Atria Newport Plaza.

On today's date LPA's William Vanegas and Brandon Lopez conducted an unannounced visit to the facility to conduct the required annual inspection. LPAs were greeted and granted entry to the facility by staff after explaining the purpose for the visit. Administrator (AD) Joanna Gonzalez was present and assisted on today;s visit. LPAs observed that AD Joanna Gonzalez has a valid Administrator certificate which expires January 18, 2027. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for 160 residents, all of which can be non-ambulatory, and has a hospice waiver for 25. The facility consists of a single building that is three stories tall. The building consists of private apartments that contain bathrooms located in the apartments. A commercial kitchen, a dining room, a wellness center, a salon, laundry rooms, medications rooms, activity rooms, and storage rooms. LPAs accompanied with AD conducted a tour of the interior portions of the faciltiy. LPA's observed the PUB 475 and all other required postings to be posted at the entrance of the facility and visible to all guest and residents in care. LPAs observed a total of 10 resident apartments. LPAs observed resident apartments to have all required items such as a bed, clean linens in good repair; meaning no strains or tares, chest drawers, a chair, a reading lamp, and a storage space for personal belongings. LPAs observed residents to have a pendant with them to call for assistance. Pendants were pressed and tested operational. LPAs inspected resident bathrooms and they all appeared to be clean and free of any mildew or debris. Toilets and water faucets tested operational and water tested between 110.1 and 120.2 degrees. Showers were observed to have slip resistant floors, grab bars, and a shower chair. CONTINUED ON LIC 809C 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 LPAs observed the facility to have a minimum of two day perishable and seve day non-perishable food supply on hand LPAs observed the facility has a three day emergency food and water supply kept in a storage room. LPAs observed multiple fire extinguishers that were fully charged and up to date. LPAs observed evacuations chairs that are accessible in each stairwell. LPAs observed that the facility had their most recent fire inspection conducted on August 18,2025. LPAs observed that the facility fire sprinklers and smoke detectors tested operational during the inspection. LPAs observed the centrally stored medication to be kept in locked medicine carts located in the medication room. LPAs observed first aid kits to be stored in each of the medication rooms and they had all the required components. LPAs observed all the facilitys chemicals and toxins to be stored in a locked storage room. LPAs observed other common areas such as the dining rooms, staff offices and activity areas to be clear of any hazards. LPAs accompanied with the AD, conducted a tour of the exterior portions of the facility. LPAs observed an outdoor shaded sitting area with furniture for residents to use. LPAs observed the exterior to be free of any hazards. LPAs tested the delay egress doors located on the exterior portions which tested operational. LPAs reviewed the 10 resident files. All the required documentation was present and current in each resident file. LPAs reviewed residents medication and medication administration records. LPAs reviewed 10 resident files as well. All required training and first aid and CPR were present and current. Based on the observations made during today's visit no deficiencies are being cited per title 22 of the California Code of Regulations. An exit interview was conducted with Executive Director Johanna Gonzalez and a copy of the report was provided.

CONTINUED FROM FORM LIC9099 Regarding the allegation that Staff did not reappraise resident when his condition changed , the following has been concluded. Resident R1 was assessed upon move-in in October 2023 and was then reassessed multiple times throughout the period of admission, with assessments reviewed for April 2024 after six months, then monthly after July 2024 once the resident was moved to the facility's memory care until R1's move-out in December. Gradual updates appear to reflect the evolution of R1's cognitive and behavioral abilities. Regarding the allegation that Staff did not provide resident's authorized person sufficient notice before changing his basic needs and services plan , the allegation is based on facility staff ordering the immediate implementation of a one-on-one caregiver starting on December 5, 2024. Per R1's admission agreement signed by all parties on September 27, 2023, the resident and their responsible party had agreed to a clause stating: " If you become a safety risk to yourself or to others during your residency, we have the right in our sole determination to obtain, at your expense, private duty personnel to provide supervision or assistance until you move from the Community or your safety is no longer at risk, and we will communicate that decision to someone on your behalf according to the Responsible Party and/or Emergency Contact information you agree to provide us. This communication will occur in advance of implementing a private duty caregiver, if reasonably possible, or soon after we have made the decision regarding your safety". Multiple incidents involving aggressive behavioral expression were reported to the responsible party as well as to the resident's primary care physician prior to the December 5 notification. Additionally, one-on-one supervision is not listed among the basic resident services for which a change in rate would require advance notice. Regarding the allegation that Staff kept resident isolated in his room , the following has been concluded: During both facility visits, licensing staff toured the memory care unit. During both visits, residents appeared free to ambulate, with no residents found to exhibit any signs of distress. Residents were observed relaxing in the unit's common area or in their respective bedrooms. Staff interviews evidenced that one of the recommended redirection strategies for some of R1's behavioral expression was to accompany the resident back to their unit to allow R1 to calm down as well as to avoid disrupting care for the other memory care residents. Interviews however did not provide sufficient evidence to corroborate that R1 was kept in their bedroom against their will. CONTINUED ON FORM 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 CONTINUED FROM FORM LIC9099-C Regarding the allegation that Staff did not provide adequate care or supervision for residents to prevent falls , the following has been concluded: R1 sustained multiple fall incidents during their admission at the facility. Multiple assessments reviewed show that the resident was identified as a fall risk upon admission. R1 sustained scalp lacerations as a result of a fall that occurred on a family outing in May 2024, as well as skin abrasions as a result of an unwitnessed fall in memory care. Two other falls occurred prior to R1's relocation to memory care and involved mobility in the facility's elevator. Such incidents did not recur after the resident moved to the unit located on the ground floor. Interviews and records reviewed did not evidence any failure to provide adequate care and supervision of a nature that would result in a fall. Regarding the allegation that Staff accepted a resident that required a higher level of care , the following has been concluded: Allegation was formulated regarding former resident R2, admitted on October 5, 2023 upon the basis of a pre-admission assessment dated September 29, 2023. Initial assessment was confirmed in the days following the move into the facility. R2 however declined rapidly and was reassessed to a higher needs profile on October 10, 2023, before being placed onto hospice care on October 12. R2 passed away with hospice present at bedside on October 14, 2023. However no elements of R2's assessment or physician report appear to indicate the resident would not have been appropriately placed at the facility or would have required continuous nursing care at the time of admission. R2 also appears to fit the criteria for acceptance and retention listed as Attachment D of their residency agreement. As a result of the evidence gathered during the investigation, all five allegations are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted and a copy of this report was provided to a facility representative.

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Executive Director Johanna Gonzalez and explained the reason for the visit. LPA observed the See Something, Say Something poster (PUB 475) posted in the entryway of the facility. The Executive Directors Administrator's Certificate expires January 18, 2025. Facility is a three story building with 112 resident rooms. Resident rooms are on all three floors. Memory care is on the first floor and has 12 rooms. The memory care unit has 2 delayed egress exits that are operational. Facility has a capacity for 160 non-ambulatory residents. The third floor is approved for ambulatory only. Hospice waiver is approved for 25 residents and no bedridden. LPA and the Executive Director toured the facility. LPA observed that all fire extinguishers throughout the facility are fully charged. The memory care unit is secured and requires a code to enter. The memory care unit has a dining room and activity room. LPA observed that all resident rooms in memory care had the required furnishings and bed linens. No obstacles or hazards observed in the memory care unit. LPA observed that there is an emergency evacuation chair at the top of each stairwell. LPA observed that in the 7 resident rooms inspected in assisted living, all the rooms had the required furnishings. LPA observed that all resident bathrooms that were inspected were clean and operational. Hot water in the bathrooms inspected measured from 107.0 degrees Fahrenheit to 112.4 degrees Fahrenheit. LPA observed the kitchen is clean and organized. LPA observed the temperature logs are posted on the refrigerators. LPA observed there is a 2 day supply of perishable and a 7 day supply of non-perishable food on hand in the kitchen. Both the memory care unit and the assisted living section have outdoor patio areas with shade for the residents to sit outside. No obstacles or hazards observed in the assisted living section of the facility. LPA observed the emergency food and water is stored on the third floor in a storage room. LPA interviewed staff and residents. LPA reviewed 10 staff files. No discrepancies observed. The 7 care staff files reviewed had the required training documented. LPA reviewed 10 resident files, no discrepancies noted. LPA reviewed resident medications, no discrepancies noted. The last fire drill was conducted on April 19, 2024. No deficiencies observed during the visit. No deficiencies are being cited as a result of this visit. An exit interview was conducted and a copy of the report provided to the Executive Director.