Stonewall Gardens Assisted Living

Allegation investigated: Staff physically assaulted resident

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced visit to the facility to deliver findings of the above allegation. LPA met with Clayshanisha Henson, Resident Service Director. The Department investigation involved interviews with staff and residents and reviews of records. On 11-06-2025, Community Care Licensing (The Department) received a complaint report with the following allegation. It was alleged that staff physically assaulted resident. Information received indicated that Staff #1 (S1) struck Resident #1 (R1) in the face while providing care during night shift. As a result, R1 sustained bruising and swelling on the face. Continued on LIC9099-C.... Substantiated The Department’s review of police report from Palm Springs Police Department confirmed the same allegation against S1, supported by two (2) photographs included in the police report. According to the police report, S1 was arrested for battery and elder abuse. The Department conducted an interview with R1 who stated R1 was hit in the face by S1, consistent with R1’s statement in the police report. The Department conducted an interview with the Administrator. The Administrator called police upon learning of the incident on 08-26-2025. The Administrator stated that S1 was the only caregiver on duty during the incident. The Administrator stated that S1 was terminated on 08-28-2025. The Department met with S1 for an interview, but S1 declined and exercised right to remain silent. The Department did not obtain any further information from S1. The Department conducted an interview with Staff #2 (S2). S2 went to R1’s room for routine morning check on 08-26-2025. R1 told S2 about being hit in the face by S1 earlier in the morning. The Department conducted an interview with R1’s hospice agency personnel who stated that a hospice nurse visited R1 on 08-27-2025 to treat R1’s injuries on the face. R1 told the hospice nurse the same account about being hit in the face by S1. The Department’s interview with R1’s relevant party who visited R1 on 08-27-2025 confirmed that R1 shared the same account about being hit in the face by S1. Based on interviews conducted and records review, the Department’s investigation found enough information to corroborate the allegation that staff physically assaulted resident. This allegation is substantiated. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. An exit interview was conducted where a copy of this report was provided, along with a copy of LIC9099D, and Appeal Rights were provided. The Department conducted an interview with the administrator, who stated that police were called, and a report was sent to the appropriate agencies after learning of the physical abuse incident. The Department obtained and reviewed the Palm Springs Police Department report which confirmed the date of the police report was filed. Based on interviews conducted and records review, the allegation that licensee did not notify relevant parties of incident is unfounded. A finding of Unfounded means the allegation could not have happened, is false, and/or is without a reasonable basis. An exit interview was conducted where a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 12, 2026 · control 18-AS-20251106134235

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(a)(8) · Plan of correction due date: Mar 19, 2026

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities, (a)In addition to the rights listed in Section 87468.1, (9)To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement was not met as evidenced by: Based on interviews conducted and records review, R1 was physically abused by S1. This posed an immediate personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Mar 12, 2026

Plan of correction: Licensee agreed to provide reminder training of personal rights and will send proof of the training by the POC due date.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA), Seo Jeon, conducted an unannounced visit to the facility for a case management visit to follow up on complaint control number 18-AS-20251106134235. The LPA was allowed entrance into the facility and met with Clayshanisha Henson, Resident Service Director. The LPA informed the Resident Service Director of the purpose of the LPA’s visit. LPA toured the interior and exterior of the facility and did not observe any health and safety concerns. LPA conducted review of staff file and observed that Staff #1 (S1) did not have criminal record clearance prior to S1’s employment at this facility. S1 had worked without being associated with the facility from March 2025 to 08/28/2025. A citation was issued. LPA conducted review of facility records and observed that the physical abuse incident occurred on 08/26/2025 was not reported to Community Care Licensing. A citation was issued. An exit interview was conducted where a copy of this report, LIC809-D, LIC421BG, and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Mar 12, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(3) · Plan of correction due date: Mar 12, 2026

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..., (3) Request a transfer of a criminal record clearance This requirement was not met as evidenced by: Based on records review, S1 did not have criminal record clearance prior to working at the facility. This posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Mar 12, 2026

Plan of correction: Licensee terminated S1 on 08/28/2025. Licensee stated that all employees will go through criminal record clearance prior to employment.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87211(c) · Plan of correction due date: Mar 12, 2026

Reporting Requirements, (c)Any suspected physical abuse that does not result in serious bodily injury...the corresponding licensing agency, and the local law enforcement agency within twenty-four (24) hours... This requrement was not met as evidenced by: CCLD did not receive any incident reports regarding the physical abuse incident occurred on 08/26/2025. This posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Mar 12, 2026

Plan of correction: Licensee agreed to send all future incident reports to Community Care Licensing Riverside Regional Office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced annual required visit. Upon entry, LPA was greeted by Nisha Henson, Care Director, and informed them of the purpose of the visit. At the time of the visit, there were three (3) staff members and 27 residents present. Brittany Cabanas, Administrator, joined later during the inspection. Facility Overview: The facility is consisted of two (2) single story buildings with 24 bedrooms and 27 bathrooms. There are no pools or known firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility has infection control plan in file. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. The hot water temperature was 118°F. LPA reviewed annual fire marshal inspection report dated 05-20-2025 and observed that the facility passed the inspection. Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Continued on LIC809-C..... Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate. Record Review and Resident/Staff Files: LPA reviewed files for four (4) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Four (4) resident files were reviewed and contained all required documentation. Health-Related Services/Incidental Medical Services: All resident medications were securely locked inside the facility medication room. LPA reviewed medications for four (4) residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 09-10-2025, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed and provided.the state’s words, verbatim · CDSS document, Dec 5, 2025

Allegation investigated: Unqualified staff providing medical care. Staff tested positive for COVID.

On November 20, 2025, the Department of Social Services staff conducted an unannounced visit to this facility to continue investigation of the above allegations and to deliver findings. The Department was met by Nisha Henson and the purpose of the visit was explained. Investigation consisted of the following: On October 28, 2021, the Department conducted an unannounced initial visit to the facility to investigate the complaint allegations mentioned above. During the visit, it was determined that the complaint required further investigation. At time of visit, the Department interviewed 5 staff (S1-S5) and 3 residents (R1-R3). The Department obtained the following pertinent documents: Email correspondence (dated: 10/25/21 at 2:44pm), Weekly Care Schedule (dated:10/4/21), Staff training certificates (dated 4/1/21), Staff Roster (no date), Kitchen schedule (no date). On November 20, 2025, the Department requested and obtain the following documents: Staff roster (dated: 11/2025), Resident Roster (dated: 11/13/25). The department reviewed 4 staff files and interviewed the Residential Care Coordinator/Business Manager (A1). Page 1 of 3 Unsubstantiated The investigation revealed the following: Allegation: Unqualified staff providing medical care. The detail of the complaint alleges that “staff are asked to do ‘medical tasks’ that they aren’t qualified to do.” On November 20, 2025, at 1:15 pm, the Department interviewed Nisha Henson, Residential Care Coordinator(A1) who denied the allegation stating there are no unqualified staff providing medical care. All the Med Techs and the care staff are qualified. On October 28, 2021, the Department interviewed 5 staff members, including the administrator (S1–S5), about the allegation. 2 of the 5 said some staff may be asked to perform tasks outside their usual scope when needed, but those staff are typically cross-trained in related duties such as medication technician and caregiver tasks. The other 3 staff said they are not asked to perform tasks outside their scope. On October 28, 2021, the Department interviewed 3 residents (R1–R3). All three residents said they are well cared for and that only medication technicians have administered their medications. On November 20, 2025, the Department reviewed 4 staff files and found that they contained required certifications and training. Additionally, the Department reviewed and evaluated the staff training certificates (dated: 4/1/21). Based on the information gathered, there is insufficient evidence to support the allegation mentioned above; Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Page 2 of 3 Allegation: Staff tested positive for COVID The detail of the complaint alleges that a staff member tested positive for COVID and was asked not to disclose information to other staff. On November 20, 2025, at 1:15pm, the Department interviewed Nisha Henson, Residential Care Coordinator (A1). A1 denied the allegation and stated the facility has a COVID mitigation plan on file that staff follows. The complaint alleges a staff member tested positive for COVID and was told not to disclose it to other staff members. COVID test results are confidential, and a positive result is not a violation of Title 22. Interviews and review of documents show the administrator addressed the positive test with staff and arranged testing while maintaining staff confidentiality. Based on the information gathered there is insufficient evidence to support the allegation mentioned above; Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. There were no deficiencies cited during today's visit. Exit interview conducted and copy of report provided. Page 3 of 3the state’s words, verbatim · CDSS document, Nov 20, 2025 · control 18-AS-20211025095214

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Seo Jeon made an unannounced visit to the facility to conduct a Case Management visit regarding a death report received on 08-15-2025. LPA met with Brittany Cabanas, Executive Director, and obtained the pertinent documentation. LPA conducted a tour of the facility for health and safety. LPA did not find any health and safety concerns at the time of the visit. There are no deficiencies being cited, per California Health & Safety Code and Code of Regulations, Title 22. An exit interview was conducted, a copy of this report were provided. LPA left the facility at 12:30 PM and returned at 01:20 PM.the state’s words, verbatim · CDSS document, Aug 18, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced annual required visit. Upon entry, LPA was greeted by Brittany Holm, administrator, and informed them of the purpose of the visit. At the time of the visit, there were 6 staff members and 24 residents present. Facility Overview: The facility is consisted of 2 single story buildings with 24 bedrooms and 27 bathrooms. There are no pools or known firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Administrator provided inspection report from fire marshal dated 7-21-2024, and the hot water temperature was 106°F. Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate. Continued on LIC809-C.... Record Review and Resident/Staff Files: LPA reviewed files for 6 staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. 3 resident files were reviewed and contained all required documentation. Health-Related Services/Incidental Medical Services: All resident medications were locked and stored in a separate medication room. LPA reviewed medications for 3 residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 11-14-2024, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed and provided.the state’s words, verbatim · CDSS document, Dec 4, 2024

Allegation investigated: Staff not supervising resident resulting in multiple falls Resident’s money was stolen

Licensing Program Analyst, (LPA) Kathleen Banrasavong conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegations. LPA met with Marketing and Resident Enrichment Director, Brian Trout, where LPA explained the purpose of the visit and the elements of the allegations. The investigation consisted of observation, interviews with staff members and residents, and records review. On 12/07/2020, Community Care Licensing received a complaint alleging that Staff did not supervise resident resulting in multiple falls and Resident’s money was stolen. It was reported that R1 was being hospitalized due to multiple falls and that staff members were not supervising the resident. Information obtained from an interview with Administrator, Chad Boeddeker stated R1 would sustain bruises occasionally due to being a fall risk. Administrator reported R1 would not request staff assistance when ambulating. Information obtained from interviews with additional staff members indicted there were no issues with assisting the residents during this time period. Interviews with residents corroborated that they were able to get assistance if requested. After reviewing R1’s records, he was indicted to be a fall risk and had regular 30 minutes intervals room checks. LPA was unable to interview R1 due to the resident passing away in March 2021. LPA also attempted to interview R1’s responsible party, but LPA was unable to obtain contact. Unsubstantiated In regards to the allegation of Resident’s money was stolen, it was alleged that the facility did not safeguard R1’s money. The Marketing and Resident Enrichment Director, Brian Trout stated that they have a safeguarding form that the client’s fill out prior to become residents at the facility. If any theft or loss occurs, the policy is to notify the police if the value is over $25.00. Information obtained from an interview with Staff Member stated that they overheard R1 mention they had lost their wallet; however, the staff member could not recall specific details pertaining to the incident. Additional interviews could not provide any information to corroborate or refute the allegation. Therefore, due LPA unable to obtain information from pertinent parties, this allegation is deemed unsubstantiated at this time. Based on the LPA’s observation, interviews, and record review, the allegations may have happened or is valid, but there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report, were discussed with and provided to the Marketing and Resident Enrichment Director, Brian Trout.the state’s words, verbatim · CDSS document, May 17, 2024 · control 18-AS-20201207165056

Allegation investigated: Resident is being illegally evicted.

Licensing Program Analyst (LPA), Kathleen Banrasavong made an unannounced visit to the facility to deliver findings on complaint investigation regarding the allegation listed above. LPA spoke to the Executive Director, Lauren Vincent over the phone and met with Kitchen Chef, Brian Lebeuf and explained the purpose of the visit and the elements of the allegation. LPA Banrasavong conducted the investigation which consisted of observation, interviews with staff members and resident, and record reviews. On 02/28/2024, Community Care Licensing received a complaint stating that the facility is illegally evicting Resident (R1). It was reported that the facility did not follow the 30-day eviction guidelines, did not properly serve the resident, and did not give the resident proper resources to find alternative housing. During the LPA’s initial visit, LPA was able to speak to R1 and confirmed that he was properly served with the 30-day notice on the date that the facility submitted the notice to Community Care Licensing’s Regional Office. R1 stated that there were resources available and Executive Director, Lauren Vincent has been assisting in trying to help find alternative housing. Unfounded Documentation provided to the resident indicated an outstanding balance due to failure to pay rent under the residency agreement. The balance included fees from unpaid rent since September 2022 until the present month of March 2024. During the LPA’s interview with Executive Director, Lauren Vincent, it was concluded that the eviction notice was served to the resident in his room, along with several resources to help find alternate housing. It was advised that there were two (2), 30-day eviction notices served to the resident on October 19, 2023, and December 29, 2023. Based on LPAs observations, records review, and staff and resident interviews, this agency has investigated the complaint alleging that the facility is illegally evicting the resident. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint. An exit interview was conducted, and a copy of this report was provided to the Executive Director, Lauren Vincent over the phone and Kitchen Chef, Brian Lebeuf as evidenced by his signature.the state’s words, verbatim · CDSS document, Mar 27, 2024 · control 18-AS-20240228155354

Allegation investigated: Staff did not ensure resident attended his medical appointments Staff did not meet resident's dietary needs Staff mismanaged resident's medication Staff falsified residents' records Administrator is not at the facility a sufficient amount of time

Licensing Program Analyst (LPA), Kathleen Banrasavong made an unannounced visit to the facility to deliver findings for a complaint investigation regarding the allegations listed above. LPA met with Executive Director, Lauren Vincent over the phone and met with Kitchen Chef, Lebeuf and explained the purpose of the visit and the elements of the investigation. LPA Banrasavong conducted the investigation, which consisted of observation, interviews with staff members, residents, and record reviews. LPA was unable to interview additional witnesses in order to obtain pertinent information. On 02/12/2024, Community Care Licensing received a complaint alleging that the facility is not ensuring resident is attending his medical appointments. The LPA attempted to reach out to the Reporting Party (RP) on three separate occasions but was not able to make contact with the RP. LPA interviewed the resident (R1) that was named in the complaint. During the interview, the resident indicted that they had no issues with getting any resources needed to attend their medical appointments. The resident indicted that they did not miss any medical appointments. The resident also indicted that they were able to get their medications on time, without any issues. They stated that there was always a Med Tech available when they needed one. R1 stated that they did not have any issues or concerns with the facility and it’s care and supervision. Unsubstantiated During the initial 10-day visit, the LPA spoke to the Administrator, Lauren Vincent over the phone and the Marketing & Resident Enrichment Director, Brian Trout in regards to the Administrator’s hours and schedule at the facility. It was alleged that the Administrator was not at the facility for a sufficient amount of time. The random 5 residents that the LPA interviewed stated that that was not an issue for them. The staff also echoed that sentiment. The Administrator stated that she was present at the facility for a sufficient amount of time to meet the needs of the residents. In regards to the allegations that the facility is not meeting resident’s dietary needs, after record reviews, interviews with the Head Chef and Marketing and Resident Enrichment Director, there was no resident who resided that the facility, that had a special dietary plan or restriction. The LPA randomly interviewed residents who stated that they had no issues with getting medication or being transported to their doctor’s appointments. The LPA reviewed 5 random medications and MARS, in which it appeared that the medications were accurately dispensed and logged. The Med Tech, Nisha Henson, stated that there were no issues with residents receiving their medications. In regards to the facility falsifying records, the LPA was not able to interview additional witnesses regarding the complaint. The Marketing & Resident Enrichment Director, Brian Trout and Executive Director, Lauren Vincent denied this allegation. The residents interviewed indicted that they did not have any issues or concerns regarding this complaint. Based on LPAs observations, records review, and staff and resident interviews, this agency has investigated the complaint alleging that the facility, Staff did not ensure resident attended his medical appointments, Staff did not meet resident's dietary needs, Staff mismanaged resident's medication, Staff falsified residents' records, Administrator is not at the facility a sufficient amount of time are unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to the Executive Director, Lauren Vincent over the phone and provided to Kitchen Chef, Brian Lebeuf as evidenced by his signature.the state’s words, verbatim · CDSS document, Mar 27, 2024 · control 18-AS-20240212161807

Allegation investigated: Staff are not transporting residents to medical appointments. Administrator is not on the premises for a sufficient number of hours. Facility is not following residents dietary plan. Facility does not have a nurse available to assist residents in care.

Licensing Program Analyst (LPA), Kathleen Banrasavong made an unannounced visit to the facility to deliver findings for a complaint investigation regarding the allegations listed above. LPA spoke to the Executive Director, Lauren Vincent over the phone and met with Kitchen Chef, Brian Lebuef and explained the purpose of the visit and the elements of the investigation. LPA Banrasavong conducted the investigation, which consisted of observation, interviews with staff members and residents, and record reviews. LPA was unable to interview additional witnesses in order to obtain pertinent information. On 02/12/2024, Community Care Licensing received a complaint alleging that staff are not transporting residents to medical appointments, Administrator is not on the premises for a sufficient number of hours, facility is not following residents dietary plan, and facility does not have a nurse available to assist residents in care. In regards to the allegations that staff are not transporting residents to medical appointments, LPA interviewed Resident (R1) and advised that they had no issues with obtaining any resources regarding their medical appointments and did not miss any medical appointments. It was also advised that there was always a Med Tech available and there were no issues or concerns. It was also alleged that the facility does not have a nurse available to assist residents in care. Marketing & Resident Enrichment Director, Brian Trout, stated the facility has six (6) med techs in total. There are different Med Techs for each shift, which accounts for the AM, PM, and weekend shifts. Unsubstantiated In regards to the allegation that the Administrator was not present at the facility for a sufficient number of hours, LPA reviewed the Administrator’s training and schedule. The Administrator stated that she is present at the facility and there to meet the needs to the residents. Information obtained from interviews with residents and staff stated there were no issues or concerns regarding Administrator being at the facility. In regards to the allegations that the facility is not meeting resident’s dietary needs, after record reviews and interviews with administrator and staff, it was advised that there was no resident who resided at the facility, that required a special dietary plan or restriction. Head Chef, Brian Lebeuf corroborated that there were no residents that have any restrictions or special diets. It was advised that residents are able to substitute and have alternative meal options if they choose. Based on LPAs observations, records review, and staff and resident interviews, this agency has investigated the complaint alleging that staff are not transporting residents to medical appointments, Administrator is not on the premises for a sufficient number of hours, facility is not following residents dietary plan, and facility does not have a nurse available to assist residents in care. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to the Executive Director, Lauren Vincent over the phone and provided to the Kitchen Chef, Brian Lebeuf as evidenced by his signature.the state’s words, verbatim · CDSS document, Mar 27, 2024 · control 18-AS-20240212154137

Allegation investigated: Resident sustained unexplained bruising while in care. Staff did not safeguard resident's personal property.

Licensing Program Analyst (LPA), Stephanie Martinez, conducted an unannounced visit to the facility to conclude the investigation into the above allegations. The LPA met with Interim Administrator, Lauren Kabakoff, and informed her of the purpose for the visit. A report was received by the Department alleging Resident One (R1) was observed with unexplained bruising to their neck on or around March 15, 2021. Administrator Chad Boeddeker was interviewed and reported R1 was observed with bruising; however, he stated R1 returned to the facility from a hospitalization with the injuries. He reported R1 would sustain bruises occasionally due to being a fall risk. He reported R1 would not request staff assistance when ambulating. Resident records were obtained on 03/23/2021. R1's Physician's Report (California) was reviewed; the document revealed the resident had no motor impairment or paralysis, was not confused or disoriented, and had no history of skin conditions or breakdown. An interview with R1 could not be conducted due to the resident passing away in March 2021. Additional staff and resident interviews could provide no additional information regarding the matter. Therefore, due to insufficient Unsubstantiated information, this allegation is deemed UNSUBSTANTIATED at this time. In addition, a report was received by the Department alleging facility staff lost R1's wallet and glasses. Staff and resident interviews reported R1 was observed to utilize glasses. One staff interview reported overhearing R1 mention they had lost their wallet; however, the staff member could not recall the circumstances surrounding the incident. An interview with R1 could not be conducted due to the resident passing away in March 2021. Additional interviews could not provide any information to corroborate or refute the allegation. Therefore, due to insufficient information, this allegation is deemed UNSUBSTANTIATED at this time. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. This report was reviewed with Interim-Administrator Kabakoff and a copy was provided.the state’s words, verbatim · CDSS document, Jan 30, 2024 · control 18-AS-20210315130523

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Janira Arreola conducted a required annual visit. LPA was greeted and was granted entry and met with Administrator, Lauren Kabakoff, who was informed of the purpose of the visit. The facility is a one story building with (24) apartments and (27) bathrooms, (1) medication room, (1) laundry room, (1) staff office, kitchen and common area/dining room. No pools or fire arms are kept at the facility. The facility is designated as a residential care facility for the elderly serving elderly between age 60 and above. LPA conducted a tour of the interior and exterior, reviewed facility documents and conducted interviews. LPA observed the following: Infection Control: LPA observed the hand washing stations in the facility had hand hygiene supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. The facility has a plan for mitigating infectious diseases and training staff on these procedures. Physical Plant: LPA observed the physical plant, floors, windows, and doors were observed to be clean and fixtures and furniture were present and in good repair. The facility's outdoor area was observed to be free of hazards and contained outdoor furniture and shaded area for clients. Laundry equipment was observed to be in good working condition. The sharp and dangerous objects were observed to be locked and inaccessible to clients. The smoke detector and carbon monoxide was operational, and the hot water temperature 108.3F. Food Service: LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. Record Review and Resident/Staff Files: LPA reviewed staff files and training that contained staff criminal clearance and updated training along with CPR/First Aid. Client files were reviewed and possessed all required paperwork. Health Related Services/ Incidental Medical Services: All client medication was locked in the medication room. LPA reviewed resident medications for residents and found all required labeling was found to be in place. Disaster preparedness: LPA reviewed the facility's emergency and disaster plan. LPA reviewed documentation showing last fire drill conducted 09/21/23. LPA observed all facility exits were clear from obstructions. No deficiencies were cited at the time of the visit. An exit interview was conducted where a copy of this report was provided to Administrator, Lauren Kabakoff.the state’s words, verbatim · CDSS document, Dec 11, 2023