Woodward Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by caregiver, LVN. Licensee Gloria Taduran arrived later. Gloria Tadurn Administrator certificate # 7028332740 expires 3/17/26. Facility has five [5] residents, none of which are on hospice. At approximately 9:15am LPA and caregiver, LVN toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered and labeled. Cleaning products and laundry soaps are located in a locked closet. All bedrooms were equipped with lighting, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathrooms had required bath mats and grab bars. Water temperature in sinks measured at 106.7 degrees F in the kitchen, 108.7 degrees F in the main bath, and 107.3 degrees F in the bathroom in the back shared room, all of which are within the allowable range of 105 to 120 degrees F. Fire extinguishers were last inspected 2/16/26. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Facility’s last quarterly disaster drill was conducted on 12/11/25. At approximately 10:00am LPA and Licensee and caregiver LVN conducted a spot check of medication and medication records. Medication is centrally stored in locked cabinets. LPA, licensee and caregiver, LVN discussed ensuring all Continued on 809C... Continued from 809... prescribed PRNs are on hand and listed on the Centrally Stored Medication Log (CSML). LPA reviewed PRN MARs. No deficiencies cited. At approximately 10:30am LPA conducted a review of five [5] out of five [5] resident files. No deficiencies cited. All half rails on order. At approximately 11:00am LPA conducted a review of five [5] out of seven [7] resident files. Staff (S1 and S2) did not have current First Aid (deficiency cited, see 809D). Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility LIC610E Emergency Disaster Plan Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with licensee and a copy of this report was given.the state’s words, verbatim · CDSS document, Feb 26, 2026

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

Type of visit: POC

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a POC visit and was greeted by caregiver, LVN. Facility Administrator Gloria Tadrun arrived later. On 2/20/25 LPA conducted the facility annual inspection and issued citations for deficiencies of the following regulations: HSC 1569.618(c)(3), HSC 1569.625(b)(2), CCR 87625(b)(3), CCR 87355(e)(3), CCR 87555(b)(27), CCR 87463(i), CCR 87412(g) and CCR 87202(a). As of today 3/20/25, the plans of corrections for these deficiencies have not been submitted to CCL. Therefore, deficiencies for regulations: HSC 1569.618(c)(3), HSC 1569.625(b)(2, CCR 87625(b)(3), CCR 87355(e)(3), CCR 87555(b)(27), CCR 87463(i), and CCR 87412(g) are being re-cited today. The plan of correction was due on 2/21/25 for HSC 1569.618(c)(3). The plan of correction required facility to submit plan to have S4 and S2 complete First Aid/CPR training. Training to be completed no later than 3/6/25. Proof of First Aid/CPR certificate/card to be submitted to CCL no later than 3/6/25. Deficiency is being re-cited today, see 809D. Failure to correct the deficiency by the plan of correction due of 3/21/25 and/or repeat deficiencies within a 12 month period may result in civil penalties. The plan of correction was due on 2/21/25 for HSC 1569.625(b)(2). The plan of correction required facility to submit plan to have all staff complete required number of hours (as identified by their start date) of training by plan of correction due date. Admin agrees to use Senior Community Learning for all staff training. Training certificates in the required number of hours for each respective staff: S1, S2. S3, S4, S5, S6, and S7 to be completed and sent to CCL by no later than 3/13/25. Deficiency is being re-cited today, see 809D. Failure to correct the deficiency by the plan of correction due of 3/21/25 and/or repeat deficiencies within a 12 month period may result in civil penalties. The plan of correction was due on 2/24/25 for CCR 87625(b)(3). The plan of correction required facility to Continued on 809C... Continued from 809... submit LIC9098 self-certifying they will ensure that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence by plan of correction due date. Deficiency is being re-cited today, see 809D. Failure to correct the deficiency by the plan of correction due of 3/21/25 and/or repeat deficiencies within a 12 month period may result in civil penalties. The plan of correction was due on 2/24/25 for CCR 87355(e)(3). The plan of correction required facility to submit to CCL facility Guardian roster print out showing S6 as being associated to the facility by plan of correction due date. Deficiency is being re-cited today, see 809D. Failure to correct the deficiency by the plan of correction due of 3/21/25 and/or repeat deficiencies within a 12 month period may result in civil penalties. The plan of correction was due on 2/27/25 for CCR 87555(b)(27). The plan of correction required facility to submit to CCL pictures of grout around kitchen sink free of black substances and film by plan of correction due date. Deficiency is being re-cited today, see 809D. Failure to correct the deficiency by the plan of correction due of 3/21/25 and/or repeat deficiencies within a 12 month period may result in civil penalties. The plan of correction was due on 2/27/25 for CCR 87463(i). The plan of correction required facility to submit current and complete Appraisal for R1, R2, and R3 by plan of correction due date, including resident or resident's responsible party's signature and date of receipt by plan of correction due date. Deficiency is being re-cited today, see 809D. Failure to correct the deficiency by the plan of correction due of 3/21/25 and/or repeat deficiencies within a 12 month period may result in civil penalties. Continued on 809C(2)... Continued from 809C... The plan of correction was due on 2/27/25 for CCR 87412(g). The plan of correction required facility to submit Health Screen with TB clearance or LIC503, LIC501, and copy of First Aid/CPR for S6 and S7 to CCL by plan of correction due date. Deficiency is being re-cited today, see 809D. Failure to correct the deficiency by the plan of correction due of 3/21/25 and/or repeat deficiencies within a 12 month period may result in civil penalties. Upon arrival today 3/20/25, LPA observed deficiency of regulation CCR 87202(a) has been corrected. LPA observed broken hospital bed has been removed and is no longer partially obstructing the emergency fire exit path. LPA asked caregiver, LVN why facility did not submit pictures of cleared path in order to clear deficiency. Caregiver, LVN explained they did send the picture to the Administrator on 3/5/25. LPA reviewed metadata of picture shown to LPA of removal and it did show the picture was taken 3/5/25. LPA advised next time, be sure to send the picture to CCL to clear the deficiency. LPA advised Administrator of the same. Deficiency is cleared. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Administrator. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given.the state’s words, verbatim · CDSS document, Mar 20, 2025

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.618(c)(3) · Plan of correction due date: Mar 21, 2025

§1569.618 Administration and management of residential care facilities; substituted qualifications; employee scheduling (c)The facility shall employ... a sufficient number of staff members to... (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times... This requirement was not met as evidenced by: Based on LPA and caregiver, LVN observation and record review, the licensee did not comply with the section cited above in that S2 has expired First Aid/CPR exp 1/10/2025. S4 did not have any CPR/First Aid on file, which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 20, 2025

Plan of correction: Facility to submit proof of First Aid/CPR certificate/card tfor S2 and S4 o be submitted to CCL no later than 3/21/25.

From the deficiency page — Deficiency type: Type A · Section cited: HSC1569.625(b)(2) · Plan of correction due date: Mar 21, 2025

§1569.625 Staff training; legislative findings; contents (2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually...This requirement is not met as evidenced by: Based on LPA and caregiver, LVN observation and record review the licensee did not comply with the section cited above in that all staff: S1, S2, S3, S4, S5, S6 and S7 did not have required training completed, which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 20, 2025

Plan of correction: Facility to submit plan to have all staff complete required number of hours (as identified by their start date) of training by plan of correciton due date of 3/21/25. Admin agrees to use Senior Community Learning for all staff training. Training certificates issued by Senior Community Learning in the required number of hours for each respective staff: S1, S2. S3, S4, S5, S6, and S7 to be completed and sent to CCL by no later than 4/3/25.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87412(g) · Plan of correction due date: Mar 21, 2025

87412 Personnel Records (g) All personnel records shall be maintained at the facility. This requirement is not met as evidenced by:Based on LPA and caregiver, LVN observation and record review, the licensee did not comply with the section cited above in that S6 and S7 did not have Health Screen, Training, TB, or any paperwork on file, which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 20, 2025

Plan of correction: Facility to submit Health Screen with TB clearance or LIC503, LIC501, and copy of First Aid/CPR for S6 and S7 to CCL by plan of correction due date of 3/21/25.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87463(i) · Plan of correction due date: Mar 21, 2025

87463 Reappraisals (i) When there is significant change in condition... or once every 12 months, whichever occurs first, the licensee shall arrange an in-person or virtual meeting or conference call to share the reappraisal with the resident, the resident's representative, if applicable, and appropriate facility staff, asspecified in Section 87467, Resident Participation in Decision Making. This requirement is not met as evidenced by: Based on LPA and caregiver, LVN observation and record review, the licensee did not comply with the section cited above in that Resident (R1) has an appraisal on file but not current (11/2023) and residents (R2 and R3) did not have an appraisal on file at all which poses an immediatel health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 20, 2025

Plan of correction: Facility to submit current and complete Appraisal for R1, R2, and R3 by plan of correction due date, including resident or resident's responsible party's signature and date of receipt by plan of correciton due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(3) · Plan of correction due date: Mar 21, 2025

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c)... This requirement is not met as evidenced by:Based on LPA and caregiver, LVN observation and record review, the licensee did not comply with the section cited above in that Staff S6 was not associated to the facility, which poses an immeidatel health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 20, 2025

Plan of correction: Facility to submit to CCL facility Guardian roster print out showing S6 as being associated to the facility by plan of correction due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87555(b)(27) · Plan of correction due date: Mar 21, 2025

87555 General Food Service Requirements(b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. This requirement is not met as evidenced by: Based on LPA and caregiver, LVN observation and record review, the licensee did not comply with the section cited above in that black substance present in grout and spotted film around sink in grout, which poses an immeidate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 20, 2025

Plan of correction: Facility to submit plan to have areas around sink free of black substances and film by plan of correction due date. Facility to submit pictures of cleaned kitchen area around kitchen sink free of black substances and film to CCL by no later than 3/28/25.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87625(b)(3) · Plan of correction due date: Mar 21, 2025

87625 Managed Incontinence (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement was not met as evidenced by: Based on LPA and caregiver observation, the licensee did not comply with the section cited above in that rooms #1 and #3 had pervasive odor of urine which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 20, 2025

Plan of correction: Facility to submti LIC9098 self-certifying they will ensure that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence by plan of correction due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by caregiver, LVN. Administrator not available to come to the facility but was available periodically via telephone. At approximately 9:00am LPA and caregiver toured the building and grounds. The facility was found to be at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered. Kitchen cabinet containing cleaning supplies was locked. Kitchen drawer with sharp knives locked. Black substance present in grout and spotted black film around sink in grout, LPA observed the same issue during last annual inspection dated 3/22/24 (deficiency cited, see 809D). Thick-it food and beverage thickener found in the pantry with prescription label torn off and date of expiration covering where label was. LPA advised this is a prescription item and cannot be shared between residents that do not have a prescription. LPA found zinc oxide and vitamin C in hall closet, unlocked and accessible to residents. LPA advised all vitamins and supplements must be stored inaccessible to residents. All bedrooms were equipped with lighting, night stand, and chest of drawers. All bedrooms in good repair; however, there was a pervasive odor of urine incontinence present in the facility, coming from rooms #1 and #3 (deficiency cited, see 809D), odor was noticeable immediately upon entering the facility. Extra hygiene products and linens were available. Resident bathroom had required bath mat and grab bar. Bathroom in room #4 has a shower that has brown substance present in shower and chunks of a white substance concentrated over the drain. LPA advised caregiver, LVN that even if the shower is not presently used, it should remain clean. Water temperature in sink accessible to residents in care measured at 113.6 and 107.1 and degrees F which is within the allowable range of 105 to 120 degrees F. Continued on 809C... Continued from 809... Fire extinguishers were last inspected today. Smoke/Carbon Monoxide detectors located throughout the are operational. Facility’s last quarterly disaster drills were conducted in 2024. LPA advised that drills must be performed quarterly. Facility has a backup generator for use during a power outage. LPA observed a discarded hospital bed partially obstructing the emergency fire exit path on the side of the house. LPA and caregiver discussed that fire exit cannot be obstructed (deficiency cited, see 809D). At approximately 10:30am LPA conducted a review of 5 staff records. LPA reviewed training documents. Training log document shows staff training completed by instructors Administrator Gloria Taduran, RN and caregiver, LVN. Training completion dates listed as: S1 hired 11/15/2023: 12/1/23: 5 hours training from CCO and 15 hours with a date 11/15, but no year listed S2 hired 11/20/2023: 6 hrs 12/6/24, 5 hours on 12/12/24, 4 hours on 12/28/24, and 7 hours on 1/8/25 S3 hired 02/07/2024: 21 hours training on 2/7, but no year listed S4 hired 11/29/2022: 15 hours on 5/1/24 S5 hired 04/06/2023: 15 hours on 4/4/24 and 7 hours on 4/7/24 S6 hired 01/20/2024: no training documented/on file S7 hired 12/20/2024: no training documented/on file LPA advised that if a staff member is within their first year of employment they must have completed 40 hours of training; 20 of which must be completed before working independently with residents; additionally, those staff that have completed their initial year of employment must complete a total of 20 hours annually (deficiency cited, see 809D). LPA discussed with Admin and caregiver, LVN accuracy of date on which the training occurred. Admin and caregiver, LVN confirmed. LPA discussed with Admin and that there are only 24 hours in a day and therefore it appears that the training records have been fabricated. Admin and caregiver, LVN agreed to cease using handwritten training log and personal training materials. Admin and caregiver, LVN agree to Continued on 809C(2)... Continued from 809C... instead use an approved vendor from which they will print the training completion certificates for each respective staff. The approved vendor they committed to using is Senior Community Learning. LPA discussed with Admin and caregiver, LVN that all personnel, whether on-call or full time must have their personnel file present at the facility. Full time regular staff (S7) and on-call staff (S6) did not have Health Screen, Training, TB, or any paperwork at all on file or present at facility (deficiency cited, see 809D). Staff (S2) has expired First Aid expired as of 1/10/2025 and staff (S4) did not have any First Aid on file (deficiency cited, see 809D). Staff (S6) was not associated to the facility, furthermore, they did not have any paperwork present at the facility (deficiency cited, see 809D). At approximately 11:30am LPA conducted review of six [6] resident records. Four [4] of five [5] residents required to have half rails on order have half rail order present on file. LPA advised be sure all residents that have half rails present also have the half rail doctor orders on file. Resident (R1) has an appraisal on file but not current (11/2023) and residents (R2 and R3) did not have an appraisal on file at all (deficiency cited, see 809D) At approximately 2:00pm LPA and caregiver, LVN conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. Facility uses a MAR. LPA advised caregiver, LVN that a MAR is not required per regulation; however, if facility uses a MAR, then CCL can audit it. A few entries for residents missing on MAR but per caregiver, medication was administered. LPA advised that a PRN MAR is required per regulation. PRN MAR present. Prescribing physician entry missing for R3 on all Centrally Stored Medication Log (CSML) entries. LPA advised that recording the date started is not required per regulation but is a best practice. Caregiver, LVN agrees to start recording the date started on CSML. LPA discussed with caregiver, LVN crushing residents' medications. Caregiver, LVN advised LPA that they crush medications for two [2] residents to mitigate choking but could not produce a doctor's order or show where the medication is prescribed as needing to be crushed to be administered. Caregiver, LVN advised LPA they will get the doctor's order and maintain it in each respective resident's file. Continued on 809C(3)... Continued from 809C(2)... Gloria Taduran Administrator Certificate 7028332740, which is currently in Pending Renewal status. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility Liability Insurance Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with caregiver, LVN. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with caregiver, LVN and a copy of this report was given.the state’s words, verbatim · CDSS document, Feb 20, 2025

The state marks this report as 11 pages; the online copy we transcribed has 8. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Gloria Taduran. Facility contact information was reviewed. At approximately 9:15am LPA and Admin toured the building and grounds. The facility was found to have black spots of film around sink in grout, ants in the pantry, and both bugs and dead ants in cabinet under the sink in kitchen. Per Title 22 regulation 87555(b)(27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects (deficiency cited, see 809D). The facility was found to be at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered, but not labeled with date of use. Admin will be sure to label all left over food. Kitchen cabinet containing cleaning supplies was locked. All bedrooms were equipped with lighting, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathroom had required grab bar and mats. Water temperature in sink accessible to residents in care measured at 108.8 degrees F which is within the allowable range of 105 to 120 degrees F. Fire extinguishers were last inspected 12/4/2023. Smoke/Carbon Monoxide detectors located throughout the facility were last tested and operational by vendor on 11/15/2023. Facility’s last quarterly disaster drill was conducted on 3/5/2024. Facility has a backup generator for use during a power outage. At approximately 10:30am LPA conducted a review of 6 resident and 5 staff records. All required documents and training present. At approximately 12:00pm LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet in the kitchen. Continued on 809C... Continued from 809... Gloria Taduran Administrator Certificate 6063245740 expired 3/17/2024, but Admin said she submitted the renewal yesterday 3/21/24. Linberge Yumul Administrator certificate #7031395740 expires 1/14/2025 and per Taduran, Yumul is the Admin of the facility jointly with her. LPA advised Admin that in addition to changing his job description on Guardian roster, Admin must submit to CCL the required documents so that CCL can approve the addition. Admin will send to CCL within 30 days from today, 3/22/2024. Facility fees are due. LPA gave LIS print out showing dollar amount due along with PIN to make payment via portal and advised Admin about fee due. LPA and Administrator discussed facility's Infection Control Plan and Emergency Disaster plan. No new updates. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility Plan of Operation Evidence of Liability Insurance- Declarations Page Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Licensee. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given.the state’s words, verbatim · CDSS document, Mar 22, 2024

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.