Sea Bluffs, the.

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. An exit interview was conducted and a copy of this report was provided to facility administrator along with appeal rights.

Licensing Program Analysts (LPAs) Kimberly Lyman and Andrea Mendivil conducted an unannounced visit to The Sea Bluffs. The purpose of today’s visit was to conduct the Annual Required inspection. LPAs were allowed entry into the facility and explained the reason for the visit. Facility is licensed for 88 non-ambulatory of which 10 may be bedridden. Facility has an approved hospice waiver for 15 residents and the facility currently has 9 residents on hospice care. Brent Broadhurst has an administrator certificate expiring on 08/09/2027. LPAs Lyman and Mendivil along with Business Office Manager Kenia Cabada toured the facility at 8:35 AM. Administrator Brent Broadhurst and Assistant Executive Director Haley Gmach joined the tour in progress. LPAs toured the physical plant, checked food service, facility records and the first aid kit. Facility appears to be clean, safe, and sanitary. Facility consists of three stories housing two memory care units and assisted living, multiple outside areas, two dining rooms, beauty salon, fitness area and movie theater. At approximately 8:45 AM, LPAs toured the first floor memory care unit and observed the delayed egress exit into the patio is chained shut from the outside (photo). It took several minutes for maintenance to unlock the door which is designated as an exit on facility floor plan. Resident apartments had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident restrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 107 and 116.4 degrees F in facility restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including tweezers, thermometer, and scissors as well as a first aid manual. LPAs observed cleaning supplies are secured. CONTINUED ON LIC 809C DATED 11/07/2025 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 Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Smoke detectors/ carbon monoxide detectors are tested quarterly in-house with the last inspection date of 10/16/2025. Fire inspections are conducted by an outside company, TRL Systems with the last inspection on 10/31/2025. Fire extinguishers are fully charged. LPAs observed evacuation chair at stairwell. LPAs toured the outside grounds and there is ample shaded seating for residents. LPAs observed ample emergency food and water. LPAs reviewed the emergency disaster plan during the visit. Plan is thorough and complete. Facility conducts monthly emergency drills with the last drill conducted on 09/24/2025. Facility provides activities in the form of games, exercise, and outings. LPAs observed residents participating in activities during the visit. LPAs reviewed select resident and staff files. Resident files contained required documents including admission agreements, current physician reports and resident appraisals. Residents #4 and #8 (R4, R8) are designated as bedridden per physician report. R4 resides in room 141 and R8 resides in room 238. Facility fire clearance indicates bedridden is not approved for those rooms. Staff files reviewed contained required documentation such as health screen/TB, required annual training and criminal record clearance. LPAs reviewed medication administration and storage. Medications are stored secured in medication carts. Medications appear to be administered per physician orders. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided as well as appeal rights.

On this day, Licensing Program Analysts (LPAs) Andrea Mendivil and Kimberly Lyman made an unannounced visit to conduct a case management visit. LPAs were greeted and granted entry into the facility. The Department received an Unusual Incident/Injury Report on 10/30/2025 for an incident that occurred on 10/27/2025. It was reported that an alarm from the back door on the 2nd floor of Memory Care was heard by staff at 10:25am. It was reported that care staff went to check the door and no one was seen. Staff then conducted a head count and found out Resident 1 (R1) was missing. It was then reported staff went searching through the Memory Care building and surrounding neighborhood. It was reported at 10:33am R1 was found sitting on a bench outside of a residential home approximately .5 miles away from the facility. R1 was escorted back to the facility and checked for injuries. It was stated R1 did not complain of pain and no injuries were noted. R1's family was notified. The facility noted they have conducted in-service training for elopements and reporting. Per review of R1's physician report dated 05/20/2025 R1 is diagnosed with dementia and is not allowed to leave the facility unassisted. During today's visit LPA's tested delayed egress exit gate and no staff responded to the gate alarms. Based on observations made deficiencies are being cited per Title 22 Division 6 of California Code of Regulations. ,An exit interview was conducted and a copy of this report, LIC 809-D, LIC 811 Confidential Names LIC 421IM and appeal rights were provided.

Based on the information gathered the preponderance of evidence standard has been met, therefore, the allegation, facility staff is in disrepair, is found to be SUBSTANTIATED. Based on this inspection, deficiencies were observed at this time in the areas evaluated per Title 22 Division 6 Chapter 8 of the California Code of Regulations. See LIC9099-D for deficiencies. This report was reviewed with Administrator and a copy of this LIC9099, LIC9099-D report was provided and left at facility. Appeal rights reviewed, and a copy provided.

On this day Licensing Program Analysts (LPAs) Fred Arias and Andrea Mendivil made an unannounced visit to conduct a required annual visit. LPAs were greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for 88 non-ambulatory residents of which 10 may be bedridden. Facility has an approved hospice waiver for 15 residents and the facility currently has 67 residents, with 7 residents on hospice. Maintanance Director (MD) Pedro Ucros and Assistant Administrator (AAD) Haley Gmach arrived shortly to conduct facility tour. AAD Gmach has a valid certificate that expires on 8/10/2025. AAD provided updated liability insurance that expires on 7/01/2025. LPAs along with MD Ucros toured the facility at 8:30 AM with AAD Gmach joining shortly after. LPAs toured the physical plant, checked food service, facility documentation and the first aid kit. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 118.6 degrees F and 119.8 degrees F in checked restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alarms were operational during today's visit. LPAs toured the kitchen on the first floor in memory care and observed sharps in a cabinet that was not locked. Continued on LIC 809-C dated 12/23/2024. 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 The first floor kitchen in memory care also had toxins under the sink that were not secured due to malfunctioning cabinet doors. MD stated cabinet doors would be replaced and secured during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Some perishable food in the assisted living area kitchen was expired including milk, salad dressing, beef, and fish. Pork patties were observed to be on a kitchen counter kept at room temperature. Smoke detectors are tested quarterly by an outside party with the latest test recorded on 4/17/2024. Fire extinguishers were fully charged. LPAs reviewed the infection control and emergency disaster plans and plans are complete and thorough. Facility last conducted emergency drills on 7/31/2024. Outside grounds were toured. Walkways around the facility were clear of hazards. There are no security bars or weapons on the premises. First aid kit contained all required items including tweezers, scissors and thermometer. Facility conducts activities in the form of exercise, arts and crafts, and group movie watching. There is shaded outdoor seating for residents. LPAs observed the emergency food and water supply. LPAs reviewed three resident files, three staff files, and ADD file. All resident files reviewed contained required documentation including admission agreements, physician reports, and resident appraisals. Staff files reviewed contained required documentation including required annual training, medical assessment/ TB, criminal record clearance and proof of CPR training. LPAs reviewed medication storage and administration. Medications are stored in a locked office on each floor. Medications are being administered per physician order. Based on the observations made during today’s visit, 2 deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided.