Royal Oaks Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with staff and explained the reason for the visit. Administrator Maria Karina Antig arrived shortly after. LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. At approx 10:00 a.m. LPA inspected the kitchen/food service area. Knives and sharp objects are stored in a locked cabinet underneath the sink. No cleaning supplies were observed kept underneath the sink. Kitchen appliances were observed to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food properly stored at this time. LPA observed medication centrally stored and resident files securely stored in this in a cabinet in front of fridge. At the time of the visit, the common area furniture's were observed to be in good condition. A sufficient supply of clean linen and towels were observed stored in the hallways cabinets. A sufficient supply of PPE and toiletries were observed stored inaccessible to residents in care in a hallway cabinet. The facility maintained a comfortable temperature of 72 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. LPA observed fire extinguishers to be fully charged and purchased in Jan, 20 2026. LPA observed six (6) bedrooms total. One (1) bedroom is designated for staff use. Resident bedrooms were observed furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are two (2) bathrooms, they were observed to be clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured between 105 - 120 degrees Fahrenheit. LPA observed staff room to be inaccessible to residents in care and empty at this time. At approx 10:30 a.m. LPA's records review of facility sketch revealed Bedrooms #5 and #6 were not notated on the original LIC 999 on file. LIC 999 on file currently lists bedrooms #5 and #6 as one (1) shared bedroom. Staff room across bedroom #6 was also not listed on LIC 999 on file. Interview and records review with Administrator revealed they emailed LIC 200 and facility sketch to the Regional Office on 01/29/2024, but did not receive a reply. All exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings throughout the common areas. There is an attached garage. LPA observed garage to be inaccessible to residents in care. LPA observed additional fridge and freezer to store extra perishable food. LPA also observed additional non-perishable supplies and canned goods, extra incontinent supplies, as well as additional furniture and medical equipment for facility use. The backyard has a covered outdoor area equipped with furniture including tables and chairs for resident use. The LPA observed one (1) self-latching gate with clear passageways clear of obstruction. There were no bodies of water noted at the time of the visit. Records review six (6) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. All records were observed to be in order at this time. Four (4) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. Medication review, medications for all residents were observed. All medications were stored properly and were appropriately documented on their respective centrally stored medication and destruction record sheets. No deficiencies were observed during medication review. Infection control / Emergency Disaster plan: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills are to be conducted quarterly; the facility’s last emergency disaster drill was conducted on 01/15/2026. The facility’s emergency disaster plan is up to date and is adequate. Both the infection control plan and the emergency disaster plan are reviewed/updated annually by the facility’s administrator. Smoke detectors and carbon monoxide detectors were tested, all alarms were functional at the time of the visit. The LPA obtained the following documents at the time of visit: LIC500 Personnel Report, LIC9020 Client Roster, and a copy of the facility’s liability insurance. Interviews were conducted during the visit. Pursuant to Title 22 of the California Code of Regulations Division 6, Chapter 8, the following deficiencies were cited (refer to LIC 809-D).Failure to correct the deficiencies may result in additional civil penalties. Exit interview conducted, appeal rights discussed and copy of report issued.the state’s words, verbatim · CDSS document, Feb 9, 2026

Allegation investigated: Staff did not pick up resident’s medication prescription in a timely manner.

Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to the facility. The purpose of the visit is to deliver investigation findings. Upon arrival LPA met with staff and staff contacted Administrator who arrived shortly after LPA. Entrance interview conducted. On 8/28/2025, the Department received a complaint with the above allegation. Information was received that resident #1 (R1) missed three doses of prescription pain medication due to staff refusing to pick it up from the pharmacy. It was alleged that the Administrator of the facility refused to pick up medication stating that she is "busy". In addition, staff also refused to pick up R1’s medications. Initial onsite visit was conducted on 09/05/2025, LPA conducted a physical plant tour with staff at approximately 11am. LPA interviewed four (4) out five (5) residents; reviewed medication records with administrator and interviewed two (2) staff from approximately 11:30am-12:45pm. LPA also discussed the allegation with Administrator. (Continue to LIC9099c). Unsubstantiated Interview conducted with Administrator indicates that R1 is self responsible; R1 is on several medications including pain medication (oxycodone). This pain medication requires a physician order for prescription to be filled by the pharmacy which R1 obtained on 08/20/2025. According to Administrator she received a text message sent by R1 which was shared with LPA, that the pain medication was ordered, and prescription was sent to Walgreens pharmacy. On 08/20/2025, Administrator went to pick medication at 12pm and the pharmacy did not have the medication ready; administrator returned at 1pm and it was still not ready, and administrator was informed that the prescription should be ready by 4pm. Administrator stated she returned at 4pm and she still had to wait at least 40min to get the medication. According to Administrator R1 was provided with the morning dose on 08/20/2025 and received the noon dose later in the evening as a result of the medication not being filled by Walgreens until after 4:30pm on 08/20/2025. Review of R1’s medication records confirmed that the paint medication was provided on 08/20/2025. Facility staff interviewed indicated that at no time did R1 go without medications. Medications reviewed during facility visits revealed that the medications were documented accordingly and administered as prescribed, on both the centrally stored medication record and the MAR for the last three months (08/2025; 07/2025 and 06/2025). R1 confirmed receiving the pain medication on 08/20/2025; R1 reported that the noon dose was given in the evening therefore R1 took another later before going to bed. Based on interview and record review, although the allegation may be valid, at this time there is insufficient evidence to support the allegation, therefore, the allegation that "Staff did not pick up resident’s medication prescription in a timely manner" is deemed UNSUBSTANTIATED at this time. No citations issued. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Oct 28, 2025 · control 29-AS-20250828085937

Allegation investigated: Staff do not ensure resident's medical needs are being met. Staff yell at resident.

Licensing Program Analysts (LPA's) Brian Balisi conducted an unannounced subsequent complaint visit to investigate the allegation list above. During today’s visit, LPA met with staff and explained the reason for the visit. Administrator Karina Antig was contacted and arrived shortly after. On 09/11/2025, from 09:30 a.m. to 02:30 p.m., LPA Balisi conducted an initial 10-day complaint visit to investigate the allegations listed above. At approximately 10:30 a.m., LPA conducted a physical plant tour, interviewed staff, resident, familes / responsible parties and reviewed and obtained copies of additional pertinent documentation relevant to the investigation. It was reported that "Staff do not ensure resident's medical needs are being met" as it was alleged that Resident #1 (R1) has requested staff to be seen by a wound specialist, due to wounds on foot. Interviews conducted and records reviewed revealed R1 has resided at this home since 05/19/2025. Unsubstantiated Upon admission a home health nurse was visiting once a week. Interviews with home health nurse of R1 revealed, on approximately 07/28/2025, they observed purple discoloration on R1's right ankle, which prompted the home health nurse to increase their visits to twice a week. On 08/05/2025, the care plan was modified. Due to R1’s inconsistent use of heel protectors, wound care was adjusted to include wrapping with gauze and to maintain dressing stability and support. Follow-up visits occurred two to three times a week for reassessment. Between 08/18 and 08/20, the dressing method was updated to include longer bandages overlapping the wound area for additional security. These remained in place most of the time but occasionally loosened when wet. By 08/25, there was no significant improvement noted. Non-adherence with heel protector use continued to impact healing progress. This concern was reported to a wound care specialist on 08/26. On 08/30, a wound care specialist visited R1 and observed the wound on the right ankle to be at a stage 2. Home health increased visits to 3 times a week and the wound care specialist visited once a week. As of today, wound care is ongoing with home health nurse conducting visits twice per week. The wound care specialist has discontinued in-person visits, as the wounds have improved and are now considered manageable under routine home health care. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Staff do not ensure resident’s medical needs are being met", is deemed Unsubstantiated at this time. It was reported that "Staff yell at resident" as it was alleged, that the Administrator Karina yelled at R1 over the phone. Interviews conducted with four (4) out of (6) residents in care revealed they have never observed any staff yell or speak inappropriately to any residents in care. Interviews further revealed that residents enjoy living at the facility and reported no concerns while living at the facility. Interviews conducted with (4) residents’ families/responsible parties indicated that none expressed concerns regarding communication with the Administrator. The Administrator denied ever yelling at any residents in care. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Staff yell at resident", is deemed Unsubstantiated at this time. Exit interview conducted and copy of report issued.the state’s words, verbatim · CDSS document, Oct 24, 2025 · control 29-AS-20250905162647

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with staff and explained the reason for the visit. Administrator Maria Karina Antig arrived shortly after. LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. LPA inspected the kitchen/food service area at approx. 10:45 a.m. Knives and sharp objects are stored in a locked cabinet underneath the sink. Some cleaning supplies were observed kept underneath the sink inaccessible to residents in care. Kitchen appliances were observed to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food properly stored at this time. LPA observed medication centrally stored and resident files securely stored in this in a cabinet to the right of the sink. At the time of the visit, the common area furniture's were observed to be in good condition. A sufficient supply of clean linen and towels were observed stored in the hallways cabinets. A sufficient supply of PPE and toiletries were observed stored inaccessible to residents in care in a hallway cabinet. The facility maintained a comfortable temperature of 72 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. LPA observed fire extinguishers to be fully charged and purchased in December 2024. LPA observed six (6) bedrooms total. One (1) bedroom is designated for staff use. Resident bedrooms were observed furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are two (2) bathrooms, they were observed to be clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured between 105 - 120 degrees Fahrenheit. LPA observed staff room to be inaccessible to residents in care and empty at this time. All exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings throughout the common areas. There is an attached garage. LPA observed garage to be inaccessible to residents in care. LPA observed additional fridge and freezer to store extra perishable food. LPA also observed additional non-perishable supplies and canned goods, extra incontinent supplies, as well as additional furniture and medical equipment for facility use. The backyard has a covered outdoor area equipped with furniture including tables and chairs for resident use. The LPA observed one (1) self-latching gate with clear passageways clear of obstruction. There were no bodies of water noted at the time of the visit. Records review began at approx. 12:05 p.m. Five (5) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. All records were observed to be in order at this time. At approx 12:40 p.m., Four (4) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. At approx 12:50 p.m. LPA did not observe first aid / CPR training for Staff #1 (S1) and Staff #2(S2). Last emergency disaster drill was conducted on Jan 18, 2025. Medications review began at approx. 02:30 p.m. All medications including PRNs were labeled, stored and inaccessible to residents in care. Medications were observed to be administered as prescribed at this time. Infection control: Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. At this time, the staff will continue to keep up signs that promotes good hand hygiene and symptoms of a communicable disease. The facility has an adequate supply of Personal Protection Equipment (PPE), and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of an infectious disease. The facility’s policies and procedures as it pertains to infection control are adequate. The LPA obtained the following documents at the time of visit: LIC500 Personnel Report, LIC9020 Client Roster, and a copy of the facility’s liability insurance. Interviews were conducted during the visit. Pursuant to Title 22 of the California Code of Regulations Division 6, Chapter 8, the following deficiencies were cited (refer to LIC 809-D).Failure to correct the deficiencies may result in additional civil penalties. Exit interview conducted, appeal rights discussed and copy of report issued.the state’s words, verbatim · CDSS document, Feb 3, 2025

Allegation investigated: Facility staff hit resident in care resulting in bruising.

Licensing Program Analyst (LPA), Martha Arroyo conducted a subsequent complaint visit to the above facility. The purpose of the visit is to deliver findings for the above allegation. The initial visit was conducted on 07/18/2024 by LPA M. Arroyo. On today's visit, LPA Arroyo met with Administrator, Karina Antig. Entrance interview. During the initial visit on 07/18/2024, LPA Arroyo conducted a plant tour at 6:38 p.m., conducted interviews with the Administrator, two (2) staff members, and five (5) residents between 5:47 p.m. and 7:12 p.m., conducted a file review at 5:20 p.m., and obtained copies of pertinent documents relevant to the investigation. Report Continued on LIC 9099C... Unsubstantiated Report Continued from LIC 9099... It was alleged that facility staff hit resident in care resulting in bruising. It was reported that Resident #1 (R1) was physically abused by Staff #1 (S1). The complainant stated that R1 was slapped on the wrist by S1 while applying lotion which resulted in a bruise and possibly a broken wrist. Record review and interviews conducted revealed that R1 gets itchy due to the medication currently prescribed. This sometimes leave a mark because R1 tries to constantly scratch. However, facility staff assist R1 is applying the lotion so that R1 does not scratch while applying it themselves. Staff stated that R1 gets lotion applied three (3) times a day to relieve the itching. Staff also added that R1 tends to make inappropriate comments to the male staff while being assisted with Activities of Daily Living (ADL’s) resulting in having two (2) staff present at all times while assisting R1. During an interview with R1, R1 was asked about the bruising on their wrist. However, R1 was unable to describe the bruising or point where the bruising was. Additional Interviews conducted with residents revealed that they had no concerns living at the facility. Residents stated that facility staff is nice and do their best to keep all the residents happy. Furthermore, residents denied facility staff being rough or aggressive with them at any time while living at the facility. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “facility staff hit resident in care resulting in bruising", is deemed Unsubstantiated at this time. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 13, 2024 · control 29-AS-20240717152528

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility unannounced to conduct a required annual visit. Upon arrival LPA met with staff (2). Staff contacted back-up administrator Karina Antig, who arrived shortly after LPA. Reason for the visit was stated. At approximately 11:45am, the LPA and administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. Smoke and carbon monoxide detectors tested and functioned properly during today's visit. KITCHEN: Knives and cleaning supplies are stored in a locked cabinet. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Medications were stored in a locked cabinet . The door to the garage, which is in the kitchen observed locked during today's visit. BEDROOMS: The LPA observed six single-occupancy client bedrooms which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting; and one staff room. RESTROOMS: Restrooms observed to be clean, sanitary and in operating condition; stocked with paper towels, toilet paper and soap. Restrooms observed with grab bars installed and shower mats. The facility had an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. COMMON SPACES: The living room, family room and dining room furniture were observed to be in good condition. The backyard patio is equipped with furniture for resident use. Resident files reviewed for completeness and accuracy at approximately 12:30pm. Five (5) out of six (6) resident files did not have an updated Needs and Services Plan. Staff files reviewed at approximately 3pm Staff 1 and 2 did not have record of TB clearance; Initial required training for staff was not met; staff lacked medication shadowing and dementia care training hours. Resident Medication records reviewed at approximately 4pm - Medication records and procedures reviewed and observed to complete and accurate. Pursuant to Title 22 CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Exit interview conducted. Copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Feb 20, 2024