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Allegation investigated: Staff mismanages residents' medications.

On 04/03/2026, Licensing Program Analyst (LPA) Regina Cloyd conducted a subsequent visit to gather information regarding the above allegation. LPA met with met with Staff and spoke with Licensee Maya Astier over the phone and the purpose of the visit was explained. Investigation consisted of the following: On 04/02/2026, LPA obtained Personnel Report, Register of Residents, Menu (March and April 2026), Pest Control Invoice and Residents #1 - #4 Emergency Contact, Physician’s Report, Patient Visit Summary, IPP, and Medication Administration Records (February 1, 2026 – April 2, 2026). LPA interviewed Staff #1 – 4 and Witness #1 – 4 and toured the kitchen area. On 04/03/26, LPA received discontinuation pharmacy orders for R4. Investigation revealed the following: Regarding the allegation, “Staff mismanages residents' medications,” it is being alleged staff will not pass out medications as prescribed and will give PRNs when they are not requested. Continue to LIC9099-C. Unsubstantiated Record review of Medication Administration Record (MAR) for Resident’s #1 - #4 revealed residents received their routine and PRN medication as prescribed. R1 received Lorazepam 1 MG as needed for anxiety (for use in school or after). R1 took it on 3/11/26, 3/24/26, 3/31/26 due to extreme anxiety and R1’s response to the medication was documented. R2 received Lorazepam (as needed for anxiety) on 02/18/26 2pm for anxiety and R2’s response to the medication was documented. R2 received Tylenol (as needed for pain) on 02/28/26, 03/01/26 - 03/04/26 and R2’s response to the medication was documented. R3's MAR revealed Lorazepam 0.5 (as needed for extreme anxiety) was given on 03/18/26, 03/19/26, and 03/21/26 for anxiety and R3’s response to the medication was documented. S1 - S2 indicated medication is provided according to MAR sheet and PRN is given when residents are experiencing behaviors. It is documented on the MAR. Interview with Responsible Parties (W1 – W3) denied the allegation. Regarding the allegation, “Staff mismanages residents' medications.,” based on record reviews and interviews, the Department found no evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, as a result, the allegation is Unsubstantiated. No deficiencies were cited. An exit interview was conducted and a copy of this report was read to the Licensee Maya Astier over the phone and provided to Staff.the state’s words, verbatim · CDSS document, Apr 3, 2026 · control 11-AS-20260324110344

Allegation investigated: Staff does not provide adequate food service for residents. Staff does not ensure residents' showering needs are being met. Staff left resident covered in insects. Staff curses at residents.

On 04/02/2026, Licensing Program Analyst (LPA) Regina Cloyd conducted an initial visit to gather information regarding the above allegations. LPA met with Administrator and Licensee Maya Astier and the purpose of the visit was explained. Investigation consisted of the following: On 04/02/2026, LPA obtained Personnel Report, Register of Residents, Menu (March and April 2026), Pest Control Invoice and Residents #1 - #4 Emergency Contact, Physician’s Report, Patient Visit Summary, IPP, and Medication Administration Records (February 1, 2026 – April 2, 2026). LPA interviewed Staff #1 – 4 and Witness #1 – 4 and toured the kitchen area and reviewed the medication. Investigation revealed the following: Regarding the allegation, “Staff does not provide adequate food service for residents.,” it is being alleged staff does not feed residents nor allow them to receive snacks throughout the day. Continue to LIC9099-C. Unsubstantiated Record review of menu revealed breakfast, lunch, dinner, and two snacks are provided. LPA observed adequate amount of perishables in the refrigerator, food in the deep freezer, and canned goods. Four out of four staff interviews (S1 – S4) denied the allegation. S2 indicated that residents eat breakfast and dinner at the facility and lunch at the day program. S3 indicated residents’ meals varies because they attend day program but on the weekend they have lunch at noon, snacks at 9:00 AM and 3:00 PM, and dinner with dessert. Interview with Responsible Parties (W1 – W3) denied the allegation. Regarding the allegation, “Staff does not provide adequate food service for residents,” based on observation, record review and interviews, the Department found no evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, as a result, the allegation is Unsubstantiated. Allegation: Staff does not ensure residents' showering needs are being met. Record review of physician’s report revealed Resident #1 and Resident #4 needs assistance with bathing and Resident #2 needs some assistance. Four out of four staff interviews (S1 – S4) denied the allegation. S2 – S4 indicated residents receive showers every day after Day Program. Interview with Responsible Parties (W1 – W3) denied the allegation. Regarding the allegation, “Staff does not ensure residents' showering needs are being met.” based on record reviews and interviews, the Department found no evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, as a result, the allegation is Unsubstantiated. Allegation: Staff left resident covered in insects. It is being alleged, staff allowed a resident to be covered in ants for a while. Record review of Pest Control invoice revealed flea treatment was provided on 10/30/2025. Four out of four staff interviews (S1 – S4) denied the allegation. S1 indicated the facility had an ant problem on the exterior and in the kitchen but never in the residents’ rooms. Interview with Responsible Parties (W1 – W3) denied the allegation. Continue to LIC9099-C. Regarding the allegation, “Staff left resident covered in insects,” based on record reviews and interviews, the Department found no evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, as a result, the allegation is Unsubstantiated. Allegation: Staff curses at residents Three out of three staff interviews (S1 – S2, S4) denied the allegation. Interview with Responsible Parties (W1 – W3) denied the allegation. Regarding the allegation, “Staff curses at residents, based on interviews, the Department found no evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, as a result, the allegation is Unsubstantiated. No deficiencies were cited. An exit interview was conducted and a copy of this report was provided to the Licensee Maya Astier.the state’s words, verbatim · CDSS document, Apr 2, 2026 · control 11-AS-20260324110344

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 09/18/2025 Licensing Program Analyst (LPA) Jose Anguiano conducted an annual required visit and met with Deanthony Hardiman. The facility is approved for four (4) ambulatory residence, age ranges 60 and over and Hospice waiver for one resident. The facility is a single- story structure in a residential neighborhood. The facility consists of 2 bedrooms, 1 bathroom, staff room, living room, dining room, laundry, and backyard patio area with shaded seating. And detached garage and office space located in the back. LPA inspected inside and outside of the facility. No bodies of water observed on the premises. All rooms inspected; beds, linens, lighting, and storage observed in good condition. Bathrooms operational with hot water measured at 117°F. Kitchen stocked with 2-day perishable and 7-day non-perishable food supply. Cleaning supplies, toxins, observed secured and inaccessible to clients. Facility was observed to be furnished, clean, and in good repair. Fire extinguisher was charged. Smoke detectors and carbon monoxide detectors were operable. Infection control practices observed, including screening protocols and sanitizing stations. Required postings observed: Infection control signs, activity calendar, and food menu. LPA reviewed 4 resident records and 4 staff records. Medication Administration Records (MARs) reviewed and found to be maintained in order. The License & Administrator was reminded of CCLD license fees that are overdue. Liability Insurance Certificate is valid and posted on the wall. The following Technical Violation was noted during today’s visit: LPA Jose Anguiano observed that a kitchen drawer containing knives was unlocked at the time of the visit. Although the drawer had a locking mechanism installed, it was not engaged, and the knives were accessible. Licensee was advised that all sharp objects must be kept inaccessible to residents at all times, per Title 22, Section 87468.2(c)(2). Licensee was reminded to ensure the locking mechanism is consistently used. This constitutes a technical violation and has been documented for follow-up during future visits. Technical Violation issued on LIC 9102. Plan(s) of Correction discussed and developed with Eddreesha Mitchell. A copy of the report, LIC 9102, and Appeal Rights were provided. No deficiencies cited. Exit interview conducted and a copy of this report was given at the time of visit, Administrator.the state’s words, verbatim · CDSS document, Sep 18, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Prelicensing

On 08/29/2024 Licensing Program Analyst (LPA) Yolanda Rosser, and Wendy Gibbs conducted a scheduled prelicensing visit at the facility listed above. LPA’s met with Antoinette Richardson and Deanthony Hardiman and purpose of the visit was explained. Application was submitted for the Residential Care Facility Elderly on 01/30/2024. The facility has a Fire clearance for four (4) ambulatory residence. Physical/Plant Structure The facility is a single - story structure in a residential neighborhood. The facility consists of 2 bedroom, 1 bathroom, staff room, living room, dining room, laundry, and detached garage and office space located in the back. LPA’s inspected inside and outside of facility. LPA’s observed all walkways to be free and clear of debris, hazards and obstruction. The gate exits from the backyard opens easily from the inside. There were no bodies of water observed on the premises. Rooms: LPA’s observed all rooms to be clean and in good repair. LPA’s observed the rooms to have all the required furniture including, beds, nightstand, dresser, chairs, and ample storage space for personal belongings for residents personal belongings. All beds were observed with required linen including mattress coverings, fitted sheets, pillows, comforters. LPA’s observed an ample supply of linen in the hallway closet. Kitchen: LPA’s observed the kitchen to be clean and sanitary. LPA’s observed all appliances to be operable and of good repair. LPA’s observed an ample supply of cookware, dishware and cutlery. LPA’s observed a Seven (7) day of non perishables, 3 day supply of perishables. There is a secured cabinet for cutlery located in the hallway. LPA measured water temperature , it measured between 105- 120 degrees. Laundry area had operable washer and dryer in good repair. Common Rooms: Two couches to accommodate residence(s), reading material was observed on coffee table. Games and activities were observed in the cabinet in the common area. Dining room has large enough area to accommodate residence(s). All hallways were observed free and clear of hazards. All rooms had ample lighting. The facility was maintained at a comfortable temperature. Bathroom: One bathroom, with a walk in shower and shower chair, with non skid mat and secured grab bars. Everything in the restroom was operable, clean and in good repair. The water temperature was measured at 110 degrees. There was hygiene supplies in the cabinet located in the hallway. Toilet was operable and in good repair. Safety: Smoke and Carbon Monoxide detectors are operable. LPA’s observed two (2) fully charged fire extinguishers. One (1) mounted in the Livingroom, entrance area and the other and mounted near the laundry area. Last serviced July 11, 2024. LPA’s inspected and observed it to have all the required items and the manual. Cleaning supplies are located in a locked closet located in the hallway. LPA’s observed Medication and file cabinet for staff and residence files located in the staff room. Medication will be secured in a locked medication cart located in the staff room. Component III: LPA’s reviewed and discussed Component III with the Administrator. Advisory recommendations: Please email the following to the LPA: CCL Signthe state’s words, verbatim · CDSS document, Aug 29, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 4 Census (if any clients in care): 0 COMP II Participants: ASTIER, MAYA AND RICHARDSON, ANTOINETTE - Applicant/Administrator Interview Method: Virtual interview (Skype, Go To Meeting, etc) On 08/01/2024, applicant/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/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 1, 2024