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.

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct a case management - incident visit. LPA met with Executive Director (ED) Sarah Stel. The purpose of the visit was to follow-up on an incident and death report received for resident (R1) who resided in the independent living section. On 04/19/2023, R1 passed away by possible carbon monoxide poisoning. R1 was found by a family member who called 911. Upon arrival of the paramedics, R1 was pronounced deceased. During visit, LPA was accompanied by ED and another staff to observe the exterior part of the cottage where R1 passed away. LPA interviewed 2 staff members (S1 - S2). LPA obtained documents to include the resident roster, staff roster, R1's face sheet (admission record), reported incident, and physician's report. Based on record review, R1 was diagnosed with a chronic degenerative disease. This case management - incident visit will be pending investigation. This report was reviewed with Executive Director (ED) Sarah Stel and a copy of the report was provided.

LPA Marrufo also obtained copies of the following documents: handwritten notes on R1’s living unit temperature readings taken every 15 minutes, graph of R1’s room temperature reading, Staff Thermostat Check Log taken 08/15/2022, Resident Roster, Invoice for Air Conditioning Unit Replacement dated 02/24/2022, Invoice for Air Conditioning Service dated 06/25/2021, Data Log for temperature in R1’s living unit, photograph of the living room thermostat in R1’s living unit, R1’s Physician Report, and R1’s Appraisal/Needs and Services Plan. During interview, R1 stated that temperature of the room would not match the temperature set by the thermostat. R1 stated that the temperature would be as much as 4 or 5 degrees warmer or colder at times compared to the temperature set by the thermostat. R1 stated to measure the temperature using both the temperature reading on the thermostat and another thermometer in R1’s possession. During visit, LPA Marrufo observed R1’s thermostat to be set at 73 degrees Fahrenheit with a measurement of the room at 75 Fahrenheit. LPA Marrufo took multiple temperature readings in various locations within R1’s living room, and the temperatures ranged from 90.1 Fahrenheit to 64.4 Fahrenheit. Administrator Sarah Stel stated during interviews that R1 had previously complained to facility staff regarding the air conditioning unit. Administrator Stel stated that the facility has replaced the air conditioning unit in R1’s living unit to meet R1’s requests. S1 stated during interview that the air conditioning unit had previously been replaced to address R1’s problems with the noise of the prior unit. S1 stated that the noise levels had been measured at 40 decibels and was measured with a decibel meter. S1 stated that after the new air conditioner unit was installed, there were still variations of the temperature. S1 also stated that a device was placed in the room to measure and record the room temperatures. S1 stated that the recordings during sleeping hours would show no variation in the temperature, and S1 stated that that implied that R1 was adjusting the temperature throughout the day. Witness W1 stated during interview that the thermostat in R1’s living unit gives a temperature reading within 2 degrees of the set temperature. W1 stated that a 2-degree range is within the manufacture’s specifications. W1 stated that the air conditioning unit is designed to be kept at a constant temperature and is not meant to be regularly adjusted. See LIC909-C for more information. 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 During telephone interviews, 4 out of 4 interviewed residents stated that their air conditioner worked properly. During tour of resident rooms and interviews with residents, LPA Marrufo observed that residents R6-R14 had thermostats had a temperature reading the same as the temperature to which the thermostat was set. R6-R14 stated to have had no problems with their thermostats or air conditioning units. Resident R1 stated to have had problems with the room temperature varying 4-5 degrees hotter or cooler than the temperature set by the thermostat. During visit on 09/06/2022, LPA Marrufo observed R1’s apartment. LPA Marrufo observed that R1’s thermostat at 3:06 PM was set to 71 Fahrenheit and the temperature was 74 Fahrenheit. LPA Marrufo observed that R1’s living unit front door was open, so R1 shut the door. During interview, R1 stated to have two thermostats, one in the living room and one in the bedroom. R1 stated to not use the thermostat in the bedroom and leaves it off. LPA Marrufo observed that the bedroom thermostat Air Conditioning fan was set to Off, the temperature was set to 73 Fahrenheit, and the thermostat measured the temperature at 77 Fahrenheit. LPA Marrufo observed that both bedroom window blinds were lifted up and sunlight was entering the bedroom. LPA Marrufo then requested R1 to turn on the bedroom thermostat Air Conditioner fan to full power and set the temperature to 71 Fahrenheit. LPA Marrufo requested R1 to lower the blinds on the bedroom windows. Both the living room and bedroom temperatures then had the same settings. At 3:47 PM, LPA Marrufo observed the living room thermostat to measure the room temperature at 73 Fahrenheit and the temperature set to 71 Fahrenheit. The bedroom thermometer was set to 72 Fahrenheit and set to 71 Fahrenheit. Based on information from interviews conducted with staff, and records reviewed, although the allegation listed above may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is unsubstantiated. No deficiencies were cited under California Code of Regulations Title 22 This report was reviewed with Sandy Narasimhan and a copy of the report was provided. Page 3 of 3.

Licensing Program Analyst Ryker Heberle (LPA) conducted an unannounced annual inspection on 07/28/2022 at 01:12pm. LPA met with facility Administrator Sarah Stel (Admin). LPA toured the facility, including activity room, kitchen, dining room, library, 10 bedrooms, 12 bathrooms, and 2 offices. All staff members observed to be wearing masks. Admin confirmed that all staff and residents have been vaccinated. Facility infectious control plan has already been submitted. No prohibited items noted in resident rooms. All emergency exits noted to be clear of obstruction. All rooms in facility noted to be clean and well maintained. Hand sanitizers, soap, and paper supplies were observed to be available. At least 2 days' supply of perishable food and at least 1 week's supply of non-perishable food was observed on the premises. Fire extinguisher observed to be last inspected in September of 2021. All cleaning supplies and chemicals noted to be in locked cabinets and closets. Smoke/carbon monoxide detectors observed. Facility temperature noted to be 73*F. Facility observed to have designated entry point. Staff took LPAs' temperature and screened for symptoms. 30 days supply of PPE was observed. Hand washing signs were observed in all facility bathrooms. Paper towels were observed in all facility bathrooms. Water temperature observed to be 109.7 *F in facility bathroom. Social distancing signs observed to be posted in all public areas. No deficiencies cited during today's visit. This report was reviewed with Administrator Sarah Stel and a copy of the signed report was provided.

On 06/17/2021 at 11:07 am, Licensing Program Analyst (LPA) Anna Bui conducted an unannounced Annual Required 1 Year visit. LPA met with Executive Director Sarah Stel, Clinical Services Supervisor Rubina Banwait, and Assisted Living Director Bettylou Hidalgo. LPA toured the facility beginning with the main entrance. The entrance had a thermometer, hand sanitizer, and sign-in log to document temperature and screening questions. Universal precautions, COVID-19 protocols, and social distancing guidelines were posted throughout the facility. Restrooms had hand soap and paper towels readily available. Hand washing sign was posted at all hand washing stations. Common areas had signs posted on the seats to promote social distancing. Staff and residents were observed wearing a mask and following COVID-19 protocols. Facility observed to have adequate supply of PPE. No deficiencies were cited during today's visit. This report was reviewed with Executive Director Sarah Stel and a copy was provided to Executive Director Sarah Stel.