The Sage Garden at Rancho Bernardo

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to House Manager Beth Aquino. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, ages 60 and above. During today’s inspection there were five (5) residents in care. Hospice waiver for six (6), bedridden approval for one (1) resident in room #1 or #4. During the visit Licensee Rina Chang arrived to the facility. LPA and house manager toured the interior and exterior of the facility and inspected a sample of rooms. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per House Manager, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Licensee Rina Chang, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Jul 20, 2026

Allegation investigated: Staff failed to provide medical treatment for pressure injuries Residents sustained unexplained injuries while in care Lack of supervision resulting in residents falling Staff yells at residents

Licensing Program Analyst (LPA) Nacole Patterson conducted a virtural visit to deliver findings regarding the above complaint allegations. LPA introduced themselves and disclosed the purpose of the visit to Licensee Rina Chang. On 12/13/2021 it was alleged that staff failed to provide medical treatment for pressure injuries, residents sustained unexplained injuries while in care, lack of supervision resulted in residents falling, and staff yelled at residents. The Department’s investigation consisted of unannounced facility visits, interviews with facility staff, residents, outside sources, and records review. Staff interviews did not corroborate the allegation, as staff denied observing other staff yell at residents. Staff informed that while a resident did suffer a skin tear and bruise, the incidents were explained and not caused by staff. Staff interviews additionally revealed that two residents were on Hospice where minor pressure-related skin conditions were common due to the nature of palliative care and hospice resident immobility. (Continued on LIC9099 p.2) Unsubstantiated (Continued from LIC9099 p.1) Staff refuted that residents were unsupervised at night, as claimed, informing that night staff remain awake during their shift to respond to resident care needs. Outside source interviews corroborated staff statements regarding residents on hospice care at the facility. Outside source interviews did not corroborate the allegations, as outside sources had not observed staff treating residents without dignity or neglecting their care. Outside sources stated that staff communicated resident needs and provided great care. Review of relevant records did not give evidence to the allegations. No records were found to show that residents suffered unexplained injuries or falls. Records corroborated staff statements regarding specific residents being on hospice care, and having pre-existing skin issues. During an unannounced facility visit, the investigating LPA directly observed all residents in the facility for evidence of the allegations and conducted a health and safety check. The LPA did not observe any unexplained injuries during the visual check of residents. Due to impaired cognition, resident interviews were not able to be conducted due to inability to verify residents as valid historians. The evidence found does not support the allegations and shows that resident co-morbidities, behavioral and medical conditions contributed to the pressure injuries, bruises, and scratches. Evidence showed that some injuries/bruises existed prior to the resident moving into the facility. Due to lack of specifics regarding which allegations pertained to specific residents, correlation of abuse was not able to determined, if any. Resident records were consistent with staff statements regarding resident care. No evidence was found to show that staff did not provide the care required for each resident in their needs & services plans. Records also showed that all five residents were being followed by either Hospice or Home Health. Evidence was not found to show that staff did not communicate care needs for any resident. Staff and outside source interviews did not corroborate the claim that staff yelled at residents. Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violations occurred, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted with Licensee Rina Chang, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Feb 14, 2026 · control 08-AS-20211213093115

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Administrator Rina Chang. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, ages 60 and above, one (1) of whom may be bedridden in either bedroom #1 or #4. During today’s inspection there were six (6) residents in care. LPA and Administrator toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per caregiver Beth Aquino, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Administrator Rina Chang, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Jun 5, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Case Management Visit. LPA was greeted by and met with Administrator Maria Rina Chang, to discuss the purpose of the visit. Today's visit is in response to the self reported death of Resident 1 (R1 - see LIC811 Confidential Names List). R1 passed away on 10/11/24. LPA conducted a wellness check at the facility; no health or safety issues were identified. No deficiencies were cited or observed on this date. An exit interview was conducted with Administrator Maria Rina Chang, who was provided with a copy of this report and Appeal Rights (LIC9056 03/22). Their signature confirms receipt of these documents.the state’s words, verbatim · CDSS document, Jan 2, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Assistant Arlene Baysa. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, one (1) of whom may be bedridden in room #1 or #4 only. During today’s inspection there were 6 residents in care. LPA and Assistant Arlene Baysa toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Arlene Baysa, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Assistant Arlene Baysa to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, May 6, 2024