Solaris 30

Allegation investigated: Licensee has abandoned the facility. Licensee has lost control of property. Licensee did not report sale of facility.

**REPORT WAS AMENDED ON 06/16/25 AND THE AMDENDED COPY WAS EMAILED TO LICENSEE** Licensing Program Analyst (LPA) Liliana Silveira conducted a virtual meeting on Microsoft Teams with Licensee Xiaoqing “Leslie” Wang to deliver complaint findings. LPA stated the purpose of the meeting with Leslie. The investigation consisted of observations, interviews and a records review. On January 30, 2025, it was alleged that the Licensee had abandoned the facility. A Licensing Program Analyst (LPA) from the Department conducted an unannounced Health & Safety check on January 31, 2025. The LPA observed that there were caregivers present, changing residents and preparing dinner for the residents. The LPA also observed that the facility was clean. Interviews with the current acting Administrator revealed that in June 2024, two Administrators had quit and left the residents with care staff. (CONTINUED ON NEXT PAGE, LIC 9099-C) Unsubstantiated (CONTINUED FROM LIC 9099) Interviews with three (3) care staff who worked at the facility during June 2024, revealed that even though the Administrators quit, care staff remained working at the facility until the Licensee came soon after to manage the facility. An interview with the Licensee revealed that in June 2024, as soon as they were informed that the Administrators quit, the Licensee returned to the facility to check on the residents and manage the facility. There was not enough evidence to support this allegation. It was also alleged that the Licensee had lost control of the property and did not report the sale of the property. A records review revealed that a Property Management Agreement provided by the Licensee, dated September 20, 2019, and with expiration date of September 20, 2029, demonstrated that the property is leased to Solaris Capital Group Inc. An interview with the Licensee revealed that they still act as property manager for the property via Solaris Capital Group Inc. The interview also revealed that the property owner has no intention of selling the property at this moment. An interview with the current Administrator, who represents a new management group, revealed that they are in current negotiations with the Licensee/Property Manager to take over the lease and have applied for a license with Community Care Licensing Division. There was not enough evidence to support these allegations. The allegations that the Licensee had abandoned the property, had lost control of the property and did not report the sale of the property are unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations occurred, therefore the allegations are unsubstantiated. LPA Silveira conducted an exit interview with Leslie. A copy of the Complaint Investigation Report (LIC9099) and Licensee Rights (LIC9058 03/22) were provided via email. Confirmation via email by Linda confirms receipt of this report.the state’s words, verbatim · CDSS document, Jun 9, 2025 · control 08-AS-20250130152909

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced Case Management visit to respond to observations and interviews from a visit conducted on 2/8/2025. LPA was greeted by, identified herself to, and explained the purpose of the visit with Administrator Jushua "Justin" Mendoza. On 2/08/2025 LPA Observed cobwebs in all bathrooms and all bedrooms. All resident doors had fingerprints and splotches of dirt. All Bathroom shelves have brown splotches and brown spots. The kitchen cabinets had outside debris/dirt and grease. The oven vent was greasy and had debris/dirt. The back yard shed was in disrepair and had a door hanging to the side. The back yard fence in disrepair: missing pieces of fence and lattice is hanging off top of fence. Based on the inspection, deficiencies were observed in the areas evaluated, and observed deficiencies is listed on the LIC 809-D page. An exit interview was conducted, and this report was discussed with Administrator Mendoza. A copy of this report and Licensee/Appeal Rights (01/2016) were provided to the Administrator at the conclusion of the visit, and his signature on this form acknowledges receipt of the rights and a copy of this report.the state’s words, verbatim · CDSS document, Feb 26, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Mar 12, 2025

(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance... for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced Based on observations, the licensee did not ensure the facility was in good repair for 5 out of 5 [R1-R5] residents, due to , cobwebs in bathrooms and bedrooms, outside debris/dirt and greasy cabinets, greasy debris/dirt stove vent, back yard shed in disrepair, back yard fence in disrepair which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Feb 26, 2025

Plan of correction: LPA spoke as well as toured the property with Administrator on 2/7/2025. Administrator was instructed by LPA to clean and repair the inside of the facility as well as the repair of backyard fencing and outside storage shed. LPA observed a clean and in good repair facility on 3/12/2025.

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced Case Management visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Justin Mendoza, Administrator & Arceli Songco, Administrator LPA briefly toured the facility, performed a health and safety welfare check. There are no residents at this facility at this time. LPA Rodgers spoke with staff. No deficiencies were observed or cited on this date. An exit interview was conducted with Arceli Songco, Administrator, Administrator, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Feb 26, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced Case Management visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Justin Mendoza, Administrator. LPA briefly toured the facility, performed a health and safety welfare check. There are five (5) residents at this facility. LPA Rodgers spoke with staff. There are no health and safety concerns at this time. No deficiencies were observed or cited on this date. An exit interview was conducted with Justin Mendoza, Administrator, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Feb 7, 2025

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Juliana Barfield conducted an unannounced complaint visit. LPA introduced herself to Maria Elena Bautista and discussed the purpose of the visit. During a tour of the facility LPA opened door to a resident (R1) bedroom. LPA smelled a strong odor of urine in the room and an unsanitary condition. Staff entered the room, confirmed the smell and agreed to clean up the unsanitary condition while LPA was onsite. A deficiency was cited Per Title 22, Division 6, Chapter 8 of the California Code of Regulations (see LIC809-D). An exit interview was conducted with Anafe Rivera to whom a copy of this report and the Licensee appeal Rights (LIC9058) were provided.the state’s words, verbatim · CDSS document, Jun 14, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Jun 14, 2024

The facility shall be clean, safe and 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.the state’s words, verbatim · CDSS document, Jun 14, 2024

Plan of correction: Staff immediately cleaned unsanitary condition and aired room to remove foul odor.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Juliana Barfield conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, an discussed the purpose of the visit with Anafe Rivera. According to the facility’s license, the facility has a maximum capacity of six (6) residents, of whom six (6) may be non-ambulatory. During today’s inspection, there were a total of six (6) clients in care. This facility does not feature a secured perimeter or delayed egress doors. LPA, accompanied by Maria Bautista toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Hot water temperature at taps accessible to clients were all compliant. There was at least 2 days supply of perishable food, and at least 7 days non-perishable food present. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters observed available to clients. Medications were labeled, as required, and stored in locked areas. (CONTINUED ON LIC809-C) (CONTINUED FROM LIC809) No pools or bodies of water were observed on the premises. Per the licensee's staff, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. Confidential records were stored in locked areas. Anafe Rivera also presented proof of current/active business liability insurance. No deficiencies were observed or cited during today's annual inspection.. An exit interview was conducted with Maria Bautista to whom a copy of this report and the Licensee/AppealRights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, May 13, 2024

Allegation investigated: Facility did not safeguard resident's personal property

Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced complaint investigation visit to conduct additional interviews and deliver findings. The LPA introduced himself and disclosed the purpose of the visit to House Manager Jushua Mendoza. Throughout the investigation, the Department secured pertinent records and conducted interviews with internal and external sources. It was alleged the staff did not safeguard a resident's personal property. On 11/22/23, it was reported to the Department staff had removed one hundred dollars from a resident’s room. An interview with Resident # 1 (R1) revealed R1 left cash in a drawer, and some of the cash had gone missing. R1 did not witness anyone removing the cash. Interviews with internal and external sources did not reveal evidence corroborating the cash was removed by staff. Unsubstantiated Based on the investigation, there was not a preponderance of evidence to prove the alleged violation occurred, therefore, the allegation was Unsubstantiated. An exit interview was conducted with House Manager Mendoza, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided.the state’s words, verbatim · CDSS document, Dec 26, 2023 · control 08-AS-20231122100344