Huntington Retirement Hotel.

On 02/10/2026, the California Department of Social Services (CDSS) – Community Care Licensing Division (CCLD), Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Administrator, Heather Argueta. The purpose of the visit was explained, and the LPA was allowed entry to the facility. The facility is licensed to operate for (155) residents, which may be (30) non-ambulatory and (5) bedridden elderly adults ages 60 and above. The facility is approved for (12) hospice residents. The Annual Licensing Fees are current. Facility Layout: The facility is a two-story building located in a commercial neighborhood. It consists of the following: (97) resident bedrooms, (97) resident bathrooms, a med room, a conference room, dining rooms, laundry rooms, a mail room, business offices, a commercial kitchen, (2) activity rooms, storage rooms, (2) public restrooms, courtyard patio area, a staff room, a salon, and a chapel. Outside Grounds: were toured no bodies of water were observed, walkways around the home were clear of hazards, and there were no security bars or weapons on the premises. The courtyard patio area has plenty of sitting space. Industrial Kitchen/Facility Food: The facility has supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. There were fire extinguishers in the kitchen area. 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 Community Rooms: There are games/activity work such as magazines, newspapers, puzzles, books for residents. There are sitting areas for residents. There is a large television for residents. Resident Bedrooms: have adequate lighting, plenty of dresser and closet space. Walls and floors were clean and in good condition. Bathrooms: Toilets, showers, and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries accessible to residents. The hot water temperature measured 112.3 Fahrenheit. Medications: were inaccessible to residents in care. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. The facility is following their plan operation regarding medication administration. There is a first aid kit that is fully stocked. Miscellaneous: Documents are posted as mandated. Last fire earthquake disaster drill was conducted on 04/24/2026. The last Annual Fire Inspection was completed by the Torrance, Fire Department on 04/22/2026. The fire sprinklers were last inspected on 10/10/2025 and they have a five (5) year certification by the Delta Fire Equipment. The Liability Insurance expiration date is 08/13/2026. The Surety Bond expiration date is 12/01/2026. The facility has a current Emergency Disaster Drill and Infection Control Plan. 5 staff records were reviewed, 5 out of 5 staff records had required documentation. 5 resident records were reviewed, 5 out of 5 resident records had required documentation. The Administrator will be emailing records to the LPA to update the Facility File. No deficiencies are being cited based observation and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted, and a copy of this report was left with the Administrator, Heather Argueta.

The investigation consisted of the following: On 01/13/2026, Witness 1 (W1) was interviewed. On 01/14/2026, interviews were conducted, and records were reviewed. Staff 1 (S1) to Staff 4 (S4), Witness 2 (W2) to Witness 3 (W3), and Resident 1 (R1) were interviewed. Facility records were reviewed which consisted of Employee Roster; Resident Roster dated 01/14/2026; 2025 In-Service Staff Trainings which consisted of Hoyer Lift Training and Gait Belt Transferring dated 01/28/2025, Resident Rights dated 11/15/2025, Gait Belt and Proper Body Mechanics Training dated 12/01/2025, Resident Rights dated 12/19/2025, and Transferring and Gait Belt Transfers dated 12/23/2025. R1’s records were reviewed which consisted of Physicians Report dated 12/04/2023; Resident Appraisal dated 01/13/2026; Identification And Emergency Information dated 07/07/2024; and Service Assessment Form dated 01/13/2026. 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 Investigation revealed the following: Allegation: “Staff improperly transferred resident resulting in injury”, it is being alleged that staff improperly transferred R1 resulting in their right knee being injured. Interviews conducted with R1 revealed the following: R1 denied the allegation, furthermore, R1 indicated that their right knee was not injured and their right knee does not hurt. Interviews conducted with W1 to W3 revealed the following: 3 out of 3 witnesses denied the allegation. Interviews conducted with W1 revealed the following: W1 indicated that on 01/08/2026, they did not observe any injuries or bruises on R1’s right knee, furthermore, W1 states that the next day a Physical Therapist tested R1’s right knee and did not observe any injuries on R1’s right knee. Interviews conducted with S1 to S4 revealed the following: 4 out of 4 staff denied the allegation. R1’s records reviewed revealed the following: there are no Unusual Incident Reports nor Medical Records indicated that R1’s right knee was injured. In-Service Staff Trainings revealed the following: staff were training on Gait Belt transfers throughout the year of 2025 for example, Gait Belt Transferring dated 01/28/2025, Gait Belt and Proper Body Mechanics Training dated 12/01/2025, Transferring and Gait Belt Transfers dated 12/23/2025. Based on interviews and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff do not treat resident with dignity and respect”, it is being alleged that during R1’s transfer on 01/06/2026 a staff laughed at R1. Interviews conducted with R1 revealed the following: R1 agreed with the allegation, additionally, R1 indicates that S4 laughed at them during the transfer and stated that Staff 3 (S3) was present during the transfer. Interviews conducted with S3 and S4 revealed the following: S3 and S4 denied the allegation, furthermore, S3 and S4 indicated that they assisted R1 with the transfer on 01/06/2026. Interviews conducted with W2 revealed the following: W2 denied the allegation, furthermore, W2 indicated that they were present during R1’s Service Assessment on 01/13/2026 and R1 indicated that staff did not laugh at them and that they are overall satisfied with the facility. Service Assessment Form dated 01/13/2026 revealed the following: “Resident states they love it here. They decline all allegations made with wellbe.” People present during the meeting were R1, S1, S2, W2, W3, R1’s family, and Welbe Health. In-Service Staff Trainings revealed the following: staff were trained on Resident Rights on 11/15/2025 and 12/19/2025. Based on interviews and records reviewed this allegation is unsubstantiated. Although the allegation 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 provided. An exit interview was conducted, and a copy of this report was left with the Administrator, Heather Argueta and Resident Care Coordinator, Corina Kahl.

Investigation revealed the following: Allegation: “Staff improperly transferred resident resulting in injury”, it is being alleged that staff improperly transferred R1 resulting in their right knee being injured. Interviews conducted with R1 revealed the following: R1 denied the allegation, furthermore, R1 indicated that their right knee was not injured and their right knee does not hurt. Interviews conducted with W1 to W3 revealed the following: 3 out of 3 witnesses denied the allegation. Interviews conducted with W1 (is a medical professional) revealed the following: W1 indicated that on 01/08/2026, they did not observe any injuries or bruising on R1’s right knee, furthermore, W1 states that the next day a Physical Therapist tested W1’s right knee and did not observe any injuries on W1’s right knee. Interviews conducted with S1 to S4 revealed the following: 4 out of 4 staff denied the allegation. R1’s records reviewed revealed the following: there are no Unusual Incident Reports nor Medical Records indicated that R1’s right knee was injured. In-Service Staff Trainings revealed the following: staff were training on Gait Belt transfers throughout the year of 2025 for example, Gait Belt Transferring dated 01/28/2025, Gait Belt and Proper Body Mechanics Training dated 12/01/2025, Transferring and Gait Belt Transfers dated 12/23/2025. Based on interviews and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff do not treat resident with dignity and respect”, it is being alleged that during R1’s transfer on 01/06/2026 a staff laughed at R1. Interviews conducted with R1 revealed the following: R1 agreed with the allegation, additionally, R1 indicates that S4 laughed at them during the transfer and stated that Staff 3 (S3) was present during the transfer. Interviews conducted with S3 and S4 revealed the following: S3 and S4 denied the allegation, furthermore, S3 and S4 indicated that they assisted R1 with the transfer on 01/06/2026. Interviews conducted with W2 revealed the following: W2 denied the allegation, furthermore, W2 indicated that they were present during R1’s Service Assessment on 01/13/2026 and R1 indicated that staff did not laugh at them and that they are overall satisfied with the facility. Service Assessment Form dated 01/13/2026 revealed the following: “Resident states they love it here. They decline all allegations made with wellbe.” People present during the meeting were R1, S1, S2, W2, W3, R1’s family, and Wellbe Care. In-Service Staff Trainings revealed the following: staff were trained on Resident Rights on 11/15/2025 and 12/19/2025. Based on interviews and records reviewed this allegation is unsubstantiated. Although the allegation 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 provided. An exit interview was conducted, and a copy of this report was left with the Administrator, Heather Argueta and Resident Care Coordinator, Corina Kahl.

Investigation revealed the following: Allegation: “Staff verbally abuses the residents.” Interviews conducted with R1 to R10 revealed the following: 10 out of 10 residents denied the allegation, moreover, residents indicated that management has fixed the problems they have had with staff. Interviews conducted with S1 to S8 revealed the following: 8 out of 8 staff denied the allegation. Observations on 12/22/2025 revealed the following: staff were not observed verbally abusing residents. 2025 In-Service Staff Training's revealed the following: staff were trained on Resident Rights on 11/15/2025 and on 12/19/2025; staff were trained on proper ways to communicate with residents on 11/15/2025. Based on interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. Allegation: “Staff does not meet the needs and services of the residents.” Interviews conducted with R1 to R10 revealed the following: 10 out of 10 residents denied the allegation, furthermore, residents indicated that their needs are being met. Interviews conducted with S1 to S8 revealed the following: 8 out of 8 staff denied the allegation. Observations on 12/22/2025 revealed the following: staff were observed assisting residents during lunch time and staff were observed assisting residents with their wheelchairs. 2025 In-Service Staff Training's revealed the following: staff were trained on Safety Checks on 11/15/2025; staff were trained on Meals, Showers, Care Plans, Assisting Residents with Heathers on 10/23/2025. Based on interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff does not respond timely to the residents alerts”, it is being alleged that staff do not respond to call lights/pull cords in a timely manner. Interviews conducted with R1 to R10 revealed the following: 1 out of 10 residents agreed with the allegation; 9 out of 10 residents denied the allegation, additionally, residents indicated that staff normally respond in 3 minutes to 10 minutes. Observations on 12/22/2025 revealed the following: Room 202’s pull cord was pulled at 12:16 PM and at 12:18 PM a caregiver came into the room; Room 257’s pull cord was pulled at 12:20 PM and at 12:23 PM a caregiver came into the room; Room 242’s pull cord was pulled at 12:25 PM and at 12:29 PM a caregiver came into the room; Room 227’s pull cord was pulled at 12:30 PM and at 12:37 PM a caregiver came into the room. 2025 In-Service Staff Training's revealed the following: staff were trained on Answering Call Lights in a Timely Manner on 03/04/2025. Based on interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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 provided. An exit interview was conducted, and a copy of this report was left with the Administrator, Heather Argueta and Resident Care Coordinator, Corina Kahl.

On 11/12/2025, at approximately 1:30 PM, an office meeting was held to discuss Complaint 11-AS-20220913161318. Present at the meeting were Stephanie Cifuentes, Licensing Program Manager (LPM), Ulysses Coronel, Licensing Program Manager (LPM), Socorro Leandro, Licensing Program Analyst (LPA), Heather Arguetta, Administrator and Corina Khal, Resident Care Coordinator. During the meeting, LPM Cifuentes reviewed the details of the complaint. On September 13, 2023, the Department substantiated an allegation: Resident sustained fractures while in care At the time the findings were delivered on September 13, 2023, the Department indicated that an enhanced civil penalty determination was pending, pursuant to Health and Safety Code Section 1549(e)(1)(A). The Department is reviewing the complaint for enhanced civil penalty for physical abuse pursuant to H&S 1549(e)(1)(A). The total amount for the civil penalty totals $10,000 for a serious bodily injury. An exit interview was conducted, and a copy of this report was provided together with the appeal rights.

Investigation revealed the following: Allegation: “Staff did not provide meals to residents in care in a timely manner”, it is being alleged that meals take 30 minutes up to an hour to be served. Interviews conducted with R1 to R10 revealed the following: 10 out of 10 residents denied the allegation. Interviews conducted with S1 to S7 revealed the following: 7 out of 7 staff denied the allegation. Interviews conducted with W1 to W7 revealed the following: 7 out of 7 witnesses denied the allegation. Records Reviewed of the “New Resident Welcome Packet” under “Dietary Services” states the following: Breakfast is served at 8:00 am, Lunch is served at 12:00 pm, and Dinner is served at 5:00 pm. Observations on 10/02/205 during lunchtime revealed the following: the dining room tables were set up at around 11:30 am; the dining tables had placemats, and each placemat had cutlery set up, a cup of water and a cup of juice; residents started to go into the dining room at around 11:35 am; a caregiver left the dining room with a mobile food tray carrier at around 11:40 am and then again around 11:50 am; the serving staff started serving soup, salad, and coffee at around 11:57 am; the serving staff started serving entrees at around 12:13 pm; the serving staff started serving desert at around 12:20 pm. Observations on 10/02/205 during dinner time revealed the following: the dining room tables were set up for at around 4:20 pm; the dining tables had a placemats, and each placemat had cutlery set up, a cup of water and a cup of juice; residents started to go into the dining room at around 4:30 pm; the serving staff started serving residents starters at around 4:50 pm. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff did not provide medication assistance to residents in care in a timely manner.” Interviews conducted with R1 to R10 revealed the following: 10 out of 10 residents denied the allegation; furthermore, residents indicated that they receive their medication. Interviews conducted with S1 to S7 revealed the following: 7 out of 7 staff denied the allegation, furthermore, staff indicated that they have not heard of any complaints regarding this allegation. Interviews conducted with W1 to W7 revealed the following: 7 out of 7 witnesses denied the allegation, moreover, witnesses indicated that the facility does a good job at providing residents with medication and calling them if the resident requires a refill. Observations on 10/02/205 revealed the following: at around 11:20 am the Medication room was toured, and it was organized; at around 11:40 am MedTech’s started passing out medications in the dining room and finished passing out medications around 12:37 pm; at around 4:35 pm MedTech’s started passing out medications in the dining room. Records reviewed of Medication Administration Records (MARs) for R1 to R10 revealed the following: there is no documentation indicated that medications were not passed out on time. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “ Staff are not able to properly transfer residents in care due to lack of staffing”, it is being alleged that when using Hoyer lifts only one staff uses the equipment instead of two staff. Interviews conducted with R1 to R10 revealed the following: 9 out of 10 residents denied the allegation; 1 out 10 residents did not know how many staff use the Hoyer lift when transferring residents. Interviews conducted with S1 to S7 revealed the following: 7 out of 7 staff denied the allegation, furthermore, staff indicated that they have not seen or heard of only one staff member using the Hoyer lift. Interviews conducted with W1 to W7 revealed the following: 7 out of 7 witnesses denied the allegation, moreover, witnesses indicated that they have seen two staff members using the Hoyer lift and/or have not seen only one staff member using the Hoyer lift. Residents’ records reviewed revealed the following: R1 to R10 have doctors’ orders for Hoyer lifts. Staff records reviewed revealed the following: staff training on “Caregiver Safety Tips” which includes how to use a Hoyer lift; staff signatures acknowledging the following “I acknowledge that I will always call for another person to help when operating the Hoyer lift and agree to follow company policy at all times. I acknowledge that I received a handout of this policy”; staff signatures acknowledging that that they have received and read the “Employee Handbook”, which includes a section of mandatory “Training and Education.” Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff vape inside the facility.” Interviews conducted with R1 to R10 revealed the following: 9 out of 10 residents denied the allegation; 1 out of 10 residents were unable to answer the question. Interviews conducted with S1 to S7 revealed the following: 7 out of 7 staff denied the allegation. Interviews conducted with W1 to W7 revealed the following: 7 out of 7 witnesses denied the allegation. Observations on 10/02/2025 and 10/03/2025 revealed the following: no staff, residents, nor visitors were observed smoking/vaping inside the facility. Staff records reviewed revealed the following: “Drug Free Workplace Policy” with staff signatures; “Code of Conduct” in the workplace; and staff signatures acknowledging that that they have received and read the “Employee Handbook”, which includes a section on “Drug-Free Workplace.” Based on the department’s interviews and observations this allegation is unsubstantiated. Although the allegation 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 provided. An exit interview was conducted, and a copy of this report was left with the Resident Care Coordinator, Corina Khal.

It is being alleged that a resident in care had some cards stolen while receiving care at the facility. On 09/05/25 from 10am- 12pm LPA conducted interviews with R1-R8 regarding the allegation above, 5 of 8 residents denied the allegation above and report they have not had any property stolen while receiving care at Huntington Retirement Hotel. 3 of the 8 residents interviewed reported having items stolen from there bedrooms. Additionally, 2 of the 8 residents indicated reporting missing items to staff and staff assisted with looking for the items however items were never found. 1 of the 8 residents stated the did not reporting missing items to staff. On 1:10pm -2:30pm LPA conducted interviews with S1-S5 regarding the allegation above, 5 of 5 staff interviewed denied the allegation above and stated that management will conduct investigation when a resident reports missing any property. On 09/05/25 LPA conducted interview with W1 regarding the allegation above, per W1 there are no concerns about the care being provided at Huntington Retirement Hotel. W1 continued to report that the cards that were stolen are cards used for transportation access only and are not connected to any of residents funds, cards are being replaced. On 09/05/25 LPA conducted a review of grievance report dated: 08/28/25, per report resident reported (2)missing wallet that only had a transportation card in it, report indicated that a search was conducted, however all personnel belongings were not searched as resident was receiving services outside of the facility at the time of the search was conducted. 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. Exit interview conducted, and a copy of this report was provided.

Allegation: “Questionable Death”, it is being alleged that Resident 1 (R1) passed away in the TV (activity) room without anyone noticing. Interviews conducted with S4, S5, and S11 (were witnesses to the incident) revealed the following: 3 out of 3 staff denied the allegation. Interviews conducted with W10 and W11 revealed the following: 2 out of 2 witnesses denied the allegation. Interviews conducted with R14 to R19 (were witnesses to the incident) revealed the following: 2 out of 6 residents denied the allegation. 4 out of 6 resident interviews were inconclusive. R1’s records revealed the following: R1’s Service Assessment Form dated 01/14/2025 indicated that R1 required full assistance in daily living. R1’s Unusual Incident Report and Death Report dated 07/12/2025 indicated that R1 was declining in health; R1 was seen earlier that day by Home Health around 9:30 AM; R1 was in the activity room and checked around 11:10 AM; R1 was in the dining room and checked around 12:09 PM and paramedics were called due to R1 being unresponsive; paramedics came to the facility and pronounced R1’s death. Based on the department’s interviews and records reviewed this allegation is unfounded. Unfounded: This agency has investigated the complaint alleging "Questionable Death." We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint. No deficiencies were provided. An exit interview was conducted, and a copy of this report was left with the Administrator, Heather Argueta and Resident Care Coordinator, Corina Kahl. 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 Investigation revealed the following: Allegation: “Licensee does not ensure facility has enough staff to meet the needs of the residents who require two person assist”, it is being alleged that when using Hoyer lifts only one staff member uses the equipment instead of two staff members. Interviews conducted with R2 to R13 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S10 revealed the following: 10 out of 10 staff denied the allegation. Interviews conducted with W1 to W9 revealed the following: 9 out of 9 witnesses denied the allegation. Observations on 08/04/2025 revealed the following: two staff members were observed using a Hoyer lift. Based on the department’s interviews and observations this allegation is unsubstantiated. Although the allegation 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. Allegation: “Staff are not properly assisting residents who are a fall risk.” Interviews conducted with R2 to R13 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S10 revealed the following: 10 out of 10 staff denied the allegation. Interviews conducted with W1 to W9 revealed the following: 9 out of 9 witnesses denied the allegation. Records reviewed of In-Service Training dated 07/15/2025 revealed the following: staff were trained on Policy: Fall Occurrence Checklist. Records reviewed of Resident Service Assessment Form revealed the following: there are two sections in the form that address fall risk; one section is named Safety and the other Mobility, both sections state if resident has had a history of falls and the prevention measures that are being implemented. Based on the department’s interviews and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff yell at residents.” Interviews conducted with R2 to R13 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S10 revealed the following: 10 out of 10 staff denied the allegation. Interviews conducted with W1 to W9 revealed the following: 8 out of 9 witnesses denied the allegation. 1 out of 9 witnesses agreed with the allegation. Observations on 08/04/2025, 08/06/2025, 08/07/2025, and 08/13/2025 revealed the following: staff were not observed yelling at residents. Based on the department’s interviews and observations, and this allegation is unsubstantiated. Although the allegation 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. Allegation: “Staff do not offer engaging activities for residents.” Interviews conducted with R2 to R13 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S10 revealed the following: 10 out of 10 staff denied the allegation. Interviews conducted with W1 to W9 revealed the following: 9 out of 9 witnesses denied the allegation. Observations on 08/04/2025, 08/06/2025, and 08/13/2025 revealed the following: the facility follows their activity schedule; activities are from Monday to Sunday and start from 9:30 AM to 4:00 PM; activities vary from fitness, music, personal care, bingo, movie & popcorn, market trips, religious studies, cooking classes, etc. Records reviewed of Resident Service Assessment Form revealed the following: there is a section for Activities and Resident Preferences are noted. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff are not meeting residents bathing needs.” Interviews conducted with R2 to R13 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S10 revealed the following: 10 out of 10 staff denied the allegation. Interviews conducted with W1 to W9 revealed the following: 8 out of 9 witnesses denied the allegation. 1 out of 9 witnesses agreed with the allegation. Observations on 08/04/2025, 08/06/2025, 08/07/2025, and 08/13/2025 revealed the following: residents were observed clean and well groomed. Records reviewed of Resident Service Assessment Form revealed the following: there is a section for Bathing, and it states if residents are independent, require assistance, and how often residents would like to be bathed. Record reviewed of Shower Books for August 2025 revealed the following: the facility has a shower schedule for each floor; the shower schedule is from Monday to Sunday; the time is divided from morning, evening, and nocturnal time. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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 provided. An exit interview was conducted, and a copy of this report was left with the Administrator, Heather Argueta and Resident Care Coordinator, Corina Kahl.

The investigation consisted of the following: On 07/30/2025, interviews were conducted, and facility records were gathered. Staff 1 (S1) to Staff 8 (S8) were interviewed. On 08/04/2025, interviews were conducted, and a tour of the facility was conducted. Witness 1 (W1) and Resident 1 (R1) to Resident 11 (R11) were interviewed. A tour of the facility consisted of observation of lunch time. On 08/06/2025, interviews were conducted, a tour of the facility was conducted, and records were reviewed. Interviews conducted consisted of: Resident 12 (R12), Staff 7 (S7), Staff 9 (S9), and Staff 10 (S10). A tour of the facility consisted of the kitchen and activity room. Records reviewed consisted of 9 resident medications along with their Medication Administration Records (MARs). On 08/07/2025, interviews were conducted, and records were reviewed. Witness 2 (W2) to Witness 8 (W8) and Staff 11 (S11) to Staff (12) were interviewed. Resident, staff, and facility records were reviewed. 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 Investigation revealed the following: Allegation: “Staff left resident on floor soiled for an extended period of time”, it is being alleged that a resident fell at night and was found the next morning. Interviews conducted with R1 to R12 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S12 revealed the following: 12 out of 12 staff denied the allegation. Interviews conducted with W1 to W8 revealed the following: 8 out of 8 witnesses denied the allegation. Based on the department’s interviews this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff mismanages residents’ medication logs”, it is being alleged that facility staff hides, destroys, removes medication and medication documentation. Interviews conducted with R1 to R12 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S12 revealed the following: 12 out of 12 staff denied the allegation. Interviews conducted with W1 to W8 revealed the following: 8 out of 8 witnesses denied the allegation. On 08/06/2025, records reviewed and observations of 9 resident medications along with their MARs revealed the following: 9 out of 9 resident medications along with their MARs were in compliance. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff does not follow residents’ food diet.” Interviews conducted with R1 to R12 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S12 revealed the following: 12 out of 12 staff denied the allegation. Interviews conducted with W1 to W8 revealed the following: 8 out of 8 witnesses denied the allegation. Observations of lunch time on 08/04/2025 revealed the following: residents were being provided with their specialized diet. Each dining room table has diet cards for each resident. Diet cards consist of residents’ name, room number and diet (an example of a diet can be mechanical soft, thick liquids, no fish, allergic to peanuts, regular diet, etc.). Observations and records reviewed of the kitchen on 08/06/2025 revealed the following: The kitchen has diet slips and resident roster with their diet description posted on the wall. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff serves expired foods”, it is being alleged that staff served expired food and unsafe food. Interviews conducted with R1 to R12 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S12 revealed the following: 12 out of 12 staff denied the allegation. Interviews conducted with W1 to W8 revealed the following: 8 out of 8 witnesses denied the allegation. Observations of lunch time on 08/04/2025 revealed the following: no unsafe nor expired food were provided to residents. Observations of the kitchen on 08/06/2025 revealed the following: no unsafe nor expired food were observed in the freezers, fridges, or pantry. Record reviewed of Dietary Quality Control Survey dated 06/16/2025 revealed the following: the facility received an 84% score. Record reviewed of Dietary Quality Control Survey dated 07/01/2025 revealed the following: the facility received an 87% score and no mention of expired food. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff does not communicate with residents’ responsible party.” Interviews conducted with R1 to R12 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S12 revealed the following: 12 out of 12 staff denied the allegation. Interviews conducted with W1 to W8 revealed the following: 8 out of 8 witnesses denied the allegation. Records reviewed of 2025 Unusual Incident Reports (UIRs) demonstrate a history of facility contacting residents’ responsible party. Based on the department’s interviews and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff does not ensure a safe and healthy environment for residents”, it is being alleged that residents are not receiving care and supervision. Interviews conducted with R1 to R12 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S12 revealed the following: 12 out of 12 staff denied the allegation. Interviews conducted with W1 to W8 revealed the following: 8 out of 8 witnesses denied the allegation. Observations on 07/30/2025, 08/04/2025, and 08/06/2025 revealed that residents are receiving care and supervision. Records reviewed of Employee Schedules from April 2025 to July 2025 revealed the following: the facility has staff from Monday to Friday 24 hours a day. Medical Technicians and Caregivers staff are on facility grounds 24 hours a day. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Staff vapes inside the facility.” Interviews conducted with R1 to R12 revealed the following: 11 out of 12 residents denied the allegation. 1 out of 12 residents were unable to answer questions. Interviews conducted with S1 to S12 revealed the following: 12 out of 12 staff denied the allegation. Interviews conducted with W1 to W8 revealed the following: 8 out of 8 witnesses denied the allegation. Records reviewed of Drug Free Workplace Policy revealed the following: staff are not to use controlled substances as it affects the workplace. Observations on 07/30/2025, 08/04/2025, and 08/06/2025 revealed the following: there were no staff vaping/smoking inside the facility. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. An exit interview was conducted, and a copy of this report was left with the Administrator, Heather Argueta.

Investigation revealed the following: Allegation: “Staff do not provide adequate food service for the residents”, it is being alleged that the facility provides poor quality food for residents in care (e.g. food that is rotten and stale). Interviews conducted with R1 to R9 revealed the following: 9 out 9 residents denied the allegation. Interviews conducted with S1 to S9 revealed the following: 9 out 9 staff denied the allegation. Observations revealed the following: On 5/7/2025, the department toured the kitchen area and observed good quality foods. The facility recently received a new shipment of fresh produce, meats, and dry goods. Thus, the dry goods pantry was well stocked as well as the freezers and fridges. The department did not observe stale food or food that was expired. Around 12:00 PM, the department observed residents receiving good quality well-balanced lunch meals. Around 2:00 PM, the department observed an all-staff In-Service Training regarding Dietary Dysphagia and Different Diets. Records reviewed revealed the following: Dietary Quality Control Survey from March 2025 to May 2025 indicate that the facility has good quality foods. Weekly Menus from March 2025 to June 2025 indicate that the facility serves well balanced meals to residents in care. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. An exit interview was conducted, and a copy of this report was left with the Resident Care Coordinator, Corina Kahl.

Investigation consisted of the following: On 2/27/2025, a tour of the facility was conducted which included the dining room and kitchen area; 6 staff and 1 witness were interviewed; records were gathered. On 2/28/2025, a tour of the dining room was conducted during breakfast time and lunch time; a tour of the kitchen was conducted; pictures were observed of meals (pictures were dated and timestamped); 1 staff and 10 residents were interviewed; records were reviewed which consisted of staff roster, resident roster with their diet description, 5 residents physician’s reports (of residents who have special diets according to their physician), Healthcare Menus Direct for Recipe: Beef Goulash, staff records, Weekly Menus from December 2024 to June 2025, Cooks Spreadsheet for Spring Cycle Menus from March 2025 to May 2025, Dietary Quality Control Survey for January 2025 to February 2025, and Select Menu. Investigation revealed the following: Allegation: “Facility does not provide diets as prescribed by the resident(s) doctor”, it is being alleged that the facility does not provide residents with meals as prescribed by the residents’ doctor. Interviews conducted revealed the following: 10 out 10 residents denied the allegation, 7 out of 7 staff denied the allegation and 1 out of 1 witness denied the allegation. Observations revealed the following: The kitchen has diet slips and resident roster with their diet description posted on the wall. Each dining room table has diet cards for each resident. Diet cards consist of resident’s name, room number and diet (an example of a diet can be mechanical soft, thick liquids, no fish, allergic to peanuts, regular diet, etc.). On 2/28/2025, during breakfast and lunch time the department observed food being served to residents according to their dietary needs. On 2/28/2025 during breakfast and lunch time the department observed staff assisting residents with feeding for residents that require assistance. On 2/28/2025, before lunch time the department observed kitchen staff follow the Healthcare Menus Direct to create special diets (e.g. purees). Records reviewed revealed the following: In the kitchens office there is a Diet Slip binder (which consist of each residents diet) and a Healthcare Menus Direct binder for example the Recipe: Beef Goulash has a section for Special Diets such as low fat, low cholesterol, mechanical soft, dysphagia, pureeds, renal, gluten free and describes how to cook each special diet. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. 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 Allegation: “Facility does not provide menus that match foods that are served to residents”, it is being alleged that what is on the menu is not the same as the meals that residents are served. Interviews conducted revealed the following: 7 out 10 residents denied the allegation, 3 out 10 residents do not read the menus, 7 out of 7 staff denied the allegation and 1 out of 1 witness denied the allegation. Observations revealed the following: On 2/28/2025, the department observed that the facility followed the menu for breakfast and for lunch time. The Administrator has a large collection of pictures taken for lunch and dinner meals consisting of the regular meal and special diets such as mechanical soft and pureeds (each picture is dated and timestamped). The department observed that each meal corresponds with the Weekly Menu for February 24, 2025. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. Allegation: “Facility does not provide good quality food”, it is being alleged that the food the facility provides to residents in care is not edible (e.g. food scraps thrown together). Interviews conducted revealed the following: 10 out 10 residents denied the allegation, 7 out of 7 staff denied the allegation and 1 out of 1 witness denied the allegation. Observations revealed the following: On 2/27/2025, the department toured the kitchen area which consisted of the dry good storage, freezers, fridges, etc. The department observed good quality food for example meats, vegetables, dairy products, and bread. On 2/28/2025, the department observed good quality breakfast and lunch meals being served to residents in care. Records reviewed revealed the following: Dietary Quality Control Survey for January 2025 to February 2025 indicates that the facility has good quality foods. The Administrator has a large collection of pictures taken for lunch and dinner meals consisting of the regular meal and special diets such as mechanical soft and pureeds (each picture is dated and timestamped). The department observed that meals looked of good quality. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation 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. An exit interview was conducted, and a copy of this report was left with the Administrator, Heather Argueta.

On 02/14/25, Licensing Program Analysts (LPAs) Ernand Dabuet and Jose Anguiano conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Resident Care Coordinator Carina Kahl. LPA Dabuet explained the purpose of today’s visit. The facility is licensed to operate for (155) residents, which may be (30) non-ambulatory and (5) bedridden elderly adults ages 60 and above. The facility is approved for (12) hospice residents. Currently, the facility has (82) assisted living residents, (15) residents in memory care, and (8) hospice residents. The facility is a two-story structure located in a commercial neighborhood. It consists of the following: (97) resident bedrooms, (97) resident bathrooms, a med room, a conference room, dining rooms, laundry rooms, a mail room, business offices, a commercial kitchen, (2) activity rooms, storage rooms, (2) public restrooms, courtyard patio area, a staff room, a salon, and a chapel. LPAs, Kapel, and the Maintenance Director toured the physical plant. There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident's personal belongings was observed. Bed linens, comforters, and bath towels were stocked during the visit. The resident rooms were inspected: #116, #119, #122, #124, #201, #203, #209, #216 and #246. Emergency call buttons were in working condition. Bathrooms were operational with water temperature measured at 105.2 – 112.9 degrees F. A comfortable temperature was maintained in the facility at 72 - 74 degrees F. LPAs observed that the facility was to be furnished during the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and inaccessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. (Evaluation Report continues LIC 809-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 Fire extinguishers were charged, and smoke detectors and carbon monoxide were operable in each resident's room. Disaster, evacuation, and fire Drills are conducted, with records of 01/25/25 being the last drill. Facility fire cleared approved for delayed egress exits. During the visit, LPAs observed the facility's infection control practices. LPAs observed screening protocols for visitors, staff, and residents and sanitizing stations in common areas and restrooms. All mandated inspection control posters, including the Activities Calendar and Food Menu, were posted. LPAs conducted an audit of resident #1-#6 (R1-R6) out of (97) service files, and staff #1-#5 (S1-S5) out of (93) personnel files were all complete. A review of the Medication Records Administration (MAR) was maintained in order and accurately. The facility is current on CCLD annual fees. The administrator certificate for Heather Argueta #7001895740 is valid through 11/25/25 . The facility has a Liability Insurance Certificate valid with policy # MKLV5PSM001282 effective 01/01/25 through 01/01/2026. No deficiencies were noted during this annual visit. An exit interview was conducted with Corina Kahl, and a copy of the report was provided.

Investigation Revealed the Following: #1 Allegation: Resident sustained injury while in care This complaint alleges that (R#1) sustained a wound on the right leg due to a dilapidated bed frame while in care at the facility. This complaint alleges, (R#1) sustained a 6-inch skin tear on the right leg when making contact with a sharp metal piece on (R#1)’s bed frame. LPA was unable to find documented evidence or witness accounts of (R#1) sustaining an injury due to the bedframe being in disrepair. LPA found documentation stating (R#1) experienced an unwitnessed fall in (R#1)’s room at approximately 10:00 p.m., on 9/3/2022, and sustained an injury to the right leg and was bleeding. (R#1) stated the injury occurred when (R#1) was walking to the restroom in the dark and could not see what was in the way when the injury occurred. After the injury occurred (R#1) called for Staff to assist. Staff responded and found (R#1) laying on the floor and (R#1)’s right leg was bleeding. Staff then contacted 911 and EMS responded to the call in approximately (5) minutes. (R#1) was then transported to the hospital. LPA Iniguez conducted an interview with the facility Administrator (A#1) on 3/28/24. (A#1) stated that a family member requested (R#1)’s bed frame be replaced as it was in disrepair, and this caused the injury to (R#1)’s leg. (A#1) stated she inspected (R#1)’s bed frame and found it safe for use; however, she honored the family members request to replace the bed frame. In addition, (A#1) stated that they do not know how (R#1) sustained their leg injury it was unwitnessed. During an interview on 3/28/24 with the Maintenance Director (S#9), he stated that prior to (R#1) 's moving into the facility, he assembled and inspected (R#1)’s room furniture. He did not observe that the bed frame was in disrepair and safe for use. On 10/25/22, LPM Lourdes Montoya conducted interviews with at the facility and found the following: During interviews with residents (R#2-R#10), (9) out of (10) residents did not express concerns about safety in the facility. Evaluation Report continues LIC 9099-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 During interviews with (A#1) staff (S#2-S#7), (2) out of (7) facility staff stated they inspected (R#1)’s bed frame and found it safe for use. Out of the (7) staff members interviewed, (6) have not observed residents injured while in care. #2 Allegation: Resident sustained fungal infection. The details of this complaint allege that (R#1) sustained a fungal infection due to lack of showers while residing at the facility from 08/09/22-10/29/22. During the records review, LPA Iniguez reviewed (R#1)’s Service Assessment Plan dated 8/9/22. In this plan, it is written that (R#1) required a level- 7 in Hygiene and Grooming, which means the facility staff must assist them daily with personal hygiene and grooming. In addition, under the Bathing service, (R#1) had a level -10, which means (R#1) would receive assistance with bathing three times a week. In addition, LPA Iniguez obtained and reviewed copies of the facility shower schedules for the period of 8/11/22 until 10/25/22. These schedules reflect the facility staff assisted (R#1) with bathing (3) times per week consistently during the time (R#1) resided at the facility. LPA conducted an interview with (A#1), who stated the cause of the fungal infection was unknown; however, Home Health visited (R#1) daily and cared for (R#1)’s health needs. LPA obtained Home Health care plan indicating, on 10/14/2022, Home Health began applying an antifungal topical medication (R#1)’s legs and the last application for this topical medication ended 10/16/2022. On 10/25/22, LPM Lourdes Montoya conducted interviews with at the facility and found the following: Interviews were conducted with (R#2-R#10), (9) out of (10) Residents were not aware of or observed (R#1) with a fungal infection on the legs. Interviews with staff (S#2-S#7), revealed (6) out (7) were not aware of (R#1)’s fungal infection. Evaluation Report continues LIC 9099-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 #3Allegation: Staff did not order prescribed medication for resident The details of the complaint alleged that the facility failed to order (R#1)’s prescribed medication for a fungal infection on (R#1)’s right and left lower legs. During the course of this investigation, LPA Iniguez obtained documentation confirming on an order for Micanazole 2% antifungal cream dated 10/13/22. The detail of this complaint alleges the cream was not ordered or applied to (R#1)’s fungal infection on 10/14/22,10/15/22, and 10/16/22; however, home Health records confirm Micanazole 2% antifungal cream was applied to (R#1)’s fungal infection by a Home Health nurse on 10/14/22,10/15/22, and 10/16/22. LPA reviewed the Medication Administration Record and found a notation indicating Home Health would administer this medicated cream. On 10/25/22, LPM Lourdes Montoya conducted interviews with at the facility and found the following: During interviews with residents (R#1-R#10), (9) out of (10) stated that they were not aware of, nor have they observed medication not being ordered for a Resident. During interviews with staff (S#2-S#7), (6) out of (7) stated they were not aware of, nor have they observed medication not being ordered for a Resident. #4 Allegation: Staff inappropriately handled residents roughly. The details of the complaint alleged that facility staff “hit (R#1) on the face” by Staff S#8, on 10/12/22, when S#8 assisted (R#1) with a shower. LPA conducted an interview with the Administrator (A#1). (A#1) stated that she is aware of this allegation as it was reported to her by (W#1) on 10/12/22. W#1 stated that during a phone conversation with (R#1) on 10/12/22, (R#1) reported the incident to (W#1). Evaluation Report continues LIC 9099-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 (A#1) stated on 10/12/22, an Unusual Incident Report and, on 10/13/22, a Suspected Abuse of a Dependent Adult/ Senior (SOC 341) was sent to CCLD. (A#1) stated S#8 was suspended following the report, and the facility conducted an internal investigation. (R#1) was interviewed during the facilities investigation and asked if (S#8) had “hit” (R#1), and (R#1) stated that they did not remember if (S#8) had hit them. S#8 was interviewed and denied “hitting” (R#1) when assisting (R#1) on 10/12/22. The facility found no physical signs of (R#1) having been “hit”. The facility was unable to find evidence to support S#8 “hit” (R#1). (A#1) states the alleged incident was reported to the Torrance Police Department on 10/13/22. The Torrance Police Department officers visited the facility on 10/18/22 and 10/19/022. The officers conducted interviews with (R#1) and staff members. During the police department interviews with (R#1), (R#1) stated that they believe they raised their voice at S#8, but S#8 did not hit them. LPA Iniguez was informed that a report was not going to be created for the alleged incident and there would be no further follow-up. On 10/25/22, LPM Lourdes Montoya conducted an interview with (R#1). R#1 stated that while S#8 aided (R#1) in the shower, on 10/12/22, S#8 was rude and not patient. R#1 did not recall being physically “hit” by S#8 while S#8 provided assistance to R#1. On 10/25/22, LPM Lourdes Montoya conducted interviews with at the facility and found the following: During an interview with Resident (R#1), they stated that they were aware of, nor have they observed facility staff inappropriately handling them roughly. During interviews with residents (R#2-R#10), (9) out of (10) residents stated that they were not aware of, nor have they observed a staff inappropriately handle a resident in care roughly. During interviews with staff (S#2-S#7), (6) out (7) staff stated that they were not aware of, nor have they observed a staff inappropriately handle a resident in care roughly. Evaluation Report continues LIC 9099-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 #5 Allegation: Staff screams at residents. The detail of the complaint alleges that facility is not properly trained to work with dementia Residents. During the course of this investigation, LPA Iniguez obtained copies of the 2022 mandatory facility staff training. These trainings included Dignity and Respect, Dementia Training, Dementia and Hygiene, and Personal Rights of all Residents. According to (A#1) statement, new staff shadow the Resident Care Coordinator for two days, followed by shadowing a seasoned caregiver for five days or more as needed. Furthermore, (A#1) stated that to train new staff to work at the dementia unit, they start with 12 hours of video training about dementia care, postural supports, diets, and fall risk. After the two days of video training, they shadow a seasoned caregiver for ten days or more as needed. On 10/25/22, LPM Lourdes Montoya conducted interviews with at the facility and found the following: During an interview with facility administrator (A#1) stated that she has not heard or observed a facility staff screamed at a resident. During an interview with resident 1, (R#1) stated that they have not observed or heard facility staff scream at them. During an interview with residents, (9) out of (10) residents stated that they had not heard or observed a staff scream at a resident in care. During an interview with facility staff, (6) out of (7) staff stated that they had not heard or observed a staff scream at a resident in care. Evaluation Report continues LIC 9099-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 #6 Allegation: Staff inappropriately disciplined resident in care The details of the complaint alleged that as a form of punishment, the facility s

Investigation Revealed the Following: Allegation: Facility staff are threatening to evict resident. The details of the complaint alleged that facility staff are threatening to evict resident due to lack of payment. During the records review, LPA Iniguez reviewed (R#1)’s admission agreement dated 9/8/2022 with (R#1) as the primary signature and (W#1) as a responsible person. The admissions agreement states the monthly rate for accommodations & basic services, Level of care, and new resident admission fee; this page was signed by (R#1) and (W#1) on 9/8/2022. In addition, in the admissions agreement 4, Term-Clause (d)(i). Termination by Us with 30 days’ prior Notice), it is stated that if any of the following events occur, we may terminate this agreement and require you to vacate your unit and the community thirty (30) days after we have notified you or your responsible party: I: Nonpayment of the rate for basic services within ten (10) days of the due date. This clause was signed by (R#1) and (W#1) on 9/8/2022. In addition, LPA reviewed the In-Home Communications Notes from 9/23/2022 to 1/23/2023; in the notes, facility staff made several attempts to reach out to (W#1) regarding (R#1)’s nonpayment of basic rate and level of care these fees were not paid since (R#1)’s moving date back in 9/8/2022, the facility was unable to reach (W#1) via telephone or mail. Also, the facility sent to (R#1)’s POA three notices of outstanding account balance fees using Certified mail services, one dated 10/24/2022, the second dated 1/24/2023, and the third one dated 3/22/2023. Evaluation Report continues LIC 9099-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 Furthermore, the facility sent monthly bill statements to the (W#1) address regarding (R#1) balance dues from 9/23/2022 to 5/31/2023. On 2/7/2023, the facility served (R#1) a 30-day eviction notice; this Notice was faxed to the Regional Office as a Special Incident Report on 2/17/2023. Also, the Notice shows that (R#1) has an outstanding balance of $20,279.73. The discharge date for this Notice was 3/8/2023. During an Interview with the Administrator (A#1), she stated that (R#1)’s daughter never paid their rent for over six months, (R#1)’s daughter would pay with a personal check and came out of funds all the time. In addition, (R#1)’s daughter has never paid the admission fee since the beginning. Also, (A#1) stated that (S#1) never threatened (R#1) for non-payment of services, (S#1) and I followed the eviction procedures since (R#1)’s POA did not pay the admissions fee, monthly basic fees, and level of care. During interviews with residents (R#1-R#10), (9) out of (10) residents stated that they have never been threatened by the facility staff for non-payment of monthly rent. During interviews with staff (S#1-S#5), (5) out (5) facility staff stated that (S#1) did not threaten to evict (R#1) for non-payment of fees. Allegation: Facility staff are refusing to allow resident to have visitors. The details of the complaint alleged that facility staff are refusing to allow resident to have visitors due to lack of payment. During the records review, LPA Iniguez examined the facility's COVID-19 Family Visitor Screening Sheets and observed that (R#1) received visits from family and friends who were allowed to enter the facility after proper screening. The dates of the visits were: 9/8/22, 9/9/22, 9/13/22, 9/24/22, 10/5/22, 10/16/22, 11/24/22, and 11/28/22. Evaluation Report continues LIC 9099-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 During an interview with the administrator (A#1), she stated that (S#1) did not prohibit (R#1) from having visitors because of the non-payment of fees. During interviews with residents (R#1-R#10), (9) out of (10) residents stated that no facility staff has ever refused them to have visitors due to lack of monthly fees. During interviews with staff (S#1-S#5), (5) out (5) facility staff stated that (S#1) did not refuse for (R#1) to have visitors due to their lack of monthly fees. Allegation: Facility staff are refusing to allow resident to participate in activities and Outings. The details of the complaint alleged that facility staff are refusing to allow resident to participate in activities and outings due to lack of payment. During an Interview with the Administrator (A#1), she stated that (S#1) did not prohibit (R#1) from participating in the facility activities or outings. During interviews with residents (R#1-R#10), (9) out of (10) residents stated that no facility staff has ever told them not to participate in activities or outings offered by the facility because of non-payment of monthly fees. During interviews with staff (S#1-S#5), (5) out (5) facility staff stated that (S#1) did not prohibit (R#1) from participating in the facility activities or outings. Evaluation Report continues LIC 9099-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 Allegation: Facility staff are withholding medication from resident due to lack of payment. The details of the complaint alleged that facility staff are withholding medication from resident due to lack of payment. During the records review, LPA Iniguez reviewed (R#1)'s Medication Administration Records (MARs) dated 9/22 to 2/23. LPA observed (R#1) received their medications as prescribed by their physician. During an interview with the administrator (A#1), she stated that (S#1) cannot give that order; only the resident’s physician can. During interviews with residents (R#1-R#10), (9) out of (10) residents stated that no facility staff has ever withheld their medications because of the non-monthly payments. During interviews with staff (S#1-S#2), (5) out of (5) facility staff stated that (S#1) did not withhold (R#1)’s medications because of non-monthly payments. During this investigation, LPA found did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation(s) are found to be UNSUBSTANTIATED. 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. An exit interview was conducted, and a copy of the Complaint Report was given to Corina Kahl /Administrator.

On 03/22/2024 at 9:00 AM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at Huntington Retirement Hotel Facility. LPA Jose Calderon was allowed entry into the facility by Administrator Heather Argueta. The facility is licensed for 155 residents aged 60 and over. Currently, there are (100) residents residing in the facility 60 years or older. LPA Jose Calderon explained to Administrator Heather Argueta the purpose of the 1-year Annual Inspection visit, and escorted LPA Jose Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Jose Calderon reviewed: Ten (10) resident service records, ten (10) resident medication records, and LPA Jose Calderon interviewed ten (10) residents and six (6) staff members for a visit. LPA Jose Calderon inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 03/13/2024 . The two-story commercial building consists of ninety-seven (97) resident bedrooms, ninety-seven (97) resident bathrooms, five (5) common bathrooms, dining room, commercial kitchen, staff room, office area, library, Media room, Garden area, washer and dryer/ storage area, backyard with umbrella with table and chairs. No weapons are stored on the premises. The Commercial Kitchen was inspected and observed to be clean and operational. A 2-day supply perishable and 7-day supply of non-perishable foods are present in the facility kitchen. Emergency Water Storage is in found inside the kitchen area. 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 LPA Jose Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Jose Calderon observed the following during inspection of resident’s rooms #108, #111, #112, #123, #133, #138, #141, #201, #222, #225: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Jose Calderon observed fully stocked closet with bedding, towels, and toiletries supplies . Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA Jose Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 113 degrees Fahrenheit, and bathroom #2 hot water temperature properly measured at 111 degrees Fahrenheit, and Bathroom #3 hot water temperature properly measured at 110 degrees Fahrenheit. Commercial kitchen hot water temperature properly measured at 118 degrees Fahrenheit. Facility sixty (60) Carbon Monoxide and one hundred twenty (120) Smoke Detectors hard wired and connected were tested and are working properly. The facility twenty (20) Fire Extinguishers were checked and found to be fully charged and accessible . All exit doors in the facility have alarm systems. All toxins and knives are locked/secured and inaccessible to residents. Medications are centrally stored and in a locked medication room. Facility first aid kits (10) are fully stocked with manual was checked and in order. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to residents. Six (6) staff files were checked and have the required documents. The facility does handle resident's money/cash resources. HUB International Bond Company #40830507 for $15,000.00 was valid at the time of inspection. All the required documents are posted in the facility in a clearly visible area. LPA Jose Calderon noted the Administrator Heather Argueta Certification # 6007006740 expiration date of 11/25/2023 was NOT valid at time of visit. Commercial General Liability Policy #HFF0218512311 policy period from 01/01/2023 to 05/01/2024 underwritten by Hudson Insurance company coverage 1,000,000/3,000,000 is valid at time of inspection. LPA Jose Calderon spoke to Administrator Heather Argueta who will email full copy of insurance contact which shows all coverages to LPA Jose Calderon no later than 04/02/2024 . All the required documents are posted in the facility in a clearly visible area to all staff, clients, and guests. LPA Jose Calderon reviewed LIC500 and noted all staff associated to facility per LIS. LPA Jose Calderon reviewed the resident roster, LPA Jose Calderon confirmed residents’ interview are on resident roster. 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 LPA Jose Calderon advised the Administrator Heather Argueta to continuously monitor the Centers for Disease Control (CDC) website and Community Care Likening Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. . According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Jose Calderon did not observe deficiencies therefore no citations were issued at this time. Annual Licensing fee IS current. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Heather Argueta.

INVESTIGATION REVEALED THE FOLLOWING: Allegation: Facility staff yelled at the resident. The details of this complaint alleged that resident #1 (R1) was yelled at by a facility staff. On 03/05/24, the complainant witnessed staff #1 (S1) yell at (R1). The complainant reported that (S1) had commanded (R1) to get out of bed inappropriately. This incident was a disturbance and it was witnessed by staff #2 (S2) who diffused the situation. On 03/13/24 between 11:13 am - 11:27 am, the Department interviewed resident #1 (R1). (R1) claimed to have lived at Huntington Retirement Hotel since 02/06/23. (R1) claimed to enjoy living in this community and stated the staff had treated (R1) well. (R1) claimed not to have experienced or observed any type of verbal or mistreatment by any staff. (R1) stated that (R1) is auditory impaired and does not usually have hearing devices in place. It would result in having individuals speak to (R1) in a higher level volume. (R1) does not construe staff of being disrespectful or abusive when they do have to speak with (R1) at this volume level. (R1) denied the incident ever happened on 03/05/24. On 03/13/24 between 12:08 pm - 12:37 pm, the Department interviewed staff #1- #2 (S1-S2). (S1-S2) were identified by the complainant. (S1-S2) denied the incident ever occurred on 03/05/24 with (R1). (S2) claimed not to have witnessed or had knowledge of such incident. (S2) stated to be a mandated reporter, and if such unwarranted behavior ever occurred it would be reported. (S1) denied ever acting inappropriately toward any residents in care and does not support the assertion . On 03/13/24, 11:30 am - 02:10 pm, the Department interviewed administrator #1 (A1) and staff #1-#5 (S1-S5). (A1) and (S1-S5) indicated that resident's rights are being protected and promoted through training and staff meetings. Mandatory annual In-Service Training on this topic completed on 11/27/23. Additional training included: Caregiver Training (dated: 06/23/23), Direct Care Orientation Training (dated: 06/13/23), Employee Orientation Training (dated: 06/13/23), Time and Attendance (dated: 06/09/23), and Resident's Rights (dated: 06/09/23). (A1) expressed that the Resident's Personal Rights are discussed during Resident Council meetings. Evaluation Report continue LIC 9099-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 On 03/13/24, 10:00 am - 11:12 am, the Department interviewed (9) out of (9) residents #2-#10 (R2-R10) who reported no mistreatment or inappropriate verbal treatment by staff. (R2-R10) expressed their appreciation for the facility's staff and the healthy and safe environment it promotes. On 03/23/24 between 02:10 pm – and 02:21 pm, the Department interviewed family representative witness #1 (W1) to (R1). (W1) claimed the facility is well maintained and managed. (W1), who is very involved with (R1's) care during weekly visits, has not witnessed any staff acting inappropriately toward residents. Based on gathered information, there is no evidence to corroborate the allegation " Facility staff yelled at the resident . Based on information gathered, an inspection of the facility, observation, and interviews conducted, an analysis of records reviewed, the Department found no evidence to support the allegation mentioned above. Although the allegation 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. An exit interview was conducted with Heather Argueta, and a copy of this report was provided.

Investigation Revealed the Following: Allegation: Resident sustained fracture while in care The details of the complaint alleged that resident sustained fracture while in care at the facility. During the records review, LPA Iniguez reviewed the Physicians Report for Residential Care Facilities for the Elderly-LIC 602A dated (6/29/21); it is written that (R#1) can care for their own toileting needs. Also, one of the physical Health Statuses of (R#1) was a visual impairment that could have contributed to (R#1)’s falling history. In addition, (1) out of (10) prescribed medications (R#1) were taking could have contributed to their falls; LPA consulted an internet database regarding the side effects of medications, and it is stated that (1) medication’s side effect is “blurred vision, vision change, reduced vision.” Moreover, LPA reviewed (R#1)’s schedule of ADLs, and it is written there that (R#1) needs full assistance getting up in the morning and going to bed, going to the toilet, assistance with dressing, changing briefs for continence care, full assistance with showers on Tuesday, Thursday and Saturday, full escort to their meals, and safety checks every (2) hours. Moreover, LPA Iniguez observed (R#1)’s Admissions Agreement; it is stated there that (R#1) had between (88-122) Personal Care Points and a total of (4) on Personal Care Level, LPA asked (A#1) what does these points consist, (A#1) stated that on admission day, facility evaluates residents to see what kind of level of care the resident will need, then depending on the level of care points accumulated and at the end a total is added to see what Personal Level of Care is need it to take care of the resident. Then, these instructions are written on an ADL schedule sheet for facility staff to follow. Evaluation Report continues LIC 9099-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 In addition, LPA Iniguez reviewed a Special Incident Report dated (8/16/21). Is it written there that (R#1) was in the bathroom accompanied by their private caregiver when they took a fall in the bathroom? (R#1) had a private caregiver assist them in their room. During an Interview with the Administrator (A#1), she stated that (R#1)’s family wanted them on a tight schedule set by their family. Also, (A#1) stated that (R#1) did not want to follow that schedule, which caused a problem with their family. (A#1) tried to mediate what the family wished versus what (R#1) wanted. During interviews with residents (R#1-R#10), (8) out of (10) stated that they did not need assistance going to the bathroom and that they had not sustained a fracture due to not being assisted by facility staff. During interviews with staff (S#1-S#9), (9) out (9) stated that facility staff assisted (R#1) every time they need it to go to the bathroom and as need it, plus (R#1)’s private caregiver will let them know when they need it to go. Also, (9) out of (9) stated that (R#1) did not sustain fractures due to lack of assistance from staff. Allegation: Resident sustained unexplained injuries while in care. The details of the complaint alleged that a resident sustained unexplained injuries while in care at the facility. During the records review, LPA Iniguez reviewed (R#1)’s medication list dated (4/26/2021). LPA Iniguez consulted an internet database regarding the side effects of medications; LPA found that out of the (10) medicines that were prescribed to (R#1), (4) medications possible side effects could have contributed to the unexplained skin tear and bruising (R#1) experienced. In addition, LPA inspected the Physicians Report for Residential Care Facilities for the Elderly-LIC 602A dated (6/29/21). It is written there that (R#1) did not have a history of skin condition or breakdown. Moreover, LPA reviewed (R#1)’s ADL’s schedule; it is stated that (R#1) “has thin, sensitive skin. Please be very gentle since he bruises easily”. Evaluation Report continues LIC 9099-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 During an Interview with the Administrator (A#1), she stated that they did not sustain unexplained injuries when (R#1) was living at the facility. Also, (A#1) stated that (R#1)’s family usually hired a private caregiver who was with them. During interviews with residents (R#1-R#10), (8) out of (10) stated that they had not sustained unexplained injuries while living there. During interviews with staff (S#1-S#9), (9) out (9) stated that (R#1) did not sustain unexplained injuries when they resided here. Allegation: Staff are not following resident's toileting plan. The details of the complaint alleged that facility staff did not follow the residents’ toileting plan. During the records review, LPA Iniguez reviewed the ADL schedule created by the facility upon (R#1)’s admission; it is written there that (R#1) “needs to be toileted when he gets up in the morning, after every meal and before bedtime, assist them on their commode and wheel them over the toilet. Also, let them sit there for a while; otherwise, they say they are done and will not finish”. Additionally, LPA reviewed the Service Assessment Form dated (5/14/21) in the Bathing section; it is written that (R#1) needs complete baths up to three times a week, Bladder Management (R#1) requires continent assistance with physical assistance going to the toilet. This Service Assessment is signed by (R#1) and the responsible party. During an Interview with the Administrator (A#1), he stated that facility staff assisted (R#1) with their toileting needs, and they used adult diapers but were never left on a soiled diaper for an extended period. Also, (A#1) stated that (R#1)’s family wanted them on a tight toileting schedule set by their family. (A#1) stated that (R#1) did not want to follow that schedule, which caused a problem with their family. (A#1) tried to mediate what the family wished versus what (R#1) wanted. Evaluation Report continues LIC 9099-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 During interviews with residents (R#1-R#10), (7) out of (10) stated that they do not need assistance with toileting. (1) out of (10) stated that they do not need assistance with toileting. Also, (6) out of (10) residents stated that they do not use adult diapers, only (3) out of (10) used them. Out of the (3) residents who used adult diapers, (2) out of (10) stated that they have never been left on a soiled diaper for an extended period. During interviews with staff (S#1-S#9), (9) out of (9) stated that (R#1) received assistance from facility staff with their toileting needs, and they do not confirm that (R#1) was left in a soiled diaper for an extended time. Allegation: Staff leave resident's room unsanitary. The details of the complaint alleged that facility staff leaves resident’s room unsanitary. During the facility tour, LPAs inspected (8) residents’ rooms, but they did not find the rooms unsanitary. During an Interview with the Administrator (A#1), she stated that housekeeping cleaned (R#1)’s room every day for light cleaning, every week for deep cleaning, and as needed since (R#1) owned a small dog. During interviews with residents (R#1-R#10), (8) out of (10) stated that facility staff clean their rooms every day and that their rooms have been safe by them. During interviews with staff (S#1-S#9), (9) out of (9) stated that (R#1) 's room was cleaned mostly every day and as needed, and (R#1)’s room was never left unsanitary by facility staff. Evaluation Report continues LIC 9099-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 During this investigation, LPA found did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation(s) are found to be UNSUBSTANTIATED. 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. California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted, and a copy of the Complaint Report was given to Heather Argueta /Administrator.

Investigation Revealed the Following: Allegation: Facility staff spoke inappropriately to resident. The details of the complaint alleged that facility staff spoke inappropriately at a resident in care. During the records review, LPA Iniguez reviewed the mandatory staff training notes performed on 11/27/23. The training was regarding the personal rights of residents. During an interview with the Administrator (A#1), she stated that all staff know the residents' rights, and we just did training on 11/27/23, which was mandatory for all staff. In addition, per (A#1), she said no staff member has ever spoken inappropriately to a resident. During interviews with staff (S#1-S#10), 10 out of 10 stated that they knew the residents' rights and had never spoken inappropriately to a resident. During interviews with residents (R#1-R#10), 10 out of 10 stated that they were aware of their rights and that the facility staff treated the residents respectfully. Also. 10 out of 10 said no staff member has ever spoken to them inappropriately. Allegation: Resident was left in a soiled diaper for an extended period of time. The details of the complaint alleged that facility staff are leaving residents in soiled diapers for an extended period of time. During the records review, LPA observed the facility staff schedule for October, November, and December 2023; LPA observed enough staff coverage for morning, afternoon, and nighttime. During an interview with the administrator (A#1), she stated that the facility has the necessary staff to provide care and supervision for residents in care. Also, per (A#1), the residents get assistance with their continence needs every two hours and as needed. In addition, (A#1) stated that no resident has been left in a soiled diaper for an extended period. During interviews with staff (S#1-S#10), 10 out of 10 stated that the facility has the necessary staff to provide care and supervision to residents in care, and they assist the residents with their continence needs every two hours or as needed. Also. 10 out of 10 stated that no resident has ever been left in a soiled diaper for an extended period. During interviews with residents (R#1-R#10), 10 out of 10 stated that the facility has the appropriate staff to provide care and supervision for the residents in care, and the staff assist them every hour to two hours or as needed in changing their adult diapers. Also, 10 out of 10 stated that they have not been left in a soiled diaper for an extended period. Evaluation Report continues LIC 9099-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 During an Interview with witness number 1 (W#1), he stated that on 12/6/23 at approximately 10:00 am, I was providing therapy sessions to R#1. At approximately 10:30, we finished the session, and R#1 told me that they needed a caregiver because they soiled their dependents; right after that, I looked for a caregiver and told them about R#1 needing assistance with changing. LPA asked (W#1) if he witnessed (S#1) being rude towards (S#1) he said no. LPA compared the time given by RP and by (W#1), the amount of time RP stated they were left in a soiled diaper was less than 1 hour. During this investigation, LPA found did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation(s) are found to be: UNSUBSTANTIATED. 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. California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted, and a copy of the Complaint Report was given to Heather Argueta /Administrator.

Investigation Revealed the Following: Allegation: Staff are yelling at resident The details of the complaint alleged that a staff member yelled at a resident in care. During the records review, LPA Iniguez reviewed staff yearly and quarterly training regarding residents' personal rights. All staff have taken the training. During an interview with the Administrator (A#1), she stated that all staff know the residents' rights and do annual and quarterly training. In addition, per (A#1), she said no staff has yelled at a resident before. (A#1) said, "We do not scream or yell at our residents in a mean way; we only speak loudly to them when they have a hard time hearing us." During interviews with residents (R#1-R#10), 10 out of 10 stated that they like the staff members at the facility, and no staff has ever yelled or screamed at them. During interviews with staff (Ca#1-Ca#6) and (Ho#1-Ho#6), 12 out of 12 stated that they are familiar with the resident's rights, and 12 out of 12 said that they have never yelled or screamed at a resident. Allegation: Staff are not meeting resident's hygiene needs The details of the complaint alleged that facility staff are not meeting residents’ hygiene needs. During an interview with the administrator (A#1), she stated that the facility staff assists residents with their hygiene needs. (A#1) said that they do not have a written changing schedule for residents, but they have a policy of checking residents every 2 hours or even every 1 hour, and of course, if residents need to be changed immediately, they will do it. During interviews with residents (R#1-R#10), 8 out of 10 stated that they do not need assistance with bathing or dressing; they can do it themselves. On the other hand, the two residents needing assistance with their ADLs state that the facility staff helps them daily or when required.in addition, 10 out 10 residents stated that they have never wore the same clothes for over a week. During interviews with Care staff (Ca#1-Ca#6), 6 out 6 stated that the facility does have a written resident’s changing schedule, but it has a policy of checking residents every 2 or 1 hour in case the residents need immediate assistance, they will do it on the spot. In addition, 6 out of 6 care staff members stated that they have not seen or heard that a resident has not gotten a shower in over a week, nor a resident wearing the same clothes for over a week. 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 Allegation: Staff are not cleaning resident's room The details of the complaint alleged that facility cleaning staff are not cleaning residents’ rooms properly. During the records review, LPA Iniguez reviewed the facility cleaning schedule; it can be observed on the days and rooms scheduled to be cleaned, incontinence level, and deep weekly cleaning schedule. During the facility tour, LPA Iniguez observed 10 residents' rooms, which appeared clean and sanitary. In addition, LPA opened and looked at the residents' refrigerator; it also seemed clean and sanitary. During an Interview with the Administrator (A#1), she stated that the facility has nine housekeepers cleaning residents' rooms. In addition, (A#1) noted that every day, the cleaning staff takes out the trash, makes/changes the bedding and towels, and takes the residents' soiled clothes to the laundry. If the residents need the room to be clean, the staff will do it now. Also, (A#1) stated that they do a weekly deep cleaning that includes vacuuming, dusting, cleaning the shower and toilet, changing linen, defrosting the fridge, and cleaning and dusting balconies. Furthermore, (A#1) stated that the facility has a person who oversees washing the resident's clothes, working seven days a week. During interviews with residents (R#1-R#10), 10 out of 10 stated that the facility staff keeps their rooms clean. Also, 10 out of 10 stated that the cleaning staff, including the refrigerator, cleans their room every day and every week. During interviews with cleaning staff (Ho#1-Ho#6), 6 out 6 stated that the facility has a cleaning schedule, and they clean the rooms based on it. Also, 6 out of 6 stated that they tend to the residents' rooms daily for a light cleaning and every week for a deep cleaning; in the deep cleaning, the cleaning staff defrosts and cleans the resident's refrigerator. In addition, 6 out of 6 staff said that they take the residents' soiled clothes to the laundry room, and when they are cleaned, they put them back in their rooms. Also, 6 out of 6 cleaning staff said they can differentiate soiled clothes from clean ones. 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 Allegation: Staff are not providing adequate food service to resident The complaint details alleged that the facility is not providing adequate food service to residents in care. During the records review, LPA Iniguez reviewed the facility menus from May to November 2023. All menus followed the Food and Nutrition Board of the National Research Council guidelines. In addition, LPA observed in the menus that the facility serves residents well-balanced and nutritious meals that include a portion of protein, starch, and vegetables. In addition, LPA observed the alternate menu, and it can be observed that there is a variety of dishes, such as salads, sandwiches, and fruit/vegetable platters. During a kitchen tour, LPA Iniguez observed that the facility has a variety of perishable and non-perishable food available for residents' consumption. During an Interview with the Administrator (A#1), she stated that the facility serves well-balanced and nutritious meals to residents, and in case they don’t like what they are serving, they have an alternate menu that offers a variety of meals. During interviews with residents (R#1-R#10), 10 out of 10 stated that the facility serves well-balanced and nutritious meals. During interviews with staff (S#1-S#10), 10 out of 10 stated that the facility serves well-balanced and nutritious meals. Allegation: Staff are not allowing residents to have a camera in her room. The details of the complaint alleged that the facility does not allow residents to have cameras in their rooms. During the records review, LPA Iniguez reviewed the resident's admission agreement/house rules; in there, it is stated that "to protect the dignity and privacy of our residents, we do not permit the use of nanny cams or other video surveillance devices in the resident unit." Upon moving into the facility, every resident or resident's POA signs this agreement. In addition, LPA reviewed the department's policy for video surveillance cameras inside residence rooms; if a resident or resident's POA wishes to put a camera inside the room, the facility will need an exemption from licensing. 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 an interview with the administrator (A#1), she stated that residents or POAs could only have cameras inside their rooms with the facility's and CDSS/community care licensing's consent, but they recommend not having them to protect the residents' privacy. During interviews with residents (R#1-R#10), 10 out of 10 stated that they had yet to try to set up a video camera in their room and were aware of the facility rules regarding video cameras. During interviews with staff (Ca#1-Ca#6) and (Ho#1-Ho#6), 12 out 12 stated that residents can put cameras in their rooms, but they need special permission from the facility first. During this investigation, LPA found did not find sufficient evident to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation(s) are found to be: UNSUBSTANTIATED. 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. California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted, and a copy of the Complaint Report was given to Heather Argueta /Administrator.

Investigation Revealed the Following: Allegation: Facility overcharged a resident in care. The details of the complaint alleged that the facility overcharged a resident while in care. During the records review, LPA Iniguez reviewed the following: LPA assessed the email from the facility that was sent to (RP) stating where the billing error was; the email stated the following: "Good Afternoon, (RP), I hope you are doing well. I apologize for the delay. After reviewing (R#1) 's account, we have found that in January and February of 2022, there was an SSI increase of $132.40 each. However, after further reviewing it with the administrator, we have decided to clear the balance owed. The balance might still show in next month's statement, but you can disregard it. If you have any questions, please let me know. Best Regards, (S#2)-Business Office Assistant-Huntington Retirement-(310) 370-5828". In addition, during the facility records review, LPA examined FAS. LPA found that during this current year of 2023, no similar allegations were found. During the Interview with the Reporting Party (RP), she stated that on 10/20/23, the Licensing Program Analyst spoke with (RP) over the phone; LPA asked (RP) what concerns she had right now about the overcharge of the facility to the resident. (RP) stated that the facility did not explain to her what these overcharges come from. (RP) stated that (R#1) is under the PACE program at WELBE. Finances are distributed between private income, Social Security income, Medical and Medicare. LPA mentioned to (RP) that he will investigate this allegation next week. On 10/20/2023 at approximately 6:30 PM, (RP) texted LPA on his work cell phone. She stated that she had just received an email from the facility regarding (R#1). it was a billing error, and they will waive the charges. In addition, LPA asked (RP) to forward him the email she received from the facility to him for investigation purposes. On 10/21/2023, (RP) emailed LPA stating: "Hello Alfonso, Let's keep the case open until Huntington removes this invoice. At this time, I do not think you need to go out there. I am forwarding you the email for confirmation. Thank you again and have a good day. (RP)". Evaluation Report continues LIC 9099-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 During an Interview with the Administrator (A#1), she stated that the people in charge of the billing at the facility are the Business Office Manager (S#1), the Business Office Assistant (S#2), and me. Also, (A#1) stated that the facility has never overcharged a resident while in care. In addition, (A#1) noted the following: (R#1) is in the Medical and SSI program, and at the beginning of every year, most residents get an increase in income from SSI. When the residents receive an increase from SSI, we increased the board rate, and that was the charges regarding (R#1). The two-month increase was from January and February of 2022 and is only the increase amount. We have cleared the amount of (R#1)’ s balance. During interviews with Residents (R#1-R#10), 10 out of 10 stated that they do not handle their finances directly; a family member or legal representative does it. Also, 10 out of 10 stated that the facility has never overcharged them. During interviews with staff (S#1-S#10), 9 out of 10 stated that the person(s) who handles the billing for the residents at the facility is (S#1), (S#2), and (A#1). Also, 9 out of 10 stated they had never known or heard about the facility overcharging residents. During this investigation, LPA found did not find sufficient evident to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation is found to be UNSUBSTANTIATED. Although the allegation 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. California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted, and a copy of the Complaint Report was given to Nina Rejuso/LVN.

On 09/28/2023, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced annual required visit using the new CARE Inspection Tool. LPA called and spoke with Administrator Heather Argueta Upon arriving at the facility, LPA met with Resident Coordinator (RC) Corina Kahl and explained the purpose of today's visit. Administrator Heather Argueta later arrived and assisted with the visit. The facility is licensed to serve up to 155 clients 60 years or older, 5 of which may be bedridden, and 30 of which may be non-ambulatory and this facility has an approved hospice waiver for 12 terminally ill residents. The current staff census was 30 and the resident census was 103 at the time of visit, The Facility Annual Fees are current during today’s visit. The administrator’s certificate expires on 11/25/2023. During the visit, LPA Richard toured the facility with RC Corina Kahl. LPA randomly inspected 11 resident bedrooms, the kitchen, 2 dining rooms, living room, pantry, library, chapel, pool room, medication room, TV/Entertainment room, indoor activity areas, and outdoor patios. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. There are working lights or lamps in each room at the time of visit. There are grab bars for each toilet and shower used by residents. Showers have non-skid mats. LPA tested the pull emergency cord notification system of the resident in bedroom # 111 and observed the caregiver responded within 2 minutes and turned off the signal. REPORT CONTINUED IN LIC 809C 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 LPA checked resident bedrooms 220, 217, 210, 207, 202, 136, 115, 114, 111, 104, 102 and observed the hot water temperatures are within 105 degrees Fahrenheit and 120 degrees Fahrenheit which are in compliance with Title 22. LPA observed a two day supply of perishable and a one week supply of non-perishable food. There are additional refrigerators and freezers in the pantry area which contain emergency storage of food supplies and water. The kitchen is clean, organized, and sanitary. All storage areas for cleaning solutions, toxins, knives, and hazardous items are in a secured cabinet and inaccessible to residents. LPA observed the smoke detectors were tested by the maintenance supervisor and they were operable. Two operable carbon monoxide detectors located on the first floor and two detectors on the second floor were observed. Fire extinguishers were last serviced on 08/31/2023. The last facility fire drill was conducted on 09/14/2023. There are no pools or bodies of water on the premises. There are no firearms on the premises or other dangerous weapons. Potentially dangerous items are kept inaccessible to residents with dementia. Centrally stored medications are locked in the medication room. The first aid kit has all the required supplies. Toxic chemicals are locked and inaccessible to residents with dementia. The facility has a written emergency disaster plan posted at the entrance of facility. The facility is maintained at a comfortable temperature. During the visit, LPA observed the following to be in compliance: the facility's infection control practices; residents, sanitizing stations in common areas and restrooms; every staff was wearing a face covering; the facility has a 30-day supply of Personal Protective Equipment (PPE) stored. All mandated inspection control posters were posted. The facility has a Mitigation Plan Report approved by CCLD. Exit interview conducted. A copy of this report was provided to Administrator Heather Argueta.

The investigation revealed the following: Allegation: Due to staff neglect resident developed a pressure injury while in care. It is alleged that resident 1 (R1) developed a pressure injury while in care of the facility due to the staff’s neglect. R1 was admitted to the facility on 9/11/2021. A review of her service assessment form, completed on 9/04/2021 shows resident was independent in mobility and activities of daily living. After R1’s 3/22/2022 hospitalization, records show that R1 was admitted to St. Liz Hospice Care on 4/8/2022. R1’s initial hospice assessment noted that R1 had poor skin turgor and her skin was easily prone to bruising and tearing. It was also noted that due to R1’s limited mobility she was a high risk for skin breakdown and that primary caregivers were instructed to turn and reposition R1 every 2 hours and to provide adequate skin care. As of 4/8/2022 there was a physician’s order by the hospice for skin care maintenance to R1’s buttocks area to prevent skin breakdown and redness. A review of facility records shows that on 5/10/2022 an open sore was seen on R1’s buttocks and both hospice and family were informed. Per W1, R1 was diagnosed with a stage 2 pressure ulcer to the sacral coccyx area on 5/12/2022, which W1 described as redness. LPM Cifuentes interviewed Staff S1-S5 and attempted to interview S6. S6 was no longer employed by the facility and could not be contacted for an interview. LPM asked staff if resident was repositioned every two hours as stipulated in the hospice care plan. Of those interviewed, 5 out of 5 answered yes. LPM also asked staff who handled R1's wound care, and 5 out of 5 staff inteviewed stated the facility does not handle wound care, that only a nurse can do that. S1 added during their interview that hospice nurses handled the wound care for R1 and that R1 had an alternating pressure mattress. S2 stated during the interview that the facility does not keep logs regarding the repositioning of residents. LPM noted that notes from St. Liz Hospice account for the wound care provided to R1 by hospice nursing staff Based on interviews, observation, information received, and records reviewed there was not enough evidence to support the allegation. Although the allegation 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 deemed Unsubstantiated. There were no deficiencies cited. Exit interview conducted with Corina Kahl and redelivered to Heather Argueta.