Sage Glendale Senior Living.

Cont. from LIC 9099 It was alleged that the resident #1 (R1) fell out of bed the day he was admitted to the facility. Staff revealed that fall risk residents are identified during initial assessment. Based on initial assessment, if the resident is a fall risk, they draft specific plan of action with preventive measures. R1 was fully independent and not a fall risk resident. Although R1 was not a fall risk, they requested assistance two (2) times. First time for fall incident and second time after injuring themselves in the bathroom. For both incidents R1 was assisted by the staff and no medical attention was required. Residents interviewed during this investigation did not address any concerns regarding their assistance. A review of R1’s facility file revealed that R1 was admitted as an independent resident. R1 was not identified as a fall risk and did not require frequent checks or specific supervision to prevent falls. No information or evidence was available to support the allegation. Therefore, based on interviews, and record review, the allegation is unsubstantiated at this time. Staff are not answering resident call buttons in a timely manner. It was alleged that R1 pushed the button on their neck alert and no one came to his room. R1 called family members to call the Facility so that they could pick him up. The Staff call 911 to lift R1. Staff interviewed during this visit revealed that when residents push their pendant usually, they try to respond as soon as possible. Sometime residents not only push call buttons, but also either call front desk or their responsible party may call front desk. Average time to respond is between 7 to 10 min. Staff #1 (S1) and staff #2 (S2) stated that R1 used their pendant 2 times and both times they responded within 5-7 minutes. The information provided during investigation does not support the allegation. Therefore, based on interviews, observation, and record review, the allegation is unsubstantiated at this time. Staff are not meeting residents’ bathing needs. It was alleged that on June 26, 2025, when R1 was getting ready for the doctor’s appointment, R1 smelled as if they hadn’t been bathed/showered in days. Staff indicated that they have shower schedule and they are following shower shceduel. Staff were unable to recall providing shower assistance to the R1. Other residents interviewed during this visit did not address any concerns regarding their bathing assistance. A review of R1’s record verifies that R1 did not require bathing assistance. The information provided during investigation does not support the allegation. Therefore, based on interviews and record review, the allegation is unsubstantiated at this time. Cont. on LIC 9099-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 Cont. LIC 9099-C Staff are not properly notifying responsible parties of residents change in condition Staff did not seek timely medical attention for resident in care It was reported that R1’s foot was scratched and inflamed, and shown signs of infection and the facility did not report R1’s responsible party. R1 had inflammation on their foot and facility did not seek medical attention. R1 was sent to ER when they visited the doctor for routine appointment. Staff interviewed during investigation were unable to recall seeing R1’s foot swollen. They stated R1 was able to ambulate and never complained about their foot or legs getting swollen. S1 and S2 verified that there were 2 instances when they assisted R1 and both times R1 was assisted by the caregivers and med techs and did not articulate any pain or discomfort. R1 insisted that he does not require medical care. A review of R1’s file revealed that a resident did not have a health condition requiring specific follow up or medical assistance/care. R1’s health condition was not changed during their stay in the facility. Records verified the information provided by staff. Other residents interviewed during investigation did not reveal any information regarding their medical care or timely medical assistance. Based on interviews and record review, there is not enough information and/or evidence to verify the allegations. Therefore, the allegations are deemed unsubstantiated at this time. Staff did not adequately ensure residents’ room was clean and orderly Staff did not ensure residents laundry was washed Staff were not properly addressing pests in the facility It was reported that R1 room often had rotting food, trash was piled, laundry was not being washed, and there were bugs all over R1’s bed, clothes, and in the linen closet." During facility inspection LPA did not observe any food, piled trash or dirty laundry in residents’ rooms. Staff revealed that residents’ rooms are checked every day. The trash is picked up every morning and as needed. R1 was always ordering food in his room. They would take the tray there and after an hour they would go and pick up the food. No staff had seen rotten food or bugs all over R1’s room including closets. Staff also revealed that R1 was getting laundry service as per request. When R1 wanted their clothes to be washed or bed to be changed, they informed staff to come and pick up the laundry. Other residents interviewed during this visit had no issues regarding housekeeping or laundry services. The information available during this visit does not verify the allegations. Therefore, based on inspection, observation, interviews and record review, the allegations are unsubstantiated at this time. Exit interview conducted. Copy of this report was provided.

Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted unannounced case management Annual Continuation visit to the facility. LPA met with ED and explained the reason for the visit. LPA informed ED that this visit was conducted to complete Required 1 year inspection initiated on 02/10/2025. During this visit at 1:45p.m., LPA and ED toured the physical plant areas inside and outside to ensure there are no health and safety hazards in the facility. LPA was informed of several active cases of COVID-19 in the facility. At approximately 2:25p.m. LPA reviewed seven (07) out of seventy-five (75) residents records and they were complete at the time of this visit. LPA reviewed five (05) staff files and they had criminal record clearance and Cardiopulmonary Resuscitation (CPR) certificate at the time of this visit. All required documents were appropriately signed and dated. Exit interview was conducted. A copy of this report was provided to the Executive Director.

Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required One (1) year inspection visit at this facility today. LPA met with Executive Director and explained the reason for the visit. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools. At 11:15a.m. LPA and E.D. toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. This is an RCFE with a capacity of 113, The census is currently 81. The facility is a five (05) story building with underground parking. The 1st floor consists of the following: a lobby area, administrative offices, dining area, activities room, T.V. room, kitchen, theater, conference room and outdoor patios. The 2nd floor is for Memory Care. The 3rd to 5th floor is for Assisted Living. The passageways and walkways are free of hazards and free from obstruction. The facility maintains a comfortable temperature at 75°F. There are carbon monoxide detector installed in the facility. Fire extinguishers are located all throughout the facility and last inspected on 04/25/2024. The fire extinguishers and carbon monoxide detectors were observed to be fully charged and in compliance. The facility is equipped with emergency pull alarm and sprinkler system. Facility Fire drill was last conducted on 01/08/2025. There is only one entrance being utilized at the facility, all required posters were posted at the entrance. The facility has central air and heating accommodations. During today's visit, in addition to the physical plant inspection LPA interviewed eight (08) out of eighty-one (81) residents. A tour of the physical plant was conducted and the following was noted: Kitchen: The kitchen appliances and fixtures were functional. Food supplies was sufficient amount for two (02) days of perishable and seven (07) days of non-perishable was stored in covered containers at the appropriate temperatures. Cont. on LIC 809-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 Knives and sharp objects were observed to be locked and inaccessible to residents. Storage areas for cleaning solutions, toxics, knives, and hazardous items were secured and made inaccessible to residents. Walls, ceiling, and floor is in good repair, ample supply of dishes, cups, glasses and utensils for the current census. Dining area: The dining area was observed to be neat, clean and in proper order. Walls, ceiling, tables, chairs and floor is in good repair. Laundry rooms: There are laundry rooms located on each floor of the building. All toxins such as laundry detergents, cleaning agents were observed to be inaccessible to the residents in laundry rooms. Medication: Medications are centrally stored in the locked medication stations located on floors two and three. The medications were observed to be locked and inaccessible to residents. There are multiple complete first aid kits in the facility. Bedrooms: LPA randomly selected resident’s apartments on each floor. Resident bedrooms were properly furnished with appropriate beddings and linens with sufficient lighting. Hygiene for residents was observed and hallways/passageways are lit. There were enough clean linen available in the closets. Each resident’s apartment has their own restroom. Bathrooms: LPA randomly selected resident’s bathrooms on each floor. The bathrooms were observed to be clean properly supplied, functional fixtures and appropriate grab bars in showers and toilets. The hot water temperature measure range was between 106.3 – 119.3 degrees Fahrenheit within Title 22 Regulations. Common Areas : LPA observed common areas on every floor. All furnishings are in good repair, lighting is good, walls, ceiling and floors are also in good repair. Surrounding Grounds : The front grounds of the facility are well landscaped and have a leveled walkway to the entrance. All passageways were observed to be clear from obstruction. The outdoor area was enclosed, and no bodies of water were observed. Due to time constraints, LPA had to terminate the visit and will return on a later date to complete the Required - 1 Year inspection by reviewing medication, residents and staff records. No health and safety issues noted at the time of this visit. An exit interview was conducted. A copy of this report was provided to the Executive Director.

At 10:30 a.m. on 02/10/2025 Licensing Program Analyst (LPA) Antonia Alvizar-Etitma conducted an unannounced case management visit. LPA met with Executive Director, Peter Bonilla and disclosed the reason for the visit. Today’s case management visit was conducted to ensure the safety and welfare of evacuees from the RCFE- Continuing Care Retirement Community Montecedro (LIC# 197610430), due to Eaton Fire. At 11:15a.m. E.D. and LPA toured the facility. At approximately 11:50a.m. LPA interviewed four (04) out of five (05) residents from Montecedro. Interviews with residents reveal that they are doing well, Sage Glendale is meeting their needs and Montecedro is providing the service. LPA was not able to interview a resident because they were out of the community with family at the time of this visit. LPA observed all residents well kept, clean and groomed. No immediate health or safety hazards were observed during today’s visit. Exit interview conducted. Copy of 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

Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced 1 year required inspection visit. LPA met with the Administrator Angela Smith and explained the reason for today's visit. This is an RCFE with a capacity of 113, The census is currently 69. The facility is a 5 story building with underground parking. The 1st floor consists of the following: a lobby area, administrative offices, dinning area, activities room, T.V. room, kitchen, theater, conference room and outdoor patios. The 2nd floor is for Memory Care. The 3rd to 5th floor is for Assisted Living. The passageways and walkways are free of hazards and free from obstruction. The facility also counts with two operable elevators. The facility fire clearance is maintained in conformity with State Fire Marshall regulations. The facility operates and is within capacity limits. Carbon monoxide and smoke detectors were tested and all were operable. No bodies of water were observed in or around the facility. The facility maintains a comfortable temperature of 75 degrees F. Hot water temperature was measured in the kitchen and in resident bathrooms and was within the required 105 degrees F and 120 degrees F. LPA observed the resident rooms to be properly furnished. Centrally stored medicines are kept in the medication room and are locked. There is a functioning call system in each residents' room. Outdoor and indoor passageways were observed to be free and clear of obstructions. Pesticides/poisons are not stored in food areas, kitchen, or where kitchen equipment/utensils are stored. LPA observed there to be a minimum of one (1) week of nonperishable foods and two (2) days of perishable for the number of residents being served. Total daily diet has quality and quantity to meet resident's needs. 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 smoke detectors are hardwired and interconnected and observed to be operational. There are carbon monoxide detectors in the facility. Fire extinguishers are located throughout the facility and were last serviced in April of 2024 . The bathrooms were checked for cleanliness and proper operation. LPAs observed the appropriate grab bars in the showers and toilets. Medications-LPAs observed medication cart in the medication room to be locked and inaccessible to residents. There are eight (8) complete first aid kits. No health and safety issues noted at the time of this visit. Exit interview conducted. A copy of this report was issued and signature obtained.

(continued from LIC 9099) The facility was about to refund the money to R1's family member on 04/14/23 but the check payment made by R1's family already bounced at that time, so no refund check was issued. Based on the information gathered during this and prior visit. The allegation is deemed unsubstantiated at this time. Exit interview conducted. Copy of this report issued.

An unannounced Case Management Incident visit was conducted on this day by Licensing Program Analyst (LPA) Rosaura Valenzuela. The purpose of this visit is to follow-up on an incident report that was submitted to Licensing on 4/04/24 regarding Resident #1 (R1). LPA met with LVN Mary Lou Dominguez and explained the reason for the visit. It was reported that on 3/31/2019 at approximately 3:21 pm staff received a call from R1's spouse indicating that R1 had overdosed on prescribed medication. 911 was called and R1 was transported to the hospital. On 4/08/2014, LPA Valenzuela spoke to LVN Mary Lou Dominguez. Interview revealed that R1 is still at the hospital. Facility is awaiting the discharge orders and to conduct a reappraisal before accepting R1 back to the community. LPA requested and reviewed the following documents: R1's physician report, medication list, pre-appraisal, and medication orders from the physician. Records revealed that R1 is depressed. R1 does have approval from their doctor to self-administer their own medication. Facility contacted the hospital and asked what the laboratory results were. Hospital staff indicated that blood work was unremarkable. Apparently R1 did not ingest the medication that was reported to have been taken. No health and safety issues noted. Exit interview conducted and a copy of the report was issued.