Twin Oaks Garden II

Type of visit: Required - 1 Year

On 03/18/26, Licensing Program Analyst (LPA) Aziz Faizi made an unannounced visit to the facility to conduct a required annual inspection. LPA was greeted and granted entry by Administrator Snezana Lukic who was informed of the purpose of the visit. The facility is a one-story home with six (6) resident bedrooms with restrooms and two (2) bathrooms, a staff room, a kitchen, dining room, living room, laundry room, and staff office. Resident bedrooms had the required bedding, furniture, and lighting. Bathrooms had grab bars and non-skid mats in the showers. There are no pools or known firearms on the premises. LPA toured the facility's exterior and observed outdoor pathways were free of obstructions. Outdoor shaded seating area is available for the clients in care. The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. LPA toured the kitchen and observed the facility has a two-day supply of perishable foods and more than a seven-day supply of non-perishable foods, which are stored in a safe and healthy manner. LPA observed knives and sharp instruments secured in locked kitchen cabinet. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 105.4°F. Fire extinguisher located next to the entry door meeting department's requirements expiring 06/18/2026. Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate expiring 07/07/2027. LPA reviewed files for three (3) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Three (3) resident files were reviewed and contained all required documentation. All resident medications were securely locked. LPA reviewed medications for three residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire/earthquake drill conducted on 02/10/2026, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed and provided.the state’s words, verbatim · CDSS document, Mar 18, 2026

Allegation investigated: Staff are restraining a resident Facility is exceeding hospice waiver capacity

On 6/5/2025, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced visit to the facility to investigate the allegations listed above. LPA met with Tanja Lukic who identified themselves as one of the administrators. Lukic was informed of the purpose of the visit. During today's visit, LPA toured the facility, conducted interviews, and obtained copies of pertinent records. Regarding the allegation, "Staff are restraining a resident" it was alleged staff tied Resident 1 (R1) to a chair in their room by wrapping a fleece blanket around R1 and the chair R1 sat in. It was further alleged R1 was observed sitting on a cushion that is used to restrain residents. LPA toured the facility and did not observe R1 with a blanket or other object tying them to their wheelchair. LPA observed R1 sitting on a cushion in their wheelchair. R1 was unqualified for an interview as LPA determined them to be an unqualified historian. As a result, LPA conducted an interview with R1's responsible person who reported the following information. R1's primary care physician provided a prescription for the soft blanket tied in front to assist with postural support and avoid them from slipping out of their wheelchair. When R1 goes into the community without the cushion, R1's responsible person has noticed R1 will slip out of their wheelchair. Unsubstantiated R1's friends/family visit R1 at the facility approximately three (3) times per week and no one has reported observations of R1 being restrained in the facility. Friend/family visits are unannounced and R1 is always observed well kept with no foul odors, eating well, and with clean bedding. R1's responsible person did not express any issues or concerns with the care and supervision R1 receives in the facility. LPA reviewed a prescription order for R1 dated 1/21/2025 stating R1 "needs a soft blanket tied in front for postural support and safety". Lukic was interviewed and reported the soft blanket tied in the front is occasionally placed on R1 for better support and to prevent them from falling. Lukic added R1 has the ability to untie the soft blanket on their own and staff was trained on how to properly tie the soft blanket. One (1) staff was interviewed and corroborated the information provided by Lukic. Regarding the allegation, "Facility is exceeding hospice waiver capacity" it was alleged the facility is licensed to house two (2) hospice residents and currently has four (4) residents on hospice. LPA conducted a record review which noted on 3/1/2024, the facility was granted a hospice waiver increase for a total of three (3) residents. Lukic was interviewed and reported Resident 2 (R2), Resident 3 (R3), Resident 4 (R4), and Resident 5 (R5) are currently receiving hospice services at the facility. A review of admission agreements and hospice care plans note R2, R3, and R4 were admitted to the facility sometime in 2023 or 2024 and all three (3) residents were admitted to hospice in 2024. A review of R5's admission agreement and hospice care plan indicates R5 was admitted to the facility on 5/3/2021 and to hospice on 5/23/2025. On 5/22/2025, LPA received an email from Licensee, Snezana Lukic with a hospice waiver increase request to house four (4) terminally ill residents at a time. Lukic reported the facility has not accepted any new residents who were on hospice upon admission to the facility and licensee submitted an hospice waiver increase request as soon as they learned R5 would be admitted to hospice. Although the allegations may have happened or is valid, there is no preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was reviewed and provided to Lukic along with a Confidential Names list (LIC 811).the state’s words, verbatim · CDSS document, Jun 5, 2025 · control 18-AS-20250529081241

Type of visit: Required - 1 Year

On 3/27/2025, Licensing Program Analyst (LPA) Janette Romero made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Licensee, Snezana Lukic and Administrator, Tania Lukic who was informed of the purpose of the visit. The facility has a fire clearance to serve six (6) non-ambulatory elderly residents. The facility also has an approved hospice waiver for three (3) and LPA was informed three (3) residents are currently receiving hospice services at the facility. During today's visit, there was two (2) staff and six (6) residents present. Licensee's administrator certificate expires on 7/7/2025. LPA toured the facility with Lukic and observed the facility is made up of a one-story home with six (6) resident bedrooms with restrooms, two (2) bathrooms, a staff room, kitchen, dining room, living room, laundry room, and staff office. Resident bedrooms had the required bedding, furniture, and lighting. Bathrooms had grab bars and non-skid mats in the showers. No bodies of water were observed on the premises. Indoor and outdoor pathways were free of obstruction. The facility met Departmental requirements for a two-day supply of perishable foods and seven-day supply of non-perishable foods. Medications are secured in a locked kitchen cabinet. Administrator tested one (1) of the smoke alarms/carbon monoxide detectors and LPA observed it to be operational. LPA also observed a charged fire extinguisher mounted near the entrance. The facility's certificate of liability insurance expires on 5/5/2025. Staff present have a criminal record clearance and are associated with the facility. Resident files reviewed had updated physician's reports and Departmental required records. The facility reported they do not manage the residents' cash resources. LPA reviewed the facility's Fire Drill & Evacuation log noting the facility's last fire drill was conducted on 2/20/2025. Long Term Care Ombudsman's contact information, residents' personal rights, complaint procedures, facility sketch, and emergency phone numbers are visibly posted near the front entrance/living room. During today's visit, LPA did not observe any issues or concerns. An exit interview was conducted and a copy of this report was reviewed and provided to Licensee Lukic.the state’s words, verbatim · CDSS document, Mar 27, 2025

Type of visit: Required - 1 Year

On March 08, 2024, Licensing Program Analyst (LPA), Venus Mixson conducted an unannounced annual required visit and met with Snezana Lukic, the Administrator, who was informed of the purpose of the visit. The Facility File review was conducted in the Regional Office and additional forms were requested and reviewed on site. LPA Mixson toured the facility, along with the Administrator, Snezana Lukic and inspected the inside and outside of the facility. The facility is licensed for six but is currently operating at five, and is located at 1961 Edwin Lane San Marcos, CA. 92069, and the facility phone number is (760) 471-8704, and is operable. Infection Control: The LPA observed restrooms and the kitchen, and each was equipped with liquid soap and paper towels for hand washing. LPA Mixson observed gloves and cleaning supplies to do regular cleaning of the facility. The LPA reviewed the facility's infection control plan and found all required infection control measures. LPA Mixson observed additional hygiene supplies at the facility. The LPA reviewed infection control training conducted with facility staff which met the department requirements. Physical Plant/Planned activities: LPA Mixson observed the resident bedrooms each was equipped with required furniture as per regulations. Fixtures and furniture were in good repair and were present. The outdoor area was observed to be free of hazards. The laundry room was observed to be locked. The hot water temperature was recorded and logged within regulations. Food Service: LPA Mixson observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. The LPA observed the facility met the required two day supply of perishable and seven day supply of non-perishable foods. Care & Supervision: five staff and five residents which is adequate per facility type and within the regulations. Records Review: LPA Mixson reviewed staff and resident files, conducted staff and residents interviews, and reviewed Previous Community Care Licensing forms. There were no Title 22, Division 6 Regulation violations observed or cited during today’s visit. An exit interview was conducted, and a copy of this report was provided to the Administrator, Lukic Snezana.the state’s words, verbatim · CDSS document, Mar 8, 2024