Saint Jarielle Residential Care 2

LPA interviewed the administrator and S1 and neither could provide details pertaining to the activities that the facility has for the residents. During the 10-day complaint visit, LPA did not observe any activities at the facility and LPA observed the TV was broken (The facility was cited on 10/29/2025 and the TV has been replaced). The State Official also reported that during his/her visits, there were no activities at the facility. After the investigation, this allegation is deemed to be substantiated. Based on interviews and record reviews during the investigation, the preponderance of evidence standard has been met. Therefore, this allegations were determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with caregiver and the administrator who was on the phone. A copy of the report and the appeal rights were 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 LPA interviewed resident # 2 (R2) who stated that staff are assisting and providing the care that R2 is required. LPA interviewed staff #1 (S1) who stated that they offered R1 to get out of bed but R1 did not want to due to R1's physical condition. After the investigation, this allegation is deemed to be unsubstantiated. Regarding the allegation of- due to lack of supervision, resident went into another resident's room during the night, the reporting party stated that resident #3 (R3) enter R1's room at night, covering R1 with a blanket which resulted R1 being scared and panicking. As part of the investigation, LPA interviewed R1, R2, and S1. According to S1, when the incident happened, R1 and R3 were roommates so R3 did not enter another resident's room and R3 thought R1 was cold so R3 walked over to R1’s bed and covered R1 with a blanket. S1 stated that after the incident, they moved R3 to another room and there were no further incidents. According to R1, S1 was present when it happened and S1 redirected R3 to another room. R1 stated that he/she was scared but it did not happen again after R3 was transferred to another room. According to R2, R3 never entered his/her room and there were always staff members at the facility. After the investigation, this allegation is deemed to be unsubstantiated. Although the above investigations 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 allegation is UNSUBSTANTIATED. Report was discussed with caregiver and the administrator who was on the phone. A copy of the report was 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 LPA interviewed S1 who stated that they offered R1 to take a shower but R1 preferred to have sponge baths in bed, and they provided that several times a week. During the 10-day complaint visit on 10/19/2025, R1 appeared to be cleaned and well-groomed. After the investigation, this allegation is deemed to be unfounded. Regarding the allegation of Reporting Requirement- the reporting party stated that resident #3(R3) went into R1's room and covered R1 with a blanket up to R1's and this incident was not reported to CCL. As part of the investigation, LPA interviewed the administrator and S1. The administrator stated that R1 and R3 were sharing a room and R3 thought R1 was cold so R3 went to R1's bed and covered R1 up to the neck. The administrator stated that they did not report it to CCL because it was not a reportable incident and there was no injuries to both residents. The administrator stated they moved R3 to another room after the incident and there were no further incidents. LPA interviewed S1 who stated that she was present when this happened and R3 was concerned that the roommate (R1) was cold so R3 covered R1 with a blanket and R1 got scared. S1 stated that R3 was moved to another room right away and both residents were fine afterwards. After the investigation, this allegation is deemed to be unfounded. Based on interviews, and record reviews, the department has determined that the allegation was false, could not have happened and/or is without a reasonable basis, therefore the allegation is UNFOUNDED. Report was discussed with caregiver and the administrator who was on the phone. A copy of the report was provided.

On 6/13/2025, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Lead Caregiver, John Guintu. Licensee, Nancy Uy was notified of the visit but was not able to attend. The facility currently provides care for 3 residents none of which with a current diagnosis of dementia. LPA continued with a tour of the facility with staff, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers located in the kitchen was found to be charged. Smoke detector were observed in resident bedrooms tested. LPA observed a carbon monoxide detector in the hallway to be non-functioning and in need of replacement. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations, with food stored in the kitchen refrigerator found to have appropriate coverings, enough for residents in care. There was a supply of hygiene products and paper products available for residents. Resident's bedroom have lighting & appropriate furnishings and bedding items. Restrooms for resident use were equipped with non-slip mats, grab bars and kept in good condition. There is a large outdoor patio equipped with appropriate shading for resident use. LPA conducted a sample file review for residents found that 2 of 3 residents do not have physician's reports on file and 1 of 3 residents does not have a needs & service plan on file. Upon a sample review of staff files LPA found that 1 of 2 caregiver staff do not have current 1st aid & CPR certification on file. Upon interview with resident (R1), it was stated that the facility staff do not provide any supplies for activities or engagement. LPA observed an unplugged television in R1's room and found that the television is not connected to basic television channels compared to other residents in care. R1 stated that they aren't encouraged to participate in any exercise or activities while under the facility care. Continued onto 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 LPA will return at a later date for the purpose of an annual continuation visit to review medications, staff training and emergency response records. Administrator, Nancy Uy is in the process of updating their administrator certification Acting Administrator, Joanna Casandra Uy's administrator certificate 7035656740 is valid through 9/29/2026 LPA requested the following documents be sent to CCL by COB 6/20/2025: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan Deficiency cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties.