The Hills of South Lane II

Allegation investigated: Facility illegally evicted residents in care.

On 9/4/2026, Licensing Program Analysts (LPA's) Edith Conchas, Matthew Aguilar and Leslie Mendiveles conducted an announced visit at the rengional office to conclude the investigation and provide the findings for the above mentioned complaint. LPA met with Allen Medina. The investigation consisted of interviews with relevant parties and record review. Allegation Facility illegally evicted residents in care. Interview with RP (RP), Witness 1 (W1), and Witness 2 (W2) all stated that the facility did not provide written eviction notices and residents were directed to relocate without proper notice. Record review revealed an email chain between family members and facility staff regarding relocation concerns. LPA did not observe the email to include a formal written eviction notice as required under Title 22. Interview with Staff 1 (S1) stated that the sheriff’s department served an eviction notice to the facility on June 12th, 2026, and that the facility lost control of the property on June 24, 2026. Staff 1 confirmed all residents had vacated prior to LPA’s visit on June 24th, 2026. RP reported R3 move out on June 25, 2026. Continue to LIC9099-C Substantiated Based on the evidence gathered, the allegation is Substantiated. A substantiated findings means the allegation is valid because the preponderance of the evidence standard has been met. During today’s visit, deficiencies were issued. An exit interview was conducted, and this report and appeal rights were discussed and provided to Facility owner Allen Medina.the state’s words, verbatim · CDSS document, Sep 4, 2026 · control 56-AS-20260615114057

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224 · Plan of correction due date: Sep 8, 2026

(a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5). This requirement is not met as evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above by not generating a closure letter and submitting it to CCLD, Licensee did not surrender the facility, license and 3) did not provide a written letter within the time required to the residents in care which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 4, 2026

Plan of correction: Licensee stated that he will provide an acknowledment confirming that he will adhere to and comply with eviction procedures> Licensee will submit wirtten documentaion by POC date.

Type of visit: Case Management - Legal/Non-compliance

On 06/15/2026, at 2:00PM Licensing Program Analyst (LPA) LaVette Farlow arrived at the facility, unannounced to conduct a Case Management visit. LPA identified herself and met Marc Zalameda and gained access to the facility. LPA attempted to contact Maricel Nepomuceno, Administrator who's licensee is posted in the facility and left a voicemail and Regina Chavez who is listed as the Administrator on CCLD record. Regina's number was not a working number. LPA informed Caregiver Marc that this visit is being conducted to follow up on the facility's compliance with Health & Safety Code Section 1569.38. Health & Safety Code 1569.38 requires the licensee to post a written notice and the accusation notice received must be posted in a conspicuous location in the facility and shall remain posted until the deficiencies that gave rise to the accusation notice are resolved. During the tour of the facility on 06/15/2026, LPA observed that the accusation and written notice that the facility received was not posted, as required by law, at the front door, near entrance of the facility, kitchen, and inside the facility near the Common Area, and Dining Room. LPA also, observed a for sale sign in front of the property. LPA inquired to verified the status of the sale and if an eviction notice was issued to responsible parties, or the residents in care. LPA was unable to verify that proper notice was provided. LPA conducted a tour of the facility and the following was observed: LPA did a health and safety check. LPA observed two (2) day(s) supply of perishable food and seven (7) day(s) supply of non-perishables food and snacks. LPA observed 3 residents and 2 staff. Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. ***Continued on LIC809C*** During today's visit, LPA observed two (2) Caregiver providing care and supervision and verbally confirmed that: 1.) The accusation notice was not posted at the facility, and the written notice to residents and/or responsible party if any and long term care ombudsman (LTCO) were not sent as required by law since 05/08/2026. 2.) Written notice in at least 14-point type was not posted in a conspicuous location in the facility since 5/8/2026. 3.) Per Title 22 Regulation the Eviction Procedures were not followed and residents or residents responsible parties have not received an eviction notice or assistance with relocation 05/08/2026. Caregiver was informed that a deficiency will be issued today. An exit interview was conducted where this report, LIC809, LIC809C, LIC809D and Appeal Rights were discussed, and copies were provided to Caregiver Marc Zalameda.the state’s words, verbatim · CDSS document, Jun 15, 2026

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.38(f) · Plan of correction due date: Jun 16, 2026

Health and Safety Code (HSC) 1569.38 Posting of licensing reports; disclosure ... (f)The notice required to be posted pursuant to subdivision (e) shall remain posted until the deficiencies that gave rise to the notice are resolved. This requirement was not met as evidenced by: Based on observation, interview and record review, the Licensee did not comply with the section cited above by not ensuring that the written notice and the accusation notice received were posted in a conspicuous location in the facility and shall remain posted until the deficiencies that gave rise to the accusations notice are resolved which poses potential health, safety, and personal rights risks to resident in care.the state’s words, verbatim · CDSS document, Jun 15, 2026

Plan of correction: Licensee will post the accusation notice in the conspicuous location and will send a written notice and provide proof regarding the accusation to the resident, residents responsible party if any and long term care ombudsman (LTCO) on plan of correction (POC) due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87224 · Plan of correction due date: Jun 16, 2026

Eviction Procedures: 87224 licensee may evict a resident one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph Based on observation, interviews and record review, the Licensee did not comply with the section cited above by not ensuring a written notices and procedures were provided to the residents or residents responsible parties in three (3) out of three (3) residents in care which poses potential health, safety, and personal rights risks to resident in care.the state’s words, verbatim · CDSS document, Jun 15, 2026

Plan of correction: Licensee will follow title 22 regulation regarding the eviction procedures provide proof of notice and assistance with relocation and any other regulatory procedures regarding the eviction process.

Type of visit: Required - 1 Year

On 4/3/2026, Licensing Program Analyst (LPA) E. Conchas made an unannounced annual visit to the facility. LPA met with caregiver, Marc Zalameda, and explained the purpose of the visit. During today's visit LPA conducted an overall facility tour, interview and record review. At the time of the visit there were two (2) staff and two (2) residents present. The facility census has not changed. The facility was observed to have operable utilities (gas, water, electricity) Water temperature in the resident’s restroom was 115.8 degrees Fahrenheit. The facility was observed to have a 2-day supply of perishable and a 7-day supply of nonperishable food items. The facility temperature was at 71 degrees Fahrenheit. The following was observed, reviewed and cited. · LPA interviewed one staff member who revealed that they have not been paid for hours worked and not provided relief by licensee for more than week for providing care. The covering staff has quit, and no schedule documented of the current staff hours worked. Three deficiencies were cited. · LPA observed no management or designated personnel staff available. Technical was cited. · LPA observed facility records. LPA observed facility did not have an emergency disaster plan and an Infection control are not updated. Two deficiencies were cited. · Staff records review revealed staff were missing training required for the special resident in care required and annual training. Two deficiencies were cited. Continue to LIC 809-C LPA observed resident’s restroom did not have a maintained grab bar. Technical was cited. Deficiencies and Technical's were cited. An exit interview was conducted, and a copy of this report was provided to caregiver.the state’s words, verbatim · CDSS document, Apr 3, 2026

The state marks this report as 12 pages; the online copy we transcribed has 10. You can request the full file from the county licensing office.

Type of visit: Case Management - Deficiencies

On 3/16/2026, Licensing Program Analyst (LPA) E. Conchas made an unannounced visit to the facility to conduct a health and safety check. LPA met with Administrator, Regina Chavez, and explained the purpose of the visit. During today's health and safety check LPA conducted an overall status of the facility. At the time of the visit there were three (3) staff and (4) residents present. The facility census has not changed. The facility was observed to have operable utilities (gas, water, electricity). The facility was observed to have a 2-day supply of perishable and a 7-day supply of nonperishable food items. The facility temperature was at 70 degrees Fahrenheit. Two deficiencies was cited. An exit interview was conducted, and a copy of this report was provided to Administrator, Regina Chavezthe state’s words, verbatim · CDSS document, Mar 16, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87213 · Plan of correction due date: Mar 17, 2026

87213The licensee shall have a financial plan that...assures sufficient resources to meet operating costs for careof residents;shall maintain adequatefinancial records; and shall submit such financial reports as may be required upon the written request of the licensing agency. This requirement is not evidence by; Based on interviews, the licensee did not ensure employees are receving their paychecks timely. Two staff interviews conducted confirmed that the two staff have not been paid, and have received partial pay. This poses an immediate health and safety risk for persons in care.the state’s words, verbatim · CDSS document, Mar 16, 2026

Plan of correction: The licensee to pay staff and submit a financial plan on how they will ensure the staff receive there pay that is due, and for all pay periods moving forward. Financial plan to be submitted via email or Fax by POC

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87411(a) · Plan of correction due date: Mar 17, 2026

87411Personnel Requirementsl(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs ...The physical arrangement of the facility require such additional staff for the provision of adequate services. This is not met by; Based on interviews, the licensee did not ensure suffiicent staff are available to relieve care staff from their duties. Two staff interviews reveal staff have not had a day off in the past two weeks. This poses an immediate health and safety risk for persons in care.the state’s words, verbatim · CDSS document, Mar 16, 2026

Plan of correction: Administrator will schedule relieve staff immediatly. And willl provide the monthly staff schedule of all staff including the covering staff by POC date and to be submitted via email.

Type of visit: Case Management - Health Checks

On 3/11/2026 at 9:10 am, Licensing Program Analyst (LPA) E.Conchas made an unannounced visit to the facility to conduct a health and safety check. LPA met with administrator, Regina Chavez, and explained the purpose of the visit. During today's health and safety check LPA conducted an overall status of the facility. At the time of the visit there were two (2) staff and (4) residents present. The facility census has not changed. LPA observed the residents eating breakfast. The facility was observed to have operable utilities (gas, water, electricity). Water temperature measured between 115-120 degrees Fahrenheit. LPA observed liability insurance was current. The medications were observed to be locked and inaccessible to the clients in care. The facility was observed to have a 2-day supply of perishable and a 7-day supply of nonperishable food items. No deficiencies were cited. An exit interview was conducted, and a copy of this report was provided to administrator, Regina Chavezthe state’s words, verbatim · CDSS document, Mar 11, 2026

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) E. Conchas conducted an unannounced Health and Safety check visit to the facility. LPA met with the Marc Zalameda, Caregiver. LPA conducted interviews and toured the facility inside and out. The facility is a five (5) bedroom, three (3) bathroom, one (1) staff room,living room kitchen and dinning area. The condition of the home was clean and in good repair. LPA observed the food supply was adequate. There was a two (2) day supply of perishable food items and seven (7) day supply of nonperishable food items. Utilities were all functioning. The facility room temperature was measured at 71 degrees Fahrenheit. The hot water in two of the residents restrooms measured at 114.2 and 115.3 degrees Fahrenheit. LPA observed four (4) clients, three (3) staff and a resident guest during the visit. Interviews reveal on February 17th, 2026 a power outage occurred at approximately 7:00 am during the breakfast service; electricity returned around 2:30 pm. On 2/5/2026 facility received a Notice on Water service to this property informing if payment was not received by 2/13/2026 the turn off date would be on 2/17/2026. Interviews reveal the water was not shut off and has been maintained on. During todays visit, LPA did not observe imminent health & safety concerns. However, LPA did not observe a proof of liability insurance a deficiency was cited. One (1) deficiency was cited during this visit. An exit interview was conducted where this report was discussed and provided to Marc Zalameda, Caregiver.the state’s words, verbatim · CDSS document, Feb 24, 2026

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.605 · Plan of correction due date: Mar 24, 2026

1569.605 Liability insurance;coverage requirements...On ($1,000,000) per occurrence and three million dollars ($3,000,000)in the total annual aggregate caused by the negligent act or omissions to act of, or neglect by,the licensee or its employees.This requirement is not met as evidenced by: Based on observation the licensee did not comply with the section cited above by not providing proof during visit poses an potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Feb 24, 2026

Plan of correction: Licensee/ administrator was not here to discuss POC. LPA requesting a current copy to be provided by or before 3/24/2026 via email.

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) E. Conchas conducted an unannounced Health and Safety check visit to the facility. LPA met with the administrator, Regina Chavez . LPA toured the facility inside and out. The facility is a five (5) bedroom, three (3) bathroom, one (1) staff room living room kitchen and dinning area. The condition of the home was clean and in good repair. No Code Enforcement Issues were observed. LPA observed the food supply was adequate. There was a two (2) day supply of perishable food items and seven (7) day supply of nonperishable food items Utilities were all functioning. The facility temperature was measured at 75 degrees. The hot water was measured at 114.6 in the residents restrooms. LPA observed four (4) clients during the visit. There was a charged fire extinguisher, operating dual smoke alarms, and carbon monoxide detectors. During todays visit, LPA did not observe imminent health & safety concerns. No deficiencies were cited during this visit. An exit interview was conducted where this report was discussed and provided to the administrator, Regina Chavez.the state’s words, verbatim · CDSS document, Jan 22, 2026

Type of visit: Prelicensing

On 03/26/2025, Licensing Program Analyst (LPA) Becky Mann conducted an announced visit to the facility for purpose of Prelicensing evaluation. LPA met with Administrator Regina Chavez. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to the Central Applications Bureau (CAB) on 07/15/2024 for a total capacity of six (6), six (6) Non-ambulatory. LPA observed the following: Structure: Facility has five (5) bedrooms, three (3) bathrooms, living room, dining area and kitchen. There's an attached garage. Bedrooms: Each resident bedrooms accommodate any non-ambulatory resident. All resident bedrooms were furnished with beds, mattresses, chairs, closets, linens, adequate lighting and sufficient storage space . Bathrooms: The three (3) resident/staff bathrooms have a working toilet, wash basin, and shower. LPA verified water temperature was measured between 107 to 110 degrees Fahrenheit. Kitchen/Laundry: An adequate supply of dishes, glasses, utensils, pots, and pans were observed. Knives/sharp instruments were secured in a locked drawer. Refrigerator/freezer were in working condition. There is sufficient storage for perishable food. Laundry room with washer and dryer was in the laundry area. Laundry detergents and cleaning supplies were observed in the laundry room in a locked cabinet. Living/Family room: There's a living/family room with adequate seating for all residents and a working TV. Linens and Hygiene Supplies: An adequate supply of linens were stored in the facility. Yards/Outside: Patio furniture for outdoor seating observed. Self-latching handle gate on right side of the house that leads into the backyard. All outdoor pathways were free of obstructions. Emergency Phone Numbers, and Exit Plan: Facility sketch was observed posted in the dining area. General items: One (1) fire extinguisher were charged. The smoke detectors and carbon monoxide detectors were tested and were observed to be in working order. Resident records and staff records will be stored in a locked cabinet in the hallway area. First Aid kit with required components and locked area for medication storage was observed. LPA observed a facility phone, and which is operational. There is enough Emergency water supply and the required 72-hour emergency food supply for residents and staff available at the facility. Component III was completed on this day. The facility was evaluated in accordance with the California Code of Regulations (CCR), Title 22, Division 6, Chapters 1 and 6 to ensure the health and safety of residents in care. Facility is ready for licensure. An exit interview was conducted, and a copy of this report, LIC809 and LIC809C was discussed and provided to Administrator Regina Chavez.the state’s words, verbatim · CDSS document, Mar 26, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Interview Method: Telephone interview On 2/26/2025, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting Pre-licensing readinessthe state’s words, verbatim · CDSS document, Feb 26, 2025