Cottages at Artesia Anaheim, the

W1 provided their email account to AD that stated that something drew their attention to S1 and got the impression that S1 spoke to R1 roughly. W1 informed AD via email that they observed S1 pummeling R1s back and shoulders as though playfully, good natured, or mock aggression once S1 saw W1 look over. Witness #2 (W2) informed LPA that W1 informed them that they did not actually see an incident occur between S1 and R1, but saw S1 pummeling/massaging R1s back and found it disturbing. Witness #3 (W3) informed LPA that they had no concerns of R1s care and was at the facility every day to check on R1. W3 informed LPA that they do not believe the incident occurred as reported and had no complaints regarding R1s care. W3 informed LPA that they spoke to facility staff and confirmed that the AD informed them of the alleged incident verbally. LPA interviewed staff and 5 of 5 staff denied the allegations. LPA interviewed 6 residents in care and 2 of 6 residents informed LPA that they have never been harmed or yelled at by facility staff. 4 of 6 residents did not confirm or deny the above mentioned allegations. LPA was unable to view video footage at the facility due to it already being recorded over. LPA was unable to interview R1 due to no longer residing at the facility. LPA reviewed staff training for S1 and observed personal rights training was last conducted on August 18, 2025. The investigation into the facility allegation of staff did not follow reporting requirements revealed the following: It was alleged that staff did not cross report an alleged incident that occurred. The SOC341 was submitted to LPAs email inbox on January 30 th 2026, stating that on January 23 rd , 2026, they were informed of an incident where S1 was handling R1 in a rough manner. LPA interviewed AD and informed LPA that they sent an SOC341 to licensing and the Ombudsman and notified R1s family. AD was unable to verify when they sent the form to the ombudsman. LPA interviewed Witness #4 (W4) and informed LPA that they did not receive an SOC341 from the facility regarding the incident that occurred. Continue on LIC9099C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Based on information gathered and interviews conducted, the Department is unable to ascertain if the above allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, the allegations are deemed UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was left at the facility.

LPA observed a LIC621 for R1 that does not state they have hearing aids as their personal property at the facility that was signed and dated by facility staff on November 25, 2025. LPA observed a theft and loss policy stating that the Responsible Party of the resident shall fill out an LIC621 on the day of move in and all items will be discharged at the time of move out. The policy also states that if an item goes missing, the resident or responsible party can fill out a LIC9060 theft and loss record form. LPA did not observe an LIC9060 for R1. LPA observed a notice of transfer/discharge for R1 from Downey Post Acute stating that on November 25, 2025, R1 will be transferred to the facility. This form has an itemized list of R1s belongings and upon discharge R1 had 2 hearing aids that were noted on the form. This document was signed and dated by W1 and nursing staff on November 25, 2025. Upon interviews with two of three staff it was revealed that R1 arrived at the facility with the clothes they were wearing and their cell phone, and no hearing aids. One of three staff informed LPA that they arrived via non emergency ambulance without family or their responsible party. Two of three staff informed LPA that they did not recall R1 having hearing aids during their short time at the facility. One of three staff informed LPA that R1 did not have hearings aids or a watch and was not informed if staff had received such items. Upon interviews with W1 it was revealed that they handed staff R1s hearing aids, but could not recall the staffs name. W1 informed LPA that they did not fill out a valuables and property form for R1. W1 informed LPA that they are not sure about a watch. Regarding the allegation of Staff was verbally abusive towards resident revealed the following: It was alleged that staff would yell at R1 and call them derogatory names. Upon interviews with three of three staff it was revealed that they never have verbally abused R1 and had not observed other staff in the facility verbally abuse residents. Upon interviews with four of four residents it was revealed that two of four residents were unable to confirm or deny if they had heard staff verbally abuse residents. Two of four residents informed LPA that they have never been verbally abused and had not heard staff verbally abuse other residents in care. Based on interviews, the Department is unable to ascertain if the above allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, the allegations are deemed UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was left at the facility.

Licensing Program Analyst (LPA) Hanna Gough made an unannounced visit to the facility to conduct a health and safety case management visit. LPA was greeted and granted entry by staff. LPA met with Administrator (AD) Nora Rodgers and discussed the purpose of the visit. LPA introduced herself to the facilities new AD and answered any questions they had as a new AD of the community. LPA printed requested documentation during the visit such as a blank physicians report and needs and services plan. LPA toured the facility and observed the medication room to be locked and made inaccessible to residents in care. LPA observed residents relaxing in their rooms and watching tv in the dining room. LPA toured the outdoor patio area and it was clean and free of debris and obstructions. Based on today's observations no deficiencies are being noted per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was left at the facility.

Licensing Program Analyst (LPA) Hanna Gough conducted an unannounced health and safety visit to the facility. LPA was greeted and granted entry by staff. LPA met with Administrator (AD) Aldo Apostol and discussed the purpose of the visit. The facility appears clean and sanitary. LPA was introduced to the new AD and discussed any questions that they had. LPA and AD toured the facility and observed a staff meeting taking place in the dining room. LPA observed residents napping in their rooms and on the outdoor patio visiting with family. Residents appeared to be clean and well taken care of. LPA observed resident medication with AD and a medtech on duty. Based on today’s observations no deficiencies are being noted per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted an a copy of this report was left at the facility.

Licensing Program Analyst (LPA) Hanna Gough made an unannounced visit to the facility for the purpose of conducting a case management health and safety check. LPA was greeted and granted entry by staff and met with Administrator (AD) Rose Martellotti and discussed the purpose of the visit. LPA toured the facility and observed residents in care relaxing in their bedrooms and watching tv in the dining room. Facility appeared clean, safe and sanitary. No health and safety concerns noted during the visit. AD requested LPA print a POC letter for complaint number 22-AS-20240426093629. Based on today’s observation no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Rose Martellotti and a copy of this report and POC letter clearance was given at the time of the visit.

Regarding the allegation that staff inappropriately touched resident: it was alleged that on October 27, 2023, R1 was observed crying loudly and reported that S1 inappropriately touched their chest. One staff interviewed stated that on October 27, 2023, R1 told them that the staff who cleans the rooms “grabbed them” but did not provide a name or description of the staff, but the staff also reported that when R1 does not get what they want they engage in behavioral outbursts. Department staff reviewed the Facility’s Video Footage regarding R1 showing the outside of R1’s room, but obtained no information corroborating the allegation. When interviewed, AD stated that they conducted an investigation into the allegation and found no information corroborating that S1 acted inappropriately with residents. Per the Facility’s Investigation Summary dated November 8, 2023, AD interviewed R1, S1, and four other staff and did not obtain information corroborating the allegation. Per the Facility’s Staff Statement dated October 28, 2023, four staff stated that R1 has a history of behavioral outbursts while S1 “is not capable of hitting anyone.” Department staff interviewed R1 who showed some confusion, did not present with any signs of injury or abuse, denied any inappropriate incidents, stated they feel safe living at the facility and have no concerns at the facility, and denied knowing who S1 was. Per R1’s Physician’s Report dated November 25, 2022, R1 has dementia and is noted to have confusion. Per AD, R1 has a history of making false statements and also engages in self-harming behavior and blames the resulting injuries on staff. LPA reviewed the Facility’s Video Footage regarding R1 which shows R1 hitting themselves on the chin with an object and, per AD, R1 accused staff of causing a bruise on their chin after engaging in this behavior. LPA interviewed S1 who denied the allegation. LPA reviewed S1’s Staff File, interviewed five additional residents, and interviewed three additional staff and did not obtain information corroborating the allegation. The information obtained did not corroborate the allegation. Regarding the allegation that staff threw food at resident: it was alleged that on October 27, 2023, S1 was observed throwing cookies at R1. Department staff reviewed the Facility’s Video Footage regarding R1 showing the outside of R1’s room, but obtained no information corroborating the allegation. When interviewed, AD stated that they conducted an investigation into the allegation and found no information corroborating that S1 acted inappropriately with residents. Per the Facility’s Investigation Summary dated November 8, 2023, AD interviewed R1, S1, and four other staff and did not obtain information corroborating the allegation. Per the Facility’s Staff Statement dated October 28, 2023, four staff stated that R1 has a history of behavioral outbursts while S1 “is not capable of hitting anyone.” 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Department staff interviewed R1 who showed some confusion, did not present with any signs of injury or abuse, denied any inappropriate incidents, stated they feel safe living at the facility and have no concerns at the facility, and denied knowing who S1 was. Per R1’s Physician’s Report dated November 25, 2022, R1 has dementia and is noted to have confusion. LPA interviewed S1 who denied the allegation. LPA reviewed S1’s Staff File, interviewed five additional residents, and interviewed three additional staff and did not obtain information corroborating the allegation. The information obtained did not corroborate the allegation. Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the allegations that staff inappropriately touched resident and staff threw food at resident occurred as reported. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, these allegations are deemed unsubstantiated. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the plan of corrections for one type B deficiency cited during the investigation of complaint #22-AS-20240213154220.. LPA was greeted and granted entry by facility staff after explaining the reason of the visit. Administrator Aurelia Olais was present and assisted with the visit. On February 27, 2024, LPA issued a type B citation for failure to meet the requirements of the California Code of Regulations Section CCR 87303(i)(1)(A) regarding Maintenance and Operations on the operation and accessibility of the facility's call system. During today's visit, LPA verified that the pull cords for the call system were within reach of the residents and that the missing pull cords had been replaced. A proof of an in-service training conducted on February 28, 2024 was provided to LPA by facility administrator via email. During the visit, at least three residents were observed to be provided with an inaccessible pull cord, including one resident for whom the pull cord was positioned at the foot of the bed with no ability to adequately alert facility staff. As a result, a civil penalty is assessed for failure to correct the earlier violation of the California Code of Regulations for the seven-day period from March 28, 2024 until April 3, 2024. An exit interview was provided and a copy of this report along with appeal rights and civil penalty assessmenr were provided to a facility representative.

On today's date, Licensing Program Analyst (LPA)LPA Quiroz conducted a Case Management-Other inspection visit while conducting ten day inspection visit regarding complaint control #22-AS-20231113104340. LPA Quiroz met with Administrator (AD) Aurelia Olais and Office Manager (OM) Pamela Bracamonte and discussed purpose of today's Case Management-Other visit. During today’s visit, LPA Quiroz along with (OM) Bracamonte conducted a facility tour inspection of facility premises. On or about 10:47am, while inspecting dining-room area, LPA Quiroz observed Resident 1 (R1) attempting to fill his water bottle from water system placed in dining-room area. LPA Quiroz observed water system to not be functional and operational as evidenced by (R1) not able to fill their water bottle and requesting water from kitchen staff. (OM) Bracamonte indicated "We had to turn it off because it was leaking." (AD) Olais indicated "I didn't know it was leaking but I will order one today." LPA Quiroz provided consultation on the following California Code of Regulations: Maintenance and Operation : 87303 (a) (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. (AD) Olais provided receipt invoice of water system purchase during today's visit. An Advisory Note Technical Violation (LIC 9102 TV) was conducted during today's visit addressing CCR 87303(a). An exit interview was conducted with (AD) Aurelia Olais. A copy of this report along with Confidential Names- LIC 811 and LIC 9102 TV were provided at exit.

Licensing Program Analyst (LPA) Celine De Perio made an unannounced case management visit to this facility to follow up on a Special Incident Report (SIR) received on 12/27/22, which occurred on 12/16/22. LPA De Perio was greeted and granted entry by staff on duty and LPA De Perio explained reason for visit. For today's visit, there are a total of 21 residents in care, of which 5 are on hospice. As of today, there are no active COVID cases in the facility as verified. LPA De Perio met with staff 1 (S1),staff 2 (S2) and facility administrator (AD) Aurelia Olais and conducted interviews regarding resident identified in SIR. S1, S2 and AD Olais stated that the incident reported via SIR happens "all the time". LPA De Perio conducted a tour of the resident's room and interviewed resident. LPA De Perio also reviewed and obtained copies of pertinent documents. At this time, no citations have been issued and no deficiencies have been issued. LPA De Perio conducted an exit interview with AD Olais and a copy of this report was provided to the facility.

Licensing Program Analyst (LPA) Patricia Velazquez conducted an announced visit to The Cottages at Artesia Anaheim. LPA Velazquez was allowed entry into the facility and met with Administrator Aurelia Olais. The purpose of today's subsequent Pre-Licensing visit was to follow-up on the issues that were present during the initial Pre-Licensing visit dated 06/13/2022. The following issues were observed and required correction: Obtain chairs for the resident rooms Obtain a First Aid manual Obtain lamps for the resident rooms On today's visit the aforementioned items have been addressed and corrected. The items reviewed during this visit are in compliance. The Pre-Licensing is now complete. The license will be granted upon completion of a final review and approval from the Licensing Program Manager and the Central Applications Bureau. LPA Velazquez reviewed Title 22 Section 87608 Postural Supports and provided a copy of said regulation. Administrator Aurelia Olais acknowledged receiving a copy of this regulation. An exit interview was conducted with Administrator Aurelia Olais and a copy of this report was provided at the time of this visit.

Licensing Program Analyst (LPA) Patricia Velazquez conducted an announced Pre-Licensing visit with Component III Orientation at The Cottages at Artesia Anaheim. LPA Velazquez conducted the visit with Administrator Aurelia Olais and Licensee Diluvan Hassan. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to the Central Applications Bureau (CAB) on 02/18/2022 for a capacity of 22 non-ambulatory residents and 16 bedridden residents. LPA Velazquez along with Administrator Olais and Licensee Hassan observed the following: Structure: Facility is a one story building with 38 resident bedrooms, 16 bathrooms, dining room which doubles as an activity room, office, medication room, laundry room and kitchen. The facility has a beige stucco exterior. There are 2 courtyards outside with shading and seating for residents. Signal System: The facility has a signal system that was tested and found to be in operating condition. Staff responded to the pull cords within 2 minutes of pulling the cords. Bedrooms Residents : All bedrooms accommodate non-ambulatory residents with bedrooms 111, 112, 114, 115, 116, 117, 118, and 119 designated for bedridden residents. Emergency lighting were present in the facility. The resident bedrooms accommodate the residents' furnishings but some rooms were missing chairs and lamps. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Bathrooms: All bathrooms have a working toilet, wash basin, and walk-in shower. Grab bars were secure and a non-skid mat was in place. Linens and Hygiene Supplies: Adequate supply of linens and hygiene supplies were located in a linen cabinet in a hallway as well as the resident rooms. Appliances: Refrigerator, freezer, dishwasher, 2 washers and 2 dryers, microwave, gas stove top, and an oven. Emergency Phone Numbers, Exit Plan: Posted in the entry area of the facility and readily available for review. Postings: The Complaint poster was posted in the entry area of the facility. Coronavirus (COVID-19) postings were observed posted throughout the facility. Food Service and Menu: There was an adequate supply of 7 day non-perishable and 2 day perishables present in the facility. The sample menu was available for review. The emergency food supply was located in a supply closet. Smoke and Carbon Monoxide Detectors: Smoke detector and Carbon Monoxide alert systems were interconnected tested by the Fire Marshal and found to be operational. Fire Extinguisher: Fully charged and were mounted on the walls throughout the facility. Fire Clearance: Approved on 05/31/2022 for 22 non-ambulatory residents and 16 bedridden residents. The facility has not been approved to have delayed egress or secure locked perimeters. Toxins and Sharps: The cleaning supplies were locked and stored in a storage closet. The knives and other sharp items were locked in a cabinet located in the kitchen. Water Temperature: Tested and recorded in 10 resident bathrooms and ranged between 106.6 - 116.6 degrees Fahrenheit. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Medications, First Aid Kit & Manual: The facility has 2 First Aid kits which were checked and found to be in order. One First Aid kit is located in the medication room and the other is located in the office. The facility was missing a First Aid manual. Medication is stored in a locked cabinet located in the medication room. Resident and Staff Files: Resident and staff records are stored in the office. Reading Material, Games, Equipment, & Materials: The facility had materials, games, and equipment present in the facility that commensurate with their plan of operation. Component III: Conducted at the Pre-Licensing visit, information was provided about how to operate the facility within compliance. The following items need to be addressed prior to licensure: Obtain chairs for the resident rooms Obtain a First Aid manual Obtain lamps for the resident rooms Facility does not appear ready for licensure. Any items noted during today’s visit are to be corrected by June 14, 2022. LPA Velazquez will conduct a subsequent Pre-Licensing visit on June 14, 2022 to review the items listed above. An exit interview was conducted with Administrator Aurelia Olais and Licensee Diluvan Hassan a copy of this report was provided at the time of this visit.