Emerald Valley.

***CONTINUE FROM 9099C*** Allegation: Staff do not ensure residents’ dietary needs are met — Unsubstantiated During the investigation, LPA reviewed facility menus, including special diet menus posted in the kitchen, and interviewed S4, who demonstrated knowledge of residents’ dietary restrictions, and food preparation procedures. Documentation reviewed reflected that residents’ dietary needs and restrictions were identified in their records and incorporated into meal planning. LPA observed the kitchen area and food storage, which appeared organized, and adequately stocked. Residents interviewed did not report concerns regarding food access, meal quality, or staff withholding food. This agency has investigated the investigations above. We have found that the allegations were 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, a copy of this report provided. 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 ***CONTINUE FROM 9099*** LPA interviewed seven staff (S1–S7), three residents, and one responsible party for R2. Interviews conducted did not reveal disclosures or observations consistent with physical abuse, humiliation, or mistreatment by staff. Residents interviewed did not report being sprayed with water, forced into showers, or physically harmed. Staff consistently denied the allegation and reported that residents are treated with dignity and respect. The responsible party for R2 interviewed also did not express concerns regarding staff conduct or treatment of residents. LPA also reviewed Staff files, including notes and reports. No reports of misconduct by the staff were documented. LPA toured the facility including three resident rooms, the memory care unit, and common areas. No evidence of abuse, unsafe practices were observed. LPA also checked the water temperature. Water temperature was measured at 112.9 F. Allegation: Staff do not distribute residents’ medications as prescribed — Unsubstantiated LPA reviewed five resident files (R1–R5), including physician reports, needs and services plans, and Medication Administration Records (MARs). Records reviewed showed medications were documented as administered in accordance with physician orders. No discrepancies were identified during records review. Staff interviewed described medication administration procedures consistent with facility policy and regulatory requirements. Additionally, no residents interviewed reported missed medications or concerns related to medication administration. ***CONTINUE ON 9099C***

On 12/16/2025 at 11:27 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to deliver amended report for complaint #15-AS-20250425125708 . LPA met with Executive Director Janelle Douglas and explained the purpose of the visit. Amended report delivered to Executive Director. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

It was alleged that staff mismanaged resident's medication; however, based on the investigation, including interviews, record reviews, and observation, there was insufficient evidence to support the allegation that staff mismanaged a resident’s medication. Medication administration records and staff documentation were consistent with prescribed orders, and no discrepancies were observed during the review. Staff demonstrated appropriate medication handling and administration procedures in accordance with facility policy and regulatory requirements. Allegation: Staff speak inappropriately to residents in care During the course of the investigation, LPA conducted 6 staff and 6 residents' interviews. It was alleged that staff spoke inappropriately to residents in care. Based on the investigation, including interviews with 5 staff, 6 residents, and a review of relevant records, there was insufficient evidence to support the allegation that staff spoke inappropriately to residents in care. Residents interviewed did not report instances of verbal mistreatment, and no witnesses or documentation corroborated the allegation. Staff demonstrated appropriate and respectful communication with residents during observations. Based upon interviews conducted and records reviewed, LPA has investigated the above allegations and found that it is Unsubstantiated. A finding that the complaint allegation/s are Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview is conducted, and a copy of this report is provided.

Allegation: Staff administered medication to the resident without consent. Based on interviews, record reviews, and documentation obtained during the investigation, there is insufficient evidence to support the allegation that staff administered medication to a resident without consent. Medication Administration Records (MARs), physician orders, and resident records were reviewed and showed no discrepancies or indications of unauthorized medication administration. Interviews with staff and residents revealed consistent procedures for obtaining consent before administering medications, in accordance with physician orders and facility policy. Although the allegation may have been made in good faith, there was no direct evidence or witness statements confirming that staff administered medication to any resident without consent. Therefore, the allegation is determined to be unsubstantiated . Allegation: Staff are not properly trained. Based on interviews, record reviews, and documentation obtained during the investigation, there is insufficient evidence to support the allegation that staff are not properly trained. Staff training records, personnel files, and required certification documentation were reviewed and found to be current and in compliance with Title 22 regulations and facility policy. Interviews with staff confirmed they had received training appropriate to their assigned duties, including ongoing in-service and annual training. Although the allegation may have been made in good faith, there was no evidence to indicate that staff lacked the necessary training to perform their responsibilities. Therefore, the allegation is determined to be unsubstantiated . Report continues on LIC 9099 C2... 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 Allegation: Staff are not following infection control practices. Based on interviews, observations, and record reviews conducted during the investigation, there is insufficient evidence to support the allegation that staff are not following infection control practices. Observations during the inspection showed staff adhering to proper infection control procedures, including the use of personal protective equipment (PPE), proper hand hygiene, and sanitation practices consistent with facility policies and Title 22 regulations. Interviews with staff confirmed that they had received infection control training and understood the required protocols. Review of training records and facility policies indicated that infection control practices are regularly reviewed and reinforced. Although the allegation may have been made in good faith, no evidence or observation confirmed that the staff failed to follow infection control practices. Therefore, the allegation is determined to be unsubstantiated . Allegation: Facility is overcharging the resident in care. Based on interviews, record reviews, and documentation obtained during the investigation, there is insufficient evidence to support the allegation that the facility is overcharging the resident in care. A review of resident financial records, admission agreements, and billing statements showed that charges were consistent with the agreed-upon rates and services outlined in the resident’s contract. Interviews with facility staff and residents (or responsible parties) confirmed that fees and billing practices were explained and documented in accordance with regulatory and facility requirements. No discrepancies or unauthorized charges were identified during the investigation. Although the allegation may have been made in good faith, there was no evidence to substantiate claims of overcharging. Therefore, the allegation is determined to be unsubstantiated. Report continues on LIC 9099C3... 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 Allegation: Staff do not ensure residents are provided with activities. Based on interviews, observations, and record reviews conducted during the investigation, there is insufficient evidence to support the allegation that staff do not ensure residents are provided with activities. Review of the facility’s activity calendar, resident participation logs, and staff schedules confirmed that planned activities are offered on a regular basis in accordance with Title 22 requirements and facility policy. Interviews with residents and staff indicated that a variety of activities are available, including group and individual options, and residents are encouraged—but not required—to participate. Observations during the visit also confirmed that activities were being conducted and residents were engaged. Although the allegation may have been made in good faith, there was no evidence to indicate that staff failed to provide or encourage resident participation in activities. Therefore, the allegation is determined to be unsubstantiated. Allegation: Staff do not provide adequate food service. Based on interviews, observations, and record reviews conducted during the investigation, there is insufficient evidence to support the allegation that staff do not provide adequate food service to residents. Meal service was observed during the visit, and food was found to be properly prepared, well-portioned, and served at appropriate temperatures. The facility’s menu was reviewed and found to meet residents’ nutritional needs in accordance with Title 22 regulations and physician or dietician recommendations. Interviews with residents and staff indicated that meals are provided on schedule, with alternative options available for those with dietary restrictions or preferences. Review of food supply records and storage areas confirmed that the facility maintains an adequate quantity and quality of food. Although the allegation may have been made in good faith, there was no evidence to indicate that staff failed to provide adequate food service. Therefore, the allegation is determined to be unsubstantiated. Report continues on LIC 9099C4... 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 Allegation: Facility is not in good repair Based on observations, interviews, and record reviews conducted during the investigation, there is insufficient evidence to support the allegation that the facility is not in good repair. During the inspection, the physical plant, resident rooms, common areas, and outdoor spaces were observed to be clean, safe, and well-maintained. No health or safety hazards were identified, and all fixtures, furnishings, and equipment appeared to be in proper working condition. Interviews with residents and staff indicated no ongoing maintenance concerns, and review of maintenance logs showed that repair requests are addressed in a timely manner. Although the allegation may have been made in good faith, there was no evidence to indicate that the facility failed to maintain the premises in good repair. Therefore, the allegation is determined to be unsubstantiated. Allegation: Facility has pests. Based on observations, interviews, and record reviews conducted during the investigation, there is insufficient evidence to support the allegation that the facility has pests. During the inspection, all indoor and outdoor areas—including resident rooms, kitchen, dining area, and storage spaces—were observed to be clean and free of any signs of pest activity. Interviews with staff and residents revealed no recent reports or sightings of pests. Review of pest control service records confirmed that the facility maintains a regular pest control contract and receives routine inspections and treatments as needed. Although the allegation may have been made in good faith, there was no evidence to indicate the presence of pests at the facility. Therefore, the allegation is determined to be unsubstantiated. Report continue on LIC 9099C5... 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 Allegation: Staff do not securely store residents' personal items. Based on interviews, observations, and record reviews conducted during the investigation, there is insufficient evidence to support the allegation that staff do not securely store residents’ personal items. During the inspection, residents’ rooms and storage areas were observed, and personal belongings appeared to be properly stored. Lockable storage options were available to residents who wished to secure their valuables. Interviews with residents and staff indicated that residents are encouraged to keep personal items in their designated areas and that the facility has policies in place to safeguard residents’ belongings. Review of records revealed no reports or complaints of missing or mishandled items. Although the allegation may have been made in good faith, there was no evidence to indicate that staff failed to securely store residents’ personal items. Therefore, the allegation is determined to be unsubstantiated. Based upon interviews conducted and records reviewed, LPA has investigated the above allegations and found that it is Unsubstantiated. A finding that the complaint allegation/s are Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview is conducted, and a copy of this report is provided.

***CONTINUE FROM 9099*** S1 also reported that R1 was encouraged to use pendent for assistance in daily activities in addition to regular check-ins. S3 stated that he always went to R1s room to offer assistance and "passed on notes to the next caregiver on shift". LPA reviewed communication log, check-in schedule, and internal caregiver notes. LPA reviewed staff schedule for the month of March and April. On 4/14, S3 stated that he "found R1 on the floor outside of his room with blood coming from R1's head. S1 stated that "911 was called by the med tech, W1 was notified, and R1 was taken to the hospital immediately". W1 stated that she is unable to provide hospital records and pictures. Review of R1's care plan and staff assignment sheet revealed that R1 was on a total assist with activities of daily living. Allegation: Staff did not refund resident according to the resident’s Admission Agreement- Unsubstantiated Review of R1s payer summary revealed that W1 paid the facility $16998.38 on 04/08/2025. On 04/21 W1 was refunded 10081.67 which included 5081.76 for the the part of the month that R1 was not residing at the facility. The summary also showed that R1 was refunded one time move in fee of $5000. W1 stated that she did receive 10081.67 from the facility. S4 stated that "what we have in the admission agreement is what we follow". LPA reviewed the ledger and the admission agreement for R1. Allegation: Staff mismanaged resident medication - Unsubstantiated Review of R1 record revealed that R1 was at the facility for 18 days. W1 stated that she received a call regarding missing medication. No staff member at the facility could verify that called her regarding missing medication. S2 stated that only 1 over the counter medication was missing. S2 further stated that W1 "called and mentioned that she will bring the over the counter medication to the facility". LPA checked the MAR for R1. No missing medication was marked on R1's MAR. LPA also reviewed a sample of resident's (R2,R3) medications. There was no missing medications reported on R2's and R3's MARs. ***CONTINUE ON 9099C*** 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 ***CONTINUE FROM 9099C*** This agency has investigated the above allegations. We have found that the allegations were 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, a copy of this report provided.

On 8/19/2025 at 10:30am Licensing Program Analysts (LPAs) Ardalan Gharachorloo and Kelly Nguyen arrived unannounced to conduct a Required - 1 Year inspection at approximately, and met with Interim Executive Director, Vercina Curley and explained the purpose of the visit. LPAs toured the facility with the Interim Executive Director and observed some COVID-19 precaution signs posted in common areas to promote hand washing and physical distancing. Infection Control Policies last updated on 12/4/2024. This facility is licensed to serve up to 80 residents. There are 4 floors being used and the facility consists of living room/front area, activity rooms, gym, theater room, indoor outdoor dining and 80 private residence rooms. No accessible bodies of water or fire safety hazards observed. Fire Extinguisher were found to be charged and serviced 9/3/2025. Floors have stair evacuation chairs. The facility has hard wire Smoke alarms, fire sprinklers that are serviced yearly and Carbon monoxide detectors. Hot water measured at an average of 102.6 Degree Freiheit of sample residents’ apartments. Fire Drill last conducted on 7/18/25. Liability Insurance issue on 6/1/2025 to 6/1/2026 under Amador Valley I, LLC 7601 in addition to DBA Emerald Valley. Car registration issue from 9/30/24 to 9/30/2025. LPAs reviewed 6 clients’ records and 10 staff records, and all were complete. A sample of 6 residents’ medications were reviewed. Exit interview conducted with Interim Executive Director a copy of this report is provided No deficiencies cited during this inspection

On 08/02/2024 at 11:00 AM Licensing Program Analyst (LPA) L. Alexander conducted an unannounced Case Management visit regarding an incident that was reported to CCLD on 06/19/2024. LPA met with Executive Director, Marissa Espinoza and explained the purpose of the visit LPA received a SOC 341 from Reporting Party (RP) indicating that there was a altercation between R1 and R2. Staff immediately intervened and separated both R1 and R2. No further issues with the residents. LPA L. Alexander collected documents pertinent to the incident report. No deficiencies issued during the visit. Exit interview conducted and a copy of this report was provided.

On 07/26/2024 at 11:27 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Executive Director, Marissa Espinoza and explained the purpose of the visit. LPA toured the facility including but not limited to 4 residents’ apartments, bathrooms, multiple activity rooms, kitchen, common area and courtyard. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 75 degrees F. The hot water temperature in a residents’ shared bathroom was measured at 115 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medications, sharps and toxic are locked and inaccessible to residents in care. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 09/10/2023. Emergency Disaster Plan was last posted on 02/16/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 06/13/2024. LPA reviewed 6 residents records and 6 staff records, and all were complete. LPA also reviewed a sample of resident’s medications and medication logs. The following documents were reviewed during the visit: LIC 500 Personnel Report, LIC 610E Emergency Disaster Plan, Liability Insurance and Current Administrator’s Certificate renewal documents. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 12/5/2023 at 2:30 PM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator (ADM) Marissa Espinoza and explained the purpose of the visit. The required annual inspection is incomplete and LPA will return to complete inspection at a later date. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.