Rincon Assisted Living

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Kelly Dulek conducted a Case Management - Other visit to the facility for the purpose of issuing Immediate Exclusion orders. LPA arrived at the facility at 10:10 AM and initially met with facility staff. Program Manager Lesley Jamon was contacted via telephone and arrived at 10:47 AM. LPA explained the reason for today's visit. Entrance interview conducted. Order of Licensee/Facility of Immediate Exclusion from Facility was issued by the LPA in reference to facility staff Lazaro (Ariel) Vargas. LPA Dulek issued the Order to Facility Designee Lesley Jamon. The Order regarding Exclusion from Facility indicates that Lazaro (Ariel) Vargas is not allowed to have contact with clients and is not allowed to be physically present at the facility. The Order regarding Individual Exclusion indicates that Lazaro (Ariel) Vargas is not allowed to have contact with clients or to be present at any facility licensed by the California Department of Social Services. Facility Designee confirmed that Lazaro (Ariel) Vargas is no longer employed at the facility. Exit interview conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, May 13, 2026

Allegation investigated: Staff engaged in inappropriate sexual behavior with resident(s)

Licensing Program Analyst (LPA) Kelly Dulek conducted a subsequent visit with the purpose of delivering findings for the above allegation. LPA initially met with facility staff, who stated no management staff was present. Facility Designee Lesley Jamon arrived at 01:55PM. Entrance interview conducted. During an initial visit conducted on 11/25/2025, LPA interviewed staff at 01:40PM. LPA, along with Facility Designee Lesley Jamon toured the facility at 02:57PM to ensure there are no immediate health and safety hazards. LPA reviewed and obtained copies of relevant documents. LPA informed Facility Designee that the allegation was referred to and accepted for investigation by Community Care Licensing Division (CCLD)'s Investigations Branch (IB). IB investigator conducted both in person and telephonic interviews with staff, residents, and other relevant parties on the following dates: 12/18/2025, 01/21/2026, 01/22/2026, 03/05/2026, 03/13/2026, 03/19/2026, 04/03/2026, 04/09/2026, and 04/16/2026. Investigator Report Continued on LIC 9099-C Substantiated also reviewed documents, including but not limited to resident file information, shift notes, incident report, staff documents, and police report. Throughout the course of the investigation, LPA Dulek reviewed all relevant information obtained. The following was then determined: The complaint alleges that Staff #1 (S1) touched Resident #1 (R1)’s breast and pinched R1’s nipples during a haircut. Interview with R1’s mental health provider revealed that R1 had a noticeable change in behavior in November 2025. When asked, R1 did not wish to disclose what had upset them and R1 said they would deal with it. Later, R1 reported that while S1 was cutting R1’s hair, S1 pinched both of R1’s nipples and R1 slapped S1’s hand away. Interviews revealed that on or around 11/12/2025, R1 requested S1 cut their hair. S1 does cut various residents’ hair when requested, but typically the haircuts take place in a facility common area, such as the dining room. However, R1’s haircut took place in their room, where there are no cameras present. Interviews with staff and other credible persons revealed that R1 is honest and does not have any history of fabrication. Although S1 denied they inappropriately touched R1, S1 did acknowledge they may have “accidentally” touched R1’s breast during the haircut. During the investigation, Resident #2 (R2) reported they had sexual intercourse with S1 on two (2) occasions when S1 took R2 out of the facility for a drive. Interview with residents revealed that S1 is “really chummy with the females” and has been observed to pay special attention to R2 while at the facility. Staff interviewed also reported that S1 and R2 often sit together at the facility and leave together regularly, not only for scheduled medical appointments. According to R2, “everything [with S1] was consensual.” R2 indicated that approximately six (6) months ago during the summer, there were two (2) times R2 and S1 had sexual relations inside S1’s personal vehicle. The first incident involved physical contact, including touching and kissing, and S1 touched R2’s intimate areas. In the second incident, R2 reported having sexual intercourse with S1. S1 denied having any sexual relationship with R2. S1 smiled and laughed as S1 explained that it was R2 who made sexual advances toward S1, including R2 exposing themselves to S1. S1 did recount that on one occasion after their work hours, S1 observed R2 on the street and S1 offered R2 a ride in their personal vehicle. S1 acknowledged that it was inappropriate to drive a resident in a personal vehicle. This behavior violates the facility’s staff code of ethics, which S1 had signed on 09/12/2024. Documents reviewed and interviews with their respective mental health professionals confirmed that both R1 and R2 are conserved and unable to make their own medical or psychiatric decisions, including consenting to any type of sexual encounter. Therefore, although R2 indicated their interactions with S1 were Report Continued on LIC 9099-C “consensual,” R2 acknowledged it was inappropriate for any resident to have this type of relationship with a staff member due to the various mental health issues the residents in the facility have been diagnosed with. Many residents in the facility were aware of the allegations and reported concern for both R1 and R2 in their interactions with S1. Additional mental health professionals working with various residents in the facility expressed concern for not just R1 and R2, but the psychological impact this inappropriate behavior has had on many residents at the facility. Based on information gathered during the course of the investigation, there is sufficient evidence to support the allegation; therefore, the allegation “staff engaged in inappropriate sexual behavior with resident(s)” is deemed SUBSTANTIATED at this time. Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiency was cited (refer to LIC 9099-D.) Facility Designee was informed that failure to correct the deficiency may result in civil penalties. Exit interview conducted, appeal rights discussed and a copy of today's report and appeal rights were provided via email.the state’s words, verbatim · CDSS document, Apr 29, 2026 · control 29-AS-20251124113209

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.58(a)(2) · Plan of correction due date: May 1, 2026

§1569.58 (a) (2) Engaged in conduct that is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility, or the people of the State of California. This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the above cited section, as 2 residents reported having inappropriate sexual interactions with S1 and S1 transported a resident alone in their personal vehicle, which posed an immediate personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Apr 29, 2026

Plan of correction: Facility designee agreed to consult with corporate and Administrator and come up with a plan related to the incident, which will include staff training. Plan will be sent to CCL by POC due date.

Allegation investigated: Staff told resident not to talk to licensing

Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced initial complaint visit related to the above allegation. Upon arrival, the LPA met with facility staff. Facility Designee arrived at 01:55PM and LPA explained the reason for the visit. Entrance interview conducted. During today's visit, LPA interviewed Program Manager at 02:05PM. Additionally, during the course of the investigation, LPA conducted telephone interviews with Resident #1 (R1) and two (2) additional relevant persons. The following was then determined: Complaint indicates that two (2) facility managment staff spoke with Resident #1 (R1) and told R1 they should not have spoken to licensing staff. LPA interviewed R1,who stated that is not what they had said, but that management staff had instead encouraged R1 to be patient while management worked with R1 to Report Continued on LIC 9099-C Unsubstantiated resolve concerns between R1 and their roommate. R1 indicated that with the encouragement of facility staff, they were able to talk with their roommate and come to a resolution to the conflict R1 and their roommate were having. R1 stated everything is fine and they are free to talk to licensing whenever they wish. R1 stated there was a misunderstanding with what was reported. Interview with program manager revealed that prior to an unrelated licensing visit, R1 had expressed some concerns with their roommate and had requested the roommate change rooms. Management was aware of this situation and was working with both residents to resolve the interpersonal conflict the two (2) had been having. After licensing staff visited the facility, R1 explained the concern they had with their roommate to licensing staff. Management did follow up with R1 to further discuss their concerns and explain the actions the facility was taking to assist R1 in resolving this conflict. Management has since discussed with both roommates and problems have been resolved. 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 conducted. A copy of today's report was provided via email.the state’s words, verbatim · CDSS document, Apr 29, 2026 · control 29-AS-20260422143545

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced visit at the facility in conjunction with an unrelated complaint visit that was conducted on today’s date. LPA met with Facility Designee Lesley Jamon. During the investigation, LPA observed deficiencies unrelated to the complaint allegation. While investigating a complaint at the facility, it was discovered that the staff, including the Administrator were aware of a sexual abuse allegation involving Staff #1 (S1) and Resident #1 (R1) on 11/24/2025, when police visited the facility. The Administrator reported that she did not file an incident report at that time because she lacked details of the alleged event. An incident report referencing the sexual abuse allegation that was discovered on 11/24/2025 was submitted to the Regional Office on 01/30/2026. A report of suspected dependent adult/elder abuse (SOC 341) was not submitted with the incident report. Administrator stated that if she had knowledge of any sexual misconduct at the facility, she needed to report it, however, Administrator also stated that she does not report anything without sufficient details about an incident and that it is her job to ensure they investigate the allegations prior to reporting. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Program Manager was informed that failure to correct the deficiencies may result in civil penalties. Exit interview conducted, today's reports and appeal rights were reviewed and issued.the state’s words, verbatim · CDSS document, Apr 29, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87211(c) · Plan of correction due date: May 1, 2026

87211(c) Any suspected physical abuse that does not result in serious bodily injury of an elder or dependent adult shall be reported...within twenty-four (24) hours as required by Welfare and Institutions Code Section 15630(b)(1). This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the above cited section, as Administrator and other mandated reporters had knowledge of the sexual abuse allegation on 11/24/2025, but did not report until 01/30/2026, which posed an immediate safety risk to persons in care.the state’s words, verbatim · CDSS document, Apr 29, 2026

Plan of correction: Facility designee agreed to consult with corporate and Administrator and come up with a plan related to the incident and reporting requirements, which will include staff training. Plan will be sent to CCL by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87405(d)(2) · Plan of correction due date: May 1, 2026

87405(d)(2) Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7)... (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement is not met as evidenced by: Based on interview and observation, the licensee did not comply with the above cited section as Administrator was unaware of the mandated reporting requirement to report all cases of suspected abuse, which poses a potential safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 29, 2026

Plan of correction: Facility designee agreed to consult with corporate and Administrator and come up with a plan related to the incident, which will include staff training. Plan will be sent to CCL by POC due date.

Allegation investigated: Staff does not ensure residents' hygiene needs are being met. Staff does not ensure residents are provided clean clothing.

Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced initial complaint visit related to the above allegations. Upon arrival, the LPA met with Facility Designee and explained the reason for the visit. Entrance interview conducted. During today's visit, LPA interviewed two (2) staff and six (6) residents between 10:47AM and 11:52AM. LPA toured the facility along with Facility Designee at 11:54AM. LPA reviewed and obtained copies of relevant documents and made observations during the facility tour. The following was then determined: Complaint indicates that the Reporting Party (RP) was concerned about the hygiene and availability of clean clothes for multiple residents in the facility, including Resident #1 (R1). LPA interviewed various residents, including R1, all of whom indicated multiple showers and personal care products are available in the facility. Record review confirmed R1 is able to shower, dress and groom independently. R1 stated they are Report Continued on LIC 9099-C Unsubstantiated incontinent, but are able to care for their own toileting needs. Staff interviewed stated that R1 prefers to sleep in and staff do attempt to remind R1 to shower and change their incontinence brief when they wake up in the morning. However, since R1 wakes up later than most residents, sometimes R1 leaves the facility before staff realize R1 is awake and staff are able to remind R1 to care for their own personal needs. R1 stated their laundry is washed every day, including their clothes and bedding. Interview revealed R1 used to have a shower aide who came to the facility to remind and assist R1 with showering, but this service has since ended. R1 stated they often refused shower even with the aide, since the shower was offered at a non-preferred time. Staff interviewed confirmed R1 frequently refuses showers, which has been communicated to R1's case manager. R1 reported they prefer to shower and dress themselves for privacy reasons. Interviews revealed R1 changes clothes multiple times a day and has clean clothes available in their room at all times. During today's visit, R1 appeared relatively clean and clothes were observed to be clean. R1's room appeared tidy and with no odors observed. Other residents interviewed indicated they have showers available at all times, as there are multiple functional shower rooms throughout the facility. Many residents interviewed did indicate they shower infrequently, however, all stated it is their choice when they take a shower. LPA observed staff washing laundry during the facility tour. LPA obtained a copy of the laundry schedule, which indicates there are five (5) resident rooms which have daily laundry service and the remaining rooms are washed once a week. The information obtained during the investigation did not include sufficient evidence to corroborate the allegations. Although the allegations may have happened or are valid, there is not sufficient evidence to prove the alleged violations did or did not occur, therefore the allegations"staff does not ensure residents' hygiene needs are being met" and "staff does not ensure residents are provided clean clothing" are deemed UNSUBSTANTIATED at this time. No citations issued. Exit interview conducted. A copy of today's report was provided via email.the state’s words, verbatim · CDSS document, Apr 13, 2026 · control 29-AS-20260406104907

Allegation investigated: Staff did not administer resident's medication as prescribed. Staff did not safeguard residents personal belongings. Staff are allowing resident to smoke inside the facility. Staff are not providing adequate food service to residents.

Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced subsequent complaint visit related to the above allegations. Upon arrival, the LPA met with Facility Designee Veronica Pereyra and explained the reason for the visit. Entrance interview conducted. During today's visit, LPA interviewed three (3) staff and one (1) resident between 01:26PM to 03:10PM and LPA obtained copies of pertinent documents. During an initial complaint visit on 02/12/2026, LPA interviewed facility designee at 12:12PM, Program Manager at 12:43PM, toured the facility with Program Manager at 02:03PM, and LPA interviewed six (6) residents from 02:20PM to 03:15PM. LPA reviewed and obtained copies of relevant documents.Throughout the course of the investigation, LPA attempted to contact Resident #1 (R1) multiple times via telephone, but LPA did not receive a call back. LPA also interviewed Facility Administrator during an unrelated visit. The following was then determined: Report Continued on LIC 9099-C Unsubstantiated Allegation "Staff did not administer resident's medication as prescribed:" The complaint alleges that from 12/28/2025 to 01/08/2026, staff withheld medications from R1 without explanation. Interview revealed that R1 had been away from the facility from mid-December until 12/27/2025. When R1 returned to the facility, R1 wanted their medications surrendered to them personally. At the time, R1 was conserved and unable to manage their own medications. Interviews revealed that R1's conservator instructed the facility staff on how to handle R1's medications and not to release the medications to R1. At that time, R1 was also taken to the hospital and medications were changed. Staff again reached out to R1's conservator related to R1's medication and R1's conservator made the decision to withhold medications until R1 visited their psychiatrist. LPA reviewed medication records for R1 for that time period, which reflect the conservator's communication and that the facility followed R1's conservator's direction. Other residents interviewed indicated they always get all their medications and there have never been problems with their medications.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. Allegation "Staff did not safeguard residents personal belongings:" According to the complaint, various residents have had personal items missing. LPA interviewed residents, and two (2) indicated they have had items missing. LPA reviewed the files for these residents and did not observe personal property inventories for either resident. Management staff stated that residents who were residing at the location prior to the change of ownership did not fill out their personal property forms. Interview revealed that resident doors do lock, however residents indicated they do not lock their doors. Some residents stated they have somewhere to lock items to safeguard them in their rooms, however most residents have not requested a lock box. Staff interviewed indicated they will follow up with residents to inquire whether they would like a lock box. Staff stated frequently residents misplace items and with staff assistance, all items reported have been recovered. 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. Report Continued on LIC 9099-C Allegation "Staff are allowing resident to smoke inside the facility:" The complaint alleges a resident has been allowed to smoke inside the facility building. Interviews during the initial visit revealed some residents have seen a resident light up their cigarette in the hallway while they were walking outside to the smoking area, a few steps inside the building. It should be noted this resident was not the one reported in the complaint. LPA inquired with residents if staff were aware of this resident's behavior to which residents indicated staff were not aware, as they haven't reported it to staff. Following the initial visit, staff did approach this resident and issued a verbal warning to the resident. During the subsequent visit, LPA confirmed with the resident they have received a verbal warning and that staff do not allow residents to smoke inside. All residents interviewed stated there are rules in the facility and that smoking indoors and in non-designated areas is prohibited. No residents nor staff reported that the individual resident named in the complaint has been seen smoking inside at any time. 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. Allegation "Staff are not providing adequate food service to resident:" The complainant alleged that the food is very bland. LPA interviewed residents related to the facility food and all seven (7) of seven (7) residents interviewed are happy with the food served at the facility. LPA reviewed the facility's four (4)-week menu, which consists of a variety of foods in all food groups. Interview with staff revealed the facility does consult with a dietician, who has created the menu to be nutritionally balanced to meet the needs of the residents in the facility. All residents and staff interviewed indicated residents can always request an alternate to the menu item if they prefer. Breakfast, lunch, dinner, and three (3) snacks are served daily. 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 conducted. A copy of today's report was provided.the state’s words, verbatim · CDSS document, Apr 2, 2026 · control 29-AS-20260211112820

Allegation investigated: Staff do not prevent residents from smoking in non-designated areas

Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced initial complaint visit related to the above allegation. Upon arrival, the LPA met with Facility Designee Irina Zendejas and explained the reason for the visit. Entrance interview conducted. During today's visit, LPA interviewed designee at 12:12PM, Program Manager at 12:43PM, toured the facility with Program Manager at 02:03PM, and LPA interviewed six (6) residents from 02:20PM to 03:15PM. LPA reviewed and obtained copies of relevant documents. During an initial complaint visit conducted on 12/19/2025, LPA interviewed designee at 12:22PM, toured the facility with designee at 12:49PM, and LPA attempted to call Resident #1 (R1) at 01:01PM. LPA requested copies of the LIC 500 and the resident roster be sent via email. Throughout the course of the investigation, LPA reviewed all documents obtained. The following was then determined: Report Continued on LIC 9099-C Unsubstantiated The complaint alleges that residents continue to smoke in non-designated areas, close to the facility doors and windows, which allows smoke to enter the facility. During both the initial and subsequent complaint visit, LPA observed designated smoking areas in the back of the facility, a sufficient distance from the facility entrances. LPA observed residents utilizing the designated smoking areas appropriately. Interview with staff and residents revealed that there are designated smoking areas which are used regularly for residents who smoke. However, sometimes residents do violate the rules and are observed smoking in a non-designated areas, usually in an outdoor courtyard in the back of the facility. When staff see a resident smoking in an unapproved area, staff ask the resident to move to a designated smoking area. The staff do give verbal warnings to all residents who are caught in violation of the house rules related to smoking. Staff interviewed indicated that for repeat offenders, the facility would follow their policies for all house rules violations, which includes verbal warnings and if continuing to re-offend, residents may be issued written warnings and possibly an eviction notice if warranted. At this time, only verbal warnings have been issued to various residents. Residents interviewed are aware of the facility's policies related to smoking only in designated areas, but admitted that sometimes they break the rules and staff do verbally warn them when in violation. 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.the state’s words, verbatim · CDSS document, Feb 12, 2026 · control 29-AS-20251215154626

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Kelly Dulek conducted a case management - incident visit regarding multiple self-reported incidents which occurred at the facility between 11/08/2025 and 11/17/2025. LPA initially met with facility staff. Entrance interview conducted. The Woodland Hills North Regional Office (RO) received self-reported incident reports as follows: three (3) received on 11/11/2025, three (3) received on 11/14/2025, and three (3) received on 11/18/2025 all related to Resident #1 (R1). During today's visit, LPA interviewed R1 at 02:12PM and toured the facility with R1. LPA also interviewed facility designee at 02:40PM and obtained copies of documents related to R1. Interviews revealed that R1 was issued a 30-day eviction notice. Facility Designee informed LPA that the facility is awaiting a signature from R1's conservator. LPA reminded Facility Designee to ensure a copy of the notice is sent to the RO within 5 days of issuing the notice. No deficiencies observed. Exit interview conducted. Copy of report was provided.the state’s words, verbatim · CDSS document, Nov 20, 2025

Allegation investigated: Unqualified staff are administering medication to residents Licensee does not ensure that employee records are accurate Facility staff are forcing residents to work Facility staff do not provide quality meals to residents Facility staff do not properly disinfect dishes Facility staff do not assist residents with hygiene Facility staff do not ensure residents have clean clothing

Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced initial complaint visit related to the above allegations. Upon arrival, the LPA met with Facility Designees Irina Zendejas and Veronica Pereyra and explained the reason for the visit. Entrance interview conducted. During today's visit, LPA interviewed management at 11:30AM, toured the facility with management at 12:00PM, LPA made observations and took photographs, from 12:10PM to 02:38PM, LPA interviewed residents and staff. LPA also reviewed and obtained copies of relevant documents. The following was then determined: Report Continued on LIC 9099-C (p.2) Unsubstantiated Allegation "Unqualified staff are administering medication to residents:" The complaint alleges that staff administering medications to the residents lack the training to do so and "know nothing" about medications. LPA reviewed four (4) employee files of those staff designated to administer medications. Two (2) of the four (4) staff hold valid RCFE Administrator certificates and therefore have verified training in medication administration. All four (4) of four (4) staff have eight (8) hours of additional documented training in medication administration for the current calendar year and the previous year. As this facility recently changed ownership, all training was conducted with the previous licensee. LPA confirmed through interview with residents and staff that only the four (4) staff administer medications and no one else. Management further clarified that all staff, including kitchen, housekeeping, and maintenance are all trained in medication administration in case of emergency. 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. Allegation "Licensee does not ensure that employee records are accurate:" LPA reviewed four (4) staff records during today's visit. All four (4) staff files reviewed contained all documents required per Title 22 regulation, including but not limited to: health screenings, TB test results, background clearance, and training records. Interview with management revealed that under the prior ownership, the records did need some work, however, when the new licensee took over, management ensured all staff records are complete and accurate. 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. Allegation "Facility staff are forcing residents to work:" LPA interviewed staff, management and residents related to this allegation. Interview revealed that the facility does have an incentive program. Residents can request to sign up for a task and the residents are paid for each day a chore is completed. Work assignments include table setting, bussing, meal service, and sweeping outside. Residents interviewed that participate in the incentive program reported they are happy they have an option to keep them busy and engaged. Residents stated the program is a good thing for them Report Continued on LIC 9099-C (p.3) and they are glad to be able to participate. Both residents and staff denied that anyone is "forced to work." LPA also interviewed residents that do not participate in the incentive program who indicated the program is optional and they have decided not to participate. 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. Allegation "Facility staff do not provide quality meals to residents:" LPA reviewed the facility's four (4)-week menu, which consists of a variety of foods in all food groups. Interview with staff revealed the facility does consult with a dietician, who has created the menu to be nutritionally balanced to meet the needs of the residents in the facility. LPA observed today's lunch, which consisted of a chicken quesadilla, soup, salad, dessert and a choice of beverage. LPA also observed a variety of foods in the facility pantry, refrigerators and freezers. Food is delivered weekly through Sysco. Interviews with residents revealed the food is adequate. Some residents commented that the food is more processed than they prefer, however it is varied in nature and many of the meals are good. All residents and staff interviewed indicated residents can always request an alternate to the menu item if they prefer. Breakfast, lunch, dinner, and three (3) snacks are served daily. 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. Allegation "Facility staff do not properly disinfect dishes:" During today's visit, LPA observed kitchen staff utilizing a three (3)-step process for cleaning the dishes after lunch service. In one sink, a staff was observed scrubbing the dishes with soap and water. In another sink, staff was able to rinse the dishes and then the third sink is utilized to disinfect the dishes. Staff interviewed stated the the kitchen staff do wash with soap and disinfect all dishes used in food preparation and service. Residents interviewed stated the kitchen staff wash the dishes right away after meals are completed and also indicated they have never seen any dirty dishes being used. 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 Report Continued on LIC 9099-C (p.4) allegation is deemed UNSUBSTANTIATED at this time. Allegation "Facility staff do not assist residents with hygiene:" The complaint alleges that residents are dirty, not showering and their hygiene needs are not met. Interviews with staff and residents revealed that most residents in the facility are independent and do not require assistance with showers. There is a shower schedule for the six (6) residents identified who do need assistance taking showers. These residents are assisted twice a week. All other residents shower independently. All residents are encouraged to shower as often as they prefer, with a minimum of two (2) showers per week. Staff stated there are residents who refuse to take showers, but that is their right to refuse. If residents regularly refuse, their case manager, conservator (if conserved) and doctor are all notified. The team then works together to come up with a solution for that individual resident. During today's visit, LPA observed all residents appeared to be clean and their hygiene needs met. 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. Allegation "Facility staff do not ensure residents have clean clothing:" LPA interviewed residents and staff related to the facility's laundry service and clothing changes. Residents interviewed stated their laundry is washed weekly on a scheduled day, which includes all linens and clothing. Residents can request additional laundry service if needed as well. Laundry staff is scheduled from 07:00AM to 11:00PM every day. Laundry staff were observed washing, drying and folding resident laundry during today's visit. LPA obtained a copy of the laundry schedule indicating the days of the week each resident's laundry is assigned. Residents and staff stated all residents are encouraged to put on clean clothing each day, but there are some residents that refuse. Residents stated it is their right to refuse to change clothes. 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 conducted. A copy of today's report was provided.the state’s words, verbatim · CDSS document, Nov 6, 2025 · control 29-AS-20251103113647

Allegation investigated: Staff do not prevent residents from smoking in non-designated areas

Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced initial complaint visit related to the above allegation. Upon arrival, the LPA met with Facility Designee Irina Zendejas and explained the reason for the visit. Entrance interview conducted. During today's visit, LPA interviewed management at 12:33PM, toured the facility with management at 01:06PM and took photographs, from 01:27PM to 02:43PM, LPA interviewed five (5) residents and two (2) additional staff. LPA also reviewed and obtained a copy of the facility's house rules. At 03:35PM, the LPA conducted one (1) additional resident interview and facility tour. The following was then determined: The complaint alleges that residents of the facility smoke outdoors too close to the building and it bothers non-smokers. Interviews with both residents and staff revealed that most of the residents in the facility smoke cigarettes and there are very few non-smokers. Residents interviewed indicated there are four (4) designated Report Continued on LIC 9099-C Unsubstantiated smoking areas. LPA observed outdoor smoking areas to contain shaded seating and have appropriate smoking receptacles. LPA observed there are no smoking signs posted around the outside of the building. LPA reviewed the facility's house rules, which indicate "smoking is not permitted within the interior confines of the facility. It is permitted in designated areas only." Residents interviewed stated they are aware of the designated smoking areas, however, not all residents abide by the facility policies. Staff interviewed indicated they regularly remind residents of the facility's smoking policies, however, there are some residents that repeatedly violate these policies. Residents interviewed stated once staff reminded residents of the where to smoke, the problem has been resolved. Staff indicated they have ordered additional signage to further remind residents of the smoke-free areas. 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 conducted. A copy of today's report was provided.the state’s words, verbatim · CDSS document, Oct 28, 2025 · control 29-AS-20251024100205

Type of visit: Prelicensing

Licensing Program Analysts (LPAs) Kelly Dulek and Valeria Conway conducted a pre-licensing inspection for this proposed facility on 08/19/2025 at 10:12AM. This is a change of ownership application. Rebecca (Becky) Spring will be the Administrator for the proposed facility and was present during today’s visit. Also present during today’s visit were facility representatives Lesley Jamon and Juliana Anos. An application to operate a Residential Care Facility for the Elderly (RCFE) was received on 12/04/2024. Component II was completed on 08/07/2025. Fire clearance was granted on 01/27/2025 for 54 (fifty four) non-ambulatory residents. During today's visit the private room numbers were updated on the approved fire clearance to match the facility sketch. Room #20, 23, and 25 are private rooms. The facility has a pending hospice waiver for 4 (four) residents. During today's visit, Component III was reviewed with the facility representatives. The facility consists of 27 (twenty seven) total bedrooms – 24 (twenty four) shared rooms and 3 (three) private rooms. There are 5 (five) shower rooms, 2 (two) full shared bathrooms, there are shared jack-and-jill style half-baths throughout the facility and a designated staff restroom. Shared facility space includes a common tv room, game/reading room and dining area. There is currently a total of 50 (fifty) residents residing at the facility. A tour of the facility was initiated at 10:43AM with facility representatives. LPAs inspected facility for Fire Safety, Personal Accommodations and Services, Medication Procedures, and Food Service. The following was noted: Report Continued on LIC 809-C Fire extinguishers throughout the facility had various service dates - 1 (one) unit with a service date of 11/15/2024 was observed to be outside the green "fully charged" range. Fire alarms and carbon monoxide detectors were tested during today's visit and were functional at that time. LPAs observed all required postings on the wall. Kitchen: The facility kitchen was observed to be clean and functional, with inaccessible knives and sharp objects. The facility follows a menu and has a contracted dietician consultant. Bedrooms: There are 27 total bedrooms in the facility. 3 are private resident bedrooms and 24 are shared resident bedrooms. Various resident rooms were observed and were properly furnished with at least one chair, night stand and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens. Bathrooms: LPAs observed various resident bathrooms, which were clean, properly supplied and had functional fixtures. LPAs observed all bathrooms to have grab bars and slip-resistant surfaces. Residents have sufficient amounts of supplies for personal hygiene. LPAs checked water temperature in various bathrooms during the visit, all measured within regulation of 105-120 degrees F. Common Areas: These included the common tv room, game/reading room, and dining area. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. LPAs observed cameras throughout the common areas. Representatives indicated camera use is addressed in the pending facility's plan of operation and Admission Agreement. There is a designated telephone available for resident use. Cleaning supplies are stored in a locked cabinet. Surrounding Grounds (Outdoors): There were various shaded areas with proper furniture for outdoor use. There are no bodies of water on the premises. The fence separating the facility patio area from the parking lot had no gate, but had an open space for a gate, leaving a large opening in the fence. At this time, there are no residents with a dementia diagnosis or elopement or wandering behavioral expressions. Licensee representatives were advised that if any residents accepted for care do have behavioral expressions that might put the resident at risk with the condition of the fence, protective measures will need to be taken to protect the resident. Medication: Medication room was observed locked and contained all resident medications and medication records. First aid supplies are available in both the medication room and the staff office. Infection Control Plan and Emergency Disaster Plan: During today's visit, the LPAs reviewed the facility's infection control plan and emergency disaster plan, both of which were complete and recently updated. Report Continued on LIC 809-C (p.3) The following items need to be corrected and proof sent to CCL prior to licensure: - Signal system meeting the requirements of Title 22, 87303(i) to be installed and functional - Proof of all fire extinguishers serviced within the last 12-months and indicated as fully charged - Sufficient quantity of emergency food and water - Any necessary additional corrections addressed on the Annual visit report for the currently licensed facility This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating under the new license until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted with facility representatives. A copy of report was provided via email.the state’s words, verbatim · CDSS document, Aug 19, 2025

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Change in Ownership (CHOW) Capacity: 54 Census (if any clients in care): 50 COMP II Participants: Rebecca Spring, Administrator Jason Meek, Applicant Interview Method: Virtual interview (Microsoft Teams) On August 7, 2025, Applicant and 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 and Administrator’s understanding of 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, Aug 7, 2025