The Gardens of Riverside

Allegation investigated: Resident sustained fracture due to staff neglect or physical abuse. Staff do not allow resident to have visitors. Staff do not allow resident to leave the facility.

Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegations. LPA Singh met with front staff and granted entry to the facility.Administrator was informed and arrived during the visit. LPA Singh met Facility Administrator Griselda Gracie Garcia and discussed the purpose of the visit. LPA Singh interviewed staff, residents and obtained pertinent information pertaining to this complaint. First Allegation:-Resident sustained fracture due to staff neglect or physical abuse. LPA Singh interviewed staff, residents, During the investigation, the LPA interviewed Resident #1's responsible party and Power of Attorney (POA), who confirmed that on July 26, 2026, the resident experienced a fall in the dining area after taking a wrong turn. The facility immediately called 911 and notified the POA, who arrived quickly as the resident was transferred to the hospital to check for a fracture resulting from the fall. The resident has since been taken to urgent care, an orthopedic appointment, and subsequent follow-ups. Unsubstantiated Two(2) out of Two(2) staff and Four(4) out of Four Residents stated that facility does not neglect the residents and do supervises the residents. Furthermore, Residents, Resident #1 and family (POA) expressed happiness with the care provided by the facility staff, describing them as very kind and caring toward the residents. Second Allegation:-Staff do not allow resident to have visitors. LPA Singh reviewed records and according to sign in/out sheet family and friends of Resident#1 are visiting Resident#1 regularly. Two(2) out of Two(2)Staff, Resident#1's responsible party, and Four(4) out of four(4) residents confirmed that family visitations are permitted during designated hours and sign in/out sheet reflects family visitation for resident#1 at the facility. Third Allegation:-Staff do not allow resident to leave the facility. LPA Singh reviewed records and, according to the needs and services documents, Resident #1 participates in family outings and attends medical appointments with family members. Additionally, two (2)out of two staff members, the resident's responsible party, and four(4) out of four residents confirmed that the facility allows residents to leave the premises safely with their family and friends. The investigation did not provide any evidence or witnesses that indicated these interactions took place or that there was any neglect/lack of supervision by the facility staff. There is insufficient evidence to prove that Resident sustained fracture due to staff neglect or physical abuse, Staff do not allow resident to have visitors and Staff do not allow resident to leave the facility, thus, the allegations are Unsubstantiated. Therefore, based on the evidence gathered during the investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, this report LIC9099 was signed by LPA Singh and Facility Administrator Griselda Gracie Garcia.the state’s words, verbatim · CDSS document, Aug 4, 2026 · control 56-AS-20260731115328

Allegation investigated: Staff did not seek medical attention to resident resulting in hospitalization.

First Allegation: Staff did not seek medical attention to resident resulting in R#1’s hospitalization. Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to deliver findings on a complaint alleging Staff did not seek medical attention to resident resulting in R#1’s hospitalization. LPA Singh met with Wellness Director Victoria Ong, facility representative. The investigation conducted by Department staff consisted of interviews and reviews of pertinent records. Department Staff substantiated the allegation of neglect and lack of care and supervision regarding Resident #1, concluding that staff failed to seek timely medical attention, which ultimately led to the residents’ hospitalization. During an interview, the family of Resident #1 reported observing significant signs of physical and cognitive decline during a visit on September 29, 2025, two days before the resident was transferred to the hospital. Substantiated These symptoms included pronounced lethargy, incoherent speech, an inability to complete a routine walk, and a noticeable decrease in appetite, all of which went unaddressed by facility personnel at the time. Facility staff reported to department Staff that they did not observe a change in Resident #1’s condition until October 1, 2025, when the resident failed to get out of bed. Although the facility notified the family that day, it was the family who, upon arrival and observation of the resident’s decline, insisted on an immediate hospital transfer. Resident #1 was subsequently admitted to Park view Community Hospital suffering from a blood sugar level in the 600s, diabetic ketoacidosis, and hyperglycemia. The clinical evaluation further revealed hemodynamic instability, altered mental status, dehydration, and severe electrolyte imbalances, including hypokalemia, hyperkalemia, and hypernatremia. Staff indicated that R1’s diabetes was controlled by diabetic medication. However, there was no documentation or formal orders showing why the medication was discontinued on July 13, 2025. Based on the evidence the allegation that Staff did not seek medical attention to resident#1 resulting in hospitalization due to neglect/lack of care and supervision is Substantiated. A substantiated finding means that the allegation is valid because the preponderance of the evidence standard has been met. California Code of Regulations (Title 22, Division & Chapter number) are being cited on the attached LIC 9099D). An Immediate civil penalty for a violation has been assessed in the amount of $500.00. An exit interview was conducted where reports (LIC9099, LIC9099-C & LIC9099-D) LIC 421BG (6/17) and Appeal Rights were discussed and provided to Wellness Director Victoria Ong, Facility representative at the conclusion of the visit. Third Allegation:- Staff did not ensure resident was fed. During the investigation department Staff interviewed Staff, the facility staff stated they provided food to the resident while at the facility. The facility staff also observed Resident#1 with a decrease in appetite the last two days prior to him being sent out to the hospital, was caused due to ketoacidosis and state of his health at that time. According to Staff R#1 normally had a very good appetite and when R#1 had a decrease in appetite, it alerted the staff to the change in condition. Staff did not ensure that the resident was hydrated and Staff did not ensure resident was fed are Unsubstantiated due to the possibility that the dehydration and decrease in appetite was caused due to ketoacidosis and state of his health at that time. Based on the evidence found during the investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where reports (LIC9099, LIC9099-C were discussed and provided to Well-ness Director Victoria Ong, Facility representative at the conclusion of the visit.the state’s words, verbatim · CDSS document, May 19, 2026 · control 56-AS-20251008213046

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87466 · Plan of correction due date: May 20, 2026

Observation of the Resident..The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning...When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, documented.. brought to the attention of the resident's physician and the resident's responsible person...This requirement is not met as evidenced by: Based on the evidence, the Licensee/Staff failed to provide timely medical attention, resulting in hospitalization of Resident#1, which pose immediate health, safety, and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 19, 2026

Plan of correction: Licensee to train all staff on CCR 87466 and submit proof of Training Log to LPA Beena Singh by POC due date. Licensee stated to submit signed Statement of Understanding on CCR 874666 and submit to LPA Singh by POC due date.

Allegation investigated: Staff did not administer resident's medications as prescribed.

Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegations. LPA met with Facility Administrator Griseld Gracie Garcia and discussed the purpose of the visit. Regarding Allegation:- Staff did not administer resident's medications as prescribed. LPA Singh did a walk through of the facility and conducted interviews with Staff and residents. Five(5) out of five(5) Residents and Five(5) out of Five(5) Staff stated that staff administer medications to residents as prescribed and residents does not have any issues with the medications and residents always gets their medications on time. Licensing Program Analyst (LPA) Singh conducted a comprehensive records review for Resident #1, focusing on the individual's Medication Administration Records (MARs) and physician reports. Unsubstantiated Licensing Program Analyst (LPA) Singh conducted a comprehensive records review for Resident #1, focusing on the individual's Medication Administration Records (MARs) and physician reports. The review confirmed that the resident’s documentation was accurate and consistent with medical evaluations, noting no discrepancy. Furthermore, the findings indicated that all records were maintained in accordance with physician orders, and medications morphine was administered exactly as prescribed every two hours as needed. Based on LPA’s observations, staff and resident interviews, and relevant documentation, the allegations are determined to be Unsubstantiated. An Unsubstantiated finding means that although the allegations may be valid or could have occurred, there is insufficient evidence to support that the alleged violations did or did not happen. An exit interview was conducted with Facility Administrator Griselda 'Gracie' Garcia, and a copy of this report was provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Apr 30, 2026 · control 56-AS-20260421084324

Allegation investigated: Staff did not meet resident’s hygiene needs.

On 04/30/2026, Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to initiate and deliver findings on a complaint alleging Staff did not meet resident’s hygiene needs. LPA Singh met with Facility Administrator Griselda Gracie Garcia, facility representative and was informed of the visit, the investigation conducted by LPA Singh consisted of interviews and records review. Allegation:Staff did not meet resident’s hygiene needs. LPA Singh conducted a quick tour of the facility, interviewed residents and staff, obtained pertinent documents. According to the Innovage Social Worker, Resident #1 is currently undergoing treatment for a persistent foot fungus at one of the rehabilitation center, with plans for a transfer to a new facility once his medical care is complete, this condition is not a new development, as it has afflicted the resident since his initial admission to the Garden of Riverside and was managed by Innovage nurses throughout his stay there. Unsubstantiated However, the Resident’s health deteriorated significantly following a recent hospitalization, during which the fungus worsened to the point that a referral to a rehabilitation center became necessary for specialized recovery and specialized care. Interview with Five(5) Residents and Five (5)Staff determined that Staff did meet residents hygiene need and never neglect the residents hygiene needs under their care at the facility. Based on the evidence found during the investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted with Facility Administrator Griselda Gracie Garcia, LIC 9099 report was discussed and a copy was provided at the end of the visit.the state’s words, verbatim · CDSS document, Apr 30, 2026 · control 56-AS-20260212151830

Allegation investigated: Staff handled resident in a rough manner resulting in an injury.

Licensing Program Analyst (LPA) Beena Singh made an unannounced visit to the facility for the purpose of delivering findings into the above complaint allegation. LPA met with Facility Administrator Garcie Garcia. and explained the reason for the visit. Regarding the allegation:- Staff handled resident in a rough manner resulting in an injury. LPA Singh conducted a walk thorough of the facility and interviewed staff and residents. Five(5) out of Five(5) residents and Five(5) out of Five(5) staff stated that staff never handles residents in a rough manner and are always kind and professional with residents in care. LPA's observation, interviews with family and Staff, Due to a decline in cognitive status, Resident #1 lacks the mental capacity to identify the specific staff member allegedly involved in an incident of rough handling. Unsubstantiated While the resident is unable to provide a reliable assessment of the event, Family-POA (who was present during the time of LPA's visit) reports that they visit the facility three to four times weekly and have only observed positive, professional interactions between the staff and the resident. Furthermore, records review and LPA's observation revealed Resident #1 have no bruises, marks, or clinical evidence to support the claims of rough treatment, and the responsible party maintains that they have never witnessed any misconduct during their frequent visits. LPA Singh interviewed Five(5) residents and Five(5) Staff and Five out of five residents and five out five Staff stated staff never handles residents in a rough manner and always being careful while transferring or showering the residents. Based on the evidence found during the investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted with Facility Administrator Griselda 'Gracie' Garcia, and a copy of this report was provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Apr 30, 2026 · control 56-AS-20260224160252

Allegation investigated: Facility staff not allowing family to visit resident. Facility not providing adequate supervision for residents.

Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegations. LPA met with Administrator Griselda Gracie Garcia, and discussed the purpose of the visit. First Allegation:-Facility staff not allowing family to visit resident. During the investigation, LPA Singh was not able to find sufficient evidence to corroborate the allegation. Five(5) out of Five(5) staff and Five(5) out of Five(5) residents confirmed that family visitations are permitted during designated hours, provided that family members notify management or staff of their intent to visit. During the inspection, LPA Singh reviewed the facility's log records, which verified that Resident #1’s family members were consistently allowed to meet and visit with them at the facility. Unsubstantiated Second Allegations:-Facility not providing adequate supervision for residents. During the investigation, LPA Singh was not able to find sufficient evidence to corroborate the allegation. Five(5) out of Five(5) staff and Five(5) out of Five(5) residents confirmed that facility provide them with constant supervision and Staff always takes good care of the residents in care. Based on the evidence found during the investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted with Facility Administrator Griselda Gracie Garcia, and a copy of this report was provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Apr 30, 2026 · control 56-AS-20260218161029

Allegation investigated: Staff refused to accept resident back from hospital.

Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to initiate and deliver findings on a complaint alleging Staff refused to accept resident back from hospital. LPA Singh met with Facility Administrator Griselda Gracie Garcia, facility representative and was informed of the visit, the investigation conducted by LPA Singh consisted of interviews and records review. Allegation:-Staff refused to accept resident back from hospital. LPA Singh interviewed and reviewed records staff and residents; four(4) out of four (4) staff present on the day at the incident reported that R#1 has exhibited behavioral episodes over the past few months. On January 22, 2026, R#1 was observed swinging a walker at other residents, attacking staff, and attempting to leave the facility. Staff reported that Community Care Licensing Department(CCLD) had been notified of Unsubstantiated R#1’s ongoing behaviors, and the family had been informed. R#1 was evaluated by InnovAge physicians, and medications were adjusted; however, the Power of Attorney(POA) later discontinued the medication, which resulted in an increase in R#1s behavioral issues. The facility administrator stated that the facility is not evicting R#1. R#1 was sent to the hospital for a health evaluation and change of condition due to 5150 call to the emergency services, and once medication is initiated and behavioral symptoms stabilize, R#1 may return to the facility. The facility informed R#1’s family and InnovAge of the change in condition and the need for hospital evaluation due to safety of the staff and residents at the facility. Statements, records, and interviews obtained did not provide sufficient information to corroborate the allegation that Staff refused to accept resident back from hospital. Based on the evidence found during the investigation, the allegations, Staff refused to accept resident back from hospital, listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) LIC 809C were discussed and provided to Facility Administrator Griselda Gracie Garcia.the state’s words, verbatim · CDSS document, Jan 28, 2026 · control 56-AS-20260123094442

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Beena Singh made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met Executive Director Griselda Garcia and was granted entry to the facility. The facility is a fifty (50) bedroom, fifty (50) bathroom home with a kitchen/dining area, living room/activity room. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of ninety-eight (98) non-ambulatory residents and the current census is eighty-six (86) residents. LPA was accompanied by Facility Administrator Griselda Gracie Garcia to conduct a general overall inspection, which included, but was not limited to, the following:, Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA Singh inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night-stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures 110F in the bathroom. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Fire drill dated-11/14/2024. Fire extinguishers were also observed at the facility. Posters such as personal rights, the CCL complaint poster, labor laws, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. There is a Medicine Room with the resident’s medications locked. LPA Singh observed complete first aid kit and first aid book at the facility. Food Service: More than seven (7) days’ supply of Non-perishable foods and more than three (3) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. All kitchen staff have their updated SERV Safe Certification and food handler’s card. Menus and daily meal plan was posted in the common area and dining hall. Care & Supervision: The facility has an Executive Director present in the facility with appropriate and enough hours to appropriately manage the facility. The facility has enough staff to provide care and supervision to the residents in care. Record Review: LPA Singh reviewed ten (10) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA Singh observed resident files reviewed were complete. LPA reviewed five (5) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications/Medication Administration Record (MAR) were audited, and are updated. Liability Insurance valid through 1/6/2025 to 1/6/2026, workers Comp-3/10/2025 to 3/10/2026. Fire drill was conducted on 11/20/2025. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report LIC809, LIC809C was discussed and provided to Executive Director Griselda Garcia.the state’s words, verbatim · CDSS document, Jan 28, 2026

Allegation investigated: Lack of staff supervision resulting in resident eloping from facility.

On 12/01/2025, Licensing Program Analyst (LPA) Beena Singh made an unannounced visit to the facility for the purpose of initiating an investigation into the above complaint allegation. LPA met with Facility Administrator Griselda Gracie Garcia and explained the reason for the visit. For the allegation, Lack of staff supervision resulting in resident eloping from facility. LPA spoke to Administrator who stated Resident#1 (R1) did not eloped from the facility on 11/22/2025, Administrator reported that Resident in question followed workers from the side gate and staff brought R1 back from the front facility door and informed the family. Administrator stated staff do provide adequate supervision for resident in care and do follow and supervise residents. LPA interviewed five (5) staff and five(5) out of five stated facility staff supervises residents in care and denies the allegation that lack of staff supervision resulted in resident eloping from facility. Unsubstantiated Based on the evidence gathered during today’s investigation, the allegation listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means 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 this report (LIC9099) were discussed and provided to Facility Administrator Griselda Gracie Garcia.the state’s words, verbatim · CDSS document, Dec 1, 2025 · control 56-AS-20251124154956

Allegation investigated: Staff hit a resident while in care. Staff threatened a resident while in care.

On 8/12/2025 at 11:50 AM, Licensing Program Analysts (LPA) Beena Singh conducted an unannounced visit to the facility to deliver findings on a complaint alleging neglect/lack of supervision. LPA Singh met with Facility Executive Director Griselda Gracie Garcia, facility representative, and was granted entry into the facility. The investigation conducted by Department staff consisted of interviews and reviews of pertinent records. First Allegation: Staff hit a resident while in care. The allegation of Physical abuse against resident#1 (R1) is found to be Unsubstantiated. While the resident made verbal statements alleging that R1 was “hit” by a caregiver, there were no direct witnesses to the alleged physical abuse. Records show that R1 has cognitive impairment and dementia, making R1 unable to consistently recall or provide accurate information about the incident. In addition, caregivers reported that R1 has a history of confusion and making inconsistent statements. Unsubstantiated There was no direct observation, forensic evidence (like a medical report of an injury consistent with abuse), or other witness statements to support the claim that the injury was intentionally caused. Therefore, based on the evidence gathered during the investigation, the allegations listed above is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Third Allegation: Staff threatened a resident while in care. The allegation of staff threatened resident 1 (R1) is found to be Unsubstantiated. While the resident made verbal statements alleging that R1 was “threatened” by a caregiver, there were no direct witnesses to the alleged staff threatening R1. Due to the victim’s diagnosis R1 was unable to recall the incident or provide accurate information in a consistent manner. Based on the evidence, there is insufficient evidence to prove that staff willingly threatened R1. Therefore, the finding is found to be unsubstantiated, it means there isn't enough evidence to confirm that the allegation occurred. Based on the evidence gathered during the investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted where this report (LIC9099), LIC 9099C was discussed and provided to Facility Executive Director Griselda 'Gracie' Garcia. This incident occurred while the resident was being assisted by a staff member without the required Hoyer lift or the assistance of a second staff person, directly violating the resident's documented care plan. This failure to follow established protocols resulted in a preventable injury to R1. Based on observations, interviews, record reviews, and the totality of evidence gathered, there is sufficient evidence to support the allegation. The preponderance of evidence standard has been met, leading to the substantiated finding of Neglect/Lack of Care & Supervision. An exit interview was conducted, and this report (LIC809) LIC 809C, LIC809D and Appeal Rights were discussed and provided to Facility Executive Director Griselda Gracie Garcia.the state’s words, verbatim · CDSS document, Aug 12, 2025 · control 56-AS-20250325093823

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87411(a) · Plan of correction due date: Aug 13, 2025

CCR 87411 Personnel Requirements – General-(a) Facility personnel shall at all times be sufficient in numbers.. In facilities licensed for sixteen or more.. to ensure provision of personal assistance and care as required in Section 87608, Postural Supports..The licensing agency may require any facility to ..provide...additional staff for the provision of adequate services. Based on evidence, the licensee did not ensure sufficient staff to prevent R1 from falling and sustaining multiple injuries, which poses a potential Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 12, 2025

Plan of correction: Licensee/ facility administrator agrees, will submit proof of training to LPA Beena Singh by the plan of correction (POC) due date on 8/13/2025. Plan of Correction: - POC due date-8/13/2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Beena Singh conducted an announced pre-licensing visit to the facility. LPA met with Facility Director Griselda Garcia. Licensing Program Analysts (LPA) Beena Singh conducted an announced pre-licensing visit to the facility. The purpose of the visit was to conduct a required comprehensive pre-licensing inspection for Change of ownership (CHOW)LPA met with Facility Administrator Facility Administrator Griselda Garcia. Facility Administrator/Director-Griselda Garcia accompanied LPA Singh on a tour of the inside and outside of the facility The facility is a fifty (50) bedroom, fifty (50) bathroom home with a kitchen/dining area, living room/activity room. The facility is a Residential Care Facility for the Elderly (RCFE). The facility has application for a capacity of ninety-eight(98), 88 non-ambulatory and 10 bedridden delayed egress clients and the current census is seventy-eight (78) residents. The pending application is for Residential Care Facility for Elderly (RCFE). This is an application for change of ownership (CHOW). The physical plant, in general, was in good repair. The buildings and grounds are free from hazards. The indoor and outdoor passageways are free of obstruction. There are firearms, or ammunition. All bedrooms are furnished with a bed, night stand, dresser, and chair. All bedrooms have adequate lighting for resident use. Bathroom's toilet, shower and tubs are in good repair and have non-skid mats. LPA measured and observed the water temperatures in the bathrooms to be at 115 degrees F. LPA observed food storage and preparation areas to be clean and sanitary. Refrigerator and freezer are maintained at appropriate temperatures. All appliances are clean and operating properly. Dishes, glasses, and utensils were in good condition. There is a sufficient supply of linens, towels, and personal hygiene items. The first aid kit was reviewed; all items are present. The backyard is completely enclosed with functioning gate to exit to front yard. The outdoor space is suitable for client use. LPA observed fully charged fire extinguisher present in the facility. Smoke alarms and carbon monoxide are present and functional. Facility has a designated area (Med-Room) where medications are stored and locked. The facility had a designated area where staff and client records will be stored. Emergency disaster plans, personal rights, and complaint procedures were posted in a prominent area. There is adequate seating in the common areas. Facility had a supply of activities for the clients. Facility has 1 delayed egress door in Jasmine Building and 4 delayed egress doors in Magnolia Building. facility has any video surveillance. Pre-licensing inspection is complete, and no corrections are needed to be made. The Comp III presentation was completed during today's visit. An exit interview was conducted, and a copy of this report was provided to Facility Administrator/Director-Griselda Garcia.the state’s words, verbatim · CDSS document, Jan 16, 2025

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility of the Elderly (RCFE) Application Type: Change in Ownership (CHOW) Capacity: 98 Census (if any clients in care): 78 COMP II Participants: Griselda Garcia, New Administrator Steven Aron, Applicant Interview Method: Telephone interview On January 6, 2025 at 9:15 AM, Applicant and 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. During COMP II, CAB analyst confirmed Applicant and 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 Readiness Exit interview conducted with Applicant and Administrator. Copy of report sent via email and request to return sign copy by end of business day today.the state’s words, verbatim · CDSS document, Jan 6, 2025