Toluca Lake Manor Senior Assisted Living Llc

Basic services shall at a minimum include: (a) Care and supervision as defined in Section 1569.2.This requirement is not met as evidenced by: Based on interviews, evidence provided, and file review, the licensee did not comply with the section cited above as on 04/03/2026 R1 left the facility without staff assistance which posed a potential health and safety risk to residents in care.

87705 Care of Persons with Dementia(d) The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates...This requirement is not met as evidenced by: Based on observation the licensee did not comply with the section cited above as the living room sliding door, bedroom #3, R1's room, and the front gate of the facility were missing properly functioning auditory alarms which posed a potential safety risk to residents in care.

Based on record review the licensee did not comply with the section cited above as two residents files were observed to be missing copies of and/or signatures on their inventory of property and valuables which poses a potential personal rights risk to clients in care.

Based on record review the licensee did not comply with the section cited above as one resident file was observed to be missing proof of a negative TB test which poses a potential health risk to clients in care.

Based on record review the licensee did not comply with the section cited above as one resident file was observed to be missing a medical assessment which poses a potential health risk to clients in care.

Basic services shall at a minimum include: (a) Care and supervision as defined in Section 1569.2. This requirement is not met as evidenced by:Based on interviews conducted, evidence submitted and file review, the licensee did not comply with the section cited above. Facility staff failed to provide the necessary care and supervision to Resident #1 which allowed Resident #1 to elope from the facility unassisted, which poses an immediate health and safety risk to residents in care.

(5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. This requirement is not met as evidenced by: Based on record review, the licensee failed to comply with the section cited above as one resident, with a diagnosis of dementia, did not have their physicians report updated annually which poses a potential health risk to clients in care.

Based on record review, the licensee did not comply with the section cited above as a resident that was identified as bedridden by their physician resides in a room that is not designted in the facility's fire clearance as a bedridden approved room which poses an immediate health, safety or personal rights risk to persons in care.

Based onrecord review, the licensee did not comply with the section cited above as one (1) resident was identified by their physician as total care which poses a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above as one (1) staff member had a positive intradermal TB test and no chest x-ray which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above as the kitchen contained expired food items which poses a potential health risk to persons in care.

Based on observation, the licensee did not comply with the section cited above as a perscription medication inhaler was unsecured in a kitchen cabinet which poses an immediate health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above as two (2) out of two (2) resident files did not contain PRN medication logs which poses a potential health risk to persons in care.

Based on record review, the licensee did not comply with the section cited above as one (1) employee file was missing their health screening which poses a potential health, safety or personal rights risk to persons in care.

Care of Persons with Dementia: The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident.This requirement was not met as evidenced by: All 5 outside exiting doors were not equipped with auditory devices, which poses a potentional health and safety risk to the residents in care.

Basic services shall at a minimum include: (a) Care and supervision as defined in Section 1569.2.This requirement is not met as evidenced by:interviews conducted and file review, the licensee did not comply with the section cited above. Facility staff failed to provide the necessary care and supervision which allowed Resident #1 to easily elope from the facility on multiple occasions which posed a potential health and safety risk to residents in care.

Incidental Medical and Dental Care: 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: 1. the facility shall contact the doctor prior to each dose, describe symptom,receive directions, 2. date and time of contact w/ doctor, physician' direction are documented 3.date, time, dosage taken & resident response is documented.

Based on observation the licensee did not comply with the section cited above as the backyard and along the side of the home was observed with unstored ladders, mops, brooms, discarded items which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above in all counts. The gate was visually observed to be secured with a chain and a padlock, however on closer inspection, the chain that secured the gate could easily be slipped off the post without the need of a key and this poses an immediate health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above in 1 out of the 2 bathroms tested for the water temperature, the water temperature in the bathroom located by bedroom #4 read 98.8 degrees Fahrenheit which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above, per review of the facility food] there was sufficient perishable foods for 2 days but insufficient non-perishable foods observed in the pantry] which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above the residents were left alone with Joe Senga, prospective hire as caregiiver while regular staff stepped out of the facility to do an errand, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above in 1 out of 4 staff observed at the facility, Joel Senga, prospective caregiver was observed alone and providing care to residents at the facility and he did not have a criminal record clearance to be present at the facility, which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above in 1 out of 1 count of cabinets check, the licensee did not ensure that the cabinet under the kitchen sink that contains the cleaning and disinfecting solutions that was visually observed to be secured by a chain and padlock but did not ensure that the chain could not be slipped off the knobs which poses an immediate health, safety or personal rights risk to persons in care.

Based on observationthe licensee did not comply with the section cited above since the sun room was being used to store , resident diapers, dog food, plastic containers, foldable bed, toiletries, which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation the licensee did not comply with the section cited above in 2 our of 2 counts of screens inspected, it was observed that the screen by the kitchen table had holds in the screen and the screen on the sliding screen door in bedroom #3 was ripped which poses/posed a potential health, safety or personal rights risk to persons in care.

Error

87465 Incidental Medical and Dental Care (h)(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.This requirement is not met as evidenced by: Based on observation, the licensee failed to comply with the section cited above as medications were observed unlocked and accessible to residents which is a health and safety risk to residents in care.

Based on LPA's observation, the licensee did not comply with the section cited above as there were two (2) medications accessible in the kitchen refrigerator which poses an immediate health, and safety risk to persons in care.