Huntington Manor.

(Continued from LIC 9099) Staff provided LPA with email records that revealed the Administrator followed up with the fire alarm service company to prevent the cancellation. A representative from the company confirmed via email to the Administrator that the facility account had been brought current and the cancellations have stopped. Further records confirmed the facility payment to the fire alarm service company was processed and approved on July 8, 2026. The Department has investigated the above-mentioned allegation. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate this allegation and therefore deemed unsubstantiated. An exit interview was conducted with Chief Operating Officer Lynn Drummond, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided at the conclusion of the visit.

Although the email that appeared to be on the surface an eviction notice, no eviction was pursued. This allegation is Unsubstantiated. It was further alleged that the eviction was in retaliation for the family expressing their concerns regarding the care R1 was provided. As R1 was not evicted this allegation is also Unsubstantiated. Lastly it was alleged that the facility staff are not meeting R1's needs. Interviews revealed that R1 was challenging to care for due to R1’s behaviors. Interviews revealed that despite R1’s behaviors, care was provided to R1. This allegation is Unsubstantiated. Based on the evidence obtained during the complaint investigation, the allegations above are UNSUBSTANTIATED, meaning there isn’t enough evidence to prove a violation occurred. An exit interview was conducted at the conclusion of the visit, A copy of this report and licensee rights are left at the facility.

The Department’s investigation consisted of a tour of the facility, a review of facility records, and interviews of facility staff. The investigation revealed that the facility has no record of R1 residing at the facility. Staff members interviewed who worked at the facility at the time of the allegations have no recollection of R1. Interviews revealed that when a resident activates their call button, staff respond immediately to resident or as soon as possible, resident’s rooms are cleaned daily, and deep cleaning is done weekly. Interviews did not reveal any concerns about residents being treated disrespectfully. Interviews with staff revealed that dietary concerns are accommodated at the facility. These allegations are Unsubstantiated. It was further alleged that: • Facility has not provided a written statement of rate increases. • Facility has not provided a copy of the updated admissions agreement. The allegations regarding the lack of written statement of rate increases and an updated admission agreement are also unsubstantiated as no records could be reviewed regarding R1 Based on the evidence obtained during the complaint investigation, the allegations above are UNSUBSTANTIATED, meaning there isn’t enough evidence to prove a violation occurred. An exit interview was conducted with Martha Villalvazo, Assistant to the Administrator; a copy of this report and Licensee's Rights (LIC9058) were provided.

Licensing Program Analyst (LPA) Janet Ngallo conducted an unannounced Case Management Visit.  LPA was greeted by and met with staff Lynn Drummond, to discuss the purpose of the visit. LPA was at the facility for a complaint investigation, when a violation was found after an interview with staff. Interviews revealed that on 05/07/2026 the facility received an eviction notice due to unpaid rent for the facility. LPA interviewed S1 and S2 who stated that residents were not notified of the eviction notice. Based on the Foreclosure Protection Act of 2011 and per HSC § 1569.686(a)(4), the licensee was required to provide notice to the Department, State Long Term Care Ombudsman, all residents, and if applicable, their legal representatives within two business days of receipt of a written notice of default of payment of rent described in Section 1161 of the Code of Civil Procedure. Therefore, a civil penalty of $100 per day is being assessed as required per HSC § 1569.686(c) commencing 05/07/2026, through 05/26/2026 totaling $1,900 and will continue up until the maximum amount of $2000 or when notification requirements are met. One(1) deficiency is additionally being cited per Health and Safety Code on the attached LIC 809-D. An exit interview was conducted with Chief Operating Officer Lynn Drummond, to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058 03/22) were provided. Their signature below confirms receipt of these documents.

DR provided a splint/brace and R1s family declined to have surgery. Staff stated they never saw R1 fall only one time R1 slid out of his wheelchair and at that time R1 had no injuries. Staff did report R1 showed aggression and sometimes would hit the walls with R1s fists, but R1 never complained of any pain. Staff stated they did not see any swelling of R1s left wrist. The time and the date of injury could not be conclusively established as staff denied R1 had any falls while at the facility only the one time of sliding out of R1s wheelchair with no injuries. The cause of R1s fracture remains unknown and there is no evidence to prove the neglect/lack of care allegation. For the allegations of Facility was not sanitary and was in disrepair, the department conducted a visit on 8/7/2023 and found no evidence of immediate health and safety risks. Regarding the allegation of staff did not centrally store medication, all medications have proper logs for routine, PRN and controlled drugs. There were noted confirmations from med tech that the facility did receive medications for R1. For the allegation of facility did not maintain a comfortable temperature for residents, facility had scheduled maintenance checkup for air condition on 7/5/2023. A technician came to fix the air conditioner and was running during that time. Technician also came back on 7/19/2023 to fix another issue. Portable aircons were provided to residents’ rooms during this time. Regarding the allegation of Staff did not accord dignity to resident, staff members mentioned that they have not been rough with handling any resident nor have they seen other caregivers be rough with residents. Regarding the allegation of Staff were not able to communicate with residents, when the department conducted interviews to staff members, everyone was able to communicate and answer questions. Based on interviews and records review, the department has determined that 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. Report is reviewed and a copy is provided.

Licensing Program Analyst (LPA) Debbie Correia made an unannounced visit to the facility to conclude an annual licensing inspection that commenced on 9/18/2025. LPA identified themselves to Med-Tech Madla and met with Administrator Drummond and Licensee Chen to whom was explained the purpose of the visit. The facility is licensed to serve 21 residents; of which all may be non-ambulatory, 12 bedridden, and 15 whom can be receiving Hospice services. During today's visit LPA conducted a review of staff records. LPA observed all required forms were complete and up to date. The Administrator Certification, facility infection control plan, and liability insurance were all active. The facility’s last disaster drill was conducted on 7/1/2025. Facility staff were all cleared, had current CPR and First Aid certification, and required training. LPA, accompanied by Med-Tech Madla, conducted a facility tour that revealed resident rooms and bathrooms were equipped with required furnishings and safety precautions. The facility is equipped with a back-up generator. LPA observed the required postings. Hazardous materials, including but not limited to, medications and cleaning solutions were all secured in locked areas, passageways were free from obstructions. No deficiencies were cited during today's visit. This report was discussed with Licensee Chen. A copy of the report and License Rights (01/2016) will be provided at the conclusion of the visit, and signature on this form acknowledges receipt of the rights and a copy of this report.

Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced case management visit for the continuation of an Annual Inspection that began on 9/18/2025. LPA was greeted by, identified herself to, and was granted entry by Med-Tech Madla, to whom she explained the purpose of the visit. The facility is licensed to serve 21 residents, however, a review of the Resident Roster as well as a subsequent facility inspection revealed that 22 Residents were admitted to the facility. Room #4 was observed converted into a shared room which was observed to be occupied by two (2) residents (R1 and R2). A review of records also revealed that Resident #22 (R22), was admitted to the facility on August 12, 2025. It shall be noted that an application to increase the facility’s capacity was received by the Department and has been under review. During a visit to the facility on 8/14/2025, LPA Correia discussed the capacity increase with the Administrator who understood that the application was under review, and that the facility may not admit additional residents until the final License had been approved and granted by the Department. The Licensee visited the San Diego Regional Office on the following day and was reminded that the application was pending, and that the Licensee was not yet authorized to admit additional residents to the facility. While a review of records confirmed that a Fire Clearance had been granted for the additional residents, the License was not yet granted by the Department. Deficiencies were cited and listed on the attached 809(d), and further visits will be necessary to complete the annual inspection, which will be completed at a later date. An exit interview was conducted with Med-tech Gerlad Madla to whom a copy of this report, the LIC 809-D page, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided. The signature below confirms receipt of the reports

Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit for the facility for the annual required licensing inspection. LPA Correia was greeted by Med-tech Gerald Madla , identified herself, and explained the purpose of the visit. A short time later LPA met with Administrator Drummond The facility is Licensed to serve 21 residents ages 60 and above; of whom all may be non-ambulatory, 12 bedridden residents, and 15 whom can be receiving Hospice services. LPA Correia conducted a facility records review and a partial facility tour. An overall inspection of the facility began today however due to time constraints LPA was unable to complete the visit and will return later to conduct the remaining portion of this inspection. No deficiencies were cited during today's visit. This report was discussed with Administrator Drummond. A copy of the report and License Rights (01/2016) will be provided at the conclusion of the visit, and signature on this form acknowledges receipt of the rights and a copy of this report.

On August 5, 2025, the Department received a complaint that alleged the facility was in disrepair, the facility did not provide a safe environment, and the facility’s fishpond was enclosed by a dilapidated gate. During a facility tour, accompanied by Med-tech Madla, LPA observations corroborated several areas of disrepair at the facility, including damaged flooring in passageways which posed a fall risk to residents in care. LPA's observations also confirmed the gate in front of the facility’s fishpond was so severely deteriorated it was accessible to residents in care. Based on the investigation the allegations were determined to be SUBSTANTIATED. A substantiated finding means the preponderance of evidence was met. Pursuant to the California Code of Regulations, Title 22, Division 6, deficiencies are being cited on the attached LIC9099D and plans of corrections were jointly developed with Administrator Drummond. An exit interview was conducted with the Administrator; a copy of this report and Licensee's Rights (LIC9058) will be 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 Additionally, it was alleged that staff did not ensure that food was adequately stored. During the facility tour LPA observed the food was properly stored and labeled with expiration dates. Based on the investigation a preponderance of evidence did not exist to prove that the alleged violation(s) occurred, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted with Administrator Drummond to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided. This is an amended version of the original report dated August 14, 2025.

Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced case management visit to conduct follow up regarding a self-reported incident of Resident #1 (R1)'s misuse of a medication. LPA was greeted by, identified herself to, and explained the purpose of the visit with Medtech Gerald Madla. Administrator Lynn Drummond arrived later during the visit. On June 24, 2025, the Department received an incident report that described that on June 19, 2025, R1 had consumed three bottles worth of over-the-counter allergy pills from a store. R1 was found to be lethargic and was taken to the hospital via emergency services. During today’s visit, LPA conducted a health and safety check, observed residents in care, and reviewed facility records. No deficiencies were cited on today’s date. An exit interview was conducted with Administrator Lynn Drummond, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).

At 11:15 am, the facility received a telephone call from the RP indicating that R5 was on the floor in their bedroom. At 11:15 am, staff entered R5's room and checked vitals and oxygen saturation. Staff interviews revealed that R5 was not on the floor when they did resident checks at 10:05 am. Staff also noted that the resident could not have been on the floor for long because a staff member walked by R5's room at 10:45 am and witnessed R5 still in bed. Since staff did regular checks on the resident that did not exceed 2 hours, this allegation is unsubstantiated. It was alleged that staff are not following the feeding /drinking care plan. It was reported that staff were feeding R5 incorrectly, causing them to throw up and choke. After reviewing R5's needs and service plan, as well as the physician's report, it was revealed that R5 is on a modified diet that involves pureed food to be administered when they are being fed. Progress notes for R5 revealed that facility staff were aware of R5's need for pureed food and were documenting what types of food and when R5 was being fed these meals. Progress notes also revealed that staff followed the one-on-one feeding instructions specified in the physician's report and the needs and service plan. Staff interviews revealed that staff had adequate training and knowledge on how to feed a resident who is on a puree diet. Staff explained at length the process and procedure for feeding a person on a puree diet. Resident interviews revealed that they had had no issues with receiving the correct modified diet plans from the staff at the facility. Based on interviews and records reviews, this allegation is unsubstantiated. Lastly, it was alleged that staff are not ensuring the residents' diapers are changed in a timely manner. It was specifically reported that R5 was being left in diapers that were soaked through on multiple occasions. After reviewing R5's physician's report, it was revealed that R5 required full assistance with incontinence and hygiene. LPA conducted a tour of the facility and did not observe any residents who needed to be changed and could not receive assistance. LPA also observed a resident using their call pendant for assistance with being changed, and staff assisted them in a timely manner. A records review of the progress notes for R5 revealed that from 7/01/2024 through 07/30/2024, staff did two-hour checks on R5 to ensure they were rotated and if needed, changed their diaper. Interviews with staff revealed that they were checking on R5 in the appropriate two-hour window. Based on LPA observations, records reviews and interviews, this allegation is unsubstantiated. 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 This agency has investigated the complaint allegations, Resident had an unwitnessed fall resulting in the resident being on the floor for an extended period of time. Staff are not following the feeding/drinking care plan. Staff are not ensuring the residents diapers are changed timely. The Department has found that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations occurred. Therefore, the above allegations are found to be UNSUBSTANTIATED. An exit interview was conducted, and the report along with licensee appeal rights (LIC 9058 03/22) reviewed with Med Tech Gerald Madla

On 7/7/2023, R1 started receiving hospice services. R1 continued to receive services from his/her two private nurses. Records reflect that on or about 8/5/2023, a hospice nurse noted that a red area was developing on R1’s buttocks. At the time of the observation, PN 2 was present and made aware of the red area. The nurses treated the area and decided to monitor it. On 8/17/2023, PN 1 was contacted by a hospice nurse and facility staff regarding the red area on R1’s buttocks. PN 1 informed the nurse and staff that he/she was out of town and provided instruction as to how to clean the wound. PN 1 made the nurse aware that he/she would be back that night and check and reevaluate the next day. The hospice nurse noted that upon assessing the red area, the wound was closed. The skin was peeled off from cleaning, and R1’s buttocks appeared to have a light yellow film. There was no drainage or sign of bleeding at the time. R1’s physician was made aware of the wound through photos that were sent by PN 1 and facility staff. On 8/18/2023, at or about 1:00 PM, PN 1 visited R1 and tended to R1’s wound. PN 1 was not aware that there was a deep abscess in the area and began to compress on it, at which time it excreted pus and bodily fluid. At this time, PN 1 called 911, paramedics arrived, and R1 was transported to a local hospital. Hospital records note that the physician reported the chief complaint to be an area of infection with purulent drainage to the right buttock. On 8/30/2023, R1 was discharged from the hospital to a skilled nursing facility. Interview of R1’s physician, conducted during the investigation, revealed that the abscess was unforeseen, and the facility’s caregivers had nothing to do with the development of the abscess. R1’s physician noted that R1’s complex medical conditions caused the abscess to develop without symptoms. R1’s physician made it clear that R1 did not have a pressure injury on the buttocks, as was reported, but had an abscess. R1’s physician also noted that facility staff communicated with the physician, as needed, regarding any questions or concerns relative to R1’s care, and facility staff provided excellent care to R1. One of R1’s hospice nurses also noted that the facility’s caregivers were well trained, provided extra care, did a really good job, and were able to take care of R1 with all the services he/she required. Relative to the report of R1 sustaining multiple stage 2 pressure injuries on ankles and feet, records reviewed during the investigation indicate that water blisters had developed on R1’s hands and feet; however, there was no evidence obtained to indicate that R1 sustained pressure injuries in any of those areas. 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 The third allegation is that R1 did not receive timely medical attention. According to evidence obtained during the investigation, R1 had been receiving frequent care from hospice nurses and his/her private nurses, PN1 and PN 2. Prior to PN 1 compressing on the area that was later determined to be an abscess, there was no indication to facility staff that R1 had a sudden need for medical attention. At the time that PN 1 compressed and expressed fluid from the abscess, R1’s condition worsened which triggered the need for medical attention. At that time, PN 1 called 911 and had R1 transported to the hospital for medical care. Based on all of the foregoing, the above listed allegations are unsubstantiated. This finding means that although the allegations may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted with Tess Derafera, and copies of this report and Licensee/Appeal Rights (LIC 9058) were provided to the administrator at the conclusion of the visit. Administrator’s signature on this report acknowledges receipt of copies of the rights and report. 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 Records reflect that on or about 8/5/2023, a hospice nurse noted that a red area was developing on R1’s buttocks. At the time of the observation, PN 2 was present and made aware of the red area. The nurses treated the area and decided to monitor it. On 8/18/2023, PN 1 visited R1 and tended to R1’s wound. PN 1 was not aware that there was a deep abscess in the area and began to compress on it, at which time it excreted pus and bodily fluid. At this time, PN 1 called 911, paramedics arrived, and R1 was transported to a local hospital. Hospital records note that the physician reported the chief complaint to be an area of infection with purulent drainage to the right buttock. The investigation did not yield evidence to conclude that there was a change in R1’s condition until PN 1 compressed the abscess which excreted bodily fluids in response to the compression. Records reviewed and interviews conducted during the investigation revealed that PN 1 has been granted durable power of attorney by R1. Accordingly, if notification was to be provided, it would have been provided to PN 1, who was present and actively involved when the identified change in R1’s condition occurred. Based on the foregoing, we have found that the complaint allegation is unfounded, meaning that the allegation is without a reasonable basis. Therefore, as to the above listed allegation, the facility is in compliance with Title 22 regulations at this time, and we have dismissed the complaint. An exit interview was conducted with Tess Derafera, Administrator, and copies of this report and Licensee Rights (LIC 9058) were provided to the administrator at the conclusion of the visit. Administrator's signature on this report acknowledges receipt of copies of the rights and report.

Licensing Program Analyst (LPA) Juliana Barfield conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Haydee Jumulun. Administrator Tess Derarfera arrived shortly after. According to the facility’s license, the facility has a maximum capacity of twenty-one (21) residents, of whom twenty-one (21) may be non-ambulatory, of which 12 may be bedridden.. During today’s inspection, there were a total of (20) residents in care. This facility does not feature a secured perimeter or delayed egress doors. LPA, accompanied by Tess Derafera toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Hot water temperature at taps accessible to clients were all compliant. There was at least 2 days supply of perishable food, and at least 7 days non-perishable food present. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters observed available to clients. Medications were labeled, as required, and stored in locked areas. (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 LIC 809] No pools or bodies of water on the premises. According to Tess Derafera, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients. LPA interviews did not raise any licensing concerns. LPA reviewed multiple staff and client records. Files reviewed contained required documents. Confidential records were stored in locked areas. Tess Derafera presented proof of current/active business liability insurance. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Tess Derafera to whom copies of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit.