Sterling Senior Community 7

Type of visit: Office

Licensing Program Managers (LPM) Kevin Saborit-Guasch and Alisa Ortiz along with Licensing Program Analyst (LPA) Nancy Guillen met with Licensee Albert Pimentel and Michelle Kellogg in regards to concerns with consistency of complaints investigations and also wanted clarification on Title 22. The following were discussed: - Complaint Investigation Process - Expectations of collaboration between LPAs and Licensees - Appeal rights - Title 22 requirements regarding staff training, awake staff, and staff records Licensee expressed intention to continue building rapport with the department An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, May 21, 2026

Allegation investigated: Facility staff failed to properly administer resident’s medications. Facility failed to maintain a complete and accurate resident’s records.

Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to finalize an investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit. It was alleged facility staff failed to properly administer resident's medications and facility failed to maintain a complete and accurate resident’s records. LPA conducted interviews with staff and residents. LPA reviewed records obtained. The investigation determined as follows: Regarding the allegation facility staff failed to properly administer resident's medications, it was reported medications are not administered per Title 22 regulations. Interviews with one out of five residents stated they are assisted with medications. The one resident stated they receive medications after meals. The remaining five residents could not be qualified for interviews. Two out of three staff stated Staff 1(S1) assist residents with medication administration. The remaining staff stated S1 and Staff 2 (S2) assist with medication administration. Substantiated Interviews with one out of five residents stated the facility has remained in good repair overall. The remaining four residents could not be qualified for interviews. Interviews with three out of three staff stated there are maintenance persons who are available to make repairs to the facility as needed. Regarding the allegation facility is not adequately staffed, it was reported there is insufficient staff to meet the needs of the residents. LPA interviews with one out of five residents stated their needs are being met by staff and there has not been an issue with staffing. The four remaining residents could not be qualified for interviews. Three out of three staff stated there is sufficient staff coverage and several back up staff is available when needed. LPA record review of the LIC500 indicates there are seven caregivers available or on call with at least two caregivers scheduled to work from 7AM to 8PM and one caregiver scheduled to work from 8PM to 8AM. LPA reviewed schedule indicating two staff during the day shift and one staff during the night shift from March to May 2026. Based on interviews and record review, LPA is unable to corroborate the allegations. Therefore, the allegations are deemed to be UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. An exit interview was conducted and a copy of the report was left with the facility. Based on interviews and records observed, the allegation is therefore deemed unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted and a copy of the report was left with the facility representative. S1 added there has never been an instance where medications were not available or delayed. During the initial complaint visit conducted by the Department on December 14, 2023, it was observed Miralax was available at the facility. When the Department questioned who the Miralax belong to, staff stated it belonged to Resident 7 (R7). The Department did not observe Miralax in R7's medication administration record. The staff removed the Miralax from the facility and stated they would obtain a physician's order to provide to R7. Record review revealed R7 moved out of the facility on October 14, 2024. LPA reviewed R7's medication administration record for the months of September, October, and November 2023. LPA also reviewed medication list from hospice for R7 dated October 7, 2023. Neither indicates Miralax or Polyethylene Glycol Powder as part of R7's medications. Regarding the allegation facility failed to maintain a complete and accurate resident’s records, it was reported resident records and not maintained per Title 22 regulations. The centrally stored medication and destruction record for R7 was not available to review. Administrator (AD) Kian Pascual stated those records were lost when the facility transitioned into their current record keeping system. Based on interviews conducted, records reviewed, and observations, the preponderance of evidence standard has been met. Therefore, the above allegations are found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6), are being cited on the attached LIC 9099D. An exit interview was conducted and a copy of the report was left with the facility representative along with appeal rights.the state’s words, verbatim · CDSS document, Apr 28, 2026 · control 22-AS-20231211124212

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(6)(C) · Plan of correction due date: May 15, 2026

87465(h)(6)(C)Incidental Medical and Dental Care The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident...and includes: The drug name, strength and quantity This requirement is not met as evidenced by: Miralax for R7 was observed at the facility. No Centrally stored and medication list was available for R7 to review which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Apr 28, 2026

Plan of correction: AD stated medication documentation in-service training will be conducted staff. AD to provide proof of training to LPA by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(e) · Plan of correction due date: May 15, 2026

87506(e) Resident Records Original records or photographic reproductions shall be retained for a minimum of three (3) years following termination of service to the resident. This requirement is not met as evidenced by: R7's centrally stored medication and destruction record is no longer available. R7 discharged from the facility on 10/14/2024 which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Apr 28, 2026

Plan of correction: AD stated records for resident will be backed up by USB and retained for at least three years after the resident discharges. AD to submit a statement of acknowledgement of the regulation and inform LPA when backup is completed.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Fred Arias conducted an unannounced case management visit to follow up on observations made during a complaint investigation on April 28, 2026, complaint number 22-AS-20231211124212. During the staff record review, Staff 1 (S1) had a first aid/CPR training completed on April 28, 2026. S1 was not scheduled to work on today's date and is scheduled to work on the weekends. LPA asked Administrator (AD) Kian Pascual about it and AD stated S1 finished training that morning and emailed the certificate to him. LPA asked AD to show the email from S1 but AD could not produce it. AD then stated S1 completed the training and had AD log in to pay for it. AD was unable to log into the National CPR Foundation to show how that was possible. LPA spoke to S1 regarding the CPR/First Aid training. S1 did not corroborate the statements AD made to the LPA. AD admitted the statements made to the LPA were untruthful and AD stated he completed the CPR training using S1's information. Based on the schedule AD provided, S1 and Staff 2 (S2) work the day shifts on the weekends. Neither S1 or S2 has verified CPR/1st Aid training that is current. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided along with appeal rights.the state’s words, verbatim · CDSS document, Apr 28, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87207 · Plan of correction due date: Apr 29, 2026

87207 False Claims No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement is not met as evidenced by: AD made a false statement regarding CPR training for S1 to the Department. AD falsified the CPR training record on behalf of S1 which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Apr 28, 2026

Plan of correction: AD stated he will sign a statement of understanding, indicating the acknowledgement of the false statements and documents, the understanding of the regulation, and will submit the signed to LPA by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87411(c)(1) · Plan of correction due date: May 8, 2026

87411(c)(1) Personnel Requirements Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: S1 and S2 are the day shift weekend staff. Neither has verifiable CPR/First Aid training which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Apr 28, 2026

Plan of correction: AD stated S1 and S2 will complete First Aid/CPR training that is verifiable and submit proof to LPA by POC due date.

Type of visit: Required - 1 Year

On March 13, 2026, Licensing Program Analyst (LPA) Eboni Bentley conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Bentley introduced self and was granted entry into the facility by staff, after stating the purpose of the visit. Administrator (AD) Kian Pascual was present and assisted with today’s inspection. Kian Pascual has an Administrator certificate that expires on May 26, 2026. The facility is licensed to operate for six (6) non-ambulatory residents, of which one (1) may be bedridden, and has a hospice waiver for six (6) residents. The facility is a two-story building located in a residential neighborhood. It consists of the following: six (6) resident bedrooms on the lower level, two (2) staff bedrooms and an office area on the upper level, four (4) bathrooms throughout the facility, a living room area, dining area, kitchen, an outdoor covered seating area, and an attached two car garage. During the visit, LPA toured the inside and outside of the physical plant with staff. There were no bodies of water or obstructions on the premises. All rooms were inspected, beds and bedding supplies were in good condition, and storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. A comfortable temperature of 74 degrees F was maintained throughout the facility. Bathrooms were found to be clean and operational, with water temperatures in bathrooms measured between 112.0 degrees F and 117.3 degrees F. During a tour of the exterior portion of the facility, LPA observed construction materials, a basket ball hoop & frame, and a ladder left unattended by the shed, on the right side of the facility. Report Continues on LIC 809-C...... The smoke detectors and carbon monoxide detectors were operable. First aid kit is maintained and contains all the necessary elements. Emergency safety drills were last conducted on March 2, 2026. The facility has three (3) fire extinguishers that were charged, mounted, and last serviced April 4, 2025. Record of Liability Insurance was provided during the visit with a policy start date of November 18, 2025, through November 18, 2026. The facility has a device that can be used for video teleconference purposes. LPA conducted an audit of six (6) resident files (R1-R6), three (3) staff files (S1-S3), and medication and medication administration review. Resident and staff interviews were conducted. Based on today’s observations, no deficiencies are being cited as per Title 22 California Code of Regulations, Division 6, Chapter 8. An exit interview was conducted with Administrator Kian Pascual, and a copy of this report, and a technical violation were provided at exit.the state’s words, verbatim · CDSS document, Mar 13, 2026

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On July 29, 2025, at 9:10am, Licensing Program Analyst (LPA) Eboni Bentley conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Bentley was greeted and granted entry by Caregiver (CG) Maria Diocampo and Administrator (AD) Kian Pascual. LPA stated the purpose of the visit and requested Resident/Staff rosters and Personnel Record. The facility is licensed to operate for six (6) nonambulatory residents, of which one (1) may be bedridden, and has a hospice waiver for six (6) residents. The facility is a single-story building located in a residential neighborhood. It consists of the following: six (6) resident bedrooms on the lower level, two (2) staff bedrooms and an office area on the upper level, four (4) bathrooms throughout the facility, a living room area, dining area, kitchen, an outdoor covered seating area, and an attached two car garage. LPA Bentley toured inside and outside of the physical plant with AD Pascual. 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 each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be clean and operational. The water temperature measured 106.1 degrees F to 118.9 degrees F. LPA Bentley 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 a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. CONTINUE TO LIC809-C... During the visit, LPA Bentley observed all mandated inspection control posters were posted. A comfortable temperature of 72 degrees F was maintained in the facility. The smoke detectors and carbon monoxide detectors were operable. A working telephone (714-847-1364) remains available, and the facility has a device that can be used for video teleconference purposes. Emergency food, emergency water, and emergency supplies were stored in the garage. The facility has four (4) fire extinguishers that were charged, mounted, and serviced on April 4, 2025. Liability Insurance is effective November 18, 2024, and expires on November 18, 2025. Emergency safety drills were last conducted on July 10, 2025, and conducted quarterly. First aid kit is maintained and contains all the necessary elements. LPA Bentley conducted an audit of six (6) resident files (R1-R6), five (5) staff files (S1-S5), and a medication and medication administration review. LPA Bentley conducted four (2) staff interviews and six (6) resident interviews. Based on observations, interviews and record reviews, deficiencies are being cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator Kian Pascual at the end of the visit.the state’s words, verbatim · CDSS document, Jul 29, 2025