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Report continued… Further review of the residents’ financial records, including the payment ledger, showed that R1 was responsible for issuing payments to the facility. Documentation confirmed that multiple checks were issued by R1 for rent and associated charges, including: $9,000 on 01/13/2025, $1,045 on 01/20/2025, $13,788.68 on 01/30/2025, and $5,150 on 02/20/2025, totaling $28,983.68. These charges were consistent with rent, late fees, and previously returned checks. Additionally, the Administrator (ADM) reported that during R1’s hospitalization, R1’s checkbook was not in the facility's possession. Upon R1’s return, a friend assisted R1 with managing their checkbook due to outstanding rent payments. There was no evidence obtained through interviews or document review indicating that staff had access to, control over, or misuse of R1’s financial resources. It was alleged that the facility failed to safeguard the resident’s belongings- unsubstantiated Record review indicated that at the time of admission on 10/18/2024, R1 declined to complete the Resident Personal Property and Valuables form (LIC 621), opting out of documenting personal belongings with the facility. Therefore, the facility did not assume responsibility for safeguarding undocumented personal property. Report Continued on LIC 9099c1... 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 Report Continued LIC 9099c1... Interviews with staff and residents did not reveal any concerns or observations supporting allegations of financial abuse or of facility staff mishandling personal belongings. It was alleged that the staff did not report the incident to the appropriate parties- unsubstantiated During the investigation, LPA conducted interviews with R1 and R1F. Record review revealed that at the time of admission and during the period in question, Resident 1 (R1) did not have a designated Power of Attorney (POA), a responsible party, or family members involved in their care. Therefore, no facility representatives were identified to notify them of the incident. Further information obtained indicated that a POA was only recently established to oversee R1’s healthcare decisions. There was no evidence that the facility failed to notify any appropriate or legally authorized parties at the time of the incident. Although the allegations may have occurred or be valid, there is not a preponderance of evidence to prove whether the alleged violation did or did not occur; the allegations is UNSUBSTANTIATED . An exit interview is conducted, and a copy of this report is provided.

On 04/29/2026 at 12:45 PM, Licensing Program Analyst (LPA) David Doidge arrived unannounced to deliver and amendment to a complaint dated 02/13/2026. findings. LPA met with Director of Health and Wellness Robert Aurthur and explained the purpose of the visit. During the visit. LPA interviewed five (5) residents. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

Continued from LIC9099 Investigation Findings: It was reported to the department that the facility is threatening to evict a resident, claiming that the account is seriously past due. RP reported receiving a notice saying if no payment was made in full by the end of the week the facility would "escalate" including taking steps to evict. RP informed LPA that there is a past due amount on R1’s account and that the facility was not providing any documentation showing how the past due amount was totaled or assessed. LPA interviewed S1 in the facility who provided LPA R1’s payment Ledger as well as correspondence between the facility and R1’s responsible party. S1 showed LPA how R1 is billed based on R1’s assessments. While interviewing S1, RP called LPA to inform LPA that the facility had in fact sent all the documentation to RP, noting it was a communication error on the part of the RP. RP confirmed receipt of correspondence noting it had gone into a “spam folder” by RP’s mistake. LPA confirmed with S1 and reviewed email correspondence that show emails were sent and the communication between the facility and the RP has been resolved. LPA also reviewed R1’s payment ledger to confirm R1’s account is in good standing. Based on interviews and record reviews conducted, the above allegation is 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. No deficiencies cited during the visit. Exit interview conducted and a copy this report was provided.

Continued from LIC9099 Investigation Findings: It was reported to the department that on two separate occasions money was taken from a resident’s purse along with a debit card. Each room in Assisted Living has a room safe, and residents are encouraged to keep their room doors locked and valuables out away. The facility did complete a Theft and Loss Record for both incidents and notify the responsible party of both incidents. The Theft and Loss Records show that Oakland Police Department was notified for the lost credit card, but not for the missing cash. R1 stated there was one hundred dollars in R1’s purse in R1’s room, given to R1 by R1’s daughter. About a week after being given the cash, it went missing. R1 feels it was taken from R1’s room while R1 was out of R1’s room. S1 spoke with R1 about the missing cash and created a Theft and Loss Record. S1 and S3 stated that R1 is forgetful and has forgotten R1’s purse in varies places throughout the facility as well as other items. S3 told LPA that R1 will repeat stories and thoughts when talking to S3, and has often times forgotten to clean up or feed R1’s cats. S1 and S3 have voiced concerns over R1’s memory. S2, S3, and S4 reported not knowing of the incident. Neither S2, S3, nor S4 reported ever taking money from a resident, nor suspecting other coworkers of such. In record review, R1 does have Mild Cognitive Impairment and a diagnosis of Bipolar. LPA did observe R1 having difficulty remembering the order of events, and lapse in recall of when the incidents occurred. Based on interviews, the allegation is UNSUBSTANTIATED, 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. No deficiencies cited during the visit. Exit interview conducted and a copy this report was provided.

Continued from LIC9099 Investigation Findings: It was reported to the department that on two separate occasions money was taken from a resident’s purse along with a debit card. Each room in Assisted Living has a room safe, and residents are encouraged to keep their room doors locked and valuables out away. The facility did complete a Theft and Loss Record for both incidents and notify the responsible party of both incidents. The Theft and Loss Records show that Oakland Police Department was notified for the lost credit card, but not for the missing cash. R1 stated there was one hundred dollars in R1’s purse in R1’s room, given to R1 by R1’s daughter. About a week after being given the cash, it went missing. R1 feels it was taken from R1’s room while R1 was out of R1’s room. S1 spoke with R1 about the missing cash and created a Theft and Loss Record. S1 and S3 stated that R1 is forgetful and has forgotten R1’s purse in varies places throughout the facility as well as other items. S3 told LPA that R1 will repeat stories and thoughts when talking to S3, and has often times forgotten to clean up or feed R1’s cats. S1 and S3 have voiced concerns over R1’s memory. S2, S3, and S4 reported not knowing of the incident. Neither S2, S3, nor S4 reported ever taking money from a resident, nor suspecting other coworkers of such. In record review, R1 does have Mild Cognitive Impairment and a diagnosis of Bipolar. LPA did observe R1 having difficulty remembering the order of events, and lapse in recall of when the incidents occurred. Based on interviews, the allegation is UNSUBSTANTIATED, 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. No deficiencies cited during the visit. Exit interview conducted and a copy this report was provided.

On 02/03/2026 at 01:30 PM, Licensing Program Analyst (LPA) David Doidge arrived unannounced to conduct a health and safety check. LPA met with Executive Director Anna Reddy and explained the purpose of the visit. LPA toured the facility including but not limited to bedrooms, bathrooms, common area, kitchen, and outdoor area. There was sufficient supply of perishable and nonperishable foods. Multiple fire extinguishers were observed; last serviced on 07/10/2025. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

Continued from LIC9099 While riding the elevators, LPA spoke with multiple staff and residents also riding the elevators who all confirmed neither elevator had been down for longer than a few hours for service. ED provided the elevators scheduled maintenance records showing that on 11/21/2025 passenger elevator 2 got stuck between floors with no one on board. A technician arrived at 9:23 AM and by 1:08 PM left with the elevator back in service. Records show at no point either elevator being out of service for longer than a few hours. Based on the information obtained and observation, this allegation is unsubstantiated. Allegations: Staff do not ensure residents are provided supervision Investigation Findings: It was reported to the department that a resident will spend hours outside picking up leaves and no staff member or person ever goes out to help that resident. During the investigation, LPA walked around in front of the facility and encountered R1 getting ready to pick up leaves. R1 informed LPA that R1 enjoys cleaning up leaves as it provides exercise and fresh air, R1 checks the weather, dresses appropriately for comfort and mobility, and has the sense to not go out when it is raining. R1 was lucid, oriented and showed no signs of dementia or cognitive impairment. R1 is independent and prefers independent activities to social activities. LPA spoke with ED who confirmed R1 is checked on by staff and is not fond of social activities in the facility. A review of R1’s physicians Report shows R1 may leave independently with no escort and has no cognitive impairment. Based on the information obtained, observation and interviews, this allegation is unsubstantiated. Allegations: Administration qualifications Investigation Findings: It was reported to the department that the administrator quit. LPA spoke with the administrator, ED, and verified the ED had not quit. Based on observation and interview, this allegation is 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.

Continued from LIC9099 The request comes from the responsible party’s attorney who does not have standing to request those documents, therefore this allegation is unsubstantiated. The facility has since provide all requested documents. 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, a copy of this report provided.

LIC9099-C (Page 2) On 12/11/2024, LPA interviewed Residents (R2 and R3). Both residents stated that it can take up to 30 minutes for staff to respond to their call lights. LPA reviewed the facility’s call pendant report for December 2024, which showed no record of R1 activating their call pendant on 12/03/2024, 12/05/2024, or at any time during the month. The report also indicated an average response time of approximately 20 minutes. Allegation: Staff are not providing adequate food service for residents Finding: Unsubstantiated On 12/07/2024, LPA Alexander interviewed W1, who stated that on 11/26/2024, the dining room was messy around 12:30 p.m. W1 reported that the facility provides a menu to order from, but the food tastes as if it came out of a plastic bag. W1 further stated that the facility has served hot dogs in cold buns with potato chips and that the food quality is not reflective of what residents pay for. W1 also stated that a pasta dish was once served cold and expressed concern that R1 was not drinking enough water. On 12/11/2024, LPA interviewed Residents (R2 and R3), who stated that the food is sometimes cold and not always good. R3 further stated that the facility provides an “Anytime Menu” offering six entrees and five salads, which residents enjoy. LPA interviewed Staff (S2), who stated that the kitchen offers a variety of dishes daily and that residents can also order from the alternative menu. LIC9099-C Continued... 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 LIC9099-C (Page 3) LPA reviewed the facility menu dated 10/28/2024 through 12/15/2024, which shows three meals per day with varying options. During observation of lunch and dinner service, LPA observed dining staff clearing dishes promptly and cleaning tables. Residents R4–R7 were also interviewed and reported that their meals were good and generally served on time according to the posted menu. Allegation: Staff did not ensure the elevator was not in disrepair Finding: Unsubstantiated On 12/07/2024, LPA Alexander interviewed W1, who stated that only one of the facility’s two elevators was working and that it was reported repairs could take approximately two months. On 12/11/2024, LPA interviewed Staff (S1), who confirmed that elevator #2 was not operational and that a service call had been placed with KONE for repair. S1 stated that the elevator would remain out of service pending the delivery of necessary parts. LPA reviewed a KONE service order dated 12/04/2024, which indicated the installation of a new elevator drive system for elevator #2. The report stated that the existing drive had failed and was obsolete, requiring engineering and manufacturing of a compatible replacement. Due to this, the repair process was expected to take several weeks to months. Although the allegations may have occurred or may be valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur. Therefore, all allegations are UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided.

On 07/16/2025 at 11:00 AM, Licensing Program Analyst (LPA) David Doidge arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Executive Director Anna Reddy and explained the purpose of the visit. LPA toured the facility including but not limited to 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 76 degrees Fahrenheit. The hot water temperature in a shared bathroom was measured at 120 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 toxics are locked and inaccessible to residents in care. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguishers were last serviced on 07/10/2025. Emergency Disaster Plan was last posted on 07/16/2025. First aid kit was observed to be complete. Emergency disaster drills conducted monthly, last on 07/02/2025. LPA reviewed five (5) residents records and five (5) staff records; all were complete. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a case management due to a complaint visit. LPA request facility to conduct an in-service training for all care staff including but not limited to ADL and resident personal rights submitted to CCLD by 2/21/25 including all care staff signature attending the training. No deficiency issue today. Exit interview is conducted and a copy of this report is provided.

Allegation: Staff hurt resident. Unsubstantiated During the course of investigation LPA interviewed 3 residents (R) that are in care of S3. LPA interviewed 3 staff (S) that are on the same shift as S3, and one Witness (W). R1 stated that S3 assisted R1 well. R1 stated “There have not been any time that I felt that a staff hurt me. Staff and myself get along and I do get my needs meet. No staff hurt me. Staff don’t do anything intentional that hurt me. Staff treat me well”. LPA reviewed documents that facility provided related to the above allegation. Facility follow protocol and put S3 on leave while conducting the investigation. Facility concluded that S3 did not hurt R1 intentional. LPA conducted interview 3 staff that worked the same shift as S3. 3 out of 3 stated they have not witnessed nor heard S3 hurt any residents. LPA conducted interviewed with W. W stated S3 “she didn’t not hurt resident intentional, and resident was speaking to low”. Allegation: Staff do not clean the facility properly. Unsubstantiated During the investigation LPA interviewed 2 housekeeping staff, and review housekeeping daily schedule, and housekeeping cleaning check list. LPA toured the facility including but not limited to 6 residents’ apartments, bathrooms, multiple activity rooms, kitchen, common areas and courtyard. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. This agency has investigated the complaint alleging staff hurt resident, and staff do not clean the facility properly. We have found that the complaint was 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, a copy of this report provided.

On 1/15/2025 at approximately 4:15 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced at the facility for this collateral visit to have an Amended copy of the LIC 9099 and LIC 9099-C from Complaint 15-AS-20241106155241 signed by a member of the management team. Upon entry into the facility, the LPA stated the purpose of the visit to Executive Director (ED) Becca Black. The LPA reviewed the LIC 9099 and LIC 9099-C with the ED, after which the ED signed the amended documents. Exit interview conducted and a copy of this report was provided.

LPAs interviewed S2, who also stated staff in the memory care unit will take breaks in the dinning area. S3, S4 and S5 all stated that NOC staff sometimes take breaks in the dining room area and may close their eyes to get some rest. All staff stated that they have never seen NOC staff sleeping while on duty. This agency has investigated the complaint alleging staff are sleeping during the evening shifts. We have found that the complaint was 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, a copy of this report provided.

On 11/12/2024 at 12:00pm, Licensing Program Analysts (LPAs), D. Doidge and J. Sampair arrived unannounced to conduct a case management visit regarding an incident concerning R1 that occurred on 10/30/2024 that was reported to the Department on 11/02/2024. The LPAs met with Ebony Foy, Generations Program Director, and explained the reason for the visit. The incident on 10/30/2024 involved R1 injuring R2. LPAs reviewed R1s Physician's report, Service Plan and Progress notes. Ebony informed LPAs that facility is starting the process of evicting R1. Exit interview conducted. A copy of this report provided

...Continued from LIC 9099 The complaint alleges that staff did not prevent a resident from inappropriately grabbing another resident. The LPAs interviewed Witness W1 and Director Foy. The LPAs reviewed email messages concerning the incident between Residents R1 and R2 as well as facility records and health records for Resident R2. The data reviewed did not support the allegation. Although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove them; therefore, the allegation is UNSUBSTANTIATED. Exit interview conducted and a copy of this report was provided.

On 08/08/2024 at 2:20 pm , Licensing Program Analyst (LPAs) Ardalan Gharachorloo and David Doidge arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Executive Director, Stephanie Brice 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. LPAs observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 68 degrees F. The hot water temperature in a residents’ shared bathroom was measured at 116 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 07/11/2024. Emergency Disaster Plan was last posted on 06/28/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 06/28/2024. LPAs reviewed 5 residents records and 5 staff records, and all were complete. LPAs also reviewed a sample of resident’s medications. LPAs also reviewed the following files:LIC 500 Personnel Report,LIC 610E Emergency Disaster Plan, Current Administrator’s Certificate. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

...Continued from 9099 On the allegation of: Facility elevator does not work Based on records review and interview with S1 the facility has always had at least one working elevator. The facility has two elevators and if one is having issues, they communicate with Kone Response Service who is contracted to preform maintenance. S1 stated that they were having issues with one of the elevators at the end of February and was serviced on March 4 th . On the allegation of : Staff does not timely assist resident Based on records review and interview with S1 the facility has a call log showing response times of all the residents who activate their waterproof pendants. This call log also records all of the door sensors for the stairwells, doors and garage. It is a different process to reset the sensors and it takes much longer than the call buttons, so it skews their average response time. Even with the skewed numbers their average time is 23 minutes. We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. No deficiency observed or cited during this visit. Exit interview conducted and a copy of this report provided.

On 1/30/24 at 3:15 p.m., Licensing Program Analyst (LPA) Greg Clark conducted an unannounced case management visit as a result of this facility receiving residents from Vista Terrace of Belmont (VTB). LPA met with Stephanie Brice, Administrator (ADM) and explained the purpose of the visit. There are currently 2 residents from VTB remaining at this facility. ADM stated that R1 and R5 decided to stay at this facility. During the visit, LPA toured the facility including but not limited to the apartments where the residents from VTB resided (R2, R3, R4, R6 and R7). LPA observed that all the apartments were empty. There were no health/safety concerns during today's visit. No deficiencies cited during visit. Exit interview conducted and copy of this report provided.

Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a case management visit 12/18/23 to verify if an individual is currently not employed at the facility. Based on evidence obtained during today’s visit, the LPA has verified the individual is not present, employed, or residing at the facility. LPA has advised the licensee to disassociate the individual from their roster and submit an updated LIC 500. Exit interview conducted and a copy of this report provided via email.

On 11/30/23 Licensing Program Analyst (LPA) Greg Clark conducted an unannounced case management visit as a result of this facility receiving residents from Vista Terrace of Belmont (VTB). LPA met with Stephanie Brice, Administrator (ADM) and explained the purpose of the visit. There are currently 7 residents from VTB residing at this facility. During the visit, LPA toured the facility including but not limited to the 6 apartments where the residents from VTB reside. All apartments were fully furnished with a bed, chair, night stand, lamp and personal belongings. LPA observed an adequate supply of hygiene items in the resident's bathrooms. During the tour LPA spoke to 5 out of 7 residents. All residents expressed that they had all the supplies they need at this time. ADM reported that the VTB residents are tentatively scheduled to return to VTB in December 2023. Food, staffing and hygiene supplies were all observed to be adequate during visit. There were no imminent health/safety concerns on today's date. No deficiencies cited during visit. Exit interview conducted and copy of this report provided.

On 10/26/23 at 11:00 a.m., Licensing Program Analyst (LPA) Greg Clark conducted an unannounced case management visit as a result of this facility receiving residents from Vista Terrace of Belmont (VTB). LPA met with David Ayala, Resident Care Director (RCD) and explained the purpose of the visit. There are currently 7 residents from VTB residing at this facility. During the visit, LPA toured the facility including but not limited to the 6 apartments where the residents from VTB reside. All apartments were fully furnished with a bed, chair, night stand, lamp and personal belongings. LPA observed an adequate supply of hygiene items in the resident's bathrooms. During the tour LPA spoke to 5 out of 7 residents. All residents expressed that they had all the supplies they need at this time. Food, staffing and hygiene supplies were all observed to be adequate during visit. There were no imminent health/safety concerns on today's date. No deficiencies cited during visit. Exit interview conducted and copy of this report provided.

On 8/17/23 at 11:15 a.m., Licensing Program Analyst (LPA) Greg Clark conducted an unannounced case management visit as a result of this facility receiving residents from Vista Terrace of Belmont (VTB). LPA met with Stephanie Brice, Administrator and explained the purpose of the visit. There are currently 7 residents from VTB residing at this facility. R2 passed away at the facility on 8/18/23. LPA reviewed the LIC624 and LIC624A for R2 while at the facility. During the visit, LPA toured the facility including but not limited to the 7 apartments where the residents from VTB reside. All apartments were fully furnished with a bed, chair, night stand, lamp and personal belongings. LPA observed an adequate supply of hygiene items in the resident's bathrooms. During the tour LPA spoke to 6 out of 7 residents. All residents expressed that they had all the supplies they need at this time. Food, staffing and hygiene supplies were all observed to be adequate during visit. There were no imminent health/safety concerns on today's date. No deficiencies cited during visit. Exit interview conducted and copy of this report provided.

On 8/17/23 at 1:05 PM, Licensing Program Analyst (LPA) Greg Clark conducted an unannounced case management visit as a result of this facility receiving residents from Vista Terrace of Belmont (VTB). LPA met with David Ayala, Resident Care Director (RCD) and explained the purpose of the visit. There are currently 8 residents from VTB residing at this facility. During the visit, LPA toured the facility including but not limited to the 7 apartments where the residents from VTB reside. All apartments were fully furnished with a bed, chair, night stand, lamp and personal belongings. LPA observed an adequate supply of hygiene items in the resident's bathrooms. During the tour LPA spoke to 4 out of 8 residents. All residents expressed that they had all the supplies they need at this time. R4 confirmed that there is a plan to store some of his and his wife's belongings from VTB off site. Food, staffing and hygiene supplies were all observed to be adequate during visit. There were no imminent health/safety concerns on today's date. No deficiencies cited during visit. Exit interview conducted and copy of this report provided.

On 7/12/23 at 1:00 p.m., Licensing Program Analyst (LPA) Greg Clark arrived unannounced to conduct a case management visit due to receiving a death report with incorrect dates. LPA met with Stephanie Brice, Administrator and explained the purpose of the visit. LPA interviewed Resident Care Director (RCD) who wrote the death report. The death report stated R1 was found unresponsive on May 31st in her apartment by care staff. R1 was transported to Kaiser Oakland. The report then states R1's responsible party called the facility on May 1st to report R1 passed away due to a cerebral stroke. The correct date should have been June 1,2023. LPA reviewed R1's file: move-in date 1/28/22 with a diagnosis of TRA (transient ischemic attack), a DNR dated 2/16/22. R1 was categorized as independent. No other outstanding health conditions or concerns were noted. LPA advised RCD to submit a corrected death report. Corrected report received during visit. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 7/7/2023 at 12:30PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a health and safety check as a result of a priority 2 complaint. LPA met with Executive Director, Stephanie Brice. LPA toured facility including but not limited to the resident bedrooms, bathrooms, kitchen, laundry area, common area, and outdoor area. Hot water temperature was measured at 116.0 degrees F in a resident's bathroom sink. One week of non-perishable and 2-day of perishable food supplies were sufficient. Facility order food supplies twice a week. Resident's medications were kept locked in the medication room. Smoke detectors are interconnected with sprinkler system. Carbon monoxide detectors observed. First-aid kit was complete. Fire extinguisher was observed to be full. There are no accessible bodies of water observed. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report was provided.

On this day at around 11:50 am, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct case management visit in connection with a suicide incident that occurred at the facility. LPA met with Resident Care Director (RCD) David Ayala and explained the purpose of visit. LPA obtained the following records for Resident 1 (R1): 1. Physician's Report 2. Preplacement Appraisal 3. Admission's Agreement 4. Psychiatric Evaluation 5. Service Plan 6. Emergency Information 7. Letter A referral to Investigations Branch (IB) has been made. LPA advised RCD to send all incident/death reports to CCL via fax at 510-286-4204 or email to CCLASCPOaklandRO@dss.ca.gov and not to send to any LPA email address. A copy of this report was provided to RCD.