Turlock Residential

Type of visit: Annual/Random

Licensing Program Analyst, LPA, Noel Wolf Petersen Arrived unannounced to the facility, to conduct a annual inspection. LPA met with administrator Manisha punni to explain the purpose of the visit. Physical inspection was conducted: Kitchen was in good repair, LPA noted the presence of insect traps and asked for the 6 most recent pest control summary reports. There is adequate storage for 2 days perishable and 7 days non perishable foods. the menu to day is tacos. in interview, designated executive Chef gave the statement they have adequate resources to meet the needs of the clients, including menu planning authority and material requisition. Facility has some lingering malodorus smells related to incontinence care in some rooms, staff were seen cleaning the area, and further walkthough by the LPA elimitated the odors. in interview maintience director gave the statement they have adequate resources to meet the needs of the client, including staff, hours, and material requisition. Med room was inspected, regarding client medications and documentation procedure. interview with medtech staff indiated the facility process for documenting refusal should include more fields, as to the reason for the refusal. PRN/controlled substance, destruction record documentation was adequate. Exterior of the facility has adequate space for activities, there are no obvious trip hazzards. LPA noted there is no evacuation route gate, virtually every bedroom room has a sliding glass door that could be used in an emergency and the campus opens out to an area that doesn't have a fully enclosed perimiter fence Continued on c page. LPA interviewed 4 residents, 1 refused. 1 client made an observation that they were being restrained inappropriately. 1 client made an observation they were needing some personal hygiene items(q tips, wet wipes, etc). 1 client made an observation that they had not showered in two weeks. Facility provided a statement that they would reassess the client files for inapproprite use of restraint, the personal hygine items that were a part of the basic services would be delivered immediately and arrangements would be made to enable the client to be able to purchase any additional items, and the facility had recently aquired and assemebled a shower chair for the resident, and a shower would be immediately scheduled. LPA observed the facility address the concerns appropritely. The LPA observed at least 1(r2) client without the ability to rotate in bed, indicating she meets the titlle 22 definition of bedridden status. To the LPA's observation of these events, the LPA gave guidance these events could indicate quality or quantity issue in the care staff. Staff should be responsive to a basic need like assistance with leaving the bed temporarily, or supplying basic hygine items as necessary, or prioritizing a two weeks late shower when the new shower assembly is complete. The administrator should be constantly assessing staff for competency, and residents for needs being met. LPA reviewed 5 client files, 1 hospice care plan. there are significant concerns regarding the facility documentation. three(r1,r2,r5) clients have fall risks identified on thier medical assessment charting without addressing those needs in the care plan. one(r5) client is a VMRC client who is out of scope for the facility. none(0 out of 5) of the clients have a rail order and 2 of 5 have beds equiped with half rails. LPA gave guidance a medication crush order should always be followed with a camoflauge consent form, r1 appears not to have a consent while having a crush meds order in thier hospice care plan. LPA gave guidance the client files need to be self-audited, to determine if the facility has addressed needs of the clients, and for a determiniation if they are within the scope of the facilities license. beyond the VMRC client(r5), at least one client (r2) appears to have significant trouble repositioning (r2) to the observation of the LPA. is remarked on her 602 to be both "bed bound" and require "total support" with repositioning in bed. LPA asked the facility to coordinate with the VMRC about a plan for submitting an exemption to the facilitys client type regarding the client(r5). LPA reviewed 5 staff files for health screenings, backround checks, current and prejob training, and first aid certificates, all files presnnt and up to date. Administrator file was not reviewed. LPA asked for a copy of thier hiv training, the facility license, the facility certificate, the facility sketch, proof of the liability and workers comp insurances, LIC 610 to be sent the LPA's email (noel.wolfpetersen@dss.ca.gov) 1 citation was issued, a 500 $ civil pentality was also issued were given as part of this visit. a copy of the report was read and given to the administrator. appeal rights were provided. exit interview conducted.the state’s words, verbatim · CDSS document, Sep 3, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87272(a)(2) · Plan of correction due date: Sep 4, 2026

87202 Fire Clearance (a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, (2) Bedridden not following this requirement is evidinced by 1 or more persons in the facility not being able to rotate indepentantly(r2) to the observation of the LPA, 602 indicates mixed status of nonamb and requiring assistance with rotation. not following this requirement poses a risk to the health saftey and personal rights of clients in carethe state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: Facility will develop a plan to become fire cleared and submit it to the LPA tomorrow 9/4/26. if the facility choses to become firecleared by updating the fire clearance to include bedridden, the LPA will be informed at steps of the process of updates to the plan on a monthly basis.

Type of visit: Post Licensing

On 09/10/25, Licensing Program Analyst Renee Campbell arrived to the facility to conduct a post-licensing inspection. Upon entry, LPA Campbell observed residents socializing in the common areas. LPA Campbell arrived to the facility and met Manisha Punni, Administrator and explained the purpose of the visit. The facility is a one story building licensed to serve residents 60 and over. It is approved for 49 non-ambulatory residents and has a hospice waiver granted for 10 residents. Currently, the census is 41 residents with 25 staff. While walking down the hallways, LPA Campbell observed residents rooms with the appropriate furniture and fire extinguishers at the end of the hallways. LPA Campbell used the activity office where games, art supplies, puzzles and books were available for resident use. Of the 41 residents and 25 staff, 4 resident files and 3 staff files were randomly selected and reviewed. LPA Campbell consulted with the administrator regarding file organization consistency to increase ease of access for information. Using the staff roster provided by the facility, LPA Campbell confirmed that all staff have been fingerprint cleared and associated to the facility. The quarterly fire drill report log was observed. Participating staff were listed, a checklist of staff tasks was completed along with response times and non-ambulatory procedures. Staff procedures for fires were reviewed. No deficiencies were observed and cited during this visit. Exit interview held and a copy of report left.the state’s words, verbatim · CDSS document, Sep 10, 2025

Type of visit: Prelicensing

On 05/29/2025, Licensing Program Analyst (LPA) Renee Campbell arrived unannounced regarding a prelicensing inspection. This pre-licensing is for Change of Ownership (CHOW) to DBA Turlock Residential. LPA met with AdministratorJennfier Warkentin and Soon Burnam, Director of Licensing and Certification for Ensign Services, Inc. LPA Campbell inspected the physical plant of the facility to ensure compliance of Title 22 regulations. LPA Campbell observed 4 random resident units, the activity room, dining room, kitchen, and outdoor areas. The Facility has a 49-resident capacity for non-ambulatory Assisted Living residents. The facility is a one-story building. Outdoor passageways, walkways, driveways, and steps are free from obstructions. LPA Campbell did not observe hazards, such as ladders, gardening tools and/or motorized equipment in the front, back and/or side areas of the facility. Bodies of water were not observed at this time. Resident Bedrooms: LPA inspected 4 resident units. Each unit is fire cleared for non-ambulatory residents. The resident apartments/units are spacious and will easily accommodate the residents furnishings. The inspected resident units were observed to be furnished with adequate storage for resident belongings. The water temperatures for all inspected units (112, 103, 123 and 126) were approximately 120 degrees Fahrenheit (F). Bathroom: Each resident unit contains a private bathroom. All bathrooms inspected have working toilets, wash basins and full baths have showers. Toxins and Chemicals: Toxins and chemicals for cleaning are properly stored, locked, and inaccessible to residents in care in the Janitor closet.. Food Service and Kitchen: The kitchen area and dining area were inspected and observed to be in good repair. Knives, cutlery and other sharp kitchen utensils are locked and inaccessible to residents. The food supply was adequate and stored in kitchen refrigerator and walk-in pantry and consists of the following: A variety of fresh and canned fruit, vegetable and meat food items. The date of purchase was written on food items in the refrigerator and freeezer. Stove burners and oven were observed to be in good repair. Smoke Detectors/Carbon Monoxide: Each of the inspected resident units were observed to have a smoke alarms and sprinklers. Additionally, the carbon monoxide alarms are located in the hallways.. Smoke detectors are hardwired and interconnected, and they are fully operational. The facility conducts quarterly smoke alarm testing. The most recent test occurred 02/26/2025 and was passed successfully. Medications and First-Aid Kit: Resident medications were observed to be stored in the medication room and locked and inaccessible to residents in care. The first aid kit has been inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze and manual which are stored in the locked medication room. Facility, Residents & Staff Files: Facility will not be handling cash resources of residents. Records of staff and residents are stored in the Administrators office and inaccessible to staff. Component III: Conducted at the Pre-Licensing visit, on 05/29/2025 at Turlock Residential and information provided about how to operate the facility within substantial compliance. Pre licensing is complete and this facility has no deficiencies. An exit interview was conducted with Administrator Jennifer Warkentin. A copy of this report was provided. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.the state’s words, verbatim · CDSS document, May 29, 2025

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 49 Census (if any clients in care): 43 Interview Method: Telephone interview On 5/14/2025, 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 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, May 14, 2025