Saratoga Retirement Community.

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year Visit and met with Sangeetha Narasinhan, Health Services Director. During visit, LPA Marrufo toured the facility inside and out. LPA Marrufo toured the kitchen area and observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days. The first aid kit was reviewed and found to be complete. LPA toured 12 assisted living resident apartments and 4 memory care apartments. Each apartment had working lights and available bedding and clothing storage areas. The water in the resident bathrooms were between 105 F to 117 F. LPA toured bathrooms in the facility hallway and their water temperatures were between 106 F to 116 F. LPA toured the outside area and found it to be clear of obstructions. Facility records indicate the emergency fire sprinkler system was tested on 06/24/2025 and the fire alarm system was tested on 12/03/2024. The Emergency Evacuation and Disaster Drill Log indicates the last drill was conducted on 06/19/2025. LPA reviewed 7 resident records, including Centrally Stored Medication and Destruction Records, and found them to be complete. LPA reviewed 7 staff records and found them to be complete. No deficiencies were cited at this time as per California Code of Regulations, Title 22. This report was reviewed with Sangeetha Narasinhan, Health Services Director, and a copy of this report was provided.

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced case management visit regarding an incident report, regarding a death report for a resident referred to as R1. LPA met with Nursing Home Administrator (NHA) Sangeetha Narasimhan and explained the purpose of the visit. On April 11, 2025, the Department received an incident report stating on April 9, 2025, which stated resident R1 had passed away. The incident report stated R2 had left R1 in the bedroom, while R1 was taking a nap at 12:45pm. R2 returned and went straight to the couch and rested for 15 minutes. R2 then went to check on R1 and saw that R1 had passed away. The cause of death is unknown at this time. LPA requested R1's , R1's Identification and Emergency Information, house keeping schedule, admission record, physician's report, pre admission appraisal, medication list. LPA also requested a copy of R2's physicians report and pre admission appraisal. LPA requested a copy of resident R1's death certificate once it becomes available. LPAs determined this case management needs further investigation. No deficiencies cited during today's visit. This report was reviewed with Nursing home Administrator Sangeetha Narasimhan and a copy of the report was provided.

On 10/28/24, Licensing Program Analyst (LPA) Grace Donato conducted an an unannounced case management visit to deliver a copy of amended report from 10/28/24. LPA met with Clinical Services Supervisor, Rubina Banwait and explained the purpose of the visit. An amended report was delivered in reference to complaint # 26-AS-20220110162643. Report is reviewed and copy is provided.

Based on records review, on R1s progress notes, R1 just came back to the facility on 12/25/2021 after being sent to the hospital on 12/24/2021 for a fall. From 12/25/2021, there were several logs in the note about observation of resident. At 9:54am, R1 came back from hospital, alert and responsive. Encouraged to increase fluid intake. Alert charting initiated. At 4:58pm, R1 was observed to be in the sofa, alert and responsive, no respiratory distress noted, R1 stated no pain, no nausea or vomiting at this time. On 12/26/2021, at 6:34am, R1 was observed to be fine, shows confusions and stated that “something on his/her legs not normal” and denied pain. At 10:13am, a note was entered for feet treatment. At 11:46am, R1 is participating in activities, alert and responsive, no respiratory distress noted. R1 stated no pain, no nausea or vomiting at this time, mentioned having a slight headache. Care staff notified R1 is having difficulty walking. There is a weakness noted on the left leg. At 2:03pm, Care staff notified that they were trying to transfer R1 from wheelchair to bed. R1 is unable to stand and care staff. R1 was assessed, has hard time to move left leg due to weakness. There is some weakness on her left hand noted as well. 911 was called and R1 was sent to hospital. LPA was able to interview eight staff members. S1 stated that when R1 Complains of leg pain, they ask the doctor as to what medication can be given. S2 mentioned that there are no issues with care for R1, never complains but refuses care sometimes. 911 was called right away when incident happened. S3, S5 and S7 all mentioned that they call a nurse to assess when something happens. LPA is not able to confirm the date provided by the complainant since there is no form of contact provided. A co-complainant also called but the same information was provided. Regarding the allegation of staff speaks inappropriately to residents, the co-complainant (CC) stated that S1 does not help any of the residents, but instead spends time on his/her phone shopping online. The RP states that when residents call upon S1 for help, S1 yells at them. CC states that staff can hear S1 yelling at residents on the radio. The RP states that S1 does not care about the residents or their well being. page 2 of 3 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 is an amended report *** According to interviews of the 8 staff members, all mentioned of not being aware of any inappropriate treatment of residents by the staff. LPA was able to interview three residents and all mentioned that they are treated fine and are happy here in the facility. R2 mentioned that he/she is treated well by the staff, no one is inappropriate with him/her. R3 stated that they always come and help right away whenever he/she presses the pendant. R4 also mentioned that staff here are really nice and helps a lot when needed. Based on interviews, the department has determined that 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 are UNSUBSTANTIATED. Report is reviewed and copy is provided. page 3 of 3

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit. LPA met with Administrator (ADM) Sarah Stel and Health Care Administrator, Sangeetha Narasimhan stated the purpose of today's visit. During visit, LPA Rai toured the inside and outside of the facility to include the assisted living unit and memory care unit. When touring the outside area of the facility, the exits were cleared of obstruction. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. LPA Rai observed the temperature of the freezer at 0 degrees F and the temperature of the fridge at 37 degrees F. LPA Rai randomly toured resident bedrooms and they had available bedding, drawers, and functioning lights. The facility bathrooms had available soap, paper towels, and trash cans with lids. The water temperature in the bathroom sinks ranged from 110.9 degrees F - 116.6 degrees F. Fire extinguisher was observed and inspected on 09/14/2023. Facility is equipped with interconnected smoke detectors and carbon monoxide detectors. The last disaster drill was conducted on 06/14/2024 and 04/17/2024. LPA Rai reviewed facility records for 10 staff and 10 residents. LPA Rai reviewed at random resident current medications and central stored medication records. No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Administrator (ADM) Sarah Stel and Health Care Administrator, Sangeetha Narasimhan a copy of the report was provided.

Cont. HSC section 1771(d)(1) requires that “at least part of the meeting shall be conducted without the presence of continuing care retirement community personnel”, based on the times provided, part of the meeting was conducted without CCRC personnel. The statutes do not prohibit CCRC personnel being present and in this case the staff member was not asked to leave the meeting; therefore, this allegation is unfounded. Based upon the review and investigation into the third allegation (CCRC is Limiting and/or restricting the ability of residents to communicate with the Provider Board and informing them they must go through the Executive Director to communicate). AGPA reviewed Saratoga Retirement Communities Communications Policy and Residents’ Handbook, dated January 2023. Both address the communication policy and steps residents can take to address questions and issues. AGPA found that the policies are in compliance with HSC section 1771.7(c)(4). In addition, there is no evidence that the community, nor providers, failed to follow the channels of communication listed in the Communications Policy or Residents’ Handbook; therefore, this allegation is unfounded. The Department has investigated the above allegations, and has determined that the allegations are Unfounded, meaning that the allegations were not supported or proven by evidence. Findings were delivered via telephone with Sarah Stel, Executive Director. Signed copy emailed and saved in file.