Valley Spring Memory Care

Allegation investigated: Staff speaks inappropriately to residents in care Staff did not follow proper reporting requirements

On July 24, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to open a complaint regarding the allegations listed above. LPA met with Administrator Elizabeth Reynaga and Resident Care Director Natalie Levario. LPA conducted multiple interviews. Based on the interviews it was found S1 had spoke inappropriately to residents in care and was eventually terminated from the facility. This was previously cited on complaint #24-AS-20250910082422, and no citation will be issued. While reviewing R1's progress notes it was found on June 6, 2026 medication was not given due to not being available, this incident was not reported to the Dept. Based on observation, interview, & records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Exit interview was conducted and a copy of this report LIC9099, LIC9099D, and appeal rights were provided to Executive Director Elizabeth Reynaga. Substantiatedthe state’s words, verbatim · CDSS document, Jul 24, 2026 · control 24-AS-20260427142947

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1) · Plan of correction due date: Jul 31, 2026

7211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement is not met as evidenced by: Based on observation, interview, and record, the facility did not comply with the regulation listed above due to R1 had a missed medication which was not, which poses a potential health and safety risk to residents in care. reported to the Dept.the state’s words, verbatim · CDSS document, Jul 24, 2026

Plan of correction: Administrator monitor progress notes and MARs regarding medication. Statement of upates will be given to the Dept by POC due.

Allegation investigated: Staff restrained resident in care Staff refused to attend to residents in care Staff denied food to resident in care Staff did not safeguard resident's confidential information Staff denied activities to residents in care

On July 24, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to open a complaint regarding the allegations listed above. LPA met with Administrator Elizabeth Reynaga and Resident Care Director Natalie Levario. LPA conducted multiple interviews for the allegations listed above. LPA interviewed staff, residents, and family members. Interviewees did not state any of the allegations listed above happen. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview was conducted and a copy of this report LIC9099 was provided to Executive Director Elizabeth Reynaga. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jul 24, 2026 · control 24-AS-20260427142947

Allegation investigated: Staff did not follow medication orders from the physician.

On May 21, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to open a complaint regarding the allegation listed above. LPA met with Administrator Elizabeth Reynaga and Resident Care Director Natalie Levario. Regarding the allegation: Staff did not follow medication orders from the physician. LPA conducted interviews. Interviewees did not stated R1 was over medicated. LPA reviewed doctor's note and discharged papers which stated R1 was having an adverse reaction to medication trazodone. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was conducted and a copy of this report was provided to Elizabeth Reynaga- Administrator. Unsubstantiatedthe state’s words, verbatim · CDSS document, May 21, 2026 · control 24-AS-20260519091629

Allegation investigated: Staff speaks inappropriately to residents Staff do not ensure medication is properly administered Staff do not ensure resident's incontinence needs are being met

Licensing Program Analyst (LPA) K. Kaur arrived at the facility for subsequent complaint inspection. LPA met with Administrator Elizabeth Reynaga and Resident Care Director Natalie Levario and explained the purpose of the visit and reviewed the elements of the allegations. LPA delivered the following complaint investigation findings. The Department investigated the allegations listed above. Based on observations, interviews conducted and records reviewed, staff was overhead speaking inappropriately to resident. Medication was incorrectly administered by being left in residents drinks and found on the floor and in the trash. Resident’s incontinence needs are not being met in a timely manner. Residents were routinely soaked in urine, with saturated briefs, in wet and soiled bedding. The preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED. See citations on the attached LIC9099D. Exit interview was conducted with Administrator Elizabeth Reynaga and appeal rights were provided. Substantiatedthe state’s words, verbatim · CDSS document, May 1, 2026 · control 24-AS-20250910082422

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: May 4, 2026

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 conducted staff was overhead speaking inappropriately to resident by other staff and another resident’s family member.the state’s words, verbatim · CDSS document, May 1, 2026

Plan of correction: Administrator agrees to provide in-staff training on personal rights and submit records of training when completed.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(4) · Plan of correction due date: May 4, 2026

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage ... compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on interviews conducted and records reviewed Medication was incorrectly administered by being left in residents drinks and left Infront of them and found on the floor, in residents bedding and thrown in the trash.the state’s words, verbatim · CDSS document, May 1, 2026

Plan of correction: Administrator agrees to conduct medication training with staff and submit records when completed.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87625(b)(2)(3) · Plan of correction due date: May 4, 2026

87625 Managed Incontinence (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (2) Ensuring that incontinent residents are checked during those periods of time when they are known to be incontinent, including during the night. (3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement is not met as evidenced by: Based on interviews conducted and records reviewed residents were routinely soaked in urine, with saturated briefs, in soiled/ wet bedding.the state’s words, verbatim · CDSS document, May 1, 2026

Plan of correction: Administrator agrees to provide in-staff training to all staff on incontinence regulations and develop a incontinence process/plan for NOC shift to follow to ensure residents are changed in a timely manner

Type of visit: Case Management - Deficiencies

On 5/1/2026, Licensing Program Analyst (LPA) K.Kaur arrived unannounced for complaint inspection and conducted a case management in conjunction. LPA met with Administrator Elizabeth Reynaga and Resident Care Director Natalie Levario and introduced self and explained the reason for the visit. During the course of complaint investigation, the Department discovered Resident (R2) had a fall on 7/8/2025 around 5pm which resulted in hip bone fracture. Resident was in pain and did not allow brief change during NOC shift (11PM – 7AM) per records. Resident was not sent to hospital until 8AM on 7/9/2025. Deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. An exit interview was conducted with Administrator including discussing the plan of corrections. Report signed on-site. Printed copy provided with 809D page and appeal rights.the state’s words, verbatim · CDSS document, May 1, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(g) · Plan of correction due date: May 4, 2026

87465 Incidental Medical and Dental Care (g)The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis except as specified in Sections 87469(c)(2), (c)(3), or (c)(4). This requirement is not met as evidenced by: Based on interviews conducted and records reviewed; resident had a fall that resulted in an injury and 911 was not called until next day.the state’s words, verbatim · CDSS document, May 1, 2026

Plan of correction: Administrator agrees to conduct in-service training on Incidental Medical and Dental Care regulations regarding seeking medical treatment for residents. Administrator to submit proof of training when completed.

Allegation investigated: Staff do not ensure that residents are taking their medications as prescribed.

On April 23, 2026, Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver findings for a complaint of the allegations listed above. LPA met with Administrator Elizabeth Reynaga & Resident Care Director Natalie Levario. Regarding the allegation: Staff do not ensure that residents are taking their medications as prescribed. LPA conducted various interviews. No interviewee’s stated there was issues with medication. No deficiencies were found regarding the allegation listed above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was conducted and a copy of this report LIC9099 was provided to Administrator Elizabeth Reynaga. Unsubstantiatedthe state’s words, verbatim · CDSS document, Apr 23, 2026 · control 24-AS-20260330122158

Allegation investigated: Staff are not serving adequate food to residents

On April 23, 2026, Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver findings for a complaint of the allegations listed above. LPA met with Administrator Elizabeth Reynaga & Resident Care Director Natalie Levario. Regarding the allegation: Staff are not serving adequate food to residents. LPA conducted multiple interviews and was informed on more than one occasion part of the food has been burnt and residents refuse to eat the burnt food. Based on the Departments observations & interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Exit interview was conducted and a copy of this report LIC9099, LIC9099D, and appeal rights were provided to Administrator Elizabeth Reynaga. Substantiatedthe state’s words, verbatim · CDSS document, Apr 23, 2026 · control 24-AS-20260401155634

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(a) · Plan of correction due date: Apr 30, 2026

87555 General Food Service Requirements (a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement is not met as evidenced by: Based on observation & interview, the facility did not comply with the regulation listed above by serving the residents burnt food, which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 23, 2026

Plan of correction: Licensee will have additional training conducted. Verification will be sent to the Dept by PO due date.

Allegation investigated: Staff are not meeting residents hygiene needs Staff are not changing gloves in between residents

On April 23, 2026, Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver findings for a complaint of the allegations listed above. LPA met with Administrator Elizabeth Reynaga & Resident Care Director Natalie Levario. Regarding the allegation: Staff are not meeting residents’ hygiene needs & staff are not changing gloves between residents. LPA conducted various interviews. No interviewee’s stated gloves are not being changed between residents or hygiene needs are not being met. No deficiencies were found regarding the allegations listed above. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview was conducted and a copy of this report LIC9099 was provided to Administrator Elizabeth Reynaga. Unsubstantiatedthe state’s words, verbatim · CDSS document, Apr 23, 2026 · control 24-AS-20260401155634

Allegation investigated: Staff are unable to communicate with residents due to a language barrier Staff did not meet the resident's diapering care needs in a timely manner

On April 23, 2026, Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver findings for a complaint of the allegations listed above. LPA met with Administrator Elizabeth Reynaga & Resident Care Director Natalie Levario. Regarding the allegations: Staff are unable to communicate with residents due to a language barrier & staff did not meet the resident's diapering care needs in a timely manner. No interviewee’s stated there was an issue with communicating needs or diapering care not being met. No deficiencies were found regarding the allegations listed above. 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 allegations are UNSUBSTANTIATED. Exit interview was conducted and a copy of this report LIC9099 was provided to Administrator Elizabeth Reynaga. Unsubstantiatedthe state’s words, verbatim · CDSS document, Apr 23, 2026 · control 24-AS-20260318155612

Allegation investigated: Staff speak inappropriately in the presence of residents in care

On April 23, 2026, Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver findings for a complaint of the allegations listed above. LPA met with Administrator Elizabeth Reynaga & Resident Care Director Natalie Levario. Regarding the allegation: Staff speak inappropriately in the presence of residents in care. LPA conducted multiple interviews and was informed there were previously incidents where staff were arguing with each other in front of the residents. Based on the Departments observations & interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Exit interview was conducted and a copy of this report LIC9099, LIC9099D, and appeal rights were provided to Administrator Elizabeth Reynaga. Substantiatedthe state’s words, verbatim · CDSS document, Apr 23, 2026 · control 24-AS-20260318155612

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(2) · Plan of correction due date: Apr 30, 2026

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: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by: Based on observation & interview, the facility did not comply with the regulation listed above due to staff inappropriately arguing in front of residents, which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 23, 2026

Plan of correction: Staff was previously terminated and staff have been informed of corrective action leading to possible termination. Licensee will provide a statement to the Dept by POC due date.

Type of visit: Case Management - Other

On April 20, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced. LPA explained the visit was for a case management due to the Dept receiving information a vape pen was at the facility. LPA met with Administrator Elizabeth Reynaga & Resident Care Director Natalie Levario. LPA, Administrator, and Resident Care Director went to the Hacienda bathroom and looked at the very top of the shelf for the vape inside of a glove. LPA did not observe a glove or vape pen in the bathroom. At this time there is no proof of where the vape pen came from, how long it was in the building, or who it belongs to. No deficiencies were observed and no citations were issued during this visit. Exit interview was conducted and a copy of this report will be emailed to Administrator Elizabeth Reynaga by the end of the day.the state’s words, verbatim · CDSS document, Apr 20, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today for the facility’s annual inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with Administrator Elizabeth Reynaga & Resident Care Direct Natalie Levario. Facility is licensed for 50 residents and has a current census of 24. There are 3 residents on hospice and 4 with home health. Water temperature was checked common bathrooms in each community and read at 105.0 degrees Fahrenheit. Fire Extinguisher was serviced December 24, 2025 and is within the safety regulation period. Sprinkler system was last checked February 6, 2026, and passed inspection. Carbon monoxide detectors were tested and in working order. Elizabeth Reynaga Administrator's Certification expires July 24, 2026. Staff files were reviewed, are complete, and current. Resident files were reviewed, complete, and current. First aid kit on site and complete. Toxins and cleaning supplies are locked and inaccessible. There is a locked storage room for medications. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms, bathrooms, medication storage, kitchen, and outdoor areas. Bedrooms were clean, properly furnished, with adequate lighting, and in good repair. Food supply is adequate for 2-day perishable. Facility was informed to have and 7-days of non-perishable food items and additional emergency food items. Facility will provide current physician reports for the list of residents discussed during today's visit by April 1, 2026. Facility was not able to provide quarterly disaster drill log. Deficiencies observed were cited during today's inspection per California Code of Regulations, Title 22. LPA's requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing by April 10, 2026. Exit interview conducted and a copy of this report LIC809, LIC809D, and appeal rights were provided to Administrator Elizabeth Reynaga.the state’s words, verbatim · CDSS document, Mar 27, 2026

Type of visit: Office

On 03/12/2026, an informal meeting was held at the Fresno Regional Office. The purpose of the informal meeting was to discuss recently identified issues/concerns associated with the operation of the facility. The informal meeting process was explained during this meeting. The following were in attendance at this meeting: Administrator, Elizabeth Reynaga Resident Care Director, Natalie Licensing Program Manager I, Alexandria Walton Licensing Program Analyst, Brianna Miranda During this meeting the following topics were discussed: · Staffing · Medications · Reporting Requirements · Administrator Qualifications & Duties Licensee stated the following: Medication audits will be conducted, and Licensee will look into monthly training, and updating reporting incidents. A plan of correction will be provided to the Dept by March 27, 2026. The Licensee was informed that continued issues or deficiencies with the above mentioned issues, may necessitate the Department to seek further action. Exit interview was conducted and a copy of this report was provided to Administrator Elizabeth Reynaga.the state’s words, verbatim · CDSS document, Mar 12, 2026

Allegation investigated: Staff does not ensure resident's medical needs are being met by a licensed nurse. Staff did not communicate with responsible party of resident's change of care plans. Staff consumes resident's meals without consent.

On March 5, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver finding for the allegations listed above. LPA met with Interim Executive Director Natalie Levario and Administrator Elizabeth Reynaga. The Department has investigated the allegation of: Staff does not ensure resident's medical needs are being met by a licensed nurse. LPA reviewed records and conducted multiple interviews which did not state resident's medical needs were not being met by licensed nurse. The Department has investigated the allegation of: Staff did not communicate with responsible party of resident's change of care plans. LPA conducted interviews with R3's family which stated they were aware of the changes made to hospice care plan. Unsubstantiated The Department has investigated the allegation of: Staff consumes resident's meals without consent. LPA conducted multiple interviews with staff and third parties which stated they have never heard of or seen staff eating off the resident's plate. 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 allegations are unsubstantiated. Exit interview was conducted and a copy of this report LIC9099 was provided to Administrator Elizabeth Reynaga.the state’s words, verbatim · CDSS document, Mar 5, 2026 · control 24-AS-20260218114036

Allegation investigated: Staff member worked while under the influence of drugs, impairing their ability to provide adequate care and supervision, which presents a risk to residents in care Staff does not provide adequate shower service Staff does not provide adequate food service Staff interact inappropriately with residents

On March 5, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver finding for the allegations listed above. LPA met with Interim Executive Director Natalie Levario and Administrator Elizabeth Reynaga. The Department has investigated the allegation of: Staff member worked while under the influence of drugs, impairing their ability to provide adequate care and supervision, which presents a risk to residents in care. LPA conducted multiple interviews which had conflicting information regarding staff being under the influence while at work. The Department has investigated the allegation of: Staff does not provide adequate shower service. LPA conducted multiple interviews and was provided conflicting information regarding residents not being showered properly. Unsubstantiated The Department has investigated the allegation of: Staff does not provide adequate food service. LPA conducted multiple interviews and was not informed of any issues with the food service. The Department has investigated the allegation of: Staff interact inappropriately with residents. LPA conducted multiple interviews and was provided conflicting information. LPA was not provided sufficient information. 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 allegations are unsubstantiated. Exit interview was conducted and a copy of this report LIC809 was provided to Administrator Elizabeth Reynaga.the state’s words, verbatim · CDSS document, Mar 5, 2026 · control 24-AS-20260205081606

Allegation investigated: Staff do not follow reporting requirements

On March 5, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver finding for the allegations listed above. LPA met with Interim Executive Director Natalie Levario and Administrator Elizabeth Reynaga. The Department has investigated the allegation of: Staff do not follow reporting requirements. LPA conducted multiple interviews. During the interviews it was stated R2 had fallen and an incident report was not provided to the Dept regarding the resident's fall. Based on the Departments interviews & records review the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Article 7, is being cited on the attached LIC 9099D. Exit interview was conducted and a copy of this report LIC9099, LIC9099D, and appeal rights were provided to Administrator Elizabeth Reynaga. Substantiatedthe state’s words, verbatim · CDSS document, Mar 5, 2026 · control 24-AS-20260205081606

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1) · Plan of correction due date: Mar 12, 2026

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement is not met as evidenced by: Based on observation, interview, and record, the facility did not comply with the regulation listed above, which poses a potential health and safety risk to residents in care. R1 fell while at the facility. Licensee failed to report the fall to the Dept.the state’s words, verbatim · CDSS document, Mar 5, 2026

Plan of correction: Licensee stated they will be sending the required reports. Licensee will send a statement to the Dept by POC due date.

Allegation investigated: Staff did not post required signs in the facility

On March 5, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver finding for the allegations listed above. LPA met with Interim Executive Director Natalie Levario and Administrator Elizabeth Reynaga. The Department has investigated the allegation of: Staff did not post required signs in the facility. LPA observed no signs posted for oxygen in use during initial visit on 2/18/2026. LPA conducted multiple interviews. During the interviews it was stated there were never any signs up indicating there was oxygen in use. Based on the Departments interviews & records review the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Article 11, is being cited on the attached LIC 9099D. Exit interview was conducted and a copy of this report LIC9099, LIC9099D, and appeal rights were provided to Interim Executive Director Natalie Levario. Substantiatedthe state’s words, verbatim · CDSS document, Mar 5, 2026 · control 24-AS-20260217132737

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87618(b)(3)(B) · Plan of correction due date: Mar 12, 2026

87618 Oxygen Administration - Gas and Liquid (b) In addition to Section 87611(b), the licensee shall be responsible for the following: (3) Ensuring that the use of oxygen equipment meets the following requirements: (B) "No Smoking-Oxygen in Use" signs shall be posted in the appropriate areas. This requirement is not met as evidenced by: Based on observation, interview, and record, the facility did not comply with the regulation listed above, which poses a potential health and safety risk to residents in care. LPA conducted multiple interviews which stated there were not signs regarding oxygen in use.the state’s words, verbatim · CDSS document, Mar 5, 2026

Plan of correction: Licensee will sent a statement regarding procedure for posting signs of oxygen in use. Verifications will be sent to the Dept by POC due date.

Allegation investigated: Staff mishandled a resident's medication

On March 5, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver finding for the allegations listed above. LPA met with Interim Executive Director Natalie Levario and Administrator Elizabeth Reynaga. The Department has investigated the allegation of: Staff mishandled a resident's mediation. LPA conducted multiple interviews with staff, and third party. LPA was informed there was a lapse with medication due to the medical coverage changing. This cause a resident's blood pressure to be elevated and to be sent to the emergency room. Based on the Departments interviews & records review the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Exit interview was conducted and a copy of this report LIC809, LIC809D, and appeal rights were provided to Administrator Elizabeth Reynaga. Substantiatedthe state’s words, verbatim · CDSS document, Mar 5, 2026 · control 24-AS-20260204151458

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(f)(4) · Plan of correction due date: Mar 6, 2026

87464 Basic Services (f) Basic services shall at a minimum include: (4) Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing and assistance with taking prescribed medications, as specified in Section 87608, Postural Supports. This requirement is not met as evidenced by: Based on observation, interview, and record, facility did not comply with the regulation listed above, which poses a potential health and safety risk to residents in care. Resident had a lapse in medication which caused the resident to go to the emergency room for high blood pressure.the state’s words, verbatim · CDSS document, Mar 5, 2026

Allegation investigated: Staff do not provide adequate care and supervision to residents in care.

On March 5, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver finding for the allegations listed above. LPA met with Interim Executive Director Natalie Levario and Administrator Elizabeth Reynaga. The Department has investigated the allegation of: Staff do not provide adequate care and supervision to residents in care. LPA conducted multiple interviews and was informed there was no Med Tech on duty on January 1, 2026 from about 3:00AM- 7:00AM. There was only one caregiver in each of the 2 communities. Based on observation, interviews, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Exit interview was conducted and a copy of this report LIC9099, LIC9099D, and appeal rights were provided to Administrator Elizabeth Reynaga. Substantiatedthe state’s words, verbatim · CDSS document, Mar 5, 2026 · control 24-AS-20260105142846

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(a) · Plan of correction due date: Mar 12, 2026

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This requirement is not met as evidenced by: Based on observation, interview, and record, facility did not comply with the regulation listed above, which poses a potential health and safety risk to residents in care. On January 1, 2026 the facility had no Med Tech on duty from 3:00AM-7:00AM.the state’s words, verbatim · CDSS document, Mar 5, 2026

Allegation investigated: Staff do not provide residents medications as prescribed.

On March 5, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver finding for the allegations listed above. LPA met with Interim Executive Director Natalie Levario and Administrator Elizabeth Reynaga. The Department has investigated the allegation of: Staff do not provide residents medications as prescribed. LPA conducted multiple interviews and reviewed records. The records show R1 was given Hydrocodone on 1/1/2026 at 7:25 AM. Records also show R1's doctor was notified. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Exit interview was conducted and a copy of this report LIC9099 was provided to Administrator Elizabeth Reynaga. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 5, 2026 · control 24-AS-20260105142846

Allegation investigated: Staff caused injury to resident in care Staff handled resident in a rough manner Staff did not seek medical care for resident after injury

On March 5, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver finding for the allegations listed above. LPA met with Interim Executive Director Natalie Levario and Administrator Elizabeth Reynaga. The Department has investigated the allegation of: Staff caused injury to resident in care. LPA reviewed records and conducted multiple interviews with residents, staff, and third parties. During the interviews LPA was not informed of incidents regarding the allegation above. The Department has investigated the allegation of: Staff handled resident in a rough manner. LPA reviewed records and conducted multiple interviews with residents, staff, and third parties. During the interviews LPA was not informed of incidents regarding the allegation above. Unsubstantiated The Department has investigated the allegation of: Staff did not seek medical care for resident after injury. LPA reviewed records and conducted multiple interviews with residents, staff, and third parties. During the interviews LPA was not informed of any incidents regarding the allegation above and there were no specifics provided of who did not receive medical care after injury. LPA did not observer records of residents being injured and staff not seeking medical care. Although the allegations 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 allegations are unsubstantiated. Exit interview was conducted and a copy of this report LIC9099 was provided to Administrator Elizabeth Reynagathe state’s words, verbatim · CDSS document, Mar 5, 2026 · control 24-AS-20260128084336

Type of visit: Case Management - Deficiencies

On 2/13/26, Licensing Program Analyst (LPA) J. Leffall conducted a case management. The purpose of the Case Management was from an interview that LPA conducted with R1's Responsible Party. LPA reviewed R1's medications and MAR in the Med-Tech room. Based on interview and record review, the following are medication errors: Quetiapine Fumara 25 mg tablet. Take 1 tablet by mouth daily. Start date is 1/25/26. A total of 20 tablets should have punched out. A total of 26 tablets were punched out which is 6 over the required count. Vitamin D3 2000U 50 MCG take 1 tablet by mouth daily. Start date is 1/8/26. A total of 183 tablets should have been taken. A total of 195 tablets were counted in medication count which equals 12 pills under the required count. Metoprolol Suc ER 25 MG tabl ER 24H Take 1 tablet every day by mouth for 90 days. A total of 71 tablets should have been taken. The start date is January 26, 2026. A total of 72 were counted in medication count which equals to 1 pill under the required count. A citation is issued on the attached 809-D wtih appeal rights regarding medications not ordered timely. A copy of this report and Appeal Rights was distributed to Administrator whose signature confirms the receipt of this report.the state’s words, verbatim · CDSS document, Feb 13, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(4) · Plan of correction due date: Feb 14, 2026

a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. Based on records reviewed and interviews conducted, Quetiapine Fumara 25 mg tablet. Take 1 tablet by mouth daily. Start date is 1/25/26. A total of 20 tablets should have punched out. A total of 26 tablets were punched out which is 6 over the required count. Vitamin D3 2000U 50 MCG take 1 tablet by mouth daily. Start date is 1/8/26. A total of 183 tablets should have been taken. A total of 195 tablets were counted in medication count which equals 12 pills under the required count. Metoprolol Suc ER 25 MG tabl ER 24H Take 1 tablet every day by mouth for 90 days. A total of 71 tablets should have been taken. A total of 72 were counted in medication count which equals to 1 pill under the required count, which poses an immediate Health & Safety risk to the residents.the state’s words, verbatim · CDSS document, Feb 13, 2026

Plan of correction: Licensee agrees to have all medication technicians complete medication training and submit completion reports to CCLD by POC due date.

Allegation investigated: Staff caused injuries to residents in care Staff changed residents diapers without wearing gloves as a protective barrier Staff did not provide proper supervision to residents in care Staff did not provide shower assistance to residents in care

Licensing Program Analyst (LPA) Daiquiri Boyd conducted the closing complaint investigation visit to the facility. During this visit LPA delivered investigation findings regarding the above allegations. The Department has investigated the complaint alleging: Facilty staff caused injuries to resdients in care. Facility staff changed residents diapers without wearing gloves as a protective barrier. Staff did not provide proper supervision to residents in care. Staff did not provide shower assistance to residents in care. LPA could find no basis for the allegations and found safegards in place for proper care of residents. Based on the interviews conducted and/or records review the above allegation is UNSUBSTANTIATED. 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 allegations are unsubstantiated. Unsubstantiatedthe state’s words, verbatim · CDSS document, Dec 5, 2025 · control 24-AS-20250919081207

Allegation investigated: Staff spoke inappropriately to resident in care

On 6/17/2025, Licensing Program Analyst (LPA) R Bruce conducted an unannounced visit to investigate and deliver findings on this complaint. LPA met with Elizabeth Reynaga Administrator (AD) and Natalie Levario, Resident Care Director. LPA conducted interviews and reviewed records. The allegation was regarding a staff member (S1) using inappropriate language in front of/ and or directed towards the resident. There were witnesses to the incident, and the staff member in question admitted to swearing. LPA reviewed records and conducted interviews during the investigation. Based on the above information, the preponderance of evidence standard has been met. The allegation is SUBSTANTIATED. Deficiency cited on the attached 9099 D Substantiatedthe state’s words, verbatim · CDSS document, Jun 17, 2025 · control 24-AS-20250609122031

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Jun 17, 2025

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 was not met as evidenced by: Licensee did not ensure residents were spoken to appropriately. After conducting interviews it was determined that S1 spoke inappropriately to residents in care which poses an immediate health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jun 17, 2025

Plan of correction: Facility has provided retraining to S1 and placed her on probation. Training included resident rights, abuse prevention, proper care of dementia, behavioral expectations and professional standards. POC to be cleared at today's visit.

Type of visit: Case Management - Deficiencies

On 5/23/2025, Licensing Program Analysts (LPA) Rachel Bruce and Daiquiri Boyd conducted an unannounced case management visit and met with Elizabeth Reynaga, Administrator (AD). The purpose of the visit was to discuss a recent incident report submitted on May 19, 2025 from the above facility. The incident report was regarding a medication error and described that on May 16, 2025 a staff Medication Tech (MT) gave the wrong medication to a resident (R1). MT self reported the error to her supervisor and immediately R1's doctor was notified. R1 was monitored by staff and at approximately 11:30 am it was decided to send R1 to the hospital for lab work and to ensure there were no ell effects from the medication that had been given to her in error. Ultimately it was determined that there were no signs of any side effects and R1 was released to return to the facility. LPA and AD discussed the incident and the seriousness of the mistake. At today's visit the facility will be receiving a citation for the error. See attached confidential names list and deficiency page.the state’s words, verbatim · CDSS document, May 23, 2025

From the deficiency page — Deficiency type: Type A · Section cited: HSC 87464(f)(4) · Plan of correction due date: May 23, 2025

Basic Services (4) Personal assistance and care as needed by the resident ... with those activities of daily living such as ... assistance with taking prescribed medications This requirement was not met as evidenced by A medical technician self reported that she had distributed the wrong medication to a resident in care. This poses an immediate risk to the care and well being of the residents in care.the state’s words, verbatim · CDSS document, May 23, 2025

Plan of correction: The staff member will be terminated and is currently on administrative leave. The medical technician staff members have already undergone refresher training. The plan of correction will be cleared at today's visit.

Allegation investigated: Staff did not provide an authorized representative access to a resident's records

Licensing Program Analyst (LPA) R Bruce conducted an unannounced complaint investigation visit for the purpose of delivering the finding for the above allegation. LPA Bruce met with Administrator Elizabeth Reynaga. During the course of this investigation LPA reviewed facility files relevant to the complaint investigation, as well as conducting interviews. It was determined that the above allegation: Staff not providing medical records to a resident representative is UNFOUNDED. Resident R1's spouse indicated that records have been provided. Administration verified that to be true. This agency has investigated the complaint and found it be UNFOUNDED meaning that the allegation was false, could not have happened or is without a reasonable basis. The complaint has been dismissed. An exit interview was conducted a copy of the report provided to the administrator. Unfoundedthe state’s words, verbatim · CDSS document, May 6, 2025 · control 24-AS-20250410151052

Allegation investigated: Staff do not ensure resident does not physically assualt other residents Due to lack of supervisoin, resident physically assalts other residents

Licensing Program Analyst (LPA) R Bruce conducted an unannounced complaint investigation visit for the purpose of delivering the finding for the above allegations. LPA Bruce met with Administrator Elizabeth Reynaga. During the course of this investigation LPA reviewed facility files relevant to the complaint investigation, as well as conducting interviews. It was determined that the above allegations: Staff not providing supervision resulting in physical assaults and staff not ensureing that residents do not physically assualt each other are both found to be UNFOUNDED. Staff respond appropriately to incdents between residents. Due to memory/dementia issues it is unpredictable when resdient's may act out but it is not due to lack of supervision. Based on the investigation it has been determined the allegations are UNFOUNDED meaning that the allegations were false, could not have happened or are without a reasonable basis. The complaint has therefore sbeen dismissed. An exit interview was conducted a copy of the report provided to the administrator. Unfoundedthe state’s words, verbatim · CDSS document, May 6, 2025 · control 24-AS-20250214165004

Type of visit: Required - 1 Year

On 02/20/24, Licensing Program Analyst (LPA) Rachel Bruce conducted an unannounced Annual Required inspection visit. LPA introduced self, stated purpose of visit, and was allowed entrance. LPA met with Executive Director Krista Wilson and Administrator Elizabeth Reynaga. LPA toured the facility inside and out to include kitchen, dining/living room area, sample of bedrooms, and sample of bathrooms. LPA observed the facility to be clean, free from clutter, and odor free. Facility has a current census of 27 with a capacity of 50. All fire exit routes were clear and free from obstructions. Fire extinguishers (24) were current and in good standing. Water temperature read at 102 degrees Fahrenheit in the Heartland community bathroom. Water was also tested in a resident's bathroom and read at 105.8 degrees Fahrenheit. Medications are stored in a locked room. Toxins, cleaning supplies, knives and sharp objects are secured and inaccessible to residents. Facility has shared rooms and private rooms. Each room has it's own bathroom. Smoke alarms were previously tested by an outsource company and are in working condition. Last test was conducted on 12/20/2024. Fire system and security inspection was completed on 1/3/2025- no issues. LPA reviewed a sample of staff files (5) which are current and up to date. LPA reviewed a sample of resident files (5) which were current with proper documentation. No citations issued per the California Code of Regulations Tittle 22. Exit interview was conducted with Executive Director Krista Willson and Administrator Elizabeth Reynaga, copy of report LIC809 was provided to Krista Willson.the state’s words, verbatim · CDSS document, Feb 21, 2025

Allegation investigated: Staff did not seek timely medical care for residents in care Staff hit resident in care

On February 12, 2025, Licensing Program Analyst (LPA) Rachel Bruce conducted a visit to the facility for the purpose of delivering the findings on the above allegations. During the course of this investigation LPA reviewed facility files, toured facility, and conducted interviews relevant to the complaint investigation. Based on the investigative information it was determined that the above allegations: Staff did not seek timely medical care for residents in care - This was referring to two clients that were allegedly not taken to the doctor. In both cases interviews and medical records provided evidence to the contrary. Staff hit resident in care- this was referring to an incident where a resident threw a slipper at another resident. Although it was unwitnessed, police report and interview statements indicate it was resident to resident and no staff was involved or even present at the incident. Bot allegations are UNFOUNDED. This agency has investigated the complaint allegations and have found them to be unfounded. Therefore we have dismissed the complaint. Unfoundedthe state’s words, verbatim · CDSS document, Feb 12, 2025 · control 24-AS-20250207081803

Allegation investigated: Staff drinks alcohol while working at the facility Staff are not providing activities for residents

On 11/18/24 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver the finding for the allegation(s) listed above. LPA introduced herself and explained the reason for the visit and met with Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga. 1. The Department investigated the allegation: Staff drinks alcohol while working at the facility. LPA conducted multiple interviews with staff members and third parties. Interviewees stated they have never witnessed any staff members drinking at the facility or intoxicated while at the facility. 2. The Department investigated the allegation: Staff are not providing activities for residents. LPA reviewed the activity calendars at the facility and conducted multiple interviews with residents, staff members, and third parties. Interviewees stated there are various types of activities done at the facility. Examples of activities are coloring, puzzles, various games, and sometimes one on one with residents. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated . Exit interview was conducted and a copy of this report was provided to Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga. Unsubstantiatedthe state’s words, verbatim · CDSS document, Nov 18, 2024 · control 24-AS-20240523090456

Allegation investigated: Staff spoke inappropriately to residents Staff handled resident in a rough manner Staff coerced resident to take their medication by withholding food Staff mismanaged residents’ medication

On 11/18/24 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver the finding for the allegation(s) listed above. LPA introduced herself and explained the reason for the visit and met with Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga. 1. The Department investigated the allegation: Staff spoke inappropriately to residents. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated they did not witness residents being spoken to inappropriately. Some interviewees stated S1 can be firm or serious, but not inappropriate. 2. The Department investigated the allegation: Staff handled resident in a rough manner. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated they did not witness residents being handled by staff in a rough manner. Unsubstantiated 3. The Department investigated the allegation: Staff coerced resident to take their medication by withholding food. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated they did not witness staff members withholding food to coerce residents to take their medications. 4. The Department investigated the allegation: Staff mismanaged residents’ medication. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated they did not witness staff mismanaging resident's medications. LPA reviewed medication logs and did not find any discrepancies. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. Exit interview was conducted and a copy of this report was provided to Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga.the state’s words, verbatim · CDSS document, Nov 18, 2024 · control 24-AS-20240607142820

Allegation investigated: Staff caused injuries to resident in care Staff handled resident in a rough manner Staff are not meeting resident's diapering needs Facility is not kept clean Facility is not kept free of pests Staff refused to shower resident in care

On 11/18/24 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver the finding for the allegation(s) listed above. LPA introduced herself and explained the reason for the visit and met with Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga. 1. The Department investigated the allegation: Staff caused injuries to resident in care. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees did not state resident injuries were caused by staff members. 2. The Department investigated the allegation: Staff handled resident in a rough manner. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated they did not witness residents being handled by staff in a rough manner. Unsubstantiated 3. The Department investigated the allegation: Staff are not meeting resident's diapering needs. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated residents are changed after every meal, every two hours, or as needed. Some interviewees stated the residents are checked every hour. 4. The Department investigated the allegation: Facility is not kept clean. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated facility is always kept very clean. LPA toured the facility and did not find the facility to be kept unclean. 5. The Department investigated the allegation: Facility is not kept free of pests. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated there was one baby mouse found at the facility and it was removed immediately. Interviewees stated there is a monthly exterminator that services the facility. LPA toured the facility and did not find any pest debris or droppings. 6. The Department investigated the allegation: Staff refused to shower resident in care. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated residents are showered 2-3 times a week. If a resident does not want to shower the staff tried different methods to get the resident to shower and if the residents request a shower they are given a shower. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated Exit interview was conducted and a copy of this report LIC9099 and LIC9099D were provided to Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga.the state’s words, verbatim · CDSS document, Nov 18, 2024 · control 24-AS-20241115122005

Allegation investigated: Staff did not ensure resident received medical attention in a timely manner. Staff does not ensure residents are spoken to in appropriate manner. Staff does not ensure the facility is kept in clean sanitary conditions for residents in care Staff does not ensure residents care needs are being met Staff does not ensure medications are dispensed as prescribed Staff does not ensure residents records are properly managed Staff does not ensure medications are properly stored Staff does not ensure food of good quality is served to residents Staff does not ensure residents dietary plan is being followed

On 11/18/24 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver the finding for the allegation(s) listed above. LPA introduced herself and explained the reason for the visit and met with Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga. 1. The Department investigated the allegation: Staff did not ensure resident received medical attention in a timely manner. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated they have not witnessed residents not receiving medical attention in a timely manner. Interviewees stated staff are quick to assist resident in need and to be sent out to the hospital is needed. 2. The Department investigated the allegation: Staff does not ensure residents are spoken to in appropriate manner. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated they have not witnessed residents being spoken to inappropriately. Unsubstantiated 3. The Department investigated the allegation: Staff does not ensure the facility is kept in clean sanitary conditions for residents in care. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees did not report the facility to be unclean or unsanitary. LPA toured the facility and did not observe the facility to be unclean or unsanitary. 4. The Department investigated the allegation: Staff does not ensure residents care needs are being met. LPA conducted multiple interviews with residents, staff members and third parties. Interviewees did not state the resident's needs are not being met. 5. The Department investigated the allegation: Staff does not ensure medications are dispensed as prescribed. LPA conducted multiple interviews with residents, staff members and third parties. None of the interviewees stated medications are not being dispensed as prescribed. LPA reviewed medications and did not find any deficiencies. 6. The Department investigated the allegation: Staff does not ensure residents records are properly managed. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees did not state resident's records are not be properly managed. LPA reviewed a sample of resident files. 7. The Department investigated the allegation: Staff does not ensure medications are properly stored. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees did not state resident's medications are not being properly stored. LPA observed medication room and did not observe any discrepancies. 8. The Department investigated the allegation: Staff does not ensure food of good quality is served to residents. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated the food is of good quality. Multiple interviewees stated they eat at the facility and the food is great. LPA observed the kitchen which had sufficient food supply, variety, and stored food properly. 9. The Department investigated the allegation: Staff does not ensure residents dietary plan is being followed. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated resident's dietary plans are being followed. LPA reviewed food plans and did not find any discrepancies. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. Exit interview was conducted and a copy of this report LIC9099 & LIC9099D were provided to Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga.the state’s words, verbatim · CDSS document, Nov 18, 2024 · control 24-AS-20240729111516

Allegation investigated: Resident sustained an unexplained injury while in care

On 11/18/24 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver the finding for the allegation(s) listed above. LPA introduced herself and explained the reason for the visit and met with Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga. 1. The Department investigated the allegation: Resident sustained an unexplained injury while in care. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees did not recall a resident sustaining an unexplained injury while in care. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. Exit interview was conducted and a copy of this report LIC9099 was provided to Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga. Unsubstantiatedthe state’s words, verbatim · CDSS document, Nov 18, 2024 · control 24-AS-20240812083531

Type of visit: Case Management - Health Checks

On 11/18/2024 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to conduct a health and safety case management visit. LPA introduced herself and explained the reason for the visit and met with Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga. The facility reported to LPA, R1 who is currently at the hospital testing positive for fentanyl. The Emergency room reached out to the facility to inform. This medication is not prescribed to R1. LPA toured the facility and verified medications are locked and inaccessible to residents in care. LPA observed residents to be interacting with one another and with staff. ED stated none of the residents have been prescribed fentanyl. LPA did not observe any deficiencies and no citation were issued. Follow-up visit may be conducted at another time. Exit interview was conducted and a copy of this report was provided to Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga.the state’s words, verbatim · CDSS document, Nov 18, 2024

Type of visit: Required - 1 Year

On 2/5/24, Licensing Program Analyst (LPA) B. Miranda conducted an unannounced Annual Required visit. LPA introduced self, stated purpose of visit, and was allowed entrance. LPA met with Executive Director Krista Willson and Administrator Elizabeth Reynaga. LPA toured the facility inside and out to include kitchen, dining/living room area, sample of bedrooms, and sample of bathrooms. LPA observed the facility to be clean, free from clutter, and odor free. Facility has a current census of 16 with a capacity of 50. All fire exit routes were clear and free from obstructions. Fire extinguishers were current and in good standing. Water temperature read at 111.9 degrees Fahrenheit in the Heartland community bathroom. Water was also tested in a resident's bathroom and read at 106.8 degrees Fahrenheit. Medications are stored in a locked room. Toxins, cleaning supplies, knives and sharp objects are secured and inaccessible to residents. Facility has shared rooms and private rooms. Each room has it's own bathroom. Smoke alarms were previously test by an outsource company and are in working condition. LPA reviewed a sample of staff files which are current and up to date. LPA reviewed a sample of resident files which were current with proper documentation. No citations issued per the California Code of Regulations Tittle 22. Exit interview was conducted with Executive Director Krista Willson and Administrator Elizabeth Reynaga, copy of report LIC809 was provided to Krista Willson.the state’s words, verbatim · CDSS document, Feb 5, 2024