Westmont of Fresno

Type of visit: Case Management - Incident

On 06/19/2026, Licensing Program Analysts (LPAs) M Vega and A Porter arrived at the facility unannounced. LPAs conducted a Case Management visit. LPA was greeted by receptionist and stated the purpose of the visit. LPA met Executive Director - Eddie Rangel. This case management visit is being conducted for two separate Special Incident Reports (SIR) dated 05/27/2026 and 6/10/2026. Incident report dated 5/27/2026 R1 was sent to the ER and was diagnosed with an infection. Interview with ED disclosed that resident was out of the facility and when R1 returned they were observed to have a high fever and were sent out by facility per facility LVN request. The second Special Incident Report (SIR) dated 06/10/2026 reported R2 was contacted by external persons requesting money, the facility was made aware and put a stop to the situation, ED will provide LPA police report At this time, the case management visit does require a police report for incident on 06/10/2026 based on information provided by ED to LPAs. No deficiencies cited during todays visit. Exit interview completed with Executive Director. A copy of this report was provided to ED for facility records.the state’s words, verbatim · CDSS document, Jun 19, 2026

Type of visit: Required - 1 Year

On 06/19/2026, Licensing Program Analysts (LPAs) M Vega and A Porter arrived at the facility unannounced to conduct a Required Annual Inspection. LPAs were greeted by custodian and stated the purpose of the visit. LPAs met with Executive Director (ED) - Eddie Rangel. LPAs conducted tour inside and out of facility with ED. Residents were observed at the facility after breakfast in common areas and other residents were in their rooms. The facility was observed to be at a comfortable temperature of 74 to 76 degrees throughout, good repair, and no passageway obstructions or fire hazards observed. Fire extinguisher was observed with a service date of 01/15/2026. Fire alarm inspection, 03/25/2026. Fire drill recorded 05/30/2026. Generator Tested 06/13/2026. A sample of residents’ file was reviewed to have updated emergency contact, Admission agreement, Needs and Services Plan and Pre-Appraisal Plan. A sample of staff files were reviewed. Staff files were observed to have current First Aid/CPR, Health screening, and Personnel record. Staff are fingerprint cleared and associated to the facility. Dining area and Kitchen were toured. An adequate supply of perishable and non-perishable food was observed to be properly stored in walk-in freezer, walk-in refrigerator, and pantry. Refrigerator temperature was maintained at 40.0-degree F. and freezer was maintained at -10 -degree F. LPAs toured laundry room and observed chemicals were stored and inaccessible to residents in care. Continuation on LIC 809C LPAs toured a sample of resident bedrooms. Residents' rooms were toured and observed with adequately furnished with bed, dresser, and adequate lighting. Hot water temperature tested at 3 different locations, assisted living resident room at 107.2 Degrees F, Bathroom 2 tested at 113.5 Degrees F. On the memory side of things resident bathroom rested at 110.5 Degrees F. LPA observed securely fastened grab bars and non-skid mat in shower areas. Medications were stored in a locked medication room in a medication cart. Medications records were reviewed. First Aid Kit was stored in medication room and observed with all required items. Reviewed Emar and conducted medication count, accurate at time of inspection. Facility exterior was toured and observed to be free from debris. There was outdoor shaded seating available for the residents. Community Care Licensing (CCL) is always striving to have facility files that reflect the most accurate and up to date information for your facility. In an effort to maintain your facility file, please submit the most current and complete forms and/or information as identified below: Residential Care Facility for the Elderly (RCFE) LIC 308 Designation of Facility Responsibility LIC 309 Administrative Organization LIC 400 Affidavit Regarding Client/Resident Cash Resources LIC 402 Surety Bond LIC 500 Personnel Report LIC 610E Emergency And Disaster Plan For Residential Care Facilities For The Elderly LIC 9020 Register of Facility Clients/Residents Copy of current Liability Insurance Copy of current Administrator Certificate Alternate contact information including name, telephone number, & email address. Please submit the above forms/information to Fresno CCL by: 07/03/2026 As an operator of a Community Care Licensed facility it is your responsibility to be aware of and in compliance with all regulations, including Chaptered Legislation. Go to www.ccld.ca.gov to stay updated and informed. No deficiencies issued during this inspection. An exit interview was conducted with the Executive Director A copy of this report was given to ED whose signature on this form confirms receipt of these reports.the state’s words, verbatim · CDSS document, Jun 19, 2026

Allegation investigated: Faciltiy not following Admission Agreement

On 03/19/2026, Licensing Program Analyst (LPA) M Vega conducted an unannounced complaint investigation visit to the facility. During this visit LPA opened initial 10 day and delivered investigation findings regarding the above allegation. LPA was granted access to the facility by front desk staff. LPA met with Executive Director (ED) - Eddie Rangel. During the course of this investigation LPA reviewed facility files relevant to the complaint investigation. It was determined that the above allegation: “Facility not following Admission Agreement” is UNFOUNDED. Per review of Facility roster, billing agreement, and admissions agreement. Billing agreement clearly states timeframes that coverage will be provided by third party for payment to facility. 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 and a copy of the report provided to the Executive Director for facility records. Unfoundedthe state’s words, verbatim · CDSS document, Mar 19, 2026 · control 24-AS-20260317113339

Allegation investigated: Staff does not ensure visitations are not infringing on the rights of the resident

On 02/13/2026, Licensing Program Analyst (LPA) M Vega conducted an unannounced complaint investigation visit to the facility. During this visit LPA delivered investigation findings regarding the above allegation. LPA was granted access to the facility by front desk staff. LPA met with Business Office Director - Nancy Krompicha and Executive Director - Eddie Rangel 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 does not ensure visitations are not infringing on the rights of the resident is UNFOUNDED. Resident 1 (R1) and Responsible Party (RP) has no documented court order to restrict who can and cannot visit R1. Business Office Director and Executive Director 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 and a copy of the report provided to the Executive Director for facility records. Unfoundedthe state’s words, verbatim · CDSS document, Feb 13, 2026 · control 24-AS-20251215105836

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) M Vega arrived unannounced to conduct a Case Management visit on 12/12/2025. LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit. LPA served Decision and Order excluding Staff 1 (S1) from being present inside the facility. LPA requested a current and updated Personnel Report (LIC 500) and Guardian account be updated to remove S1 from the facility staff roster. A notice of completion shall be submitted to Community Care Licensing (CCL). LPA informed Administrator (AD) Eddie Rangel that S1 is not allowed to be employed and/or on any facility premises. The Decision and Order of Exclusion From All Facilities came into effect as of 11/17/2025 upon receipt of the letter. A copy of the letter was given to facility Administrator (AD) Eddie Rangel during this visit. Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed and cited. Exit interview held with Administrator (AD) Eddie Rangel, A Copy of report given.the state’s words, verbatim · CDSS document, Dec 12, 2025

Allegation investigated: Staff is not adhering to the admission agreement Staff did not ensure the facility transportation bus was fixed timely

On 11/07/2025, Licensing Program Analyst (LPA) M Vega arrived at facility and was allowed access to facility by staff. LPA conducted an unannounced inspection at the facility and met with Administrator - Eddie Rangel. The purpose of the visit was to close a complaint investigation and deliver findings regarding the above allegation. It was alleged that the facility was not, Staff is not, adhering to the admission agreement, Staff did not ensure the facility transportation bus was fixed timely. There are reports that indicate the main bus transport was in repair shop being worked on and that facility still had van to shuttle residents and also had invoices that show alternate methods of transportation available. Therefore, determined the allegation is unfounded. Continuation on LIC 9099C Unfounded This agency has investigated the complaints alleging “Staff is not adhering to the admission agreement and Staff did not ensure the facility transportation bus was fixed timely” We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened or is without a reasonable basis. We have found that the complaint was unfounded, therefore we have dismissed the complaint. No deficiencies were observed at the time of this visit nor any deficiencies issued. Exit interview conducted. A copy of this report was provided to the administrator, signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Nov 7, 2025 · control 24-AS-20251017155436

Allegation investigated: Facility does not have enough staff for residents in care Facility does not have an Activities Director

On 7/7/25, Licensing Program Analyst (LPA) M Vega arrived unannounced to deliver complaint findings. LPA introduced self, stated the purpose of the visit, and met with Administrator - Eddie Rangel. During the course of the investigation, the Department conducted record review and toured the facility. Based on documentation gathered, allegation alleging Facility does not have enough staff for residents in care and Facility does not have an Activities Director, the preponderance of evidence standard has not been met, therefore, the above allegation is found to be UNSUBTANTIATED. No deficiencies were issued. Exit interview conducted. A copy of this report was provided to the administrator, signature confirms receipt of this report. Unsubstantiated This agency has investigated the complaint alleging “maintaining, Resident bathrooms are unsanitary, Resident assaulted another resident, Facility did not seek medical services in a timely manner and Neglect / lack of supervision resulting in an injury.” We have found that the complaint(s) are unfounded, meaning that the allegations were false, could not have happened or is without a reasonable basis. We have found that these allegations were unfounded, therefore we have dismissed the allegations listed above. No deficiencies were issued. Exit interview conducted. A copy of this report was provided to the administrator, signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Jul 17, 2025 · control 24-AS-20250313163105

Allegation investigated: Staff did not respond to resident's call button in a timely manner Staff left resident in a soiled diaper for a long period of time

On 07/17/2025, Licensing Program Analyst (LPA) M Vega conducted an unannounced inspection at the facility and met with Administrator - Eddie Rangel. The purpose of the visit was to close a complaint investigation and deliver findings regarding the above allegation. It was alleged that the facility was not Staff did not respond to resident's call button in a timely manner and Staff left residents in a soiled diaper for a long period of time (R1- see attached confidential names list). Based on documentation collected and record review it has been determined that the facility does ensure R1 receives appropriate level of care per documentation received and therefore, determined the allegation is unfounded. Continuation on LIC 9099C Unfounded This agency has investigated the complaint alleging “Staff did not respond to resident's call button in a timely manner and Staff left residents in a soiled diaper for a long period of time” We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened or is without a reasonable basis. We have found that the complaint was unfounded, therefore we have dismissed the complaint. No deficiencies were issued. Exit interview conducted. A copy of this report was provided to the administrator, signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Jul 17, 2025 · control 24-AS-20250313131536

Type of visit: Required - 1 Year

On 07/10/2025, Licensing Program Analyst (LPA) M Vega arrived at the facility unannounced to conduct Required Annual Inspection. LPA was greeted by receptionist and stated the purpose of the visit. LPA met with Executive Director (ED) Eddie Rangel. LPA conducted tour inside and out of facility with ED. Residents were observed at the facility after breakfast in common areas and other residents were in their rooms. The facility was observed to be at a comfortable temperature of 74 degrees, clean, in good repair, and no passageway obstructions or fire hazards observed. Fire extinguisher was observed with a service date of 01/13/2025. Dining area and Kitchen were toured. An adequate supply of perishable and non-perishable food was observed to be properly stored in walk-in freezer, walk-in refrigerator, and pantry. Food is delivered twice a week. Refrigerator temperature was maintained at 43.0-degree F. and freezer was maintained at -6-degree F. LPA toured a sample of resident bedrooms. Residents' rooms were toured and observed with adequately furnished with bed, dresser, and adequate lighting. Hot water temperature tested at 4 different locations, assisted living resident room at 111.3 Degrees F, General Bathroom tested at 107.4 Degrees F. On the memory side of things resident bathroom rested at 110.8 Degrees F and the general restroom tested at 105.4 Degrees F. LPA observed securely fastened grab bars and non-skid mat in shower areas. Report continued on attached LIC 809C Medications were stored in a locked medication room in a medication cart. Medications records were reviewed. First Aid Kit was stored in medication room and observed with all required items. LPA toured laundry room and observed chemicals were stored and locked. Facility courtyard was toured and observed to be free from debris. There was outdoor shaded seating available for the residents. A sample of residents’ file was reviewed to have updated emergency contact, Admission agreement, Needs and Services Plan and Pre-Appraisal Plan. A sample of staff files were reviewed. Staff files were observed to have current First Aid/CPR, Health screening, and Personnel record. Staff are fingerprinted clear and associated to the facility. Community Care Licensing (CCL) is always striving to have facility files that reflect the most accurate & up to date information for your facility. In an effort to maintain your facility file, please submit the most current & complete forms &/or information as identified below: Residential Care Facility for the Elderly (RCFE): LIC 308 Designation of Facility Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly LIC 9020 Register of Facility Clients/Residents Please submit the above forms/information to Fresno CCL by: 07/24/25 As an operator of a Community Care Licensed facility it is your responsibility to be aware of and in compliance with all regulations, including Chaptered Legislation. Go to www.ccld.ca.gov to stay updated and informed.the state’s words, verbatim · CDSS document, Jul 10, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) M Vega arrived unannounced to conduct a Case Management visit on 02/21/2025 at 08:15 a.m.. LPA was greeted by receptionist and stated the purpose of the visit. Executive Director was called and notified of LPA arrival. LPA met with Executive Director (ED) Eduardo Rangel. LPA served Decision and Order excluding Staff 1 (S1) from being present inside the facility. LPA requested a current and updated Personnel Report (LIC 500) and Guardian account be updated to remove S1 from the facility staff roster. A notice of completion shall be submitted to Community Care Licensing (CCL). LPA informed Executive Director (ED) Eduardo Rangel that S1 is not allowed to be employed and/or on any facility premises. The Decision and Order of Exclusion From All Facilities came into effect as of 02/21/25 upon receipt of the letter. A copy of the letter was given to facility Executive Director (ED) Eduardo Rangel during this visit. Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed and cited. Exit interview held Executive Director (ED) Eduardo Rangel. A copy of this report was provided to the ED, whose signature on this form confirm receipt of this report.the state’s words, verbatim · CDSS document, Feb 21, 2025

Allegation investigated: Staff do not ensure privacy while providing personal care to residents

On 01/28/2024, Licensing Program Analyst (LPA) M Vega visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Eduardo Rangel and stated the purpose of the visit. During this visit LPA conducted interviews of 3 staff members interviews. 2 out of 3 staff members stated the allegations did not occur. Allegation: Staff do not ensure privacy while providing personal care to residents Although the above allegations may have happened or are 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 conducted, report signed and copy of this report was printed and provided to the Administrator for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jan 28, 2025 · control 24-AS-20241029140334

Type of visit: Case Management - Incident

On 01/28/2025, Licensing Program Analyst (LPA) M Vega arrived at the facility unannounced to conduct a Case Management visit. LPA was greeted by receptionist and stated the purpose of the visit. LPA met with Executive Director (ED) Eduardo Rangel. LPA conduced a follow-up on an incident report submitted to licensing 12/17/2024, in which it was reported that Client #1 was out of medication for 6 days. Incident was reported to ED and the client's Physician was notified. Client was placed on observation with no issues observed. Med Tech was was disciplined and retrained on medication administration and is being closely monitored for the foreseeable future with daily checks. ED stated that all Med Techs were retrained. No deficiencies were cited because immediate and appropriate action was taken.the state’s words, verbatim · CDSS document, Jan 28, 2025

Allegation investigated: Facility staff did not dispense resident’s medication as prescribed. Facility staff did not provide adequate supervision of children in care. Facility staff do not communicate with resident’s authorized representative. Facility staff left residents in soiled diapers for an extended period of time. Facility staff did not ensure restroom is clean and sanitized. The resident’s room is malodorous.

On 10/09/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Allegation: Facility staff did not dispense resident’s medication as prescribed. Based on staff interview and records review no orders to provide Zyprexa to resident 1 (R1) Although Tramadol ordered as 1 tablet by mouth every six (6) hours for pain as needed. Allegation: Facility staff did not provide adequate supervision of children in care. Based on interview and records review no children observed at the facility to supervise. . Report continues on attached LIC-9099 C Unsubstantiated Allegation: Facility staff do not communicate with resident’s authorized representative. Based on interview and records review facility communicated with resident responsible party and communication was not denied. Allegation: Facility staff left residents in soiled diapers for an extended period of time. Based on interview and records review staff check on residents every 30 minutes. Allegation: Facility staff did not ensure restroom is clean and sanitized. Based on observations during facility visits on 7/12, and 9/13, the facility staff clean residents rooms daily to maintain rooms clean and in good repair. Allegation: The resident’s room is malodorous. Based on observations during facility visits on 7/12, and 9/13, staff interview and records review facility once observed staff clean residents rooms once notified by family, residents or staff. Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Report continues on attached LIC9099-Athe state’s words, verbatim · CDSS document, Oct 8, 2024 · control 24-AS-20240705144042

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87218(a)(2) · Plan of correction due date: Oct 11, 2024

87218 Theft and Loss. (a) (2) A licensee who fails to make reasonable efforts to safeguard resident property, shall reimburse a resident for or replace stolen or lost resident property at its current value. The licensee shall be presumed to have made reasonable efforts to safeguard resident property if there is clear and convincing evidence of efforts to meet each requirement specified in Section 1569.153. This regulation was not observed as evidenced by: The facility failed to provide a replacement or monetary refund to resident when lost hearing aid for R1 while resided at the facility in June 2024, which poses health and safety risk to persons in carethe state’s words, verbatim · CDSS document, Oct 8, 2024

Plan of correction: The administrator offered to review inventory list upon moving residents in to the community. Administrator also will educate family and staff on inventory process. Administrator will provide plan of correction to LPA by POC due date, 10/11/2024

Allegation investigated: Staff did not meet infection control requirements Facility is malodorous Staff did not ensure resident had clean laundry

On 06/10/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with the AD. Allegation: Staff did not meet infection control requirements. Based on observations, records review and interviews which occurred on 06/05/2024 and 09/13/2024 no infection control violations observed and reported. 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 allegation is Unsubstantiated. Allegation: Facility is malodorous. Based off observations on 06/05/2024 and 09/13/2024 and interviews no concerns from residents of malodorous smell was observed and reported. 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 allegation is Unsubstantiated. Report continues on attached LIC9099-C Unsubstantiated Allegation: Staff did not ensure resident had clean laundry. Based of staff and residents interviews and record reviews facility providing laundry to all residents daily as scheduled based on residents hallway location. No concerns from residents interviewed that laundry was not done. 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 allegation is Unsubstantiated. Exit interview conducted report signed and copy of this report provided for facility records.the state’s words, verbatim · CDSS document, Sep 13, 2024 · control 24-AS-20240605100546

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Sep 17, 2024

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by: Based on staff interviews the facility failed to fo ensure resident room was cleaned and desinfected till 5/31/24 after resident left the facility on 5/13/24, was admited to the hospital and have not returned to the community. This poses potential health, safety and personal rights risc to person in care.the state’s words, verbatim · CDSS document, Sep 13, 2024

Plan of correction: The facility Admiinistrstor will provde a written statement on plan of correction to resolve the deficiency and maintain the facility in complaiance by POCdue date 09/17/2027

Allegation investigated: Staff did not follow infection control practices Staff did not follow reporting requirements

On 08/01/24, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with the AD. Allegation: Staff did not follow infection control practices, Staff did not follow reporting requirements . During complaint investigation the department reviewed facility files, interviewed facility staff and the Administrator. Based of files review, interview and observation no reports of not following infection control and not following reporting requirements observed during the visit on 3/22/24 and 08/01/24. 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 conducted, report signed and copy of this report provided to the Administrator for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Aug 1, 2024 · control 24-AS-20240321131338

Type of visit: Required - 1 Year

On 08/01/2024, Licensing Program Analyst (LPA) V Gorban arrived at the facility unannounced to conduct Required Annual Inspection. LPA was greeted by receptionist and stated the purpose of the visit. LPA met with Executive Director (ED) Eddie Rangel, certification number 60220138740 and expiration date 09/23/2024. LPA conducted tour inside and out of facility with ED. Residents were observed at the facility after lunch and in common areas during events. The facility was observed to be at a comfortable temperature of 74 degrees, clean, in good repair, and no passageway obstructions or fire hazards observed. Fire extinguisher was observed with a service date of 01/02/2024 Dining area and Kitchen were toured. An adequate supply of perishable and non-perishable food was observed to be properly stored in walk-in freezer, walk-in refrigerator, and pantry. Food is delivered twice a week. Refrigerator temperature was maintained at 43.0-degree F. and freezer was maintained at -6-degree F. LPA toured a sample of resident bedrooms. Residents' rooms were toured and observed with adequately furnished with bed, dresser, and adequate lighting. Hot water temperature tested at 106 degrees F. LPA observed securely fastened grab bars and non-skid mat in all shower areas. Medications were stored in a locked medication room in a medication cart. Medications records were reviewed. First Aid Kit was stored in medication room and observed with all required items. Adequate PPE supplies was observed. LPA toured laundry room and observed chemicals were stored and locked. Facility courtyard was toured and observed to be free from debris. There was outdoor seating available for the residents. Report continues on attached LIC809-C A sample of residents’ file was reviewed to have updated emergency contact, Admission agreement, Needs and Services Plan and Pre-Appraisal Plan. A sample of staff files were reviewed. Staff files were observed to have current First Aid/CPR, Health screening, and Personnel record. Staff are fingerprinted clear and associated to the facility. Community Care Licensing (CCL) is always striving to have facility files that reflect the most accurate & up to date information for your facility. In an effort to maintain your facility file, please submit the most current & complete forms &/or information as identified below: Residential Care Facility for the Elderly (RCFE): · LIC 308 Designation of Facility Responsibility · -as applicable: LIC 309 Administrative Organization · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly · LIC 9020 Register of Facility Clients/Residents Please submit the above forms/information to Fresno CCL by: 08/04/2024 As an operator of a Community Care Licensed facility it is your responsibility to be aware of and in compliance with all regulations, including Chaptered Legislation. Go to www.ccld.ca.gov to stay updated and informed. No deficiencies issued during this inspection. An exit interview was conducted with the ED. A copy of this report was given to the ED, whose signature on this form confirm receipt of these reports.the state’s words, verbatim · CDSS document, Aug 1, 2024

Allegation investigated: Facility staff did not prevent spread of scabies amongst residents and staff.

On 04/16/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with the AD. Allegation: Facility staff did not prevent spread of scabies amongst residents and staff. During this investigation LPA reviewed facility files, interview facility staff and medical personnel. Based of interviews, and records review no staff or residents contracted scabies. 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 allegation is Unsubstantiated. No deficiencies were cited during this visit. Exit interview conducted, report signed and copy of this report provided for facility record. Unsubstantiatedthe state’s words, verbatim · CDSS document, Apr 16, 2024 · control 24-AS-20240205113233

Allegation investigated: Staff do not ensure resident receives contracted services. Staff do not dispense resident’s medication as prescribed. Staff do not assist residents with care needs in a timely manner. Staff do not adequately monitor facility entrance doors.

On 04/16/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with the AD. Allegation: Staff do not ensure resident receives contracted services. During this investigation LPA reviewed resident’s files, interview facility staff and resident. Based off file review resident receives contracted services including ADA accommodation of no charge. 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 allegation is Unsubstantiated. Report continues on LIC9099-C Unsubstantiated Allegation: Staff do not dispense resident’s medication as prescribed. During this investigation department reviewed resident medications, no medication errors were observed. 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 allegation is Unsubstantiated. Allegation: Staff do not assist residents with care needs in a timely manner. Based of staff interview and history records review no files to support alleged violation. 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 allegation is Unsubstantiated. Allegation: Staff do not adequately monitor facility entrance doors. Based of LPA observation and staff interview facility doors are monitored by staff during visiting hours from 730 am to 6pm and locked during none visiting hours with call access provided. 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 allegation is Unsubstantiated. No deficiencies were cited during this visit. Exit interview conducted, report signed and copy of this report provided to administrator for facility records.the state’s words, verbatim · CDSS document, Apr 16, 2024 · control 24-AS-20240126153840

Allegation investigated: Staff does not ensure facility door locks are in good repair.

On 3/22/24, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with the AD. Allegation: Staff does not ensure facility door locks are in good repair. During complaint investigation the department interviewed facility staff and the Administrator. Based off of observations, the Administrator, staff, and residents interviews the facility door locks are in good repair. 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 conducted, report signed and copy of this report provided to the Administrator for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 22, 2024 · control 24-AS-20240221091513

Allegation investigated: Staff did not dispense medication to resident in a timely manner.

On 3/13/24, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings with the AD. Allegation: Staff did not dispense medication to resident in a timely manner. During complaint investigation the department reviewed facility records, interviewed facility staff and the Administrator. Based off of facility records review medication administration to R1 as prescribed. 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 conducted, report signed and copy of this report provided to the Administrator for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 13, 2024 · control 24-AS-20231212143827

Allegation investigated: Staff did not seek medical attention for residents with scabies.

On 2/23/24, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit. During this visit LPA toured facility inside and out and observed residents in care. Once the tour was complete, LPA discussed findings with the AD. Allegation: Staff did not seek medical attention for residents with scabies. During complaint investigation department reviewed facility records, interviewed facility staff and Administrator. The facility addressed scabies by notifying medical and administering medicine to residents effected. 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 conducted, report signed and copy of this report provided to the Administrator for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Feb 23, 2024 · control 24-AS-20231130115026

Type of visit: Office

On 02/21/2024, a scheduled informal meeting was conducted via teleconference. The purpose of the informal meeting was to discuss recently identified issues associated with the operation of the facility and to provide support on the subject matter. Informal meeting process was explained during this meeting. Present at the informal meeting were: Licensing Program Analyst, Vadim Gorban Licensing Program Manager, Brenda Chan Executive Director, Eduardo Rangel Regional VP of Operations, Cassondra Bradford This meeting was called to discuss the following issues or deficiencies: Facility staffing Care and Supervision Medications Reporting Requirements Report continues on LIC809-C Executive Director, Eddie Rangel agreed to do the following in order to bring the facility into compliance no later than 02/26/2024: The licensee and Executive Director to develop a plan of action in writing describing how the facility shall ensure compliance with the facility staffing, care and supervision, medication, and reporting requirements. Executive Director has been advised that failure to complete the above agreed action by the date will result in this Department taking following actions: CCLD may increase monitoring to ensure the facility's adherence to this plan of compliance. CCLD may take administration action against the Licensee. The Licensee was provided Technical Support Program and resources at www.cdss.ca.gov Exit interview conducted and a copy of this report provided to the Executive Director, Eddie Rangel.the state’s words, verbatim · CDSS document, Feb 21, 2024

Allegation investigated: Staff are allowing residents to share hygiene products Staff are allowing the residents to share clothes while in care Staff are disclosing the residents personal information Staff are not providing adequate supervision to the residents while in care

On 2/01/24, LPA Gorban visited the facility to deliver the findings. During this visit LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit. During this visit LPA toured facility inside and pout and observed residents in care. Once the tour was complete, LPA discussed finding with the AD. Allegations: Staff are allowing residents to share hygiene products. Staff are allowing the residents to share clothes while in care. Staff are disclosing the residents personal information. Staff are not providing adequate supervision to the residents while in care. During complaint investigation department reviewed facility records, interviewed facility staff and Administrator. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Report continues on LIC9099-A Unsubstantiatedthe state’s words, verbatim · CDSS document, Feb 1, 2024 · control 24-AS-20231103105434

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(c)(2) · Plan of correction due date: Feb 2, 2024

87465 (c)(2) Incidental Medical and Dental Care. Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidenced by: Facility failed to administer mediations as prescribed and acording to physician directions. This poses an immediate risk to health and safety to residents in care.the state’s words, verbatim · CDSS document, Feb 1, 2024

Plan of correction: AD will provide as a POA during inservice training for the facility staff on 2/01/24 and once complete, will provide a written statement to LPA by 2/02/2024 by email.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1) · Plan of correction due date: Feb 5, 2024

87211 Reporting Requirements (a)(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of occurence. This requirement was not met as evicencd by: The acility failed to provide a report to Licensing Agency following the title 22 gegulation in timely manner. This poses potentia risk to health and safety to residents in care.the state’s words, verbatim · CDSS document, Feb 1, 2024

Plan of correction: AD will provide a staff trainig and education during the facility inservice training on reporting requirements following Title 22 accordingly and in timely manner.

Allegation investigated: Staff did not respond to resident for assistance. Staff made inappropriate comment in presence of resident.

On 1/27/24, LPA Gorban visited the facility to deliver the findings. During this visit LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit. During this visit LPA toured facility inside and pout and observed residents in care. Once the tour was complete, LPA discussed finding with the Administrator. Allegations: Staff did not respond to resident for assistance, Staff made inappropriate comment in presence of residents. During complaint investigation department reviewed facility records, interviewed facility staff and Administrator. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Exit interview conducted report signed and copy of this report provided to Administrator for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Feb 1, 2024 · control 24-AS-20231106100715

Allegation investigated: Facility does not have an administrator.

On 11/07/23 Licensing Program Analyst (LPA) V Gorban visited the facility stated above to deliver findings. LPA met with Business Office Director Jennifer Fowler, explained the purpose of the visit. Administrator Patrick Frazier was notified of licensing visit. LPA toured the facility inside and out, observed residents in care and discussed findings to allegations. Allegation: facility does not have an administrator. During this investigation department reviewed facility file and interviewed administrator and staff. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have found that the complaint was unfounded, therefore we have dismissed the complaint. Exit interview conducted, report signed and copy of this report provided for facility records. Unfoundedthe state’s words, verbatim · CDSS document, Nov 7, 2023 · control 24-AS-20230915102336

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Allegation investigated: Facility alarm is in disrepair

On 9/28/23 Licensing Program Analyst (LPA) V Gorban visited facility stated above to deliver findings. LPA met with Administrator (AD) Jennifer Fowler explained the purpose of the visit and discussed findings. Allegation: Facility alarm is in disrepair During complaint investigation LPA tested facility alarm and appears is operational. LPA reviewed facility files and interviewed staff. Although the allegation “Facility alarm is in disrepair” 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 conducted, report signed and copy provided to AD for facility records. Unsubstantiated Allegation: Staff did not prevent resident from wandering from facility. Based on LPAs observations and interviews which were conducted and record reviews, the resident was found outside sleeping on the ground and staff was not aware of resident location. 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 & Chapter 8), are being cited on the attached LIC 9099D.” Exit interview conducted, report signed, and copy of this report with appeal rights provided to Administrator for facility records.the state’s words, verbatim · CDSS document, Sep 28, 2023 · control 24-AS-20230711084903

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.2(c) · Plan of correction due date: Sep 29, 2023

1569.2 (c) “Care and supervision” means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered... This was not observed as evidenced by: Based on interviews and record reviews R1's mental health, physical health , and safety was jeopardize when she end up unsupervised outside the facility in the middle of the night time. This poses an immediate health and safety risk to the residents in care.the state’s words, verbatim · CDSS document, Sep 28, 2023

Plan of correction: Administrator will provide staff in services on resident supervision, mental health, and safety. Training for dementia will be provided to staff and notify Licensing by 09/29/23

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87705(b)(2) · Plan of correction due date: Oct 16, 2023

87705 Care of Persons with Dementia. (2) Safety measures to address behaviors such as wandering, aggressive behavior and ingestion of toxic materials. This was not observed as evidenced by: Based on interviews and record reviews R1 was able unsupervised leave facility building unsupervised in the middle of the night. Facility did not provide safety measures to address wondering behavior which cause R1 being unsupervised for unknown amount of hours and outside of the facility in the middle of the night.the state’s words, verbatim · CDSS document, Sep 28, 2023

Plan of correction: Facility will provide staff training on dementia and wandering. Facility will provide completed training to Licensing by 10/16/23

Allegation investigated: Facility is in disrepair. Staff did not ensure that a resident's room is maintained at a comfortable temperature.

On 9/28/23 Licensing Program Analyst (LPA) V Gorban visited facility stated above to deliver findings. LPA met with Administrator (AD) Jennifer Fowler explained the purpose of the visit and discussed findings. Allegation: Facility is in disrepair. Allegation: Staff did not ensure that a resident's room is maintained at a comfortable temperature. During this investigation LPA observed facility, reviewed history files, facility files, and interviewed facility staff. Based on investigation listed above these allegations are Unsubstantiated. Although the allegations may have happened or are 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 conducted, report signed and provided to AD for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Sep 28, 2023 · control 24-AS-20230705085754

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.