Fremont Hills.

On 04/23/2026 at 10:00 AM, Licensing Program Analyst (LPA) P.Manalo conducted an unannounced Case Management visit regarding a self-reported death report. The facility sent in a death report on 04/22/2026. LPA met with Executive Director (ED), Beena Kumar, and explained the purpose of the visit. Death Report (LIC624A) indicated that on 04/22/2026, Resident 1 (R1) was found unresponsive by S1. S1 and S2 called 911 and CPR was performed until arrival of paramedics. During the visit, LPA reviewed and obtained the following documents included but not limited to facility’s incident report, facility's observation notes, resident's physician report, resident's assessment, and appraisal needs and services plan. LPA also conducted interviews with 6 staff members and ED. LPA will be requesting for a death certificate and police report by 05/07/2026. LPA may return at a later time. No deficiency cited during today’s visit. Exit interview conducted and a copy of this report provided.

On 03/16/2026 at 2:20 PM, Licensing Program Analyst (LPA) P.Manalo conducted an unannounced Case Management visit to follow up on the incident reports sent on 03/06/2026. LPA met with Business Office Director, Mimi Co, and explained the purpose of the visit. Executive Director, Beena Kumar, was unavailable during today's visit. Incident Report (LIC624) for R1 indicated that the incident occured on 02/20/2026 and R2's incident occured on 02/24/2026. Both R1's and R2's Incident Report was reported to the Department on 03/06/2026. Facility did not follow the reporting requirements. LPA and Co discussed the reporting requirements regulation. During the visit, LPA reviewed and obtained Resident Roster, R1's service plan dated 01/20/2026, R2's service plan dated 01/20/2026, and R2's physician fax reports. Per Co, R2 did not return back from the hospital and passed away on 03/14/2026. LPA is requesting for the facility to send R1's after visit summary from the hospital and R2's death certificate by 03/25/2026. LPA may return at a later time. A Technical Violation has been issued for Reporting Requirements, Section 87211(a)(1). No deficiencies cited. Exit interview conducted and a copy of this report provided.

On 12/15/2025 at 2:30 PM, Licensing Program Analyst (LPA) P.Manalo conducted an unannounced Case Management visit regarding a self-reported death report. The facility sent in a death report on 12/12/2025. LPA met with Executive Director (ED), Beena Kumar, and explained the purpose of the visit. Death Report (LIC624A) indicated that Resident 1 (R1) had a change in condition and was taken to the Emergency Room per Kaiser Advice Line on 12/08/2025. On 12/10/2025, R1 passed away at the hospital. During the visit, LPA reviewed incident report, death report, R1's service plan, physician report, observation notes, and physician communication log. Observation Notes and facility incident report dated 12/04/2025 revealed that the paramedics came on 12/04/2025 to assessed R1. It also revealed that the Power of Attorney (POA) refused to send R1 to the hospital. A review of the physician communication log dated 12/04/2025 showed that the facility communicated with R1's physician due to R1's change in condition. LPA will be requesting for a death certificate from the facility. LPA may return at a later time. No deficiencies cited. Exit interview conducted and a copy of this report provided.

On 10/22/2025 at 2:05 PM, Licensing Program Analysts (LPAs) P.Manalo and K. Nguyen conducted an unannounced Case Management visit regarding a self-reported incident. Director of Health and Wellness, Judith Gitonga, self-reported the incident on 10/21/2025. LPAs met with Judith Gitonga and explained the purpose of the visit. Executive Director was unavailable during today's visit. LPA P.Manalo received a self-reported incident report from facility that indicated that the Resident 1 (R1) was taken to the hospital for unwitnessed fall and R1 was treated for a hip fracture. R1 had hip surgery and is in a skilled nursing for recovery. The facility will reassess R1 before returning to the facility. During the visit, LPA interviewed Gitonga and stated that R1 had fell in R1's room. LPAs will be requesting for the following documents such as R1's physician's report, previous and new full care plan, staff schedule, progress notes, and care log for R1 by 10/30/2025. LPAs may return at a later time. No deficiencies cited during visit. Exit interview was conducted with Director of Health and Wellness and a copy of this report was provided.

Continue from LIC9099... Allegation- Staff does not treat resident with respect and dignity. It was alleged that Staff 3 (S3) yelled at R1 when asked for assistance and that S3 would leave R1’s diaper in the trash can beside R1’s bed without lining the basket with a trash bag. 4 out of 5 residents interviewed stated that the staff are nice and that they receive good care at the facility. R5 stated that when they call for help at night, R5 can fall asleep after receiving care. Interview with S2 indicated that it’s rare for S2 to observe wet diapers in the beginning of their shift on the resident and in the resident’s room, however, it could be a possibility that staff would forget to pick it up. LPA attempted to interview S3 and S4 and did not receive any call back. 3 out of 5 staff members interviewed expressed that they have not heard any other staff members speak to residents rudely. Allegation: Staff did not provide assistance to a resident in a timely manner. Based on interviews conducted with residents, each resident is provided with a call button or pendant that can be utilized to call staff, if needed. R1 stated that when R1 needed assistance at night, S3 and S4 took a long time to arrive to R1’s room for assistance. S1 also stated that during night shifts, the staff are supposed to attend to resident’s calls together. Interview with R5 indicated that when R5 needs assistance at night, R5 will use the call button and have not experienced any issues with the care at night. Also, 4 out of 5 residents interviewed stated that staff will assist them when needed. Staff interviewed revealed that when residents need assistance, staff will receive a radio call from which resident and room needs to be tended to. If a staff member was unable to attend the call, they will reach out to another staff member that is available to respond to the resident. Continue to LIC9099-C... 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 LIC9099-C... A review of the facility’s call log dated 03/25/2025 during the night shift between 1:00 AM to 4:30 AM showed that the response time varied from three seconds to about three and a half hours. S1 stated that during this time the system was having computer issues and could not clear the calls. Staff were able to reset the system at around 5:30 AM on 03/25/2025. After the computer issues were resolved, the response time for when residents would call for assistance varied from seconds to about twelve minutes that night. Although a review of the facility’s Resident Alert Call System policy dated 06/01/2025 does not indicate a response time, interviews with S6 and S7 revealed that staff will attempt to respond within 10 to 15 minutes of a residents’ call. There is no deficiency noted. Based on interviews and record reviews conducted, the above allegation is unsubstantiated. Although the allegation 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 and a copy of this report was provided.

On 06/05/2025 at 2:25PM, Licensing Program Analyst (LPA) P.Manalo conducted an unannounced Case Management visit regarding a self-reported incident. Director of Health and Wellness, Judith Gitonga, self-reported the incident on 06/02/2025. LPA met with Judith Gitonga and explained the purpose of the visit. LPA P.Manalo received a self-reported incident report from facility that indicated that the Resident 1 (R1) was taken to the hospital for upper leg pain from an unwitnessed fall on 05/29/2025. R1 was treated for a hip fracture. R1 had hip surgery on 05/30/2025 and is in a skilled nursing for recovery. The facility will reassess R1 before returning to the facility. During the visit, LPA reviewed and obtained R1's Physician's Report, Emergency ID Contact Information, Admission Agreement, Service Plan, and the facility's Fall Reduction Program. Admission Agreement showed that the resident was recently admitted to the facility on 05/26/2025. Prior to the resident's fall, the resident was already placed as a fall risk on the service plan for having multiple falls in the last 3 months. However, R1's Physician's Report dated on 05/05/2025 showed that the resident is bedridden. Since R1 is new to the facility, R1 was placed on an hourly check in. LPA may return at a later time. No deficiencies cited during visit. Exit interview was conducted with Director of Health and Wellness and a copy of this report was provided.

On 04/16/2025 at 1:55 PM, Licensing Program Analysts (LPAs) P. Manalo and K. Nguyen conducted an unannounced Case Management Visit. This is a follow up visit that was conducted on 03/14/2025 regarding an incident that was reported to CCLD on 02/27/2025 indicated that Resident 1 (R1) obtained a wound while in the hospital. LPAs met with Interim- Executive Director, Vivian Villegas, and explained the purpose of the visit. The documents that were obtained from the first Case Management visit showed that R1 was discharged from the hospital on 02/25/2025 and was placed on hospice on 03/05/2025. Moving forward, the facility will notify CCLD prior to admitting residents with prohibited or restrictive health conditions. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 03/27/2025 at 1:38 PM Licensing Program Analysts (LPAs) P.Manalo and L. Fontanilla conducted an unannounced Case Management visit. LPAs met with Interim- Executive Director, Vivian Villegas, and explained the purpose of the visit. While LPAs was at the facility to conduct a complaint investigation (15-AS-20250325125744), LPAs observed construction being done on the front patio in front of the facility. Upon verification made with Interim- Executive Director, she stated that they are working on constructing on 19 residents patios. Vivian stated that this project has been in the plan for over a year, and just got approved with a building permit. Interim- Executive Director was unsure if the construction was reported to CCLD. LPAs obtained the following documents such as building permit, plan of the renovations, and letter to family members notifying the construction. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 03/14/2025, at 2:15 PM Licensing Program Analysts (LPAs), P. Manalo and K. Nguyen arrived unannounced to conduct a case management following up an incident that was reported to CCLD on 02/27/2025 regarding R1 obtaining a wound while in the hospital. LPAs met with Director of Health and Wellness, Judith Gitonga, and explained the reason for the visit. LPAs reviewed R1's Physician's Report dated 2022, 2023, and 2025, Senior Living Standard Level of Care and Service Plan, Service Plan Report, Watermark Assessment, Elopement Risk Screening, Outside Agency Documentation, Progress Notes, and Discharge Summary. LPAs interviewed S1 and indicated that they had done an assessment prior to the resident returning back to the facility. LPAs are requesting to obtain Staff Contact information, Staff Schedule, Previous Service Plan Reports, and other notes pertaining to R1's injury (Caregiver's Notes) by 03/19/2025. LPAs will return at a later time. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On this day 09/27/2024 at 3:35 pm, Licensing Program Analysts (LPAs) Patricia Manalo and Luisa Fontanilla arrived to the facility to conduct a case management visit regarding an elopement and met with Generations Program Director, Molly Young and explained the purpose of the visit. During the visit, LPAs interviewed R1, S1, S2, and Generations Program Director. LPAs obtained R1's Physician's Report and Needs, Services Plan, and updated Care Plan. Based on interviews conducted, R1 was found outside the facility. The Union City Police Department brought R1 back to the facility. The Director states R1 was brought to the doctor the next day. R1 did not sustain any injury during the incident. Generations Program Director stated that the facility will hire additional staffing for AM and PM shifts. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

Continue from Lic9099... It was alleged that; Staff do not ensure that resident's hygiene needs are being met while in care and Staff do not ensure that resident's clothing needs are being met while in care. Based on interviews and record review, residents’ activities of Daily living (ADLs) are being cared for and staff are meeting all residents care needs in the morning by care givers. S1 stated that residents’ are on an ADL schedule which indicates that each residents’ ADLs are preformed twice or 3 times a week; some residents’ can request ADLs to be performed if needed. LPA reviewed the facilities point of care logs, which indicates that the residents’ ADLs are being met by care staff. All 3 staff stated ADLs are preformed every day to residents. All 4 residents’ stated that staff care for residents’ ADLs every day and residents’ do not have a problem with their needs being met. Some residents’ are independent and can preform their own ADLs as well. It was alleged that; Staff do not provide assistance to residents in a timely manner and Staff do not ensure that resident is provided with clean bedding while in care. Based on interviews with staff and residents, all 3 staff stated that when a resident calls for assistance, staff will go to the resident’s room to see what assistance the resident needs, and staff will assist resident with their care needs. Staff stated it takes about 5 minutes or less to response to a residents call after a resident pushes their call button or little longer if a staff is assisting other residents. All 4 residents stated that staff come to their room after the call button is pressed, and sometimes it takes little longer but staff do come to their room shortly after. All 4 residents also mentioned that staff clean their rooms and makes sure all bed sheets are clean and new for the resident to use. Page 2 of 3 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 It was alleged that, the facility is odiferous , and the facility is unsanitary. Based on observation and interviews, LPA observed that the facility is clean and sanitary. LPA did not observe the facility to be dirty and is kept clean and smells good. LPA toured the facility, and entered resident’s rooms and observed that the rooms of the facility are kept clean, sanitary and did not have any smell. Staff stated to LPA that care staff makes sure that the facility and the resident’s rooms are kept clean and do not have an odor to them. Based on Interviews and observation conducted, Although the allegation may have happened or are 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 with MCD, and a copy of this report provided. Page 3 of 3

On 9/29/2023 starting at 2:50 PM, Licensing Program Analyst (LPA) L. Fici arrived unannounced to conduct 1-Year Annual Required Inspection. LPA met with Viray, Bernadette, administrator (ADM) and explained the purpose of the visit. The facility’s fire clearance was approved for One Hundred Forty (140) non-ambulatory residents, of which Ten (10) may be bedridden. Upon entry, LPA observed three (3) staff and two (2) residents present during inspection. Starting at 2:56 PM, LPA toured facility with ADM including but not limited to one hundred nine (109) bedrooms, 109 bathrooms, kitchen, common area and backyard. The facility consists of 109 total bedrooms, which eighty five (85) bedrooms are private, and twelve (12) bedrooms are shared. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 73 Degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents'. The hot water temperature in residents’ bathroom on the second floor was measured at 119.8 Degrees Fahrenheit. Residents’ bathrooms are equipped non-skid mats. There is a minimum of one-week supply of nonperishable and 2-day supply of perishable foods. Sharps and toxins were locked and inaccessible to residents'. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was observed last serviced on 6/6/2023. First aid kit was observed to be complete. Continue on Lic809-C 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 Continued from Lic809 Starting At 4:03 PM, LPA reviewed 10 of 10 staff records. At 5:14 PM, LPA reviewed 10 of 10 residents' records. At 6:25 PM, LPA reviewed 10 of 10 residents' medications. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 10/6/2023: · LIC 308 Designation of Administrative Responsibility · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan (9 Pages) · Liability Insurance No deficiencies cited during visit. Exit interview conducted with ADM, and a copy of this report provided.

Continue on Lic9099 It was alleged that; Resident was left on the floor for an extended period of time and staff do not ensure adequate supervision is provided to residents in care. Based on interviews conducted, all staff stated that staff check on residents every hour to 2 hours to make sure residents are doing well. Staff stated that, depending on residents’ care plan, staff will check on residents more often than others to ensure that residents are doing fine. During the AM, and PM shifts, staff stated that there are 3 to 4 care staff plus one med tech, and during the NOC shift, there are 2 staff in the memory unit and 2 staff in the assisted living unit plus ones med tech. All residents stated that staff check on residents daily and often to ensure residents are doing well. It was alleged that; Staff do not ensure resident receives bathing assistance and staff do not respond to resident’s signal system in a timely manner. Based on interviews and record review conducted, staff stated that ADLs are performed on a daily basis and showers are given to all residents, usually in the mornings or as needed per resident’s needs. LPA reviewed point of care (POC) logs which indicated that staff are preforming R1’s ADLs which are documented. Staff stated when a resident calls for assistance, it alerts staff on their radio, so staff knows which room to go to. LPA reviewed facility call log, which indicated that staff are responding to R1’s calls in a timely manner when R1 calls for assistance. Residents stated that ADLs are preformed on a daily basis by staff or residents are able to care for their own ADLs without staff assisting them. Residents have also stated that when a resident calls for staff, staff are there to assist residents within 5 minutes to 10 minutes. It was alleged that; Staff do not follow resident’s dietary restrictions. Based on interviews conducted, all staff stated that if a resident has a dietary restriction, a log is created that informs staff what each resident can or cannot have. If a resident need purred food, mechanical soft foods, no certain meats, or low salt foods, etc, facility will accommodate for those dietary needs. Dietary logs are located in the memory care unit, in the kitchen and dinning area for staff to see. Based on Interviews record review conducted, Although the allegation may have happened or are 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 with ADM, and a copy of this report provided.