Sterling Senior Community 11

Type of visit: Case Management - Deficiencies

On August 12, 2026, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced case management visit to the facility in connection with the Annual Inspection visit on July 30, 2026. The LPA met with caregiver Ramona Rendon Rodriquez and explained the purpose of the visit. The Department determined the facility was not incompliance with Title 22 Regulations and was cited as follows: 87355(e)(2) - Criminal Record Clearance The inspection revealed that the facility did not comply with Title 22 regulations, LPA identified staff # 2, and #3 did not have Criminal Clearance Background Transfer Request LIC 9182 and were not associated with this facility. (S2-23) did not appear in CDSS Guardian Background Clearance System. Based on interviews, observation, and record reviews the licensee violated the California Code Regulations (CCR) of Title 22, Division 6, Chapter 8. Deficiencies are issued and an exit interview is conducted with Ramona Rendon Rodriquez. A copy of this report is provided along with the appeal rights.the state’s words, verbatim · CDSS document, Aug 12, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Aug 13, 2026

87355 Criminal Record Clearance - (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: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) This requirement is not met as evidenced by: Based onrecord review, the licensee did not comply with the section cited above. LPA identified staff # 2 & 3 did not have Criminal Clearance Background Transfer Request LIC 9182 and were not associated with this facility. (S2-S3) did not appear in CDSS Guardian Background Clearance System. This violation poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 12, 2026

Plan of correction: Licensee is to ensure that all staff prior to working in the facility obtain a Criminal Background Clearance and Criminal Background Transfer Request and provide proof of correction to CCLD by POC due date. Proof of Correction due date: 08/13/26 at ernand.dabuet@dss.ca.gov Citation: Corrected 07/31/26 both staff members transfer association in Guardian.

Type of visit: Required - 1 Year

On July 30, 2026, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with administrator Sheryl Tongol and explained the purpose of today’s visit. The facility is licensed to operate for (5) elderly residents. of which (1) maybe bedridden. The facility is approved for (6) hospice residents. Currently, there is (1) hospice resident in care. The facility is a single-story structure located in a residential neighborhood. It consists of the following: (5) resident bedrooms (1) common bathroom (1) staff bathroom, an activity room, a dining area, a kitchen, a patio, and a garage. LPA toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 105.2 degree F. A comfortable temperature of 74 degrees was maintained in the facility. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. Evaluation Report Continues LIC 809-C Fire extinguishers were charged, smoke detectors and carbon monoxide were operable. A review of the Medication Administration Record (MAR) was complete and accurate. The facility has conducted a fire drill on 07/14/26. A landline telephone was in working condition. 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. All mandated inspection control posters were posted including Schedule Menu and Plan Activities. LPA observed First Aid Kit was maintained. The facility is current on Community Care Licensing annual dues. The facility has a certificate of liability insurance policy #9733 effective 11/04/25 and 11/04/26. An audit of residents #1-#5 (R1-R5) service files and staff #1-#5 (S1-S5) personnel files revealed to be complete. T DEFICIENCIES: At 3:05 PM, the LPA observed that disinfectants, cleaning solutions, and poisonous substances were left unattended in unlocked storage areas in both the resident's bathroom and the staff bathroom, rather than being secured in locked storage. Staff #2 and Staff #3 did not have Criminal Clearance Background Transfer Request LIC 9182 and were not associated with this facility in CDSS Guardian. An exit interview was conducted with Sheryl Tongol and a copy of the report was providedthe state’s words, verbatim · CDSS document, Jul 30, 2026

Type of visit: Prelicensing

On June 12, 2025 Licensing Program Analysts (LPA) Deborah Lee conducted a pre-licensing Change of ownership (CHOW) evaluation for an RCFE facility type. Today’s pre-licensing evaluation was conducted with Albert Pimentel Narez. The licensee has applied for a license to serve ( 6 ) elderly residents ages 60 and over. The fire clearance is approved for ( 5 ) non-ambulatory and ( 1 ) bedridden on bedroom #4. A tour of the Kitchen, Dining Room, Living Room, (6) Bedrooms, (2) Bathrooms, Back Yard, and Patio with shade. The following was observed during this visit: Structure The facility is a single-story structure located in a residential neighborhood. It consists of the following: ( 6) residents' rooms, ( 2 ) bathrooms, a living area, a dining area, a kitchen, an outside seating area and an attached garage. Facility is clean, sanitary, and in good repair. Page 1 of 3 Indoor and outdoor passageways, stairways, and other areas of potential hazard are free of obstructions. All window screens are clean and in good repair, and areas of potential hazard are well-lit and equipped with sturdy hand railings. Smoke alarms operate properly. Carbon monoxide detectors operate properly. PHYSICAL PLANT LPA and Alberto Pimentel Narez toured the facility inside and outside. LPA 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 resident's personal belongings was observed. LPA observed that facility had required postings: ombudsman poster, see something say something poster, emergency numbers, clients rights, employee Federal/State wage information, facility sketch, BEDROOMS LPA inspected all six (6) bedrooms. All bedrooms were observed to have the required furniture including beds, dressers, night stands, chairs, and ample storage space for personal belongings. No resident bedroom is a passageway to another room, bath or toilet. BATHROOMS LPA inspected the facility bathrooms. In the resident’s bathroom the toilet, faucets, and shower were fully operational. All safety handrails were securely fastened. LPA observed the showers to be clean and free of mold or mildew. The water temperature measured 109.4 -degrees Fahrenheit. Page 2 of 3 FOOD SERVICE Kitchen LPA inspected the kitchen and observed all appliances to be in good working repair, including stove/oven, microwave, dishwasher, washer, dryer, refrigerator, and additional freezer. LPA observed an ample supply of cutlery, pots, pans, and bowls to be in good repair. LPA observed knives and additional sharps to be secured in locked drawers in the kitchen and are inaccessible to residents. LPA observed a 2-day supply of perishable foods and a 7-day supply of nonperishable foods. Cleaning products and toxins were secured in hall closet that is inaccessible to clients. MEDICATIONS There is a locked centralized storage area for Resident medications. RECORDS There is confidential storage of personnel records at the facility. There is confidential storage of resident records at the facility. LPA reviewed (3 ) staff files and found (3) out of ( 3) contained the required documentation, certification, and training. Liability Insurance expires on 11/14/25. LPA reviewed (3) resident files and found (3 ) out of (3 ) contained all the necessary documentation: Admission Agreement, Medical Assessments, Consent forms, ID, TB tests, Personal Rights, and Appraisal/Needs and Services plan. There are no corrections needed. Component III: Conducted during today’s Pre-Licensing visit. A copy of report provided was provided to Administrator. Page 3 of 3the state’s words, verbatim · CDSS document, Jun 12, 2025

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 6 COMP II Participants: Administrator Abigail Benedicto and Licensee Michelle Kellogg Interview Method: Telephone interview On 5/20/2025, 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, May 20, 2025