Riverside Senior Carehome

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct the Annual Inspection. LPA met with and explained the purpose of the visit with Assistant Administrator (AA) Elisa Pua. During this visit, LPA toured the facility inside & out. Resident bedrooms are found in good repair, contained required furnishings and lighting. The resident bathrooms were clean and in good repair with faucets delivering hot water. LPA observed required hygiene items and grab bars. Towels, extra bedding, and linens were stored and available for use. The kitchen was clean, in good repair with necessary items and appliances. LPA observed required food supply, PPE and paper product storage. Medications are centrally stored in a locked cabinet. A First aid kit contained required items. There are visitation areas available inside and out. Doors and passageways are unobstructed throughout the facility. LPA observed a self-releasing gate and windows have screens in good repair. Smoke and Carbon Monoxide detectors were tested during the visit. The Fire extinguishers were charged as required. LPA conducted resident and staff file reviews including medication review Deficiencies are being cited in accordance with California Code of Regulations on the attached LIC 809-D. An exit interview was conducted and Plan of Correction (POC) developed. A copy of this report was provided and Appeal Rights were provided. LPA requested the following updated forms faxed to CCLD by 3/3/26: Designation of Facility Responsibility (Lic308), Administrative Organization (Lic309), Emergency Disaster Plan (LIC610E), Personnel Report (LIC 500). Client Roster (LIC 9020), Proof of current Liability Coveragethe state’s words, verbatim · CDSS document, Feb 3, 2026

Type of visit: Required - 1 Year

On 2/22/2025, Licensing Program Analyst (LPA) M. Medina arrived unannounced to conduct the Annual Inspection. LPA introduced self, stated purpose of visit, and allowed entrance by Caregiver. Elisa Pua, Assistant Administrator contacted by telephone and arrived a short time later to conduct inspection. During facility visit, LPA toured the facility with Assistant Administrator. Facility observed to be clean, well lit, and odor free. Facility has four (4) private bedrooms and one (1) shared bedroom. Resident bedrooms toured and have required furnishings. Resident bathrooms toured, and observed fixtures to be operational. Water temperature measured at 107 degrees F. Kitchen toured, LPA observed facility to have a 2-day supply of perishable food, and a 7-day supply of non-perishable supply of food available. There is also a supply of emergency food kits stored in the pantry. Kitchen knives observed to be locked and secured under kitchen sink and inaccessible to residents. Medications are centrally stored and locked in kitchen cabinet, medications observed to have original labels and to be administered as prescribed. Laundry room observed to be locked during inspection. All chemicals are locked and secured in laundry room cabinets or locked closet in laundry room. Facility has sufficient linen for residents stored in closet near front of facility. Fire extinguisher present with a purchase date of 5/16/2024. Smoke and Carbon Monoxide detectors present and observed operational during inspection. First Aid kit present and observed to have all regulation supplies. Outside of facility toured. All exits open free of obstruction, no hazards observed. Exit gate observed to be self-latching. LPA conducted resident and staff file reviews. No deficiencies were cited during this inspection. An exit interview was conducted. A copy of this report was signed and left with Administrator for facility records. LPA received the following documents during facility visit: Register of Facility Client/Residents (LIC 9020), and Current Liability Coverage.the state’s words, verbatim · CDSS document, Feb 22, 2025

Allegation investigated: Resident left facility unassisted resulting in injury

Licensing Program Analyst (LPA) Katie Brown arrived at the facility unannounced to conduct the initial 10-Day visit. LPA met with and explained the reason for visit and elements of the allegation with Assistant Administrator (AD) Lisa Pua. LPA investigated the allegation and delivered complaint findings during the visit. On 4/5/2024, Resident (R1), who has Dementia left the facility without staff being aware. While out of the facility, R1 sustained injury and was treated at the hospital. Based on interview and record review of R1's file, the preponderance of evidence standndard has been met, therefore the above allegations are found to be SUBSTANTIATED. A deficiency is being cited in accordance with California Code of Regulations on the attached LIC 9099-D. An immediate Civil Penalty is being assessed on the attached LIC421M. An exit interview was conducted and Plan of Correction was developed. A copy of this report and Appeal Rights were discussed and left with AD, whose signature on this form confirms receipt of these documents. Substantiatedthe state’s words, verbatim · CDSS document, Apr 15, 2024 · control 24-AS-20240410115821

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.312(a) · Plan of correction due date: Apr 16, 2024

§1569.312 Basic services requirements Every facility required to be licensed under this chapter shall provide at least the following basic services: (a) Care and supervision as defined in Section 1569.2. *This requirement was not met as evidenced by: Licensee did not ensure care and supervision was provided to R1. On 4/5/24, R1 left the facility alone without staff knowing. R1 sustained injury and required hospitailzation. This poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 15, 2024

Plan of correction: AD has agreed to submit a written statement which will include revision of resident check out and AWOL procedures. Staff will be trained on revised procedures within 7 days. This statement will be emailed to CCL by POC date.

Allegation investigated: Staff sexually abused residents in care Staff conduct poses a risk to residents in care Staff do not properly store resident's medications

Licensing Program Analyst (LPA) Katie Brown arrived unannounced to the facility to conduct a subsequent complaint visit. LPA met with and explained the reason for the visit with Arlene Bautista. During the visit, LPA toured the facility and conducted interviews. The Department investigated the allegations listed above. Based on interviews, Staff (S1) has not been terminated from the facility. S1 has not been written up or removed from the facility due to allegations by residents or family members. There was nothing in S1’s employment file to document termination or restrictions to work. Interviews conducted of staff and residents did not reveal any concerns or reports of inappropriate behavior. See LIC9099C for continuation of this report. Unsubstantiated Interviews reveal that the facility did experience a Covid outbreak in October 2023. The facility reported the outbreak to all parties as required. The facility Infection Control Plan was reviewed. Staff were not observed coughing or violating Infection Control guidelines during multiple visits. There was no evidence of staff or residents smoking in an unsafe or unlawful manner. Based on observations during facility visits on 12/26/23, 12/28/23, 2/21/24 and 3/15/24 medications were properly stored and locked. Based on interview, record review and observation, the above allegations are UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur. There were no citations issued. An exit interview was conducted and a copy of this report was emailed to AD, whose signature confirms receipt of these documents.the state’s words, verbatim · CDSS document, Mar 15, 2024 · control 24-AS-20231222121140

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct the Annual Inspection. LPA met with and explained the purpose of the visit with Administrator (AD) Arlene Bautista and Assistant Administrator Elisa Pua. During this visit, LPA toured the facility inside & out. Resident bedrooms are found in good repair, contained required furnishings and lighting. The resident bathrooms were clean and in good repair with faucets delivering hot water. LPA observed required hygiene items and grab bars. Towels, extra bedding, and linens were stored and available for use. The kitchen was clean, in good repair with necessary items and appliances. LPA observed required food supply, PPE and paper product storage. Knives/sharps, cleaning/disinfecting supplies and chemicals are locked and stored separate from food. Medications are centrally stored in a locked cabinet. A First aid kit contained required items. There are visitation areas available inside and out. Doors and passageways are unobstructed throughout the facility. LPA observed a self-releasing gate and windows have screens in good repair. Smoke and Carbon Monoxide detectors were tested during the visit. The Fire extinguishers were purchased 5/12/23. LPA conducted resident and staff file reviews including medication audit. Deficiencies are being cited in accordance with California Code of Regulations on the attached LIC 809-D. An exit interview was conducted and Plan of Correction (POC) developed. A copy of this report was signed by AD and Appeal Rights were provided. LPA requested the following updated forms faxed to CCLD by 3/6/2024: Designation of Facility Responsibility (Lic308), Administrative Organization (Lic309), Emergency Disaster Plan (LIC610E), Personnel Report (LIC 500). Client Roster (LIC 9020), Proof of current Liability Coverage, Infection Control Planthe state’s words, verbatim · CDSS document, Feb 21, 2024

The state marks this report as 8 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.