Siesta Assisted Living

Allegation investigated: Staff did not report incidents to authorized reprsenatives. Resident sustained unexplained injuries.

Licensing Program Analyst (LPA) Nune Margaryan conducted a subsequent unannounced complaint visit to deliver new reports to include additional information and it does not change the findings. LPA met with Francisco Moreno. Reason for the visit was explained. During the course of this investigation, LPA requested a copy of Staff and Resident roster, conducted a tour of the physical plant, interviewed Administrator, S1, S2, R2, R3 and Family Members (FM1, FM2). LPA was unable to interview R1. R1 was hospitalized on 09/21/2025 and later passed away at the hospital. R1’s file was reviewed and copies of document were obtained pertaining to R1. During the visits LPA did not observe any immediate Health & Safety concerns during the visit. Continue 9099C Unsubstantiated The reason for the amendment is to remove confidential information. The finding will remain unsubstantiated. See hard copy for signature. In regard of allegations: Resident sustained unexplained injuries and Staff did not report incidents to authorized representatives. It was alleged that R1 was observed with bruises, lacerations, and skin tears and staff didn’t provide timely and accurate report to residents representative. During the investigation, the LPA interviewed the Administrator, staff, residents, and family members. The Administrator and staff denied the allegations. They stated that staff at the facility have not caused any injury to R1 or any other resident and that staff always provide timely and accurate reports to residents’ representatives. R1 was admitted to the facility on 06/29/25 under Hospice care with a history of skin condition and with a G-tube. Administrator stated that R1 had existing bruises due to prescribed blood-thinning medications that were administered per Hospice orders. The Administrator also stated that R1 had sensitive skin and frequently experienced itching and scratching. According to the Administrator, the itching was a side effect of prescribed medications. LPA spoke with Hospice nurse and reviewed R1’s file and Hospice documentation, which explained why R1 is prone to bruising easily. From discussions with the hospice nurse and a review of hospice and facility documentation, LPA learned that certain medications prescribed by the physician may cause side effects such as itchy skin, rashes, and increased or unexplained bruising, which can make it easier for blood to pool under the skin. They stated that they were at the facility often and were in communication with the staff and R1’s family members. Hospice nurse stated that they didn’t observe any neglection from facility administrator and staff. However at the time of visits specifically on the dates of 8/16/25 8/18/25, 8/20/22 and 8/27/25 they observed evidence of cellulitis, skin discolorations, left jaw swelling likely related to bed rail contact and a left calf wound which was later ruled out. At the time of conversation nurse expressed an opinion that skin discoloration and jaw swelling were because of side effects of medications that were prescribed by the doctor. They may cause unusual bruising or bleeding on the skin, may cause hives or itching as a reaction. Also they mentioned that calf wound was the result from the compression wraps. Nurse stated that observations were communicated with facility staff and R1’s family members and proper care was continuously provided to R1. The hospice nurse further stated that R1’s family expressed no concerns regarding the care provided by hospice and facility, which supported that the issue stemmed from a miscommunication between the facility and hospice rather than lack of proper care. LPA also spoke with R1’s responsible party, who maintained regular contact with R1, Hospice agency and the facility staff. The responsible party explained possible reasons why R1 sustained bruising on their body and skin. Continue 9099C The Administrator stated that the facility maintained regular communication with R1’s family members, responsible party, and Hospice regarding R1’s condition. The Hospice nurse was informed and aware of R1’s ongoing scratching behavior. Family members and the responsible party were informed during regular visits. The Administrator, S1 and S2 stated that R1 was repositioned regularly and monitored for skin integrity. Staff also applied Hospice provided cream for R1’s sensitive skin. The Administrator and staff further stated that Hospice was immediately informed of any changes in R1’s condition. Interviewed S1 and S2 stated that they have never observed any staff member handling residents in a manner that could cause harm or bruising. They stated that in the event of any skin condition changes, bruises, lacerations, or skin tears, staff immediately informed the Administrator, who then contacted Hospice for assistance. The LPA interviewed R1’s responsible party (FM1) and FM2. FM1 stated that they visited R1 regularly and were satisfied with the care R1 received at the facility. FM1 reported having no concerns regarding R1’s care and expressed appreciation for the attention and continuous care provided by the facility during R1’s stay. FM1 also stated that R1 tends to scratch themselves and that R1’s thin and sensitive skin may have contributed to bruising, lacerations, or skin tears. FM1 stated that R1 was taking medications that made their skin bruise easily and mentioned that this condition may be genetic, as they experience similar issues. Interviewed FM2 stated that the facility Administrator and staff provided attentive care and treated R1 with dignity. FM2 indicated that R1 always appeared happy during visits and that the staff and residents became like family. FM1 and FM2 stated that if they ever had concerns regarding R1 care, they would immediately raise them with the Administrator and report them to the appropriate agencies if necessary. The LPA also interviewed R2 and R3. They stated that all residents, including R1, have always been treated with kindness, respect, and professionalism, and they are satisfied with the quality of care provided at the facility. They also stated that R1’s family members visited frequently and maintained a good relationship with staff and residents. R2 and R3 further indicated that the Administrator and staff would immediately contact family members or responsible parties if any incident occurred. Based on statements and interviews conducted with staff, residents, and family members, as well as a review of resident and facility records, there was insufficient evidence to support the reported allegations. Although the allegations may have occurred or may be valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur. Therefore, the allegations are determined to be Unsubstantiated. Exit interview was conducted and the copy of this report was provided to Francisco Moreno.the state’s words, verbatim · CDSS document, Apr 10, 2026 · control 28-AS-20250828121346

Allegation investigated: Staff did not report incidents to authorized reprsenatives. Resident sustained unexplained injuries.

Licensing Program Analyst (LPA) Nune Margaryan conducted a subsequent unannounced complaint visit to deliver finding to the above-mentioned allegations. LPA met with Francisco Moreno. Reason for the visit was explained. During the course of this investigation, LPA requested a copy of Staff and Resident roster, conducted a tour of the physical plant, interviewed Administrator, S1, S2, R2, R3 and Family Members (FM1, FM2). LPA was unable to interview R1. R1 was hospitalized on 09/21/2025 and later passed away at the hospital. R1’s file was reviewed and copies of document were obtained pertaining to R1. During the visits LPA did not observe any immediate Health & Safety concerns during the visit. Continue 9099C Unsubstantiated In regard of allegations: Resident sustained unexplained injuries and Staff did not report incidents to authorized representatives. It was alleged that R1 was observed with bruises, lacerations, and skin tears and staff didn’t provide timely and accurate report to residents representative. During the investigation, the LPA interviewed the Administrator, staff, residents, and family members. The Administrator and staff denied the allegations. They stated that staff at the facility have not caused any injury to R1 or any other resident and that staff always provide timely and accurate reports to residents’ representatives. R1 was admitted to the facility on 06/29/25 under Hospice care with a history of skin condition and with a G-tube. Administrator stated that R1 had existing bruises due to prescribed blood-thinning medications that were administered per Hospice orders. The Administrator also stated that R1 had sensitive skin and frequently experienced itching and scratching. According to the Administrator, the itching was a side effect of prescribed medications. The LPA reviewed R1’s file and Hospice documentation, which explained why R1 is prone to bruising easily. The LPA learned that some medications prescribed by the physician may cause itchy skin, rash, and increased or unexplained bruising, making it easier for blood to pool under the skin. LPA also spoke with R1’s responsible party, who maintained regular contact with both R1 and the facility staff. The responsible party explained possible reasons why R1 sustained bruising on their body and skin. The Administrator stated that the facility maintained regular communication with R1’s family members, responsible party, and Hospice regarding R1’s condition. The Hospice nurse was informed and aware of R1’s ongoing scratching behavior. Family members and the responsible party were informed during regular visits. The Administrator, S1 and S2 stated that R1 was repositioned regularly and monitored for skin integrity. Staff also applied Hospice provided cream for R1’s sensitive skin. The Administrator and staff further stated that Hospice was immediately informed of any changes in R1’s condition. Interviewed S1 and S2 stated that they have never observed any staff member handling residents in a manner that could cause harm or bruising. They stated that in the event of any skin condition changes, bruises, lacerations, or skin tears, staff immediately informed the Administrator, who then contacted Hospice for assistance. The LPA interviewed R1’s responsible party (FM1) and FM2. FM1 stated that they visited R1 regularly and were satisfied with the care R1 received at the facility. Continue 9099C FM1 reported having no concerns regarding R1’s care and expressed appreciation for the attention and continuous care provided by the facility during R1’s stay. FM1 also stated that R1 tends to scratch themselves and that R1’s thin and sensitive skin may have contributed to bruising, lacerations, or skin tears. FM1 stated that R1 was taking medications that made their skin bruise easily and mentioned that this condition may be genetic, as they experience similar issues. Interviewed FM2 stated that the facility Administrator and staff provided attentive care and treated R1 with dignity. FM2 indicated that R1 always appeared happy during visits and that the staff and residents became like family. FM1 and FM2 stated that if they ever had concerns regarding R1 care, they would immediately raise them with the Administrator and report them to the appropriate agencies if necessary. The LPA also interviewed R2 and R3. They stated that all residents, including R1, have always been treated with kindness, respect, and professionalism, and they are satisfied with the quality of care provided at the facility. They also stated that R1’s family members visited frequently and maintained a good relationship with staff and residents. R2 and R3 further indicated that the Administrator and staff would immediately contact family members or responsible parties if any incident occurred. Based on statements and interviews conducted with staff, residents, and family members, as well as a review of resident and facility records, there was insufficient evidence to support the reported allegations. Although the allegations may have occurred or may be valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur. Therefore, the allegations are determined to be Unsubstantiated. Exit interview was conducted and the copy of this report was provided to Francisco Moreno.the state’s words, verbatim · CDSS document, Mar 10, 2026 · control 28-AS-20250828121346

Type of visit: Case Management - Deficiencies

This case management visit is conducted in conjunction with complaint investigation to address the deficiencies unrelated to the complaint. During complaint investigation LPA observed that Staff 1 (S1) has a criminal record clearance but not associated to the facility. Therefore, the following citation was issued and recorded on LIC809D. Immediate Civil Penalties Assessed. An exit interview was conducted with the Administrator, and a copy of this report was provided along with the Appeals Rights.the state’s words, verbatim · CDSS document, Aug 29, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(3) · Plan of correction due date: Aug 30, 2025

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. LPA observed that Staff 1 (S1) has a criminal record clearance but not associated to the facility, which poses an immediate health, safety or personal rights risk to persons in care. *Immediate Civil Penalites Assess*the state’s words, verbatim · CDSS document, Aug 29, 2025

Plan of correction: Staff 1 was associated with the facility at the time of visit.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nune Margaryan conducted an Annual Required visit and inspection of the facility. LPA met with Francisco Moreno, Administrator and explained the purpose of the visit. During the visit , the CARE tool was used. The facility is licensed to serve six (6) non ambulatory residents of which one (1) may be bedridden. Hospice waiver granted for four (4) residents and currently 2 residents on hospice. At the time of visit 1 resident was at the Hospital for evaluation. The facility is a single-story home, located in a residential area, that consists of a living area, dining area, four (4) resident bedrooms, two (2) bathrooms ( 1 for staff and 1 for residents), a kitchen, detached garage/ storage room. LPA toured the facility. All indoor and outdoor passageways were free of obstruction. The front and backyard are well maintained and there are no pools or large bodies of water. All rooms were properly furnished with appropriate beddings and linens with sufficient lighting. The hot water temperature was tested and was measured within Title 22 Regulation guidelines. Grab bar and non-slip mat was observed in the bathroom bathing area. Common areas included the living room and dining area were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. Facility wall thermostat was set at 74.0°F and observed to be within the required range. LPA observed detached garage/ storage room. Laundry located in the garage. There is second refrigerator in the garage. Garage/Storage door is locked. The front and backyard are well maintained and there are no pools or large bodies of water. Passageways and exits are free of obstruction. LPA observed shaded seating areas in the front of the house. Carbon monoxide detectors are present at the facility and residents bedrooms. They are tested and were operational during the visit. The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are clean and working properly. Sharps are locked and are inaccessible to residents. LPA observed plenty linens, towels in the linen closet in the dining room. Fire extinguisher observed in the facility fully charged. The first aid kit was observed and found to be in compliance with the Title 22 Regulations. LPA reviewed residents and staff files. LPA confirmed staff working have fingerprint clearances. LPA reviewed residents medications. Medications are documented properly and given as prescribed. No deficiency was observed during today's visit. Exit interview was conducted and a copy of report was provided to Administrator.the state’s words, verbatim · CDSS document, Jul 22, 2025

Type of visit: Required - 1 Year

On 9/07/23 Licensing Program Analyst (LPA) Nune Margaryan conducted an Annual Required visit and inspection of the facility. LPA met with the Administrator, Francisco Moreno. LPA explained the purpose of the visit. With the assistance of Administrator, LPA took a tour of the physical plant. Required postings were observed in the facility. Carbon monoxide detectors are present at the facility and residents bedrooms. They are tested and were operational during the visit. Fire extinguisher is located in the kitchen and were last serviced on February 2024. The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are clean and working properly. Sharps are locked and are inaccessible to residents. LPA observed plenty linens, towels in the linen closet in the dining room. Fire extinguisher observed in the facility fully charged. Fire drill was conducted on 07/01/24. There were four (4) bedrooms designated for residents' use. All rooms were properly furnished with appropriate beddings and linens with sufficient lighting. There are two (2) bathrooms at the facility ( 1 for staff and 1 for residents). The hot water temperature was tested and was measured within Title 22 Regulation guidelines. Grab bar and non-slip mat was observed in the bathroom bathing area. Common areas included the living room and dining area were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. Facility wall thermostat was set at 76.0°F and observed to be within the required range. LPA observed detached garage/ storage room. Laundry located in the garage. There is second refrigerator in the garage. Garage/Storage door is locked. The front and backyard are well maintained and there are no pools or large bodies of water. Passageways and exits are free of obstruction. LPA observed shaded seating areas in the front of the house. The first aid kit was observed and found to be in compliance with the Title 22 Regulations. LPA reviewed clients and staff files. LPA confirmed staff working have fingerprint clearances. LPA reviewed clients medications. Medications are documented properly and given as prescribed. No deficiency was observed during today's visit. Exit interview was conducted and a copy of report was provided to Administrator.the state’s words, verbatim · CDSS document, Sep 9, 2024