Hacienda Senior Living.

LPA conducted a record review and observed R1 no longer residing at this facility. LPA’s attempt to review R1’s resident file was unsuccessful due to expiration of record retention periods. LPA conducted an interview with Staff #1 (S1) who stated that R1 had a behavioral episode and swung at Staff #2 (S2). R1’s hand hit a dresser after missing S2 which resulted in bruising and skin tears. LPA attempted to interview S2, but S2 was unavailable for an interview due to being on personal leave. LPA conducted interviews with four (4) current residents, all of whom stated that all staff members have been respectful and provided intervention whenever necessary. None of the four (4) residents interviewed ever witnessed staff members causing injuries to residents in care. The Department’s investigation did not provide enough information to corroborate the allegation that staff caused injury to resident. Based on records review and interviews conducted, this allegation is unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was not conducted as the facility has been closed since 08-26-2025. A copy of this report was sent to the ex-licensee’s last known address via USPS certified mail due to the facility closure.

was unable to reach at number provided. LPA Sparkle Day attempted to call wife of (R1) and was unable to reach at number provided. R#1 whereabouts are unknown . This Facility closed 1/31/25. There is now new management. Therefore No records or files were available for review. Due to the facility closing we were unable to locate all parties involved in the complaint. Therefore we were unable to complete a full investigation. Based upon this investigation, LPA finds that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. Allegation #2 : Staff does not ensure resident is taking medication It is alleged that R#1 is not taking his medication On 5/5/2022 Licensing Program Analyst (LPA) Jesse Gardner conducted a tour of the facility and reviewed records and received copies of pertinent documentation. LPA Gardner interviewed wife of R1 . It was reported that R1 is self neglecting and refuses to take his medications On 10/10/25 Licensing Program Analyst (LPA) Sparkle Day began the follow up investigation regarding the above allegations of this complaint. On 10/10/25 LPA) Sparkle Day attempted to call Reporting party but was unable to reach at number provided. LPA Sparkle Day attempted to call wife of (R1) and was unable to reach at number provided. R#1 whereabouts are unknown .This Facility closed 1/31/25. There is now new management. Therefore No records or files were available for review. Due to the facility closing we were unable to locate all parties involved in the complaint. Therefore we were unable to complete a full investigation. Based upon this investigation, LPA finds that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. A copy of this report will be mailed to the last known address : 161 N. Hemet Street, Hemet, CA 92544

Due to facility closing we were unable to locate all parties involved in the complaint. Therefore we were unable to complete a full investigation. Based upon this investigation, LPA finds that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. Allegation #2: Facility did not seek medical attention for resident It is alleged that R#1 had seizures and facility staff failed to seek medical attention. On 6/6/2022 LPA Colvin reviewed files and documents related to prior resident (R1). On 10/10/25 Licensing Program Analyst Sparkle Day began the follow up investigation. LPA Day attempted to call Reporting Party regarding the allegation but could not be reached at the number provided. R#1 whereabouts are unknown. LPA Day attempted to call the facility. This facility has been closed since 1/31/2025 and there is new Ownership. Therefore No records or files were available for review Due to facility closing we were unable to locate all parties involved in the complaint. Therefore we were unable to complete a full investigation. Based upon this investigation, LPA finds that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. Allegation #3: Resident required emergency medical care due to facility neglect It is alleged that resident #1 developed a medical problem due to poor diet. On 6/6/2022 LPA Colvin reviewed files and documents related to prior resident (R1). On 10/10/25 Licensing Program Analyst Sparkle Day began the follow up investigation. LPA Day attempted to call Reporting Party regarding the allegation but could not be reached at the number provided. R#1 whereabouts are unknown. LPA Day attempted to call the facility. This facility has been closed since 1/31/2025 and there is new Ownership. Therefore No records or files were available for review Due to facility closing we were unable to locate all parties involved in the complaint. Therefore we were unable to complete a full investigation. Based upon this investigation, LPA finds that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. A Copy of this report will be mailed to last known address: 161 N. Hemet Street Hemet, CA. 92544

be reached at the number provided. R#1 whereabouts are unknown. LPA Day attempted to call the facility. This facility has been closed since 1/31/2025 and there is new Ownership. Therefore No records or files were available for review. Due to facility closing we were unable to locate all parties involved in the complaint. We were unable to complete a full investigation. Based upon this investigation, LPA finds that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. Allegation #2 : Neglect/Lack of supervision resulting in resident sustaining bruises It is alleged that R#1 fell in the shower causing bruising On 3/3/2022 Licensing Program Analyst (LPA), Stephanie Torres, interviewed Administrator Dunham who deny the allegation and states R#1 did not fall, R#1 lost her balance and the staff assisted her to the floor. There were no visible bruising at that time. Staff reported it right away. On 10/9/25 Licensing Program Analyst (LPA), Sparkle Day began the follow up investigation. LPA Day contacted Reporting party who indicates the above allegation was reported to her, but she did not have any physical knowledge of this. LPA Day attempted to call Aunt of R#1 regarding the allegations but could not be reached at the number provided. R#1 whereabouts are unknown. LPA Day attempted to call the facility. This facility has been closed since 1/31/2025 and there is new Ownership. Therefore No records or files were available for review. Due to facility closing we were unable to locate all parties involved in the complaint. We were unable to complete a full investigation. Based upon this investigation, LPA finds that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. A Copy of this report will be mailed to last known address: 161 N. Hemet Street Hemet, CA 92544

Licensing Program Analysts (LPAs) Seo Jeon and Abdoulaye Zerbo conducted an unannounced annual required visit. Upon entry, LPA was greeted by Marlya Dunham, administrator, and informed her of the purpose of the visit. Facility Overview: The facility has 2 separate buildings including an office. There are no pools or firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 110.3°F. Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate. Continued 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 Record Review and Resident/Staff Files: LPA reviewed files for five staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Five resident files were reviewed and contained all required documentation. Health-Related Services/Incidental Medical Services: All resident medications were securely locked. LPA reviewed medications for three residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 6-12-2024, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed and provided.

Regarding the allegation, "Facility staff did not seek medical attention for resident in a timely manner", LPA conducted interviews with staff and R1, who was reportedly bleeding from an open bruise on their arm. Staff interview revealed that R1’s injury was dressed in a bandage. However, records to corroborate this notion were not able to be reviewed. Interview with R1 indicated that R1 had never been injured while at the facility. Thus, the allegation is deemed UNSUBSTANTIATED. Finally, regarding the allegation, "Resident sustained unexplained injury while in care". It was alleged that R1 has sustained bruises on their arms from an unknown source. Interviews with staff indicated that R1 is very active in their wheelchair and will often bump into doorframes causing bruising on their arms. Staff further indicated that their needs are attended to. An interview with R1 revealed that R1 had never been injured while at the facility. Through interviews conducted with staff and residents, this allegation is UNSUBSTANTIATED. During this visit, no citations were issued, as no deficiencies were noticed per the California Code of Regulations, Title 22. An exit interview was conducted where a copy of this report, and LIC811, were provided to Mrs. Dunham.

On 9/14/2023, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced visit to the facility for a required annual inspection. LPA met with Sales and Marketing Director, Angela Jones who was informed of the purpose of the visit. LPA toured the facility’s interior and exterior with Director Jones. During the visit, there was six (6) staff and 18 residents present. The facility is made up of two (2) buildings and is approved for delayed egress. One building is designated for assisted living and the other building is designated for residents that require a higher level of care. The facility is licensed for 66 non-ambulatory residents, of which five (5) may be bedridden. LPA was informed that resident apartments are currently getting upgraded and as a result, various apartments are vacant. During the tour, LPA observed the following: LPA observed fire alarm systems, carbon monoxide detectors and fire extinguishers throughout the facility. The outside area provides shaded seating available for resident use. Indoor and outdoor passageways are free of obstruction. There are no bodies of water on the premises. LPA toured the kitchen. Food was stored in a safe and healthful manner. Facility met Departmental requirements for 2-day perishables and 7-day non-perishable food items. The facility has large dining rooms and other areas throughout the building for residents to sit and relax. Medications are secured in medication carts, only accessible to authorized personnel such as medication technicians and the administrator. Continued 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.. Cleaning solutions, knives and sharp instruments are secured and inaccessible to residents. Staff present had criminal background clearance on file and were associated to the facility. The facility's last fire drill was held on 7/20/2023. During today's visit, LPA did not observe any deficiencies. A copy of this report was reviewed and provided to Director Jones.

deemed UNSUBSTANTIATED at this time. In addition, it was reported a staff member threatened to throw R1 in jail. R1 was interviewed and reported an unknown staff member threatened the resident by stating, "next time I'm going to call the police". The resident could not provide any further details. The Administrator was interviewed and reported having no knowledge of R1 allegedly being threatened. Staff interviews reported there was no knowledge of residents being threatened. One resident interview reported R1 has physically assaulted staff in the past. It was reported staff have told R1 they would contact law enforcement if the resident hit staff again. Therefore, due to insufficient information, this allegation is deemed UNSUBSTANTIATED at this time. A finding that the complaint is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove the alleged violations occurred. This report was reviewed with Administrator Dunham and a copy was provided.