Memory Care of Contra Costa

On 01/29/2026 at 12:30 PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with , Laura and explained the purpose of the visit. The facility’s fire clearance was approved for capacity of 75 (seventy-five) residents. In which all may be non-ambulatory. Hospice waiver approved for 19 (nineteen) residents. Administrator Certificate #7008812740 expires 07/07/2027. LPA toured the facility with Tracey including but not limited to four (4) residents’ apartments, bathrooms, multiple activity rooms, kitchen, common area and courtyard. There are no bodies of water observed. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 74 degrees F. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in a sample of residents’ shared bathroom were measured at 114.2 and 116.5 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. LIC809-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 LIC809-C (Page 2) LPA reviewed 6 (six) residents records. LPA reviewed 8 (eight) staff records and 8 of 8 have current first aid training and associated to the facility. Emergency Fire Drills were conducted 10/07/2025, 11/05/2025 and 12/04/2025 on all three (3) shifts. Elopement drills were conducted on 10/23/2025, 11/13/2025 and 12/19/2025. Food Service Report was reviewed dated 12/17/2025. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 02/05/2026: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan - Reviewed Liability Insurance - Reviewed No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

LIC9099-C (Page 2) Allegation: Staff retained resident requiring a higher level of care Finding: Unsubstantiated On 01/13/2025, Licensing Program Analyst (LPA) interviewed Witness 1 (W1), who stated that they began receiving multiple bills from ambulance services and hospital visits that they were unable to pay. W1 reported that they were not the one contacting 911 or sending Resident 1 (R1) to the emergency room (ER). W1 stated that R1 was sent to John Muir Hospital in Concord because R1 “wasn’t listening.” W1 further stated that R1 had been diagnosed with frontal lobe dementia, which required a higher level of care than what the facility could provide. W1 further stated that when R1 went to John Muir Walnut Creek he was sent back to the facility on hospice because they think the "idea to not send him back and that John Muir doesn't want to keep seeing him constantly." W1 stated that R1 was only on two types of meds and once he got on hospice, seven more types of medications were added. LPA reviewed R1’s Physician’s Reports (dated 08/14/2024 and 11/06/2024), which indicate a diagnosis of possible frontotemporal dementia , with additional notes reflecting behavioral disturbance and advanced dementia , respectively. Record review showed a change in R1’s condition, with documentation of increased confusion, disorientation, refusal or forgetfulness in following instructions, and episodes of aggressive behavior. The Pre-Admission Appraisal (dated 10/22/2024) notes “Higher level of care” for Question #1. Despite these findings, the overall Care Plan identifies R1 as mostly independent in activities of daily living. LPA reviewed that 911 was called 10/28/24 and 11/10/24 per internal incident reports. 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) Allegation: Staff did not adequately manage resident’s behaviors Finding: Unsubstantiated On 01/13/2025, LPA interviewed W1, who reported that R1 exhibited aggressive and inappropriate verbal behaviors, including racial slurs and profanity directed at W1, their pet, and neighbors. W1 stated that R1’s behaviors were difficult to manage and that facility staff—many of whom were students—should have been better trained to address dementia related behavioral issues. W1 stated that despite these ongoing behavioral challenges, the facility repeatedly sent R1 to the emergency room instead of implementing effective behavior management interventions or arranging a more appropriate level of care. LPA reviewed the staff “2024 Annual Veteran Training Calendar.” (updated October 31, 2024). The training calendar shows courses on Resident Rights and Elder Abuse (in relation to Dementia), Dementia: Positive Approach and Dementia: Leading Causes of Expressions and How to Respond as examples. Allegation: Staff did not safeguard resident’s personal belongings Finding: Unsubstantiated During interviews, W1 stated that R1’s missing blanket was later located. There was insufficient evidence to determine that the facility failed to safeguard R1’s personal belongings. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations is UNSUBSTANTIATED . No deficiencies were cited during today’s visit. An exit interview was conducted with Executive Director, Tracey Ingleman and a copy of this report was provided.

On 03/07/2025 at 10:15 AM, Licensing Program Analyst (LPA) L. Alexander conducted an unannounced Case Management visit regarding incidents that was reported to Community Care Licensing Division (CCLD) on 03/02/2025. LPA met with Laura-Anne Leake-Mosley, Executive Assistant, and explained the purpose of the visit. Executive Director, Erica Diala, was not available but arrived around 11:35 AM. LPA interviewed (via phone) staff (S) S1 and S2 that witnessed the incident that took place on 03/02/2025 with resident (R) R1 and R2. S1 and S2 stated that they heard a loud scream coming from one of the rooms and they both went towards the loud noise. S1 stated that they both saw R1 slapping R2 with a plastic hanger. S1 and S2 stated that other caregivers came to assist. S1 and S2 stated that R1's responsible party was phoned and they also called 911 to which the Pleasant Hill Police Department (PHPD) was called and Emergency Medical Technicians (EMT) arrived. S1 and S2 stated that R1 did a FaceTime call with daughter and then they became calmed down. LPA interviewed S3 and S4 regarding another incident that was reported to CCLD on 03/02/2025. The incident occurred on 03/01/2025 between R1 and R3 where community cameras captured video of R1 punching R3 in the shoulder. LPA reviewed the video with S4 and observed R1 punch R3 in the hallway. R3 fell to the floor and caregivers immediately responded to the incident. S3 stated that R1's and R3's responsible parties were called as well as PHPD and EMT to check R1's and R'2 baseline. S3 stated that R3's responsible party declined for R3 to be transported to Emergency Room. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 03/07/2025 at 11:30 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct a Plan of Correction (POC) visit. LPA met with Laura-Anne Leake-Mosley, Executive Assistant, and explained the purpose of the visit. Executive Director, Erica Diala, was not available but arrived around 11:35am. On 01/29/2025, LPA conducted an Annual Inspection visit in which deficiencies were cited. The POC due date was 02/26/2025. Administrator failed to submit the POC by the due date and this is why LPA came to make a POC visit. Deficiencies not cleared: 87411(c)(1) $100 X 9 days = $900.00 During visit Laura gave copies of First Aid/CPR certificates for staff (S) S1 and S2. Deficiency cleared on 03/07/2025. Civil Penalties in the total amount of $900.00 is assessed today for failure to meet POC date for deficiencies. Exit interview conducted. A copy of this report, appeal rights provided and LIC421FC provided.

On 05/30/2024 at 3:45 PM Licensing Program Analyst (LPA) L. Alexander conducted an unannounced Case Management visit regarding an incident that was reported to CCLD on 04/26/2024. LPA met with Administrator, Erica Diala and Director of Resident Services Jonathan Centeno and explained the purpose of the visit. LPA L. Alexander interviewed S1 regarding the incident that occurred on 04/24/2024 between two (2) residents; R1 and R2. S1 stated that R1 was walking in a room and R2 was walking right behind R1. S1 stated that R2 was pulling on R1 from behind and R1 turned around and pulled a punch onto R2's face. S1 stated that both R1 and R2 fell to the floor and that R2 hit the back of their head on the floor. S1 stated that care staff and med techs came to help get both R1 and R2 off the floor. S1 stated that R1 said that they did not have pain but R2 said that they had pain so they sent R2 to the Emergency Room. S1 stated that R2 returned back to the facility the same day after all exams and testing came back negative. S1 and S2 stated that both R1 and R2 are ok today and no further issues. LPA L. Alexander collected documents pertinent to the incident report. No deficiencies issued during the visit. Exit interview conducted and a copy of this report was provided.

On 02/16/23 at 12:15 PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct Infection Control Inspection. LPA met with Executive Director, Evelyn Jensen and explained the purpose of the visit. During the Infection Control Inspection, LPA toured facility including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and courtyard. There are no bodies of water observed. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 74 degrees F. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in a sample of residents’ shared bathroom were measured at 111.9 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. Fire extinguisher was last serviced on 07/13/22. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 02/23/2023: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 5/06/2022 at 1:15 pm Licensing Program Analyst (LPA) C. Fowler arrived unannounced to conduct infection control inspection LPA met with DRS, Myrene Gaeta and explained the purpose of the visit LPA toured the facility with Myrene including but not limited to 3 residents apartments, bathrooms, multiple activity rooms, kitchen, common area and courtyard. There are no bodies of water observed. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 74 degrees F. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars. 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. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.