True Living Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 12:55PM. LPA met with staff upon arrival and Administrator Vanessa Havsgaard who arrived at 01:18PM. Entrance interview conducted. At 01:19PM, the LPA along with Administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN/LAUNDRY: The LPA inspected the kitchen/food service area at 01:19PM. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and nonperishable food. Knives and chemicals were locked and inaccessible in kitchen drawer and cabinet under the sink. LPA observed a laundry room accessed through the kitchen which is locked and inaccessible to residents in care. BEDROOMS: There are six (6) private resident bedrooms. There is one (1) staff bedroom that is being used by staff as a private living quarter. The staff room is accessed through an attached staff bathroom. All rooms have direct access to the outside. LPA observed resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, sufficient lighting, and equipped with functioning auditory exit alarms. RESTROOMS: There are five (5) full bathrooms; one (1) is for private staff use, two (2) are private bathrooms for resident use and two (2) are full bathrooms in the hallway that are designated for residents, staff, and guests. LPA observed resident restrooms equipped with grab bars and slip-resistant surfaces. Hot water temperature was measured in resident bathrooms and were between 105.3-107.4 degrees F, which is within the required range. Report Continued on LIC 809-C. COMMON AREA: The common areas were appropriately furnished, and the lighting was adequate. The facility smoke alarm system is hard wired; the smoke and carbon monoxide detectors and fire doors were tested at 01:54PM and were operable at the time of the visit. The fire extinguishers were fully charged and last serviced 12/01/2025. LPA observed required postings posted in the hallway and upon entry into the facility. OUTDOOR AREA: The backyard has a covered outdoor area equipped with furniture for resident use. There were no bodies of water on the premises. There is a self-latching gate on the side of the house designated for an emergency exit. Passageways were free and clear from obstruction. LPA observed a locked storage unit in the back yard containing additional supplies and yard equipment. MEDICATION REVIEW: At 01:56PM, LPA reviewed medications for two (2) residents. Medications are centrally stored and locked in the medication room accessed through the kitchen/laundry. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs were properly documented and logged. No errors observed during the medication review. RECORD REVIEW: Beginning at 02:05PM, LPA reviewed five (5) out of five (5) resident files and four (4) personnel files for documents including but not limited to: medical records, resident Admission Agreement, TB test, staff training, first aid, and fingerprint clearance. LPA observed five (5) out of five (5) resident files with current reappraisals but missing signatures from the residents or their responsible parties. Administrator stated they will review the reappraisals with residents and responsible parties and obtain signatures. All personnel files were in order. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control policy and emergency disaster plan. Emergency disaster plan is updated annually as required and emergency disaster drills are conducted quarterly as is required, with the last drill conducted on 04/13/2026. All documents reviewed were updated and in compliance. The following deficiency was observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22. Administrator was informed that failure to correct deficiency may result in civil penalties. Exit interview was conducted. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jun 17, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 12:10PM. LPA met with staff upon arrival and Administrator Vanessa Havsgaard. Entrance interview conducted. At 12:15PM, the LPA along with Administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN/LAUNDRY: The LPA inspected the kitchen/food service area at 12:15PM. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and nonperishable food. Food labels were inspected and checked for expiration dates and food labels had expiration date clearly marked. Knives and chemicals were locked and inaccessible in kitchen drawer and cabinet under the sink. At 12:22PM, LPA observed one (1) milk carton that expired 06/03/2025 and five (5) sauces/condiments (maple syrup, two soy sauce bottles, ketchup, and oyster sauce) that were opened and stored in the pantry but state to “refrigerate after opening.” Administrator immediately discarded the expired milk and stored the sauces at appropriate temperatures. LPA observed a laundry room accessed through the kitchen which is locked and inaccessible to residents in care. BEDROOMS: There are six (6) private resident bedrooms. There is one (1) staff bedroom that is being used by staff as a private living quarter. The staff room is accessed through an attached staff bathroom. All rooms have direct access to the outside. LPA observed resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, sufficient lighting, and equipped with functioning auditory exit alarms. Report Continued on LIC 809-C RESTROOMS: There are five (5) full bathrooms; two (2) are private bathrooms for resident use and two (2) are full bathrooms in the hallway that are designated for residents, staff, and guests. LPA observed resident restrooms equipped with grab bars and slip-resistant surfaces. Between 12:26PM-12:33PM, hot water temperature was measured in resident bathrooms and were between 105.4-106.2 degrees F, which is within the required range. COMMON AREA: The common areas were appropriately furnished, and the lighting was adequate. The facility smoke alarm system is hard wired; the smoke and carbon monoxide detectors and fire doors were operable at the time of the visit. The fire extinguishers were fully charged and last serviced 12/06/2024. LPA observed required postings posted in the hallway and upon entry into the facility. OUTDOOR AREA: The backyard has a covered outdoor area equipped with furniture for resident use. There were no bodies of water on the premises. There is a self-latching gate on the side of the house designated for an emergency exit. Passageways were free and clear from obstruction. LPA observed a locked storage unit in the back yard containing additional supplies and yard equipment. MEDICATION REVIEW: At 12:40PM, LPA reviewed medications for two (2) residents. Medications are centrally stored and locked in the medication room accessed through the kitchen/laundry. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs were properly documented and logged. No errors observed during the medication review. RECORD REVIEW: Beginning at 01:08PM, LPA reviewed five (5) out of five (5) resident files and three (3) personnel files for documents including but not limited to: medical records, resident Admission Agreement, TB test, staff training, first aid, and fingerprint clearance. All resident and personnel files were in order. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control policy and emergency disaster plan. Emergency disaster plan is updated annually as required and emergency disaster drills are conducted quarterly as is required, with the last drill conducted on 05/05/2025. All documents reviewed were updated and in compliance. The following deficiency was observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22. Administrator was informed that failure to correct deficiency may result in civil penalties. Exit interview was conducted. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jun 5, 2025

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Allegation investigated: Staff speaks to resident in an inappropriate manner. Staff does not treat resident with dignity or respect.

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a subsequent complaint visit for the allegations listed above at 12:55PM. LPA met with staff and Administrators/Licensee Vanessa Barcela and Christian Havsgaard and explained the reason for the visit. During the initial visit which took place on 08/02/2024, LPA Barutyan and Zabel Chochian conducted a brief physical plant tour, interviewed 2 (two) residents, the 2 (two) administrators, and 1 (one) staff, reviewed resident records, and reviewed and obtained copies of pertinent documents. Report Continued on LIC-9099C. Substantiated It was alleged that staff speak to residents in an inappropriate manner and staff does not treat residents with dignity or respect. On 08/01/2024, the Department received two (2) self-reported incident reports regarding two (2) staff members who no longer work at the facility as they were suspended on 07/31/2024. The incident reports stated that on 07/06/2024, two staff members were assisting a resident when Staff #1 (S1) slapped the resident. Staff #2 (S2) witnessed the incident and recognized it as abuse, but informed the Administrator later on 07/31/2024 due to fears of retaliation from S1 and Staff #3 (S3), the relative of S1. The Department received the SOC341 for this incident on 08/02/2024. The second incident report stated that on 07/12/2024 and 07/22/2024, S3 was verbally abusive to Resident #1 (R1). On 07/12/2024, R1 asked S3 for a cleaning. R1 requires a two (2) person assist and said they did not feel comfortable with S3 performing the cleaning solo, however, S3 was insistent. R1 refused the cleaning due to S3’s verbal abuse during the exchange and the potential dangers of the solo clean. On 07/22/2024 after changing the sheets on R1’s bed, R1 asked S1 and S3 to shift the bed. S1 and S3 began trying to shift the bed without unlocking the wheels and when R1 stated that the wheels need to be unlocked, S1 raised their fists at R1 asking if the resident wanted to fight them and both S1 and S3 became verbally abusive. LPAs Barutyan and Chochian as well as Brian Balisi and Trevor Byrne conducted separate case management visits for the incidents on 08/02/2024. LPAs Barutyan and Chochian interviewed the Administrators who stated that they were not aware of how S1 and S3 were treating the residents as S2 and S4 were afraid to report the abuse. LPA interviewed R1 on 08/02/2024 who stated that they felt “unsafe” and that the staff had a “hostile” relationship with R1. LPA interviewed R1 on 08/14/2024 who stated that they have “not experienced any mistreatment since the two staff left” and that they are “treated well here compared to other places [they have] stayed at and heard about.” LPA interviewed S4 on 08/02/2024 who stated that they have “had to tell [S3] to ‘calm down’ many times when [S3] is handling [R1] because [S3] gets verbally aggressive” and that “S1 and S3 have both said that they ‘wish the residents were dead.’" LPA was unable to interview S2 as they are taking a leave of absence for personal reasons. Based on incident reports submitted to the Department and interviews conducted, the allegations “Staff speaks to resident in an inappropriate manner” and “Staff does not treat resident with dignity or respect” are deemed SUBSTANTIATED at this time. The following deficiency was observed (See LIC 9099-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Administrator was informed that failure to correct the deficiency may result in civil penalties. Exit interview conducted. Appeal rights and a copy of the report was provided. It was alleged that staff handled resident in a rough manner. Resident #1 (R1) stated that on 05/30/2024, Staff #3 (S3) was “particularly rough when pulling out the dirty sheet from under [R1]” and that S3 “violently yanked the sheet–causing [R1] pain.” R1 stated that their “involuntary response was to clutch [their] hands together” which S3 “misperceived as a hostile gesture” and started raising their fists at R1, asking if the resident wanted to fight them. LPA did not observe any marks on R1 on 08/02/2024 and 08/14/2024. R1 stated that the rough-handling did not leave any marks. LPA interviewed Staff #4 (S4) on 08/14/2024 who stated that Staff #1 (S1) and S3 were verbally abusive. S4 did not witness physical abuse. On 08/01/2024, the Department received a self-reported incident report regarding two (2) staff members, S1 and S3, who no longer work at the facility as they were suspended on 07/31/2024. The incident reports stated that on 07/06/2024, two staff members were assisting a resident when S1 slapped the resident. Staff #2 (S2) witnessed the incident and recognized it as abuse, but informed the Administrator later on 07/31/2024 due to fears of retaliation from S1 and S3, the relative of S1. The Department received the SOC341 for this incident on 08/02/2024. LPA was unable to interview S2 as they are taking a leave of absence for personal reasons. LPA interviewed Resident #2 (R2) on 08/02/2024 and 08/14/2024 who stated that they have “never witnessed any type of abuse from staff as they are friendly” and that “staff is responsive and helpful.” LPA interviewed a responsible party of R1 who stated that they have not observed anything that could be concerning or heard of any mistreatment. The responsible party of R1 did not have any information supporting the allegation. LPA also reviewed R1’s request log for a two-month period dating from 05/23/2024 – 07/19/2024 that logged the specific days and times of R1’s requests, ranging from cleaning, emptying catheter bag, repositioning, and changing sheets. A sheet change for R1 on 05/30/2024 was not observed on the log. LPA observed a sheet change for R1 done on 06/09/2024 and two (2) sheet changes done on 05/26/2024 by S1 and Staff #5 (S5), but none by S3. LPA interviewed two (2) responsible parties of other residents who stated that they have not seen mistreatment by staff to residents. Responsible party of Resident #3 (R3) stated they “go unannounced to the facility just to make sure that there is no mistreatment happening.” Based on observation, interviews, and record review, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation “Staff handled resident in a rough manner” is deemed UNSUBSTANTIATED at this time. No citations issued. Exit interview conducted. A copy of today's report was providedthe state’s words, verbatim · CDSS document, Oct 22, 2024 · control 29-AS-20240802152056

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Oct 23, 2024

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1)To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not comply with the section cited above in that staff #1 and staff #2 did not treat residents with dignity and respect which posed an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Oct 22, 2024

Plan of correction: Both staff have been terminated since 07/31/2024. POC is cleared.

Allegation investigated: Resident is not accorded dignity in their personal relationships with staff.

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a subsequent complaint visit for the allegations listed above at 12:55PM. LPA met with staff and Administrators/Licensee Vanessa Barcela and Christian Havsgaard and explained the reason for the visit. During the initial visit which took place on 08/14/2024, LPA Barutyan and Zabel Chochian conducted a brief physical plant tour, interviewed 2 (two) residents, the 2 (two) administrators, and 1 (one) staff, reviewed resident records, and reviewed and obtained copies of pertinent documents. Report Continued on LIC-9099C. Substantiated It was alleged that resident is not accorded dignity in their personal relationships with staff. On 08/01/2024, the Department received two (2) self-reported incident reports regarding two (2) staff members who no longer work at the facility as they were suspended on 07/31/2024. The incident reports stated that on 07/06/2024, two staff members were assisting a resident when Staff #1 (S1) slapped the resident. Staff #2 (S2) witnessed the incident and recognized it as abuse, but informed the Administrators later on 07/31/2024 due to fears of retaliation from S1 and Staff #3 (S3), the relative of S1. The Department received the SOC341 for this incident on 08/02/2024. The second incident report stated that on 07/12/2024 and 07/22/2024, S3 was verbally abusive to Resident #1 (R1). On 07/12/2024, R1 asked S3 for a cleaning. R1 requires a two (2) person assist and said they did not feel comfortable with S3 performing the cleaning solo, however, S3 was insistent. R1 refused the cleaning due to S3’s verbal abuse during the exchange and the potential dangers of the solo clean. On 07/22/2024 after changing the sheets on R1’s bed, R1 asked S1 and S3 to shift the bed. S1 and S3 began trying to shift the bed without unlocking the wheels and when R1 stated that the wheels need to be unlocked, S1 raised their fists at R1 asking if the resident wanted to fight them, and both S1 and S3 became verbally abusive. LPAs Barutyan and Chochian as well as Brian Balisi and Trevor Byrne conducted separate case management visits for the incidents on 08/02/2024. The Administrators stated that they were not aware of how S1 and S3 were treating the residents as S2 and S4 were afraid to report the abuse. LPA interviewed R1 on 08/02/2024 who stated that they felt “unsafe” and that the staff had a “hostile” relationship with R1. LPA interviewed R1 on 08/14/2024 who stated that they have “not experienced any mistreatment since the two staff left” and that they are “treated well here compared to other places [they have] stayed at and heard about.” LPA interviewed S4 on 08/02/2024 who stated that they have “had to tell [S3] to ‘calm down’ many times when [S3] is handling [R1] because [S3] gets verbally aggressive” and that S1 and S3 have both said that they "wish the residents were dead." LPA was unable to interview S2 as they are taking a leave of absence for personal reasons. Based on incident reports submitted to the Department and interviews conducted, the allegation “resident is not accorded dignity in their personal relationships with staff” is deemed SUBSTANTIATED at this time. While the allegation is substantiated, a deficiency will not be cited as the facility was issued a deficiency today, 10/22/2024, for a similar allegation of an unrelated complaint the Department received on 08/02/2024. Exit interview conducted. Appeal rights and a copy of the report was provided. It was alleged that staff does not ensure that residents are provided activities. LPAs Barutyan and Chochian observed board games and coloring available for residents during the initial visit on 08/14/2024. LPAs observed two (2) residents playing Connect 4 with staff on an unrelated visit conducted on 08/02/2024. Interviews conducted explained that two (2) residents are unable to communicate, and the other two (2) residents prefer solitary activities. Administrator Havsgaard stated that accommodations are made for the two (2) residents who do not wish to partake in socialization activities. The Administrators have an informal movie club with Resident #1 (R1) in which they ask R1 for movie recommendations and then have discussions about the movie with R1. R1 also stated they do not want to play games with other residents and instead, prefers to read or watch TV in their room. The Administrators and staff stated that Resident #2 (R2) also does not want to play games, so they encourage socialization by creating an office-like setting and referring to R2 as their “boss.” Administrator Havsgaard also stated that they invited a neighbor over to play chess with R2. R2 and responsible party of R2 confirmed that the administrators threw a birthday party for R2. Record review of the activity schedule indicated that there are planned activities for residents. Administrators confirmed that the activities do not always happen as per schedule as residents decline the activities occasionally. Based on interviews, observation, and record review, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation “staff does not ensure that residents are provided activities while in care” is deemed UNSUBSTANTIATED at this time. It was alleged that staff does not allow resident to go on outings. Record review of R2’s physician’s report documented that R2 is unable to leave the facility unassisted. Interviews conducted with the administrators, R2, and R2’s responsible party revealed that R2 goes on outings but is accompanied by the Administrators. R2 stated that the Administrators take him/her to R2’s responsible party’s house and other outings when requested. R2 had no complaints about the frequency of outings. R2 and Administrators confirmed that Ubers are ordered for R2 and someone will accompany R2 on the car rides. Interview with R2’s responsible party confirmed that R2 is able to visit at their house and stated that “Vanessa assists [R2] on outings.” Based on record review and interviews, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation “staff does not allow resident to go on outings” is deemed UNSUBSTANTIATED at this time. Report Continued on LIC-9099C. It was alleged that licensee is financially abusing a resident in care. LPA spoke with R2 who stated that they used to be an accountant, are in charge of their finances, and that they “have friends who also help sometimes but for the most part, it's just [themselves].” LPA interviewed R2’s responsible party who stated that R2 “manages their finances and [R2] has privacy to do so.” Responsible party stated they “have no concerns of financial abuse.” Record review of R2’s physician’s report, dated 10/11/2024, documents that R2 is “able to manage own cash resources.” Administrators stated that the office area for R2 is not monitored and that R2 manages their finances on their own personal computer that others do not and cannot access. LPA Barutyan observed R2 using their computer without monitoring on 08/14/2024 and 08/02/2024. The complainant alleged that the surveillance camera in the office common area is angled to point at R2’s computer and monitor potential financial information. LPA observed a camera in the corner of the office common area that was not pointing at R2’s computer and was instead, pointing to the front of R2. During the visit, the cameras were found to contain an auditory component and the Administrators immediately removed the cameras. However, because the camera was not positioned in a way to capture information on R2’s computer, there is not enough evidence to suggest that financial abuse could have occurred. Based on observation and interviews, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation “Licensee is financially abusing resident in care” is deemed UNSUBSTANTIATED at this time. Report Continued on LIC-9099C. It was alleged that the licensee does not ensure that residents are provided with quality food while in care. On 08/14/2024 LPAs Barutyan and Chochian inspected the kitchen and observed a sufficient supply of perishable and non-perishable foods. LPAs observed a variety of food groups and food that was of good quality. Interviews with staff and residents noted that staff ask R1 what they’d like to eat and R1 buys their own food and has them labeled separately. Staff #4 (S4) stated that R2 usually requests chicken teriyaki or salmon. S4 stated that they “sometimes make mac and cheese as it is easier for the other residents to eat” and that they “always make vegetables with the meals.” S4 makes broccoli with parmesan cheese and half a bagel with cream cheese for R1 because R1 requests them with the food R1 buys for self. The facility also has specific groceries for R1 because R1 is selective of their foods (ie. specific cereals, brands) and those groceries are marked that they are for R1. Family of Resident #3 (R3) deliver lunch/dinner every day as R3 prefers their cultural foods. LPA Barutyan interviewed family of R3 and found that they have agreement with the facility to provide the lunch/dinner for R3, per family’s request. LPA reviewed a signed agreement documenting the food accommodations for R3. Family of R3 stated that the facility provides simple breakfast like oatmeal, fruits, salad and will give dinner alternatives like mac and cheese if R3 does not want the lunch/dinner that was delivered by them. LPA also reviewed records and observed a signed meal agreement between the facility and the family of R3 indicating that the family will provide R3’s meals. S4 stated that sometimes R3 does not eat the food provided by family, so S4 makes soft foods like mac and cheese and mashed potatoes and then serves the leftover dinner at a later time. LPA Barutyan interviewed R1 on 08/14/2024 who stated that they “have [their] own special diet and buy [their] own food, but staff accommodate requests when [they] ask for food.” LPA also interviewed R2 who stated that the “food is good with a good variety” and that “staff ask what food [they’d] like to eat that day.” LPA observed S4 asking R2 on 08/14/2024 what they would like for dinner during the visit. LPA interviewed responsible party of R2 who stated that they have not been at the facility during food service “but knows that [R2] gets to choose their food” and that R2 “has not had any complaints.” LPA interviewed responsible party of R1 who stated that they “do not know much about the food as [R1] buys [their] own food” and stated that they usually see breakfasts, like scrambled eggs, served to other residents when they visit R1 in the mornings. Based on observation, interviews, and record review, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation “licensee does not ensure that residents are provided with quality food while in care” is deemed UNSUBSTANTIATED at this time. No citations issued. Exit interview conducted. A copy of today's report was provided.the state’s words, verbatim · CDSS document, Oct 22, 2024 · control 29-AS-20240808112739

Allegation investigated: Staff are restraining residents in care by use of bedrails. Staff do not afford privacy to residents in care.

Licensing Program Analysts (LPAs) Angela Barutyan and Zabel Chochian arrived at the facility unannounced to conduct an initial complaint investigation for the allegations listed above at 10:15AM. LPAs met with staff and Administrators/Licensee Vanessa Barcela and Christian Havsgaard and explained the reason for the visit. During today's visit, LPAs conducted a brief physical plant tour at 10:20AM, interviewed 2 (two) residents between 10:47AM-11:06AM, the 2 (two) administrators between 11:40AM-12:25PM, and 1 (one) staff at 12:27PM, reviewed resident records, and reviewed and obtained copies of pertinent documents. At approximately 12:15PM, LPAs discussed allegations with Licensee and Administrator. Report Continued on LIC 9099-C Substantiated It was alleged that staff are restraining residents in care by use of bedrails. The complainant alleged that 3 (three) residents are restrained by bedrails. LPAs observed full bedrails on Resident 1 (R1)’s bed at 10:22AM, half-rails on Resident 2 (R2)’s bed at 10:33AM, and half-rails on Resident 3 (R3)’s bed at 10:35AM. R1 is not on hospice and does not have an order for full bedrails; R2 and R3 do not have physician’s orders for half-rails. LPAs did not observe bedrails on Resident 4 (R4)’s bed at the time of the visit. Based on LPAs’ observation and record review, the allegation “staff are restraining residents in care by use of bedrails” is deemed SUBSTANTIATED at this time. It was alleged that staff do not afford privacy to residents in care. The complainant alleged that the facility uses surveillance cameras in common areas where residents use personal computers and where meetings of resident and family groups occur. During physical plant tour, LPAs observed cameras throughout the common areas of the facility that are used for family visits and computer use. During administrator interview, it was confirmed at 12:01PM that the cameras have an auditory component and save short recordings with audio when movement is detected. Based on LPAs’ observation and interviews, the allegation “staff do not afford privacy to residents in care” is deemed SUBSTANTIATED at this time. The following deficiencies were observed (See LIC 9099-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Administrator was informed that failure to correct the deficiencies may result in civil penalties. It was alleged that resident is not afforded safe, healthful, and comfortable accommodations. The complainant alleged that R2 requests air conditioning in their bedroom, but the facility refuses to turn it on in order to save money. LPAs observed a cool temperature of 72 degrees Fahrenheit in the facility and R2’s bedroom. LPAs interviewed residents and found that residents are satisfied with the temperature of the facility. No issues or concerns were observed during resident interviews regarding comfortable accommodations. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “resident is not afforded safe, healthful, and comfortable accommodations” is deemed UNSUBSTANTIATED at this time. It was alleged that there are uncleared adults providing care and supervision to residents in the facility. All staff present at the facility during the time of the visit had fingerprint and background clearance and were associated to the facility. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “uncleared adults are providing care and supervision to residents” is deemed UNSUBSTANTIATED at this time.the state’s words, verbatim · CDSS document, Aug 14, 2024 · control 29-AS-20240808112739

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87608(a)(5) · Plan of correction due date: Aug 15, 2024

(a)Based on the individual's preadmission appraisal...Postural supports may be used under the following conditions. (5)Under no circumstances shall postural supports include tying, depriving, or limiting the use of a resident's hands or feet. This requirement is not met as evidenced by: Based on observation and record review, Licensee did not comply with section cited above. 1 (one) non-hospice resident had full bedrails and 2 (two) residents had half-rails with no physician orders. This poses an immediate health, safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 14, 2024

Plan of correction: Administrator removed full bedrail during the time of the visit. Administrator will contact physicians for half-bedrail orders and submit proof to CCL by due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(1) · Plan of correction due date: Aug 21, 2024

(a)...residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:(1) To have a reasonable level of personal privacy in...use of the Internet, and meetings of...family groups. This requirement is not met as evidenced by: Based on observation and interviews, Licensee did not comply with section cited above in that cameras with auditory component were in common areas where residents use internet and have family visits. This poses a potential personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 14, 2024

Plan of correction: Administrator removed cameras with auditory components during the time of the visit. Administrator will inform LPA of future plans to install cameras. POC is cleared.

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Case Management - Incident

Licensing Program Analysts (LPAs) Brian Balisi and Trevor Byrne conducted an unannounced Case Management – Incident visit at 9:30 a.m. for the purpose of investigating self-reported incident reports. Upon arrival, LPAs met with Program Director Christian Havsgaard and explained the reason for the visit. On 08/01/2024, the Department reviewed an incident report stating on 07/12/2024, Staff #1 (S1) was inside resident 1’s (R1) room. R1 is not bedridden but is unable to leave their bed without assistance. R1 stated that they required a cleaning that day, R1 requires a two (2) person assist with cleaning. S1 was alone at the time of the request but told R1 that they could perform the cleaning by themselves. R1 refused stating that it was unsafe for both of them, and two (2) people are required. S1 continually insisted that they could perform the cleaning solo but R1 continually refused. R1 stated that S1 was verbally abusive during the exchange. On 07/22/2024 after changing the sheets on R1s bed R1 asked S1 and Staff #2 (S2) to shift her bed. S1 and S2 began trying to shift the bed without unlocking the wheels. R1 informed the staff members that they had to unlock the wheels at which point S1 began being verbally aggressive towards the resident. S1 raised their fists at R1 and asked if the resident wanted to fight them. R1 confirmed that S1 has been verbally abusive on multiple occasions. On 07/06/2024 S2 and staff #3 (S3) were assisting resident #2 (R2) in the restroom. R2 leaned to the side and at this point S2 struck R2 in the head to straighten their body. S3 told S2 that this is elder abuse and they needed to stop. S2 stated that it is only elder abuse if it is reported. The department received the SOC341 for this incident on 08/02/2024. At approx. 09:35 a.m., LPAs conducted physical plant, interviewed staff, and reviewed and obtained copies of pertinent documentation relevant to the investigation. LPAs have determined further investigation is needed and will return at a later date to continue. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Aug 2, 2024

Type of visit: Case Management - Incident

Licensing Program Analysts (LPAs) Angela Barutyan and Zabel Chochian conducted an unannounced case management - incident visit at 2:46PM. Upon arrival, LPAs met with staff and reason for visit was explained. Staff contacted Administrator who arrived at approximately 03:00PM. Reason for the visit was discussed with the Administrator Christian Havsgaard. On 08/01/2024, the Department received an incident report stating that on 07/06/2024, two staff members were assisting Resident #1 (R1) when Staff #1 (S1) slapped R1. Staff #2 (S2) witnessed the incident and recognized it as abuse, but informed the Administrator later on 07/31/2024 due to fears of retaliation from S1 and Staff #3 (S3), the relative of S1. During today’s visit, LPAs conducted a plant tour at 02:50PM of the facility which includes six (6) resident bedrooms, one (1) staff room, four (4) resident bathrooms, one (1) staff bathroom, kitchen, and common areas to ensure there are no health and safety hazards. LPAs conducted interviews with the Administrator at 03:25PM, two (2) staff members, and two (2) residents between 03:43PM-04:19PM, conducted a file review at 03:35PM, and obtained copies of pertinent documents relevant to the investigation. Prior to issuing final licensing report, it has been determined that further investigation is needed at this time. Exit Interview Conducted and Report was Issued.the state’s words, verbatim · CDSS document, Aug 2, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Esther Cortez arrived at the facility announced at 10:15 a.m. to conduct a pre-licensing inspection. The LPA met with Applicant Representatives Christian Havsgaard and Vanessa Havsgaard. This is a change of ownership application from Bentley Hills (#195850277) to True Living Care LLC (195850435). The current capacity is for six (6) residents, the facility currently has five (5) residents. A dementia program was included in the plan of operation. The fire clearance was granted on 01/26/2024, for five (5) non ambulatory and one (1) bedridden. All bedrooms cleared for bedridden but only one (1) at any time. Applicant successfully completed Component III during today’s inspection. The LPA toured the physical plant areas inside and outside with the applicant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN: Kitchen knives are stored inaccessible in a drawer and cleaning supplies are locked in the cabinet under the kitchen sink. The supply of perishable and nonperishable food is adequate. The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. There is an adequate supply of emergency food. BEDROOMS: There are six bedrooms in the facility all for resident use. The facility has one staff bedroom that is being used by staff as a private living quarter. The staff room is accessed through an attached staff bathroom. All rooms have direct access to the outside. Lighting in the rooms appeared adequate. Resident room #1, #2, #3, #4 and #6 were set up with beds, night stands, lamps, chests of drawers, chairs, and closet space. Resident bedroom #5 was not set up with a bed. Resident bedroom #5 is currently not occupied. Report will continue on LIC809-C (2ND PAGE). BATHROOMS: There are five (5) full bathrooms. There are two (2) private bathrooms for resident use that are attached to resident bedrooms #1 and #2; there are (2) full bathrooms in the hallway that are designated for residents, staff, and guests. There is one (1) full bathroom for staff. The showers are equipped with nonskid surfaces and available nonskid mats. Grab bars were observed in the bathrooms. Hot water temperature measured in bathrooms measured between 99.0 – 123.1 degrees Fahrenheit. Applicant attempted to regulate water temperatures during visit. COMMON AREA: The common areas were appropriately furnished, and the lighting was adequate. There is a television and a cabinet with games and activities for resident use. The facility smoke alarm system is hard wired; the smoke detectors were operable at the time of the visit. The fire extinguisher was fully charged and last serviced 06/15/2023. There is a functioning telephone on the premises. Emergency exiting plans/sketch are posted in the facility hallway. Emergency telephone numbers are posted in the facility hallway. Other required postings are posted in the hallway and upon entry into the facility. MEDICATIONS: Medications are in a medication room in the kitchen which is locked and inaccessible to residents in care. The first aid supplies were complete. FILES: Resident and staff records are stored in the medication room in the kitchen which is locked and inaccessible to residents in care. LPA observed an unlocked filing cabinet with past resident documents in the entertainment area located at the back of facility. Files were locked away during todays visit. LAUNDRY: There's a laundry room in the kitchen which is locked and inaccessible to residents in care. GROUNDS: The facility has a covered car port. The LPA observed a variety of equipment underneath the covered car port which included two (2) mattresses, a stove, boxes, a disassembled hospital bed and other items. The LPA observed two Hoyer lifts outside the exterior passageways of exit #5. There is a covered patio area in the backyard with tables and chairs for resident use. There are no bodies of water on the premises at the time of the visit.The LPA observed a locked storage unit in the back yard containing additional supplies and yard equipment Report will continue on LIC809-C (3rd PAGE). INFECTION CONTROL: The facility has a central entry point for symptom screening and sanitation station for staff, residents, and visitors. The facility has an adequate supply of PPE and the facility is able to obtain additional supplies as needed. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. Facility is not compliance with Title 22 Regulations at this time. Applicant will be required to complete the following corrections and submit documentation to LPA Esther Cortez within 10 days: - Documentation of water temperatures meeting Title 22 regulations - Photo of cleared items in the carport. Upon receipt of the above items, physical plant will be in compliance with Title 22 regulations. This report will be sent to the Centralized Application Bureau (CAB). The CAB Analyst will notify the applicant when the license has been approved. The applicant is aware that they are unable to operate under the new license number until they have been notified that the license has been approved by the CAB Analyst. Failure to comply could affect approval of the license. Exit interview conducted and report issued.the state’s words, verbatim · CDSS document, Apr 11, 2024

Type of visit: Office

COMP II by CAB successfully completed Facility Type: True Living Care LLC Application Type: CHOW Capacity: 6 Census (if any clients in care): 5 Method: Telephone call with CAB COMP II Participants: Christian Havsgaard, Administrator/Owner; Shannon Betker, analyst. Applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. 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 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Apr 2, 2024