The Harvest at Fowler

Type of visit: Case Management - Deficiencies

On 5/28/2026 Licensing Program Analyst (LPA) M. Garza arrived at the facility for an unannounced case management visit. LPA met with Resident Care Coordinator, Irma Banks, explained reason for visit and was permitted entry into the facility. Administrator, Alex Zanin was contacted and arrived some time later. LPA completed a tour of the facility. A health and safety check was completed on residents in care. This case management visit is being conducted for deficiencies found during complaint investigation for complaint #24-AS-20260526083452. During investigation LPA requested and reviewed documentation and completed interviews. During interviews it was disclosed that there was an verbal altercation in the main living room area of the facility on 05/21/26 with S1 and S2. The altercation was became loud between the 2 staff and other staff had to step in to de-escalate it. Video surveillance shows there were residents in the surrounding area of where the altercation occurred. interviews disclosed both staff have been talked to previously about other incidents. Review of the Departments e-fax file for the facility shows that there have not been any special incident reports provided by the facility regarding previous incidents. Review of personnel records for S1 and S2 do not show any written disciplinary actions. A SOC 341 was not cross reported to other agencies as required by regulations. Deficiencies cited per California Code of Regulations, Title 22 on 809D. Exit interview completed with Administrator, Alex. A plan of correction was provided by Alex and reviewed by LPA. A copy of this report, deficiencies and appeal rights provided.the state’s words, verbatim · CDSS document, May 28, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(8) · Plan of correction due date: Jun 12, 2026

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (8) 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 evience by: interviews conducted, video surveillance and records reviewed. The licensee did not comply with the section cited above in that S1 and S2 had a loud verbal altercation in the main living room of the facility with residents in the surrounding vacinity. This poses a potential health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 28, 2026

Plan of correction: Administator stated they will hold an all staff training. In -service sign in sheet and training material will be provided to CCL by POC date. Administrator stated that an internal investigation is still ongoing pending the disciplinary action for S1 and S2's.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87211(a)(1)(D) · Plan of correction due date: Jun 12, 2026

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report...(D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement was not met as evidence by: Records review and interviews conducted. The licensee did not comply with the section cited above in that a report of an incident involving S1 and S2 occurring on 05/21/26 was not reported to the Department. This poses a potential health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 28, 2026

Plan of correction: Administator stated they will hold an all staff training. In -service sign in sheet and training material will be provided to CCL by POC date.

Type of visit: Required - 1 Year

On 04/24/26 Licensing Program Analyst arrived at the facility to complete an unannounced annual visit. LPA met with Administrator, Alex Zanin explained reason for visit and was permitted entry into the facility. LPA completed a tour of the facility inside and out. A health and safety check was completed on residents in care. 6 residents are currently receiving hospice services. Residents were observed in common areas and in rooms. Pathways and doors were clear and free from obstruction. Facility was without odor. Common areas were adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 01/29/26. Resident rooms observed to have the required furnishings and with adequate lighting. Sharps, chemicals and medications were located in locked cabinets/closets and cupboards. LPA observed sufficient seating under covered patio areas. The following issues were observed during today’s visit: Medication audit disclosed 1 of 4 records reviewed were not provided medications as prescribed. Deficiencies cited per California Code of Regulations, Title 22, deficiencies are being cited on the attached 809D. If not corrected, the violation with have a direct risk to the health, safety and/or personal rights of residents in care. LPA requested the following documents to be submitted to CCL by 5/1/26: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Exit interview was conducted with Administrator, Alex. A plan of correction was developed by Administrator and reviewed by LPA. A copy of this report, deficiencies, and appeal rights were discussed and provided to Administrator.the state’s words, verbatim · CDSS document, Apr 24, 2026

Type of visit: Case Management - Annual Continuation

On 4/28/25 Licensing Program Analyst (LPA) M. Garza completed an unannounced annual continuation visit. LPA met with Administrator, Alex Zanin, explained reason for visit and was permitted entry into the facility. A health and safety check on resident was conducted. Residents observed in room and in common areas. During todays visit staff files, training, hospice and disaster plan were reviewed. No deficiencies cited during todays visit. Exit interview completed with Administrator, Alex. A copy of this report was provided.the state’s words, verbatim · CDSS document, Apr 28, 2025

Type of visit: Case Management - Incident

On 4/28/2025 Licensing Program Analyst (LPA) M. Garza completed an case management visit. LPA met with Administrator, Alex Zanin, explained reason for visit and was permitted entry into the facility. LPA toured facility and completed a health and safety check on residents in care. Residents were observed in common areas and in rooms. This case management visit is being conducted for incident reports that were received by the Department that required additional information. LPA requested and reviewed residents files (physicians reports, needs and services plans, reappraisals, hospital discharge paperwork, special incident reports (SIR) and logging notes) for R1, R2, R3, R4 and R5. Incident 1:The Department received an SIR for an incident that occurred on 1/8/25 for R1. During a shower R1 fell out of the shower chair and was complaining of right should pain. R1 was sent to the hospital and upon discharge was sent to Skilled Nursing Facility with a broken clavicle. Per SIR, R1 had UTI and possible pneumonia. File review of charting notes did not disclose any previous indications of change in condition. No deficiency cited for this incident. Incident 2: The Department received an SIR for R2 for an incident that occurred on 2/21/25. Staff completed a 6am check on R2 and found them not feeling well. EMS was contacted and R2 was transferred to the hospital. Resident was treated for the flu. File review of charting notes disclosed on 2/14/25 R2 had a fall. On 2/13/25 it is noted R2 is "a bit off". On 2/15/25 it is noted R2 "not felling well". From 2/3/25-2/21/25 there were other residents ill. No SIR's received for illnesses by the Department. Deficiency cited per Title 22. CONT... CONT... Incident 3: The Department received an SIR for an incident that occurred on 3/6/25 for R3. R3 had a fall bumping their head on the dresser. R3 obtained a 2 cm laceration to the right side of their head. EMS was contacted and transported R3 to the hospital. File review completed. Physicians report dated 12/18/24 states R3 requires assistance with all ADL's and requires some supervision. Review of hospital discharge stated R3 has small abrasion on scalp and can walk with assist and walker. Deficiency cited per Title 22. Incident 4: The Department received an SIR for an incident that occurred on 4/10/2025. R4 had an un-witnessed fall hitting the back of their head and complaining of left shoulder pain. EMS was called and R4 was transported to the hospital. Resident file reviewed. Functional Capability Assessment (not dated). Physicians report dated 3/10/25 states R4 has motor impairment/paralysis with no diagnosis listed. R4 is on 2 hour checks, will sometimes assist with transferring and to the restroom. No deficiency cited. Incident 5: The Department received an SIR for an incident that occurred on 4/16/25. During a shower R5 became pail, unresponsive, drooling and shaking. EMS was contacted and transported R5 to the hospital. Discharge paperwork stated dx of syncope and a follow up with PCP in 1 week. Follow up with neurologist is scheduled for 4/29/25 and an additional appointment with the cardiologist on 8/14/25. No deficiency cited. Exit interview completed with Administrator, Alex. A copy of this report, deficiencies and appeal rights provided.the state’s words, verbatim · CDSS document, Apr 28, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87466 · Plan of correction due date: May 9, 2025

87466 Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement was not met as evidence by: file review. The licensee did not comply with the section cited above in that it was noted in the staff log book R2 was observed to be ill on 2/13/25 and was not taken to the physician. R2 was sent out via EMS to the hospital on 2/21/25. R2 did not receive timely medical attention for their illness. This poses a potential health safety and or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 28, 2025

Plan of correction: Administator stated they feel everything was completed by them with the expception of lack of documentation. Administrator stated they will generate a contact form to log attempts with family in getting timely medical attention for residents. Administrator stated they will provide a copy of this form to CCL by POC date as proof of correction.

Type of visit: Required - 1 Year

On 4/24/25 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA was met by Residential Care Coordinator, Irma Banks, introduced self, explained reason for visit and was permitted entry into the facility. Administrator, Alex Zanin was contacted and stated they were unavailable for the visit. Permission was given to complete visit with Irma. LPA completed a health and safety check on residents in care. LPA toured the facility inside and out. Residents observed in common areas and in rooms. There was 7 resident on hospice at the time of the inspection. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operate on a system. Fire extinguisher last serviced 2/5/25. Resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in laundry room. Sharps, and medications were located in locked cabinets/rooms. LPA observed sufficient seating under covered patio areas. The following issues were observed during todays visit: Various window seals throughout facility observed dirty and in need of cleaning. 2 of 6 bedrooms observed with chemicals accessible to residents in care. Gardening tools observed unlocked and accessible to residents in care. Signal system not being used for all residents. 2 of 3 files reviewed do not have a pre-admission appraisals completed. Deficiencies and TV's provided for these issues per Title 22. LPA requested the following documents to be submitted to CCL by 5/2/25: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Due to Administrator being the only one having access to staff files, LPA will return at a later date for an annual continuation. Exit interview completed with Residential Care Coordinator, Irma and Licensed Vocational Nurse, Jaspreet Gill. A copy of this report, deficiencies, TV's and appeal rights provided.the state’s words, verbatim · CDSS document, Apr 24, 2025

Type of visit: Required - 1 Year

On 5/21/24 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA was met by Administrator, Alex Zanin. LPA introduced self, explained reason for visit and was permitted entry into the facility. LPA completed a health and safety check on residents in care. LPA toured the facility inside and out. Residents observed in common areas and in rooms. There were 8 residents on hospice at the time of the inspection. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operate on a system. Fire extinguisher last serviced 2/1/24. Last fire drill was on 3/29/24. Water temperature measured in sample bathrooms. Temperature measured from 106.3 to 114.8 degrees F. Resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in linen closets. Sharps and medications were located in locked closets/rooms. LPA observed sufficient seating under covered patio areas. Sample file review completed for staff and residents. The following issues were observed during visit: Water damage stain to ceiling in room #106 in need of paint. Doors blocking exit in right side hallway. Chemicals observed in various resident bathrooms. Bar soaps observed in bathrooms. Chemicals and objects that could poses a danger to residents in activity room. Food in kitchen freezers improperly labeled/stored. room #305 observed with oxygen tank without sign posted. Hospital bed for hospice resident with railing in room #308. Facility does not have hospice care plan for hospice resident. Garden bench broken and missing seat. CONT... CONT... LPA requested the following documents to be submitted to CCL by 5/31/24: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Deficiencies cited on 809D per Title 22. Exit interview completed with Administrator, Alex Zanin. A copy of this report, deficiencies, TV's and appeal rights were given.the state’s words, verbatim · CDSS document, May 21, 2024