. R3 nodded with a yes to all three questions. (Continued on LIC 9099-C1) ****This is an amended report.**** (Continued from LIC 9099C) Based on the totality of the circumstances, there was a documented medical need for caregivers to apply medication powder to R1’s breasts. Based on the Department’s review of records, interviews and observations, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur. Therefore the allegation that: Staff inappropriately fondled resident, is Unsubstantiated. An exit interview was conducted with AD Mark Mendez and a copy of this report was provided to the facility. ****This is an amended report.****the state’s words, verbatim · CDSS document, Jul 18, 2025 · control 22-AS-20250318101709

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by caregiving staff after explaining the purpose for the visit. Administrator (AD) Mark Mendez was notified via telephone and later arrived to assist with the inspection. LPA observed that Administrator Mark Mendez submitted a Administrator renewal application to the Administrator Certification Bureau (ACB) on February 2, 2025. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six ambulatory, of which five may be non-ambulatory and one may be bedridden, and has a hospice waiver for six. The facility is a single-story home with five resident bedrooms, one of which is shared, three resident bathrooms, one of which is shared, a living room, a dining room, a kitchen, and an attached two car garage. LPA accompanied by the AD conducted a tour of the interior portion of the facility. On today's visit, LPA observed six residents in care, two of which are on hospice, and two caregiving staff present. LPA observed residents relaxing in the living room as well as their respective bedrooms. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall by the kitchen. LPA inspected the five resident bedrooms, and they were observed to be free of any hazards. LPA observed a fireplace in resident room #1. LPA observed that the fireplace is adequately screened and not in operation at the time of visit. LPA observed the resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers, and a lamp. All resident beds had clean linens and blankets. LPA observed additional linens are stored in a hallway closet. LPA inspected the three resident bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 106.7 and 112.4 degrees Fahrenheit. LPA observed the kitchen has a two day perishable and seven day nonperishable food supply on hand. LPA observed two medications to be stored in the refrigerator. LPA observed kitchen appliances to be clean and operational. The four burner gas stove lights unassisted. CONTINUED ON LIC809-C LPA observed kitchen knives are stored in a locked kitchen cabinet. LPA observed the facility has a three day emergency food and water supply stored in the kitchen. A fire extinguisher is located in the kitchen, and it was observed the be charged and up to date on service. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on February 3, 2025. The centrally stored medication is kept in a locked medicine cart located in a locked closet by the living room. LPA observed a First Aid kit is stored in the closet and it was observed to have all the required components. The door leading to the attached two car garage is kept locked and inaccessible to resident in care. LPA observed the garage is used for storage and laundry. LPA and AD conducted a tour of the exterior portion of the facility. LPA observed the exterior portion to be clear of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for resident use. The perimeter gate on the north side is self-latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed the six resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed six residents’ medication and medication records. LPA reviewed four staff files. LPA observed that Staff #4 (S4) did not have a Health Screening Report on file. All staff are background cleared and associated to the facility. Based on today's observations, deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator Mark Mendez. A copy of the report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Feb 12, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted by facility administrator (AD) Mark Mendez about the visit. For today’s visit, LPA met with AD Mendez and observed a total of 6 residents in care. LPA observed the Administrator's Certificate for facility administrator (AD) Mark Mendez which expires on 9/26/2024. LPA De Perio toured the interior and exterior portions of the facility with AD Mendez. The facility is a single level structure and is licensed for 6 non-ambulatory residents, of which 2 may be on hospice and 1 bedridden. For this visit, there are a total of 6 residents in care. LPA De Perio observed the PUB475 "See Something Say Something" poster posted in the kitchen. There are a total of 6 bedrooms, of which are 4 private resident rooms and 1 is a shared resident room. LPA De Perio toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 2 restrooms. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured to be at 106.9 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. LPA De Perio observed the emergency disaster and evacuation plan, which is posted in the facility hallway. Facility had back-up emergency food and water supply, located in the garage. LPA De Perio observed that First Aid Kit had all the required components. LPA De Perio observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA De Perio observed patio furniture under shading, and the grounds were free of any hazards. There are 2 gates in the backyard, which both were self-closing and self-latching. No bodies of water were observed. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. No citations were issued. An exit interview was conducted with AD Mendez. A copy of this report was provided and explained.the state’s words, verbatim · CDSS document, Feb 22, 2024