Shoreline Senior Living

Allegation investigated: Resident had an unexplained injury. Staff have not obtained timely medical treatment for resident.

Licensing Program Analyst (LPA) Jerome Haley made unannounced visit to begin the investigation into the complaint allegations above. LPA Haley was greeted by staff and explained the reason for the visit before entering. Regarding the allegation: Resident had an unexplained injury It was discovered Resident 1 (R1) suffered from an ingrown toenail, and document review revealed that Staff 1 (S1) informed R1’s responsible party of the ingrown toenail on more than one occasion. Additional document review revealed a letter from a family member of R1 that stated, “I have not observed any evidence of improper care of or injury to my [family member] while in the care of Shoreline Senior Living.” The letter also stated, “I am very happy with the care my [family member] is receiving at Shoreline.” Regarding the allegation: Staff have not obtained timely medical treatment for residents. Continued on LIC9099C Unfounded During the investigation it was discovered R1 suffered from an ingrown toenail and facility staff passed the information to R1’s family. According to S1, R1’s family was advised to call a podiatrist because the facility is not allowed to provide podiatry care. Document review confirmed S1 did inform R1’s responsible party on more than one occasion to schedule an appointment so R1 can receive treatment for the ingrown toenail. Based on the information gathered during interviews and document review, the allegations are deemed unfounded, meaning the allegations are false and could not have happened. An exit interview was conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 3, 2026 · control 22-AS-20210402133244

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kimberly Lyman made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents of which one may be bedridden. Facility has an approved hospice waiver for 6 residents and the facility currently has 6 residents, with 3 residents on hospice. Administrator Heather Edgington has a current administrator certificate expiring on 05/23/2027. Upon entry, facility appears clean, safe and sanitary. LPA Lyman along with Caregiver Kurutz toured the facility at 12:31 PM. LPA toured the physical plant, checked food service, facility documentation and the first aid kit. The facility consists of 4 resident bedrooms, living room, dining room, and kitchen as well as a staff room. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 105 degrees F and 110.8 degrees F in all restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. LPA toured the kitchen and observed sharps locked in a cabinet during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Smoke detectors tested operational during today's visit. Fire extinguishers were fully charged. LPA reviewed the emergency disaster plan and plan is complete and thorough. Facility conducts quarterly emergency drills with the last drill conducted on 12/21/2025. Outside grounds were toured. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. There is ample shaded seating for residents. First aid kit contained all required items including tweezers, scissors and thermometer as well as a first aid guide. Facility conducts activities in the form of exercise and music therapy. CONTINUED ON LIC 809C DATED 01/22/2026 LPA observed the ample emergency food and water supply. LPA reviewed six resident files and three staff files. All resident files contained required documentation including admission agreements, physician reports and resident appraisals. Staff files reviewed contained required documentation including annual training, medical assessment/ TB, criminal record clearance and proof of CPR training. LPA reviewed medication storage and administration. Medications appear to be administered per physician order. Based on the observations made during today’s visit, No deficiencies are being cited. Exit interview conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jan 22, 2026

Allegation investigated: Illegal eviction. Facility is retaliating against resident due to a complaint filed with licensing.

Licensing Program Analyst (LPA) Jessica Cho made an unannounced subsequent visit to continue the investigation into the above allegations. LPA was greeted and granted entry by Caregiver Jasilann Kurutz and explained the reason for the visit. Administrator (Admin) Heather Edgington arrived on premise approximately 9am to assist with the investigation. On November 16, 2021, the Department received the complaint, and the initial visit was conducted by LPAs Jenifer Tirre and Rosie Quiroz on November 23, 2021. During the course of the investigation, interviews were conducted and the following documentation were obtained during the initial visit: Physician's Report and Admission Agreement for Resident #1 (R1). On today's date, LPA Cho obtained additional documentation which includes, the Resident Rosters dated March 12, 2022 and September 9, 2025, Personnel Report, Incident Report, hospital record, eviction notice, and Stipulation for Entry of Judgement - Unlawful Detainer, and written correspondences (emails/text messages/letter) concerning R1. Unfounded The investigation revealed the following: It is alleged that the the facility is illegally evicting the resident. R1 was hospitalized on August 17, 2021 per the Incident Report dated August 18, 2021. R1 was transferred to a Skilled Nursing Facility and returned to the facility on September 6, 2021. Per review of the facility's bank statement, R1 did not pay rent in September/October 2021. The eviction notice dated September 24, 2021, approved by LPA Tirre the same day at 8:11am, was issued to R1 and to R1's representative regarding nonpayment. The eviction notice met all necessary elements of the eviction procedures of the TItle 22 Regulation. R1 did not move out by October 25, 2021 so the unlawful detainer was filed on November 3, 2021 in which the court stipulation ordered R1 to backpay the rent to the facility in the amount of $8,000.00 with additional payment as an option to extend the lock out date per the court's judgement. Regarding the allegation, Facility is retaliating against resident due to a complaint filed with licensing, it is determined that the eviction notice was issued due to nonpayment. Per review of page 13 of the admission agreement indicates that the payment is due on the 1st of each month. Page 24 of the admission agreement signed and dated by R1's representative on May 21, 2021, indicates that when a resident "is away from the facility for hospitalization... temporary placement outside this facility, the monthly rate continues" and "failure to pay this fee by the due date may result in involuntary discharge from the facility." Per review of the text messages exchanged between Admin and R1's representative, a negative Coronavirus 2019 test at the time was required to return to the facility which was not provided upon request delaying R1's return. Admin indicated that this was not a retaliatory move but a safety guideline per the Public Health. Therefore, this agency has investigated the complaint and based on the interviews which were conducted and the records that were reviewed, the following allegations: Illegal eviction and Facility is retaliating against resident due to a complaint filed with licensing are deemed UNFOUNDED. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint. An exit interview was conducted with Administrator Heather Edgington, and a copy of this report including the LIC811 were provided at exit.the state’s words, verbatim · CDSS document, Nov 3, 2025 · control 22-AS-20211116080904

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nancy Guillen made an unannounced visit for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by caregiver Marlou Babanta after explaining the purpose of the visit. Administrator (AD) Heather Edginton was notified via telephone and later arrived to assist with the visit. LPA observed the Administrator certificate was current and expires February 23, 2025. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents, of which one may be bedridden, with a hospice waiver for six. The facility is a one story home with four resident bedrooms, one staff bedroom, bathroom, half bath, living room, dinning room, kitchen, and an attached garage. During the inspection, LPA and caregiver Lady Manieda conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: LPA observed four residents in care and three staff present. Residents were sleeping in their respective bedrooms and living room after breakfast. LPA observed the See Something Say Something Poster (PUB 475) mounted on the wall by the entry way, however poster is not the correct size; a technical violation was issued on today’s date. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets with additional linens stored in the hallway. LPA observed bathrooms were clean and equipped with grab bars and non-skid floor mats. LPA observed all windows were appropriately screened. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 105.8 and 113.4 degrees Fahrenheit. LPA toured the outside of the facility and observed outdoor passageways were free of obstruction. LPA observed the backyard had a shaded sitting area with furniture for resident use. Continued on LIC 809C LPA observed the facility had a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. LPA observed four spices to be expired; a technical violation was issued on today’s date. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged and located in the dining room. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. The garage is used for storage which is kept locked and inaccessible to residents. Toxic chemicals, cleaning solutions, and disinfectants were observed to be locked and inaccessible to residents in the garage and under the kitchen sink. Medication cabinet was observed to be locked and centrally stored in the kitchen. LPA observed the First Aid Kit had all the required components. Through staff interviews and document review LPA observed the facility has not conducted any emergency disaster drills; a deficiency was cited on today’s date. Per document review LPA observed the Emergency Plan is not being reviewed annually a technical violation was issued on todays date. While waiting for the AD, LPA began review of the records. LPA Guillen reviewed four resident records. All the required documentation were present and current in the residents’ files reviewed. LPA reviewed four employee files. All employee’s present have a criminal record clearance and were associated to the facility, however no staff training has been done within the last year; a deficiency was issued on today’s date. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.the state’s words, verbatim · CDSS document, Feb 7, 2025

Type of visit: Required - 1 Year

On 2/20/2024, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by caregiver and granted entry after stating the purpose of the visit. Administrator (AD) Heather Edington arrived immediately after. The facility is licensed for six (6) non-ambulatory residents with approved hospice waiver for six (6) residents. Currently, there are four (4) Hospice residents present during today’s visit. This is a single story with a two-car garage facility. The facility has five bedrooms (4 resident rooms & 1 staff room), and two full bathrooms. At around 2:13 PM, LPA conducted a tour of the physical plant accompanied by Administrator Heather Edington, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. A comfortable temperature of 73 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. Facility has two fire extinguishers which fully charged. A review of the Medication Records Administration (MAR) was conducted, and LPA observed the records are in compliance. During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. CONTINUED ON 809C LPA observed First Aid Kit was maintained. A working landline phone was operational at phone number 714-916-0029. The last fire drill was conducted on 12/15/23. The facility had operational smoke and carbon monoxide detectors in bedrooms and common areas. The facility has current liability insurance on file effective 7/1/2023 - 7/1/2024. The facility is current on Community Care Licensing annual dues. A review of three residents (R1-R3) service files and three staff (S1-S3) personnel files revealed to be complete. The facility has the current administrator's certification on file for Heather Edington # 6050352740 Expiration 05/23/2025. No deficiencies during this inspection visit. An exit interview was conducted with Caregiver Lady Manieda, and a copy of the report was providedthe state’s words, verbatim · CDSS document, Feb 20, 2024