WHITTIER GLEN ASSISTED LIVING

10615 JORDAN RD, Whittier CA 90603

Facility 198603162 · RESIDENTIAL CARE ELDERLY (740)

93 bedsLatest official report Aug 11, 2026Licensed

Additional info
Licensee
SYCAMORE SENIOR LIVING, INC.
Administrator
BARBA AGUIRRE, ITZAYANA
Contact
BARBA AGUIRRE, ITZAYANA
License first date
Oct 1, 2019
License effective date
Oct 1, 2019
District office
MONTEREY PARK ASC · (323) 980-4934
Regional office
28
Clients served
983 - RCFE / DEMENTIA

Summary

The available records show 11 Type A and 41 Type B deficiencies for this facility.

Most recent inspection
Jul 23, 2026
Most recent deficiency
Aug 11, 2026

No later report is available, so the records do not show what happened afterward.

What Type A and Type B mean
Type A
Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
Type B
Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.

Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.

At a glance

Counts cover the five-year public record. Typical figures are the median for the 212 Los Angeles County facilities licensed for 50 or more beds.

In the available public five-year record, CCLD published 112 reports for this facility: 22 inspections, 89 complaint investigations, and 1 licensing or administrative record.

Those records contain 11 Type A and 41 Type B deficiencies.

4 deficiencies have explicit official correction or clearance evidence in the loaded records.

Official inspections
22

More than the typical 7

6 in the last 12 months

Recorded deficiencies
52

Well above the typical 8

13 in the last 12 months

Type A deficiencies
11

Well above the typical 3

5 in the last 12 months

Type B deficiencies
41

Well above the typical 5

8 in the last 12 months

Substantiated complaints
26

Well above the typical 3

7 in the last 12 months

Repeated topics
7

Last 36 months

Repeated topics

Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.

Official report history

All preserved reports from the most recent to the oldest, sortable by report type.

Complaint

Allegations2 substantiated · 1 unsubstantiated · 0 unfounded · 2 cited

Resident rightsType B
Official classification
Type B
Official code
87468.1(a)(9)
Regulation authority
CCR

What the official deficiency says

Personal Rights of Residents in All Facilities (a)(9) To have communications to the licensee from their representatives answered promptly and appropriately. This requirement is not met as evidenced by: Administrator did not respond to resident#1 (R1)’s responsible party's communication and failed to follow up with resident’s Assisted Living Waiver Program (ALWP). Based on observation and record review, the licensee did not comply with the section cited above which poses a potential health and safety risk to residents in care.

Official plan of correction

Licensee agreed to provide (1) a statement according to 87468.1(a)(9) that indicate how to prevent future occurrence. (2) in-service training regarding responding to residents’ authorized presentative timely by POC due date.

Deadline recorded: Aug 14, 2026. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Aug 14, 2026
Correction not verified in available records
View official report
Resident rightsType B
Official classification
Type B
Official code
87468.1(a)(8)
Regulation authority
CCR

What the official deficiency says

To have their representatives regularly informed by the licensee of activities related to care or services,...as appropriate to their needs. This requirement is not met as evidenced by: Administrator did not assist R1 to maintain in ALWP 60-day retention requirement to meet R1's cares and service needs. Based on observation and record review, the licensee did not comply with the section cited above which poses a potential health and safety risk to residents in care.

Official plan of correction

Licensee agreed to provide (1) a statement according to 87468.1(a)(8) that indicate how to prevent future occurrence. (2) in-service training regarding responding to residents’ authorized presentative timely by POC due date.

Deadline recorded: Aug 14, 2026. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Aug 14, 2026
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 0 unsubstantiated · 0 unfounded · 1 cited

Resident rightsType A
Official classification
Type A
Official code
87468.2(a)(4)
Regulation authority
CCR

What the official deficiency says

Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidenced by: Based on interviews, facility staff did not conduct proper checks on R1 which resulted in R1 eloping and walking outside of the facility unassisted and without anyone noticing. Records also show that R1 fell and sustained a fracture during the time they R1 was missing from the facility.

Official plan of correction

Licensee/Administrator shall ensure to comply with Title 22 Section 87468.2 at all times. Additionally, Licensee/Administrator shall develop a written Plan of Correction to ensure compliance with California Code of Regulations Title 22, Section 87468.2(a)(4). Written POC must be submitted to CCL/LPA by POC due date. An immediate Civil Penalty of $500.00 is being issued today, due to a resident sustaining injury while in care. Refer to LIC 421IM.

Deadline recorded: Jul 24, 2026. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Jul 24, 2026
Correction not verified in available records
View official report
Complaint

Allegations2 substantiated · 0 unsubstantiated · 0 unfounded · 2 cited

Medical and dental careType A
Official classification
Type A
Official code
87465(a)(4)
Regulation authority
CCR

What the official deficiency says

87465 Incidental Medical and Dental Care(a) A plan for incidental medical and dental care shall be developed by each facility. (4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on observation and record review, the medication for Resident #1 was not administered today which poses an immediate health and safety risk to residents in care.

Official plan of correction

The licensee shall submit a plan to ensure that all the residents' medications are present and refills are obtained. The plan is due by 5/6/26.

Deadline recorded: May 6, 2026. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline May 6, 2026
Correction not verified in available records
View official report
Staffing, personnel, and trainingType B
Official classification
Type B
Official code
87411(a)
Regulation authority
CCR

What the official deficiency says

87411 Personnel Requirements - General(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement is not met as evidenced by: Based on interview and record review, the facility did not employ sufficient caregivers to assist residents with their needs timely which poses a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

The licensee shall develop a plan to provide sufficient staffing to ensure residents' needs are met in a timely manner. The plan is due to LPA by 5/12/26.

Deadline recorded: May 12, 2026. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline May 12, 2026
Correction not verified in available records
View official report
Complaint

Allegations3 substantiated · 2 unsubstantiated · 0 unfounded · 3 cited

Resident rightsType A
Official classification
Type A
Official code
87468.2(a)(4)
Regulation authority
CCR

What the official deficiency says

(a) In addition to (...) residents (...) shall have the following personal rights. (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This regulation is not met as evidenced by: Based on record review and interview, the facility did not meet the above requirement in one (1) out of nine (9) residents, because R1 was unable to leave the facility unassisted and was allowed to travel on ther own by bus without a responsible adult to assist them, which posed an immediate health and safety risk to resident in care.

Official plan of correction

Licensee/Administrator is to ensure that all residents are provided care and supervision to meet their individual need at all times. Administrator shall submit the facility's plan on how all residents care plans will be adhered to by the POC due date.

Deadline recorded: May 2, 2026. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline May 2, 2026
Correction not verified in available records
View official report
Medical and dental careType A
Official classification
Type A
Official code
87465(a)(4)
Regulation authority
CCR

What the official deficiency says

(a) A plan for the indicental medical and dental care shall be developed (...) by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed. This regulation is not met as evidenced by: Based on interview and record review, the facility did not meet the above requirement in four (4) out of nine (9) residents, because R1 required insulin based on available documentation and no evidence was provided that they were provided it, along with corroborations from R2 - R4. Which poses/posed an immediate health and safety risk for residents in care.

Official plan of correction

Licensee/Administrator is to ensure that all residents are assisted with self-administered medications as needed at all times. Administrator shall submit a plan to ensure that all the residents' are assisted with their self-administered medications and injections to LPA by the POC due date.

Deadline recorded: May 2, 2026. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline May 2, 2026
Correction not verified in available records
View official report
Incident reportingType B
Official classification
Type B
Official code
87211(a)(1)(D)
Regulation authority
CCR

What the official deficiency says

(a) Each licensee shall furnish to the licensing agency such reports (...) including (...) the following. (1) A written report (...) within seven days of the occurrence (...) and disposition of the case. (D) Any incident which threatens the welfare, safety (...) or unexplained absence of the resident. This regulation is not met as evidenced by: Based on interview and record review, the facility did not meet the above requirement in 1 out of 9 residents. Because an incident report was not submitted following R1's absence and death, which posed a potential health and safety risk to residents in care.

Official plan of correction

Licensee/Administrator is to ensure that all incident and death reports are to be submitted to the licensing agency within the appropriate timeframe at all times. Administrator shall submit a plan on how the facility will ensure all incident reports are reported timely to LPA by the POC due date.

Deadline recorded: May 22, 2026. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline May 22, 2026
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 2 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 3 unsubstantiated · 0 unfounded · 1 cited

Staffing, personnel, and trainingType B
Official classification
Type B
Official code
87411(a)
Regulation authority
CCR

What the official deficiency says

(a) Facility personnel shall at all times be sufficient in numbers (...) to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed (...) for the provision of adequate services. This regulation is not met as evidenced by: Based on interviews, LPA determined that several residents have experienced delays in received care when requesting assistance through their call button, which poses a potential health and safety concern at the facility.

Official plan of correction

Licensee/Administrator is to ensure that all residents are assisted in a timely manner by staff at all times. Administrator will email LPA a plan on how the facility will ensure that there is sufficient staff to assist residents in a timely manner by the POC due date.

Deadline recorded: Dec 26, 2025. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Dec 26, 2025
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 6 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 4 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 1 unsubstantiated · 0 unfounded · 1 cited

Facility condition and maintenanceType B
Official classification
Type B
Official code
87303(a)
Regulation authority
CCR

What the official deficiency says

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This standard was not met as evidence by: Per Interviews with 4 staff and 8 residents each confirmed the above allegation stating that the elevator was in disrepair for weeks during the month of October 2025. Invoices for repairs were also provided.

Official plan of correction

Durining visit LPA tested the elevator and it was in operating condition. LPA reviewed Invoices for the repairs made and due to facility already addressing the issue and making needed repairs there is no POC needed and POC will be cleared and emailed to Administrator by end of day tomorrow 11/18/25.

Deadline recorded: Nov 18, 2025. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Nov 18, 2025
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations3 substantiated · 5 unsubstantiated · 0 unfounded · 2 cited

Medical and dental careType A
Official classification
Type A
Official code
87465(a)(4)
Regulation authority
CCR

What the official deficiency says

87465 Incidental Medical and Dental Care(a) A plan for incidental medical and dental care shall be developed by each facility. (4) The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Based on observation and record review, the medication for Resident #3 was not administered as prescribed by the physician which poses an immediate health and safety risks to residents in care.

Official plan of correction

The licensee shall submit a plan to ensure that all the residents' medications are present, obtaining refills, and staff training. The plan is due by 8/6/25.

Deadline recorded: Aug 6, 2025. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Aug 6, 2025
Correction not verified in available records
View official report
Staffing, personnel, and trainingType B
Official classification
Type B
Official code
87411(a)
Regulation authority
CCR

What the official deficiency says

87411 Personnel Requirements - General(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement is not met as evidenced by: Based on interview and record review, the facility did not employ sufficient caregivers to assist residents with their needs which poses a potential health, safety, and personal rights risk to residents in care.

Official plan of correction

The licensee shall develop a plan to provide sufficient staffing to ensure residents are assisted in a timely manner and that their needs are met. Plan due to LPA by 8/12/25.

Deadline recorded: Aug 12, 2025. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Aug 12, 2025
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 6 unsubstantiated · 0 unfounded · 1 cited

Resident rightsType B
Official classification
Type B
Official code
87468.2(a)(4)
Regulation authority
CCR

What the official deficiency says

(a) In addition to the rights listed in Section 87468.1 (...) residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This regulation is not met as evidenced by: Based on observation, record review, and interview, LPA determined that at least one resident had been drinking heavily in a common area in the facility, which poses a potential health and safety risk to clients in care.

Official plan of correction

Administrator is to ensure that the house rules are enforced by the facility staff at all times to ensure proper supervision. Administrator is to submit a written plan to LPA explaining how the facility will ensure that they will ensure the house rules related to drinking alcohol will be enforced by the POC due date.

Deadline recorded: Jan 10, 2025. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Jan 10, 2025
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 6 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 0 unsubstantiated · 0 unfounded · 1 cited

Admission, assessment, and evictionType B
Official classification
Type B
Official code
87224(a)
Regulation authority
CCR

What the official deficiency says

87224 Eviction Procedures (a)The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph... This requirement is not met as evidenced by: Based on LPA interviews and record review, Facility / administrator refusal to accept R1 back to the facility upon discharge from hospital and not providing R1 with the 30 day eviction notice which poses a potential health, safety or personal rights risk to the residents in care.

Official plan of correction

Administrator will review Title 22 Regulations, Section 87224 on Eviction Procedures, and submit a written statement to CCL ensuring that he/she understands and will comply with Title 22 Regulations pursuant to this section by the POC due date.

Deadline recorded: May 30, 2024. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline May 30, 2024
Correction not verified in available records
View official report
Complaint

Allegations2 substantiated · 3 unsubstantiated · 0 unfounded · 1 cited

Health conditions and treatmentsType A
Official classification
Type A
Official code
87628(a)(b)(2)
Regulation authority
CCR

What the official deficiency says

(a) The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood or urine specimens, and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional. (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (2) Ensuring that sufficient amounts of medicines, testing equipment, syringes, needles and other supplies are maintained and stored in the facility as specified in Section 87465(c). This requirement was not met as evidence by: Medication records were reviewed for R1. R1 was admitted to facility on 04/19/2024 and facility did not received the resident's insulin and glucose meter until 05/14/2024. R1 went 25 days without glucose testing and insulin which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will send a written plan to LPA on how facility will avoid residents from going without medication and send it to LPA by POC date which is 05/21/2024

Deadline recorded: May 21, 2024. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline May 21, 2024
Correction not verified in available records
View official report
Complaint

Allegations1 substantiated · 6 unsubstantiated · 0 unfounded · 1 cited · investigated over 2 visits

Incident reportingType B
Official classification
Type B
Official code
87211(a)(1)(D)
Regulation authority
CCR

What the official deficiency says

87211(a)(1) 87211 Reporting Requirements: (a) Each licensee shall furnish..: (1)A written report shall be submitted to the licensing agency... within seven days of the occurrence...(D)Any incident which threatens the welfare, safety or health of any resident.. This requirement is not met as evidence by: LPA observed facility reports dated 6/1/23 and 12/6/22 met the above requirement but were not reported to licensing which poses a potential health and safety risk to the persons in care.

Official plan of correction

Facility will conduct in-service training for staff and create incident reports to file from the previous mentioned dates. Administrator will provide a copy of in-service training along with names of participants to the department by POC due date provided.

Deadline recorded: May 14, 2024. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline May 14, 2024
Correction not verified in available records
View official report
Complaint

Part of the complaint whose outcome is recorded on Apr 30, 2024 · Control 28-AS-20230814092308

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 2 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 10 unsubstantiated · 0 unfounded · 1 cited · investigated over 2 visits

Health conditions and treatmentsType B
Official classification
Type B
Official code
87625(b)(3)
Regulation authority
CCR

What the official deficiency says

87625.Managed Incontinence(b)In addition to Section 87611... the licensee shall be responsible for the following:(3)Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This was not met as evidenced by: R1 was left unchanged for prolonged times resulting in rashes. This poses a potential health and safety risk to residents in care.

Official plan of correction

Facility to provide in service training to staff in regarding information on providing residents assistance with toileting needs. Letter of completion signed by staff attending to be provided to Licensing by POC due date.

Deadline recorded: Mar 7, 2024. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Mar 7, 2024
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 8 unsubstantiated · 0 unfounded · 1 cited · investigated over 2 visits

Basic services and supervisionType B
Official classification
Type B
Official code
87219(f)
Regulation authority
CCR

What the official deficiency says

87219. Planned Activities(f) In facilities licensed for fifty (50) persons or more, one staff member shall have full-time responsibility to organize, conduct and evaluate planned activities... This was not met as evidenced by Facility went about 4 months without a full time activity coordinator for the residents, which poses a potential health and safety risk to residents in care.

Official plan of correction

Facility currently has a qualified full time activity coordinator. Deficiency cleared at the time of this visit.

Deadline recorded: Jan 12, 2024. A deadline is not proof that correction was completed.

Official record says corrected or clearedOn or before Jan 11, 2024
Correction deadline recordedDeadline Jan 12, 2024
View official report
Complaint

Allegations0 substantiated · 5 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Part of the complaint whose outcome is recorded on Jan 11, 2024 · Control 28-AS-20220830111314

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations2 substantiated · 0 unsubstantiated · 0 unfounded · 2 cited · investigated over 2 visits

Health conditions and treatmentsType B
Official classification
Type B
Official code
87625(b)
Regulation authority
CCR

What the official deficiency says

Managed Incontinence. Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement is not met as evidence by: 5 of 6 staff and 8 of 9 residents collaborated the allegation that there is a odor of urine in the common dining area and kitchen area on most days.

Official plan of correction

The Executive Director will submit a written plan on how the facility will address the issue of keeping the clients clean and dry and the facility free of odors from incontinence and send it to LPA by POC dat

Deadline recorded: Oct 9, 2023. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Oct 9, 2023
Correction not verified in available records
View official report
Food serviceType B
Official classification
Type B
Official code
87555(a)
Regulation authority
CCR

What the official deficiency says

General Food Service Requirements: The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be served in a safe and healthful manner. This requirement was not met as evidence by, 8 of 9 of the residents state, there was occasions when the meals were served to them cold; meaning, it was served to them in a way that was not in a healthful manner. 4 of six staff stated the they place the food while hot on the plates but the cold plates absorb the heat and the food arrives cold.

Official plan of correction

The Executive Director shall provide a written meal service plan detailing how all meals will be served to the residents hot in a healthful manner. The required plan shall be submitted to CCL by the POC Date.

Deadline recorded: Oct 9, 2023. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Oct 9, 2023
Correction not verified in available records
View official report
Complaint

Part of the complaint whose outcome is recorded on Oct 2, 2023 · Control 28-AS-20230928134929

Health conditions and treatmentsType B
Official classification
Type B
Official code
87625(b)(3)
Regulation authority
CCR

What the official deficiency says

Managed Incontinence. Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement is not met as evidence by: 5 of 6 staff and 8 of 9 residents collaborated the allegation that there is a odor of urine in the common dining area and kitchen area on most days.

Official plan of correction

The Executive Director will submit a written plan on how the facility will address the issue of keeping the clients clean and dry and the facility free of odors from incontinence and send it to LPA by POC date.

Deadline recorded: Oct 9, 2023. A deadline is not proof that correction was completed.

Citation dismissed - not a correctionOn Oct 9, 2023

Deficiency Dismissed Type B 10/09/2023 Section Cited CCR 87625(b)(3)

Plan of correction recorded
Correction deadline recordedDeadline Oct 9, 2023
Correction not verified in available records
View official report
Food serviceType B
Official classification
Type B
Official code
97555(a)
Regulation authority
CCR

What the official deficiency says

General Food Service Requirements: The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be served in a safe and healthful manner. This requirement was not met as evidence by, 8 of 9 of the residents state, there was occasions when the meals were served to them cold; meaning, it was served to them in a way that was not in a healthful manner. 4 of six staff stated the they place the food while hot on the plates but the cold plates absorb the heat and the food arrives cold.

Official plan of correction

The Executive Director shall provide a written meal service plan detailing how all meals will be served to the residents hot in a healthful manner. The required plan shall be submitted to CCL by the POC Date.

Deadline recorded: Oct 9, 2023. A deadline is not proof that correction was completed.

Citation dismissed - not a correctionOn Oct 9, 2023

Deficiency Dismissed Type B 10/09/2023 Section Cited CCR 97555(a)

Plan of correction recorded
Correction deadline recordedDeadline Oct 9, 2023
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 2 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 5 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 2 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Part of the complaint whose outcome is recorded on Feb 22, 2024 · Control 28-AS-20220207115219

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 3 unsubstantiated · 0 unfounded · 1 cited

Resident rightsType A
Official classification
Type A
Official code
87468.1(a)(1)
Regulation authority
CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by; Based on observation, interviews conducted and file review it was revealed that the facility did not ensure Resident #2 had the capacity to establish consent for a sexual relationship when they were notified, which poses an immediate health, safety, or personal rights risk to persons in care.

Official plan of correction

The administrator will ensure the personal right of residents in all facilities The administrator will retrain staff regarding the personal right and how to handle residents personal relationships. The facility will send the staff training log to LPA by POC due date

Deadline recorded: Aug 25, 2023. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Aug 25, 2023
Correction not verified in available records
View official report
Complaint

Allegations1 substantiated · 0 unsubstantiated · 0 unfounded · 1 cited · investigated over 2 visits

Incident reportingType B
Official classification
Type B
Official code
87211(a)(1)
Regulation authority
CCR

What the official deficiency says

87211(a)(1) 87211 Reporting Requirements: (a) Each licensee shall furnish...: (1)A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence... This requirement is not met as evidence by: Based on document review licensee failed to report incidents occurred on 7/14/22 to CCLD and resident's responsible party which poses a potential personal right, health, or safety risk to the persons in care.

Official plan of correction

Administrator will request in-service training for self and wellness director from corporate and will provide a written notice to responsible party and R1 of any incidents. Administrator will provide a copy of in-service to the department by POC due date 7/21/23. Deficiency cleared as of 7/19/23.

Deadline recorded: Aug 11, 2023. A deadline is not proof that correction was completed.

Official record says corrected or clearedOn or before Jul 28, 2023
Plan of correction recorded
Correction deadline recordedDeadline Aug 11, 2023
View official report
Complaint

Allegations2 substantiated · 1 unsubstantiated · 0 unfounded · 1 cited

Resident rightsType B
Official classification
Type B
Official code
87468.1(a)(1)(3)
Regulation authority
CCR

What the official deficiency says

Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(1) To be accorded dignity in their personal relationships with staff, residents, and other persons.(3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement was not met evidenced by: Based on interview with Executive Director Michael Forsgren it was stated that R11 showed the voice recording proving the alleged verbal abuse from S1 and termination of S1 was due to this incident.

Official plan of correction

A training regarding personal rights for residents will be provided to all staff prior to POC Due date. Executive Director Michael Forsgren will also provide training materials, agenda, and a log with staff signatures/initials proving they attened the training by POC due date.

Deadline recorded: Aug 4, 2023. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Aug 4, 2023
Correction not verified in available records
View official report
Complaint

Allegations1 substantiated · 0 unsubstantiated · 0 unfounded · 1 cited

Resident rightsType B
Official classification
Type B
Official code
87217(b)
Regulation authority
CCR

What the official deficiency says

Safeguards for Resident Cash, Personal Property, and Valuables. Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff. The licensee shall give the residents receipts for all such articles or cash resources. This requirement was not met evidenced by: Based on interviews conducted, R1 has had at least one incidence in which their clothing, towels, and washcloths were not returned after being laundered; which poses a potential health and safety risk to persons in care.

Official plan of correction

Administrator agreed to: 1. Develop a written Plan of Correction (POC) to ensure compliance with California Code of Regulations Title 22, 87217. 2. Conduct/submit proof of staff training 3. Submit R1's Inventory list of personal belongings

Deadline recorded: Jul 28, 2023. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Jul 28, 2023
Correction not verified in available records
View official report
Complaint

Part of the complaint whose outcome is recorded on Jul 28, 2023 · Control 28-AS-20230512150458

Incident reportingType B
Official classification
Type B
Official code
87211(a)(1)
Regulation authority
CCR

What the official deficiency says

87211 Reporting Requirements: (a) Each licensee shall furnish...: (1)A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence... This requirement is not met as evidence by: Based on document review licensee failed to report incidents occured on 7/14/22 to CCLD and resident's responsible party which poses a potential personal right, health, or safety risk to the persons in care.

Official plan of correction

Administrator will request in-service training for self and wellness director from corporate and will provide a written notice to responsible party and R1 of any incident. Administrator will provided a copy of in-service to the department by POC due date 7/21/23.

Deadline recorded: Jul 21, 2023. A deadline is not proof that correction was completed.

Citation dismissed - not a correctionOn Jul 21, 2023

Deficiency Dismissed Type B 07/21/2023 Section Cited CCR 87211(a)(1)

Plan of correction recorded
Correction deadline recordedDeadline Jul 21, 2023
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 2 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 2 unsubstantiated · 0 unfounded · 1 cited

Administrator qualificationsType B
Official classification
Type B
Official code
87405(a)
Regulation authority
CCR

What the official deficiency says

87405 Administrator - Qualifications and Duties (a) All facilities shall have a qualified and currently certified administrator.... This was not met as evidenced by: Adminstrator Mona Tirado left the facility on 2/12/21 and was not replaced by a full time Administrator until 5/2/21. This poses a potential health and safety risk to residents in care and supervision.

Official plan of correction

Facility Administrator to review Title 22 Regulations regarding 87405 Administrator - Qualifications and Duties and submit letter to LPA signed and dated by POC due date.

Deadline recorded: Jun 2, 2023. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Jun 2, 2023
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 5 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 4 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 1 unsubstantiated · 0 unfounded · 1 cited

Licensing and administrationType B
Official classification
Type B
Official code
87213
Regulation authority
CCR

What the official deficiency says

87213.Finances.The licensee shall have a financial plan that conforms to the requirements of Section 87155, Application for License, and that...; shall maintain adequate financial records. This was not met as evidenced by: LPA reviewed R1 facility ledger statements and observed charges on R1's account that the facility was unable to provide a reason for. This poses a potential health and safety risk to residents in care and supervision.

Official plan of correction

Facility to provide in service training on proper documentation of charges or credits provided to residents in care by POC due date.

Deadline recorded: Mar 31, 2023. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Mar 31, 2023
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 6 unsubstantiated · 0 unfounded · 1 cited

Records and plan of operationType B
Official classification
Type B
Official code
87208(a)(5)
Regulation authority
CCR

What the official deficiency says

87208.Plan of Operation.(a) Each facility shall have and maintain a current, written definitive plan of operation...The plan and related materials shall contain the following:(5) Staffing plan, qualifications and duties. This was not met as evidenced by: S1 borrowed money from R1 and did not return their money. This is against the facilites staff handbook which is part of the plan of operation, and poses a potential health and safety risk to residents in care and supervision.

Official plan of correction

Facility to provide inservice training on the plan of operation policies to staff and create a plan to address borrowed money incident between R1 and S1, by POC due date.

Deadline recorded: Mar 23, 2023. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Mar 23, 2023
Correction not verified in available records
View official report
Complaint

Allegations1 substantiated · 2 unsubstantiated · 0 unfounded · 1 cited

Incident reportingType B
Official classification
Type B
Official code
87211(a)(2)
Regulation authority
CCR

What the official deficiency says

(a) Each licensee shall furnish to the licensing agency such reports... (2)Occurrences, such as epidemic outbreaks, ... which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported... to the licensing agency and to the local health officer when appropriate. This was evidence by: LPAs review showed (3) staff and (1) resident who were covid positive on 12/8/22 were not reported until 12/20/22, this poses a potential health and safetey risk to residents in care and supervision.

Official plan of correction

Facility to provide licensing report of covid positives for 12/8-12/9/22 to Licensing as well as provide documentation in letter that staff who creates incident reports has read and understands Title 22 Reporting Requirements by POC Due Date Citation cleared at the time of visit

Deadline recorded: Mar 17, 2023. A deadline is not proof that correction was completed.

Official record says corrected or clearedOn or before Mar 10, 2023
Plan of correction recorded
Correction deadline recordedDeadline Mar 17, 2023
View official report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 4 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations2 substantiated · 5 unsubstantiated · 0 unfounded · 2 cited

Admission, assessment, and evictionType B
Official classification
Type B
Official code
87456(a)(2)
Regulation authority
CCR

What the official deficiency says

87456 Evaluation of Suitability for Admission (a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (2) Perform a pre-admission appraisal. This requirement is not met as evidence by: Based on interviews and records reviewed the licensee did not comply with the section cited above which poses a potential risk to the health, safety, or personal rights of the persons in care. R1's pre-appraisal and appraisal/needs and services plan was not completed prior to being admitted.

Official plan of correction

Facility is to ensure that Title 22 Section 87456 regulations are met at all times. Additionally, a statement indicating facility understands and will comply with Title 22 Section 87456 will be submitted to CCLD by 01/27/2023.

Deadline recorded: Jan 27, 2023. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Jan 27, 2023
Correction not verified in available records
View official report
Administrator qualificationsType B
Official classification
Type B
Official code
87406(a)
Regulation authority
CCR

What the official deficiency says

87406 Administrator Certification Requirements (a) All individuals shall be residential care facility for the elderly certificate holders prior to being employed as an administrator. This requirement is not met as evidence by: Based on interviews and records reviewed the licensee did not comply with the section cited above which poses a potential risk to the health, safety, or personal rights of the persons in care. The Operations Manager did not have an administrator certificate prior to being employed.

Official plan of correction

Facility is to ensure that Title 22 Section 87406 regulations are met at all times. Additionally, a plan to comply with Title 22 Section 87406 will be submitted to CCLD by 01/27/2023. The Operations Manager has already completed the administrator courses and submitted the administrator application to Community Care Licensing Division Administrator Certification Section on 12/27/2022.

Deadline recorded: Jan 27, 2023. A deadline is not proof that correction was completed.

Corrective action reported
Plan of correction recorded
Correction deadline recordedDeadline Jan 27, 2023
View official report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded · investigated over 2 visits

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 2 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 2 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Part of the complaint whose outcome is recorded on Nov 7, 2022 · Control 28-AS-20220318101435

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 3 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations2 substantiated · 3 unsubstantiated · 0 unfounded · 2 cited

Admission, assessment, and evictionType B
Official classification
Type B
Official code
87507(e)
Regulation authority
CCR

What the official deficiency says

87507.Admission Agreements.(e)The licensee shall provide a copy of the signed and dated current admission agreement, and all subsequent signed and dated modifications, to the resident or the resident's representative...The licensee shall provide additional copies to the resident or resident’s representative upon request. This was not met as evidenced by: R1's family requested a copy of the admissions agreement as of 9/28/21 after R1 stated to staff to provide it and facility did not provide it. This poses a potential health and safety risk to clients in care.

Official plan of correction

Administrator to provide licensing with a letter stating that they have reviewed title 22 section 87507 by POC due date.

Deadline recorded: Jul 22, 2022. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Jul 22, 2022
Correction not verified in available records
View official report
Admission, assessment, and evictionType B
Official classification
Type B
Official code
87507(g)(3)(A)
Regulation authority
CCR

What the official deficiency says

87507 Admission Agreements (g) Admission agreements shall specify the following:(3) Payment provisions, including the following: (A) Rate for all basic services... Basic services rate(s), including: 1. A comprehensive description of any items and services provided.. This was not met as evidence by: R1's admissions agreement did not have a break down of how R1s rate was calculated and staff interviewed were not able to explain. This poses a potential health and safety risk to residents in care and supervision.

Official plan of correction

Administrator to provide licensing with a letter stating that they have reviewed title 22 section 87507 by POC due date.

Deadline recorded: Jul 22, 2022. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Jul 22, 2022
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 2 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations0 substantiated · 1 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 0 unsubstantiated · 0 unfounded · 1 cited

Medication handling and storageType A
Official classification
Type A
Official code
87465(c)(2)
Regulation authority
CCR

What the official deficiency says

If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly ...provided all of the following requirements are met:(2) Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidence by: Facility failed to provide Acetaminophen 325 mg, 500mg and 650 mg R1 as prescribed. Facility failed to provide Loratadine 10mg R2 as prescribed. This poses an immediate Health and Safety risk to clients in care

Official plan of correction

The Licensee shall conduct staff training on medication documentation to ensure that they are providing medication to residents as prescribed.

Deadline recorded: Mar 24, 2022. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Mar 24, 2022
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 6 unsubstantiated · 0 unfounded

No deficiencies recorded in this report
Complaint

Allegations1 substantiated · 0 unsubstantiated · 0 unfounded · 1 cited

Resident rightsType B
Official classification
Type B
Official code
87468.1(a)(3)
Regulation authority
CCR

What the official deficiency says

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(3)To be free from punishment, humiliation, intimidation, abuse, or other actions... This deficiency was evidenced by the following: Resident #1 (R1) had been financial abused by Staff #1 (S1) leading to non-authourized purchases made to R1's bank account. This poses a potential health and safety risk to residents under care and supervision.

Official plan of correction

Administrator had notified ombudsman via SOC 341 but will need to porivide a copy to Licensing. S1 was also removed as staff. Administrator conduct training for staff on Resident Personal Rights and provide LPA with proof by POC due date.

Deadline recorded: Jan 21, 2022. A deadline is not proof that correction was completed.

Plan of correction recorded
Correction deadline recordedDeadline Jan 21, 2022
Correction not verified in available records
View official report
Complaint

Allegations0 substantiated · 5 unsubstantiated · 0 unfounded

No deficiencies recorded in this report

Source and limits

California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.

Read the data methodology