Inspection
No deficiencies recorded in this report
AUTUMN MANOR, LLC #2
2365 KENTFIELD ST., Simi Valley CA 93065
6 bedsLatest official report May 4, 2026Licensed
Additional info
- Telephone
- (805) 526-8629
- Licensee
- AUTUMN MANOR, LLC
- Administrator
- FULGENTES, JENNIFER
- Contact
- FULGENTES, JENNIFER
- License first date
- May 28, 2003
- License effective date
- May 28, 2003
- District office
- WOODLAND HILLS N.ASC · (818) 596-4334
- Regional office
- 29
- Clients served
- 983 - RCFE / DEMENTIA
Summary
The available records show 3 Type B deficiencies for this facility.
- Most recent inspection
- May 4, 2026
- Most recent deficiency
- May 26, 2023
3 later reports, from May 18, 2024 through May 4, 2026, recorded no deficiencies, though the records do not say whether they were follow-ups.
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 218 Ventura County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 5 reports for this facility: 5 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 0 Type A and 3 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 5
- Recorded deficiencies
- 3
- Type A deficiencies
- 0
- Type B deficiencies
- 3
- Substantiated complaints
- 0
- Repeated topics
- 0
More than the typical 4
1 in the last 12 months
More than the typical 2
0 in the last 12 months
Fewer than the typical 1
0 in the last 12 months
More than the typical 1
0 in the last 12 months
Most this size also have none
0 in the last 12 months
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.
No topic repeats in the last 36 months
No deficiency topic appears in more than one report during that window. This does not establish that nothing repeated earlier in the five-year record, and it is not a statement about current conditions.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87412(a)
- Regulation authority
- CCR
What the official deficiency says
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. Licensee did not have a complete file for the administrator for review during todays visit. This poses/posed a potential personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/09/2023 Plan of Correction Licensee agrees to maintain an administrator file for current administrator at the facility. Submit packet for administrator to update administrator for this facility.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 1569.625(b)(2)
- Regulation authority
- HSC
What the official deficiency says
(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 1 staff out of 2 staff files reviewed; staff 1 lacked required training referenced above. This poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/09/2023 Plan of Correction Licensee agrees to provide additional training to staff 1 for the topics listed in the health and safety code. Provide a self certification that training was completed and submit copy of training record for staff 1.
Plan of correction recorded
Correction not verified in available records
Medical and dental careType B
- Official classification
- Type B
- Official code
- 87465(d)
- Regulation authority
- CCR
What the official deficiency says
(d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to communicate his/her symptoms clearly, facility staff designated by the licensee, shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 2 out of 2 resident medication and medication records reviewed. This poses/posed a potential health, safety or personal rights risk to persons in care. Resident 1 (R1) and resident 2 (R2) did not have the PRN authorization letter on file.
Official plan of correction
POC Due Date: 06/09/2023 Plan of Correction Licensee agreed to obtain and submit PRN authorization letter to R1's and R2s doctor. LIcensee also agreed to develope and maintain a corresponding log for residents who are unable to determine/clearly state symptoms for any PRN mendication. Provide completed copy to LPA for proof of correction.
Plan of correction recorded
Correction not verified in available records
Inspection
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