Whittier Glen Assisted Living

(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.

(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.

(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.

(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 regulation is not met as evidenced by: Based on resident interviews and a observation, LPA determined that 5 out of 10 residents had either been handled roughly or pushed by staff while being assisted with transfers or care, which poses a potential health and safety threat to clients in care.

(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.

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.

(a) Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment.This requirement is not met as evidenced by: Based on record reviewed, R1 LIC602A dated 08/29/2025 did not clearly indicate if resident can administer injections and test glucose levels as it was marked N/A on page 8 , #6 under Medication Management b. and c.

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.

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.

(c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of their individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations. This regulation is not met as evidence by:Based on record review, it was determined that there was no available pre-admission appraisal or recent appraisal available for C1, which poses a potential health and safety risk to residents in care.

(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.

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.

(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.

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.

87463 Reappraisals(a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. The reappraisals shall document changes in the resident's physical, medical, mental, and social condition.This requirement was not met as evidenced by: Baased on records review, Licensee failed to update R1's appraisal/plan of care to implement fall interventions due to R1's fall history that led to R1 sustaining a head laceration, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

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.

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.

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above a Resident #1-#3's hospice care plans were incomplete by not showing licensee/staff involvement in residents hospice care plan which poses/posed a potential health, safety or personal rights risk to persons in care.

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.

(b) The following food service requirements shall apply: (29) All equipment, fixed or mobile, and dishes, shall be kept clean and maintained in good repair and free of breaks, open seams, cracks or chips.This requirement is not met as evidenced by: LPA observed 3 ovens and over head vent in the kitchen not operable which poses a health and stafety risk to residents in care.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

87303 Maintenance and Operation(a) The facility shall be clean, safe, sanitary and in good repair at all times...(1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition.This requirement was not met as evidenced by: Based on observation and interview, licensee failed to maintain (2) of (5) resident restrooms inspected, clean and odorless, and (1) of (5) resident room carpets clean, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

80088 Furniture, Fixtures, Equipment, and Supplies(f) Solid waste shall be stored...in a manner that will not transmit...odors...(1)All containers...used for...solid wastes shall have tight-fitting covers kept on the containers...This requirement was not met as evidenced by: Based on observation and interview, the licensee failed to maintain trash bins with a lid to dispose of soiled adult briefs in R4's room, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

87468.1 Personal Rights of Residents in All Facilities(a) Residents...shall have...the following personal rights:(2)To be accorded safe, healthful and comfortable accommodations...and equipment.This requirement was not met as evidenced by: Based on observation and interview, the licensee failed to allow safe access to the signal system in R5's room, as there is furniture placed in front of it making it inaccessible, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

87307 Personal Accommodations and Services(3)Equipment and supplies necessary for...maintenance of adequate hygiene...shall be...available to... resident...if...unable...the licensee shall assure provision of:(C)Clean linen, including blankets...This requirement was not met as evidenced by: Based on observation and interview, the licensee failed to ensure R4 had clean blankets on their bed, which poses a potential Health, Safety, or Personal Rights risk to persons in care.

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.

(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.

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities: (a) ...residential care facilities for the elderly shall have... personal rights: (2) To have their records and personal information remain confidential and to approve their release, except as authorized by law.This requirement is not met as evidence by: Based on documents reviewed Licensee did not ensure medical diagnosis/directives were maintain confidential for residents in care which poses an immediate health, safety, or personal rights violation for the residents in care.

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.

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.

87455 Acceptance and Retention Limitations c) No resident shall be accepted or retained if any of the following apply: (3) The resident's primary need for care and supervision results from either:(A)An ongoing behavior, caused by a mental disorder, that would upset the general resident group; This what not met as evidenced by:R1's primary diagnoses led to an ongoing behavior of shouting at yelling at staff and residents that upsets the general resident group.This poses a potential health and safety risk to residents in care and supervision.

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.

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.

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

Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement is not being met as evidenced by: LPA Rea observed that the water temperature measured at 130.6 * F in staff restroom, 127.4 * F in kitchen/coffee bar area, 129 *F in common bathroom on 2nd floor, and 125.6 * F in Room #201. This poses a health and safety risk to residents in care.

(a) Each licensee shall furnish to the licensing agency such reports... (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 of any of the events specified...in (A) through (D) below... (D) Any incident which threatens the welfare, safety or health of any resident.... This was evidence by:LPA interviews and file review show that Resident fell on 3/1/22 and it was not reported until 3/10/22 when LPA visited the facility, this poses a potential health and safetey risk to residents in care and supervision.

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.