Silvercreek Home Care

Allegation investigated: Licensee accepted a resident with a higher level of care needs Licensee did not follow proper evicition protocols with resident in care

Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to initiate a complaint investigation on the above-mentioned allegation. LPA identified herself and discussed the purpose of the visit with Layla Vister. Administrator Juancho Domingo arrived shortly after. On December 2, 2025, Community Care Licensing (CCL) received a complaint alleging the facility unlawfully evicted Resident 1 (R1) and admitted a resident with a higher level of care needs More specifically, the reporting party stated that the Administrator informed them the facility could not meet R1’s needs and that R1 required a higher level of care and R1 was not allowed to return to the facility after a hospital stay. investigation consisted of unannounced facility visits, interviews with facility staff, residents, outside sources, and records review. Staff interviews revealed that R1 exhibited behavioral changes and reported chronic pain, including verbal aggression possibly related to hip pain. Staff stated they were able to meet R1’s needs but became concerned about the rapid behavioral decline. (Continued on LIC9099C) Unsubstantiated (Continued from LIC9099) Records review revealed that R1 began residency on 10/24/2025 after discharge from a skilled nursing facility. R1 was hospitalized from 11/3/2025 to 11/11/2025 and again on 11/25/2025. Staff interviews revealed that R1 exhibited behavioral changes and reported chronic pain, including verbal aggression possibly related to hip pain. Staff stated they were able to meet R1’s needs but became concerned about the rapid behavioral decline. Resident interview was not conducted due to R1’s continued hospitalization. Outside source(OS) interviews revealed that R1 was cleared to return to the facility from the hospital on 11/28/2025 following a 3-day hospital stay. on 11/28/2025 the facility Administrator requested a re-evaluation prior to readmission to the facility, citing concerns about R1’s care needs. OS confirmed that a re-evaluation was conducted and R1 remained hospitalized and is still at the hospital on 12/9/2025. No eviction notice was issued to R1 or their responsible party. LPA observations revealed no documentation of an eviction notice and confirmation from the Administrator that R1 will be allowed to return to the facility upon discharge from the hospital. Based on interviews, direct LPA observations, and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred. Therefore, the allegation is UNSUBSTANTIATED. An exit interview was conducted with Administrator Juancho Domingo, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Dec 9, 2025 · control 08-AS-20251202153935

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Amy Rodgers conducted a Case Management Visit during an unannounced Complaint Visit. LPA met with Administrator Juancho Domingo and discussed the purpose of the visit. During a complaint investigation, LPA discovered, through interviews and records review, that the facility did not submit an incident report involving Resident #1 (R1) on November 3 and November 25, 2025. Emergency services were called, and R1 was admitted to the hospital on both dates. Based on this information, one deficiencies is being cited Per Title 22, Division 6, Chapter 8 of the California Code of Regulations and is listed on an LIC 809-D. An exit interview was conducted and a copy the report, Licensee/Appeal Rights (LIC9058 03/22) were provided to Administrator .the state’s words, verbatim · CDSS document, Dec 9, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1) · Plan of correction due date: Jan 9, 2026

Reporting Requirements. A written report shall be submitted to the licensing agency...of any of the events specified in (A) through (D) below. This report shall include...date and nature of event...findings, and treatment, if any; and disposition of the case. This requirement is not met as evidenced by: Based on interviews and record review, the administrator did not report two incidents for 1 out of 6 [R1] residents, which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Dec 9, 2025

Plan of correction: Administrator stated they will attend training on reporting requirements and submit incident reports for R1 by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Caregiver Layla Vister. Administrator Juancho Domingo arrived shortly after. According to the facility’s license, the facility has a maximum capacity of six (6) residents, of whom may be non-ambulatory. LPA toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, as required, and stored in locked areas. The water temperature was measured in both bathrooms was over 126 degrees F and had a warning hot water sign. No pools or bodies of water on the premises. Per Juancho, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Resident records reviewed had required documentation. Staff records reviewed contained required documentation. No deficiencies were cited on todays visit. An exit interview was conducted with Administrator Juancho Domingo, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Dec 9, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Caregiver Layla Vister. Administrator Juancho Domingo arrived shortly after. According to the facility’s license, the facility has a maximum capacity of six (6) residents, of whom may be non-ambulatory. LPA toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, as required, and stored in locked areas. The water tempeture was measured at 111 degrees F in one bathroom and 126 degrees F in another bathroom though the bathroom had a warning hot water sign. No pools or bodies of water on the premises. Per Juancho, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Resident records reviewed had required documentation. Staff records reviewed contained required documentation. No deficiencies were cited on todays visit. An exit interview was conducted with Administrator Juancho Domingo, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Dec 5, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Caregiver Layla Vister. Administrator Juancho Domingo arrived shortly after. According to the facility’s license, the facility has a maximum capacity of six (6) residents, of whom may be non-ambulatory. LPA toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water on the premises. Per Juancho, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Resident records reviewed had required documentation. Staff records reviewed contained required documentation. No deficiencies were cited on todays visit. An exit interview was conducted with Administrator Juancho Domingo, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Feb 28, 2024

Allegation investigated: Residents were exposed to inappropriate staff behavior.

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to initiate a complaint investigation on the above-mentioned allegation. LPA identified herself and discussed the purpose of the visit with Layla Vister. Administrator Juancho Domingo arrived shortly after. On December 12, 2023, Community Care Licensing (CCL) received a complaint alleging residents were exposed to inappropriate staff behavior. During investigation, LPA Strong collected pertinent resident records as well as facility documentation and conducted interviews. According to allegation, on November 20, 2023 at around 11:30pm, Staff 1 (S1) and Staff 2 (S2) were heard having sexual relations while residents were in care. Interview with residents revealed that there was no knowledge of such incident occurring. Interview with S1 and S2 revealed that no such incident occurred. Interview with outside source did not reveal any information to corroborate that this incident occurred. Additional interviews revealed that Resident 1 (R1) had recent increased sexual behaviors against staff and R1 moved out of facility in December 2023. Unsubstantiated Based on LPA's interviews, and record reviews there is not a preponderance of evidence to prove alleged violation occurred, therefore the allegation is unsubstantiated. An exit interview was conducted with Administrator Juancho Domingo, to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.the state’s words, verbatim · CDSS document, Dec 20, 2023 · control 08-AS-20231212120348