Silvergate San Marcos Retirement Residence.

Allegation #1: Facility staff member who is not an appropriately skilled professional removed a fecal impaction from a resident. The complaint alleged that a resident pressed the call button in the bathroom and required assistance. Facility staff member, who is not an appropriately skilled professional removed a fecal impaction from a resident. On April 7, 2026, the department interviewed the administrator (A1), who denied the allegations and stated that the facility had never experienced such incidents. A1 also stated that no staff member by that name was employed at the facility. During the same investigation, the department interviewed the registered nurse (RN), who clarified that a physician's order is required before a nurse can remove a fecal impaction due to the risks to residents. The RN indicated that if a resident requires this procedure, the facility either contacts the physician or calls the Medical Emergency team for assistance. Additionally, an interview was conducted with the licensed vocational nurse (LVN), who confirmed that a physician's order is indeed required before performing a fecal impaction removal for any resident. If the order is not available, the facility will contact the Medical Emergency team or send the resident to the hospital. The department also interviewed six residents (R1-R6) on April 7, 2026, all of whom denied ever needing this type of procedure and were unaware of any other residents who had undergone it. Furthermore, a review of the facility roster and the Community Care Licensing Division’s Licensing Information System confirmed that no staff members by that name were listed. 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 Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore the allegation is unsubstantiated. No deficiencies were cited. An exit interview was conducted. A copy of this report was provided to the Administrator Joan Rink-Carroll.

Allegation #1: A facility staff member who is not an appropriately skilled professional removed a fiscal impact from a resident. The complaint alleged that a resident pressed the call button in the bathroom and required assistance. A staff member at the facility, who lacked proper training, reportedly removed a fecal impact from a resident. On April 7, 2026, the department interviewed the administrator (A1), who denied the allegations and stated that the facility had never experienced such incidents. A1 also stated that no staff member by that name was employed at the facility. During the same investigation, the department interviewed the registered nurse (RN), who clarified that a physician's order is required before a nurse can remove a fecal impaction due to the risks to residents. The RN indicated that if a resident requires this procedure, the facility either contacts the physician or calls the Medical Emergency team for assistance. Additionally, an interview was conducted with the licensed vocational nurse (LVN), who confirmed that a physician's order is indeed required before performing a fecal impaction removal for any resident. If the order is not available, the facility will contact the Medical Emergency team or send the resident to the hospital. Report Continued on LIC9099C 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 department also interviewed six residents (R1-R6) on April 7, 2026, all of whom denied ever needing this type of procedure and were unaware of any other residents who had undergone it. Furthermore, a review of the facility roster and the Community Care Licensing Division’s Licensing Information System confirmed that no staff members by that name were listed. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore the allegation is unsubstantiated. No deficiencies were cited. An exit interview was conducted. A copy of this report was provided to the Administrator Joan Rink-Carroll.

Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to obtain signatures on an amended report. During today’s visit, LPA was greeted by the Lead Front Desk Receptionist Edgar Baltazar, identified herself and met with Administrator Rink-Carroll and discussed the purpose of the visit. During today’s visit, LPA obtained Administrator's signature on an amended version of a report originally delivered on August 14, 2024. An exit interview was conducted with Administrator Rink-Carroll a and a copy of this report and the Licensee Appeal Rights (LIC 9058 3/22) were provided.

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced Case Management (CM) visit. LPA identified herself and was granted entry by Edgar Baltazar, concierge. LPA met with Joan Rink-Carroll, Director, and discussed the purpose of the visit. During today’s visit, LPA requested and obtained staff records, and provided the facility the Plan of Correction (POC) clearance letter for a CM visit conducted on 3/25/24. There were no deficiencies observed or cited during today’s visit. An exit interview was conducted with Joan Rink-Carroll, Director, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. The signature below confirms the receipt of these documents.

[Continuation of LIC 9099] Additional interviews conducted with Residents in care revealed no corroborating evidence. On December 2, 2020, an outside source records review revealed R1 filed a police report indicating the theft of cash from their apartment at the facility occurred between November 18 and November 29, 2020. The records also revealed R1 admitted to leaving their apartment unlocked at times. An outside source interview revealed the investigation with the Sheriff Department was suspended due to having no leads, R1 would leave their apartment unlocked, there are no surveillance cameras, and approximately 81 staff members employed at the facility during the time of the alleged theft. D ue to lack of evidence the finding for the above-mentioned allegation was determined to be unsubstantiated. This finding means although the allegation may have happened or could be valid, there is not a preponderance of evidence to prove that the alleged violation occurred. (See LIC 811 for confidential names) LPA Correia conducted an exit interview with DRC Naverrete. At the time of the exit was conducted with DRC Navarrete was notified a copy of the Complaint Investigation Reports (LIC 9099) and Licensee Rights (LIC9058 01-2016) will be provided at the conclusion of the visit. Signature on this report acknowledges receipt of the documents. This is an amended version of the original report delivered on August 14, 2024.

On May 08, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the Required Annual Inspection and met with the Director of Resident Care, (DRC), Ada Navarrete. The facility file review was conducted in the Regional Office and additional forms were requested and reviewed on site. The facility is licensed for 160 Elderly Adults (740) and is currently serving 81 Seniors. LPA Mixson toured the facility along with the DRC and inspected the facility inside and outside, there were no obstructions or debris to the indoor or outdoor passageways currently at the time of this visit. The facility is a two-story and multi building located at 1550/1560 Security Place San Marcos, CA. 92078 Physical Plant: The facility phone number is (760) 744-4484 and it is operable. The LPA observed a sampling of the residents’ bedrooms, and those observed were equipped with required furniture as per Title 22. LPA Mixson inspected a sampling of the facility bathrooms, and the hot water temperature tested within regulations. The bathrooms were clean, and appliances were operating appropriately currently at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. The LPA observed required postings such as "If you See Something, Say Something" the "Personal Rights" and the Ombudsman postings, and the DRC knows their Ombudsman personally. The cleaning supplies and sharp items were kept locked and inaccessible to the residents in care. There was a designated storage space for the residents and staff files, and it was locked and inaccessible to residents in care currently at the time of this visit. Medications Were stored and locked and inaccessible to residents in care, and there was a sufficient supply of medication for each resident at the time of this visit. The overall facility is clean, the furniture is in good condition. The facility heating system and other appliances were operable currently at the time of this visit, and there were safety lights for night. Food Service: Non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for residents. Dishes and utensils were in sufficient supply and stored properly, and sharps are locked. Care & Supervision : Facility has sufficient staff, 110 staff on site at the time of this visit, and 81 residents. Records Review: The LPA reviewed resident and staff files, conducted staff and resident interviews. Previous Community Care Licensing forms were reviewed. There were no Title 22, Division 6 Regulation violations observed or cited during today’s visit. An exit interview was conducted, and a copy of this report was reviewed given to the Director of Resident Care, Ada Navarrete.