Serenity Living

Type of visit: Case Management - Legal/Non-compliance

On 09/01/26 Licensing Program Analyst (LPA) M. Garza arrived at the facility to complete an unannounced case management visit. LPA met with Direct Care Staff (S1), Elaine Salcedo, explained reason for visit and was permitted entry into the facility. Tour of the facility was completed inside and out. LPA observed 3 residents present during todays visit. All residents present in the living room area. There was no music playing or television on. The room was silent. 1 of 3 residents observed to be eating breakfast. This case management visit is being conducted for complaint #24-AS-20230825152929. Purpose of this visit is to collect the facility's sign in logs from 2020 through 2026. Licensee, Josiane Jones was contacted and informed S1 the records were in storage (not located at the facility). Per S1 the records can be taken to the office by close of business 09/02/2026. During visit LPA had a discussion with S1 who confirmed that 2 of 3 residents were utilizing a bed alarms. Upon review of records it was observed that the records do not contain a prescription for bed alarms. Facility does not have an activity calendar. Interview with 1 of 3 residents disclosed they walk in the facility, watch television and from time to time read books that are in the cabinet in the living room. S1 disclosed that R3 does not like to participate in any activities. No deficiencies cited during todays visit. Exit interview completed with S1. A copy of this report provided.the state’s words, verbatim · CDSS document, Sep 1, 2026

Type of visit: Case Management - Annual Continuation

On 08/26/26 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Elaine Sauceda. LPA was granted entry. 3 clients were present during inspection. Administrator (A1) Josaiane Jones arrived shortly after LPA’s arrival. LPA toured facility with A1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at -4 degrees F and refrigerator temperature was maintained at 36 degrees F. Cleaning chemicals was observed stored and locked in garage area. Fire extinguisher was observed with a service date of: 7/14/26. Fire drill last completed on 8/10/26. Clients' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 110.8 to 117.1 degrees F. in 2 bathrooms. Outside of facility toured. Side gates were self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Medications were checked and observed kept locked in medication cart. Clients’ MARS was reviewed. Samples of medications, and medication logs were reviewed with no errors. Carbon monoxide and smoke detectors were tested and observed to be operational. All clients’ file reviewed to have all the required documents. Samples of staff files were reviewed and observed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 9/9/26: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization LIC 309, Affidavit regarding Client/Resident Cash Resources LIC 400, Liability Insurance-RCFE, Emergency and Disaster Plan LIC 610E, Personnel Report LIC500, Register of Facility Clients/Residents for LIC9020A A copy of this report was distributed to Administrator whose signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Aug 26, 2026

Type of visit: Case Management - Legal/Non-compliance

On 08/21/2026 Licensing Program Analyst (LPA) M. Garza arrived at the facility for an unannounced case management visit. LPA met with House Manager, Elaine Salcedo, explained reason for visit and was permitted entry into the facility. LPA completed tour of the facility and a health and safety check on residents in care. Licensee, Josiane Jones arrived some time later. This case management is being conducted for as part of increased monitoring for the facility. LPA requested a register of current facility residents, medical assessments for 3 of 3 residents in care and discharge paperwork for R3. No deficiencies cited during todays visit. Exit interview completed with Licensee, Josiane. A copy of this report provided.the state’s words, verbatim · CDSS document, Aug 21, 2026

Type of visit: Required - 1 Year

On 9/20/25 Licensing Program Analyst arrived at the facility to complete an unannounced annual visit. LPA met with Care Giver, Alexandria Zacarias, explained reason for visit and was permitted entry into the facility. Licensee, Josiane Jones and Care Giver, Elaine Salcedo arrived some time later. LPA completed a tour of the facility inside and out. A health and safety check was completed on residents in care. 3 resident was present during visit. Currently no residents are on hospice, receiving home health services or on oxygen. Pathways and doors were clear and free from obstruction. Facility was without odor. Common areas were adequately furnished. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Last fire drill on conducted on 6/29/25. Resident rooms observed to have the required furnishings and with adequate lighting. Sharps, chemicals and medications were located in locked cabinets/closets and cupboards. LPA observed sufficient seating under covered patio areas. The following issues were observed during today’s visit: Emergency and disaster plan incomplete. Let us know posting incorrect size. Deficiencies cited per California Code of Regulations, Title 22, on the attached 809D. If not corrected, the violation with have a direct risk to the health, safety and/or personal rights of residents in care. LPA requested the following documents to be submitted to CCL by 09/26/2025: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Exit interview was conducted with Licensee. A plan of correction was developed by Licensee and reviewed by LPA. A copy of this report, deficiencies, and appeal rights were discussed and provided. TSP was offered and accepted. LPA will make referral to TSP.the state’s words, verbatim · CDSS document, Sep 20, 2025

Type of visit: Case Management - Health Checks

On 5/28/25 Licensing Program Analysts (LPAs) M. Garza and M. Medina arrived for an unannounced case management visit. LPAs met with Designee, Elaine Salcedo, explained reason for visit and were permitted entry into the facility. Licensee, Josiane Jones was contacted and arrived some time later. LPAs completed a tour of the facility inside and out. Currently the facility has 4 residents in care. 3 observed in living area sitting in recliners and 1 in bed sleeping. Currently there are no residents receiving hospice services or home health services. This case management visit is being conducted to complete a health and safety check on residents in care and to gather documentation (residents census, staff schedule with contact information, emergency contact information, resident roster and staff roster) and verify an uncleared staff is not working at the facility. During visit LPAs observed the following: bed in bedroom #2 was without box springs (Licensee stated son preferred this way due to height with box spring). A smell of urine/feces, sufficient lighting was not supplied and the light switch was not functioning in bedroom #3. Room was observed to be dark with only 1 lamp providing light (Licensee and staff stated it was getting repaired today). Medicine closet was observed unlocked and accessible to residents in care (staff stated they were working in there upon LPAs arrival). Deficiencies cited per Title 22, Division 6, Chapter 8, deficiencies are being cited on the attached 809D's. If not corrected the violations will have a direct and immediate risk to the health, safety and or personal rights of residents in care. Exit interview completed with Licensee, Josiane. A copy of this report, deficiencies and appeal rights were discussed and provided. A plan of correction was developed by the Licensee and reviewed with the LPAs.the state’s words, verbatim · CDSS document, May 28, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87462(h)(2) · Plan of correction due date: Jun 13, 2025

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not met as evidence by: LPAs observation, the licensee did not comply with the section cited above in that LPAs observed the medication closet off the kitchen to be unlocked and accessible to residents in care. This poses an immediate health, safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 28, 2025

Plan of correction: Training will be completed with all staff. In- service sign in sheet will be completed and submitted to CCL with training material by POC date as proof of correction.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87303(a) · Plan of correction due date: Jun 13, 2025

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidence by: LPAs observation, the licensee did not comply with the regulation cited above in that, a smell of urine and feces, sufficient lighting was not supplied and the light switch was not functioning in bedroom #3. This poses a potential health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 28, 2025

Plan of correction: Bedding was immediately removed. In the future bedding will be removed and changed immediately and sanitation will be completed. Training will be completed with all staff. In-serivce sign in sheet and training material will be submitted to CCL by POC date as proof of correction.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87307(a)(3)(A) · Plan of correction due date: Jun 13, 2025

87307 Personal Accommodations and Services (a) Living accommodations and grounds...The following provisions shall apply: (3) Equipment and supplies necessary...: (A) A bed for each resident...Each bed shall be equipped with good springs, a clean and comfortable mattress, available pillow(s) and lightweight warm bedding. Fillings and covers for mattresses and pillows shall be flame retardant. Rubber sheeting shall be provided when necessary. This requirement was not met as evidence by: LPAs observation, the licensee did not comply with the regulation cited above in that, of bed in bedroom #2 was without box springs. This poses a potential health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 28, 2025

Plan of correction: Licensee stated they will obtain a letter from the family stating they do not want a box spring for the bed. This will be kept in resident file for future reference. A copy of the letter will be submitted to CCL as proof of correction.

Type of visit: Required - 1 Year

On 10/17/2024 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA was met by Direct Care Staff, Elaine Salcedo LPA introduced self, explained reason for visit and was permitted entry into the facility. Licensee, Josiane Jones was contacted and arrived some time later. LPA completed a health and safety check on residents in care. LPA toured the facility inside and out. Residents observed in common areas. Currently there are no residents receiving hospice services. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 8/14/24. Last fire drill on 5/26/24. Resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in linen closets. Sharps were located in locked closet near laundry room. LPA observed sufficient seating under covered patio areas. The following issues were observed during todays visit: chemicals and items posing a harm to residents in R3's bedroom closet, in the laundry room and in the garage unlocked and accessible to residents in care. Water temperature measured at 129.8 degrees F in the kitchen. LPA requested the following documents to be submitted to CCL by 10/25/24: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Exit interview completed with Licensee, Josiane Jones. A copy of this report, deficiency and appeal rights provided.the state’s words, verbatim · CDSS document, Oct 17, 2024

Type of visit: Case Management - Other

On 1/16/2024 Licensing Program Analyst (LPA) M. Garza completed an unannounced Case Management visit. LPA met with Direct Care Staff, Elaine Salcedo explained reason for visit and was permitted entry into facility. Licensee, Josiane Jones was contacted and informed LPA was present at the facility and the reason for visit. Licensee provided permission for Staff to complete visit and sign report. LPA completed a health and safety check on residents in care. Residents observed in common areas. During visit LPA collected and removed resident files (3) and an overflow file (1) from facility. Files will be retuned to the facility within 3 business days. No deficiencies cited during todays visit. LPA conducted an exit interview with Direct Care Staff, Elaine. A copy of this report provided.the state’s words, verbatim · CDSS document, Jan 16, 2024

Type of visit: Required - 1 Year

On 11/30/23 Licensing Program Analysts (LPA's) M. Garza and L. Salazar arrived at facility for an unannounced annual inspection visit. LPA's was met with Care Staff, Elaine Sauceda. LPA's introduced selves, explained reason for visit and were permitted entry into the facility. Licensee, Josiane Jones was contacted and arrived some time later. LPA's completed a health and safety check on residents in care. 3 of 3 residents observed having breakfast in the living room area. LPA's toured the facility inside and out. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 8/22/23. Last fire drill on 9/16/23. 3 of 4 resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in linen closets and in good repair. Sharps located in a locked laundry room closet. LPA's observed sufficient seating under covered patio areas. LPA L. Salazar completed records review. The following issues were observed at time of visit: Water temperature in bathroom #1 measured at 127.8 degrees F. Water temperature in kitchen measured at 138.7 degrees F. Food was stored in closet off the kitchen and observed to be locked. Medications were located off the kitchen in a closet and observed to be unlocked. Sign on kitchen cabinet towards living room stating "effective immediately, staff only beyond this point (no exceptions)", R1 has full bed rails, chemicals observed in hallway closet unlocked, freezer in garage needs to be defrosted, side gate #1 observed to be without latch, side gate #2 observed to be without latch and locked, right side back yard fence leaning and in need of repair. CONT... CONT... LPA's requested the following documents to be submitted to CCL by 12/7/23: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. The following resources were provided to Licensee: Entrance Checklist (LIC 9242), Resources for Dementia training, Training Regulation (87707), Function Capabilities Form (LIC 9172), Reappraisal regulation (87463), Medication Training Regulation (H&S 1569.9), and TSP for Hospice Care and Medication Guide, Due to time constraints LPA's will return to complete an annual continuation visit. Deficiencies (if any) will be cited at that time. Exit interview completed with Licensee and a copy of this report was provided.the state’s words, verbatim · CDSS document, Nov 30, 2023

Type of visit: Case Management - Annual Continuation

On 11/30/23, Licensing Program Analysts (LPAs) L. Salazar and M. Garza arrived to the facility unannounced to conduct the required annual visit. LPAs were greeted by caregiver, stated the purpose of the visit and were allowed entry into the facility. Licensee was notified and arrived shortly after. LPA L. Salazar reviewed staff and resident records. LPA M. Garza documented details of the annual visit on a separate report.the state’s words, verbatim · CDSS document, Nov 30, 2023

Allegation investigated: Staff are financially abusing resident in care.

On 10/6/2023 an NCC office meeting was conducted with Licensee Josiane Jones, Attorney Jacob Reinhardt and DIrect Care Staff, Elaine Saucedo to discuss the above allegation. The Department conducted interviews and reviewed records. It was found that the Licensee Representative, Josiane Jones added their name to R1's bank account. Based on the findings the perponderance of evidence standard has been met and the allegation is SUBSTANTIATED per Tiltle 22. Deficiency cited on the attached 9099D. An exit interview was completed. A copy of this report and appeal rights given. Substantiatedthe state’s words, verbatim · CDSS document, Oct 6, 2023 · control 24-AS-20230825152929

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87217(d)(4) · Plan of correction due date: Oct 9, 2023

Safeguards for Resident Cash, Personal Property, and Valuables - …no licensee or employee of a facility shall: become the joint tenant on any account specified in Section 87217(h) with a resident. Based on records reviewed, the licensee added herself to R1’s bank account.the state’s words, verbatim · CDSS document, Oct 6, 2023

Plan of correction: Licensee representative will submit a plan to correct and pay back the overpayment due to the resident. The plan will include the amount due, how restitution will be made and the date it will be made by. Proof of the plan overpayment will be submitted to the CCL office for review.

Type of visit: Office

An NCC was conducted on this date. Present at the meeting were: RM Brenda White, LPM See Moua and LPA Mary Garza, Licensee Josiane Jones, Attorney, Jacob Reinhardt and Direct Care Staff, Elaine Saucedo. The following deficiencies are being cited today: · Based on records review, Licensee Representative Josiane Jones charged the resident $12,000.00 for board and care services when the signed Admission Agreement states the monthly rate for the resident is $6,000.00. A rate increase notice of $800.00 effective 1/1/2020 was in the resident’s file, however, this is no date of when this notice was given to the resident. · Based on records review, a check of $375.00 was made out to staff Elaine. There is nothing in the resident’s file that documents what services were provided beyond the basic services in the Admission Agreement to warrant the payment. Deficiencies are cited on the attached 809D per Title 22. Exit interview completed with Licensee, Josiane and . A copy of this report and appeal rights provided.the state’s words, verbatim · CDSS document, Oct 6, 2023

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.50(a)(4) · Plan of correction due date: Oct 9, 2023

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. Based on records reviewed, facility staff financially abused R1. Based on records reviewed, facility staff financially abused R1.the state’s words, verbatim · CDSS document, Oct 6, 2023

Plan of correction: Licensee representative will submit a plan to correct and pay back the overpayment due to the resident. The plan will include the amount due, how restitution will be made and the date it will be made by. Proof of the overpayment will be submitted to the CCL office for review.

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.657 · Plan of correction due date: Oct 13, 2023

For any rate increase due to a change in the level of care of the resident, the licensee shall provide the resident and the resident’s representative, if any, written notice of the rate increase within two business days after initially providing services at the new level of care. The notice shall include a detailed explanation of the additional services to be provided at the new level of care and an accompanying itemization of the charges. Based on records reviewed, R1 was charged $12,000 when the signed admission agreement states the rate is $6000.00.the state’s words, verbatim · CDSS document, Oct 6, 2023

Plan of correction: Licensee representative and all staff will receive training regarding resident’s personal rights, safeguarding resident’s cash, personal property, and valuables, and Administrator Qualifications and Admission Agreement. Training will be completed by a qualified third party agent/person and will include the dates, times, signatures, and topics. Proof of the trainings will be submitted to the CCL office for review.