Follow-up on corrections·July 8, 2025

Licensing Program Anaylts (LPA) Janira Arreola conducted an unannounced visit to the facility LPA initally met with a caregiver Staff, Susan Ouithuyse and spoke with licensee Angela Zhang over the phone who were informed of the purpose of the visit. LPA met with Staff #1 (S1) upon arrival to the facility. S1 expressed they had just started working at the facility today and were the only staff present at the facility. Additionally on 06/26/2025 the licensee e-mailed the LPA copies of the new administrator Staff #2 (S2), and the new facility manager Staff #3 (S3)'s identification cards. LPA reviewed the Guardian roster of fingerprinted and associated staff and found S1, S2 and S3 have fingerprint clearance but are not associated to the facility. During the time of the visit, S2 the new administrator provided the transfer sheet LIC9182 form for S1. Interview with S2 revealed S2 and S3 have been working at the facility since 06/29/2025. Therefore the facility is being cited for S2 and S3 not being associated to the facility. A civil penalty in the amount of $100 per day for the maximum of (5) days is being issued. LPA observed (2) residents at the time of the visit. (1) resident is currently bedridden and the facility does not have a bedridden fire clearance. Therefore, the facility is being cited for fire clearance. This violation warrants an immediate $500 civil penalty. (3) residents observed during visit on 06/11/2025 were observed to no longer be residing at the facility. LPA was informed that Resident #1 (R1) passed away around (1) month ago. The licensee could not recall if they submitted an incident report for R1. A review of incident reports submitted to the regional office and revealed none for R1. Therefore, the facility was cited for not following reporting requirements for resident deaths within (7) days. LPA conducted interview with (1) confidential witness who revealed that they were informed the facility had changed ownership. LPA conducted interview with (3) staff which revealed conflicting information. Upon arrival to the facility LPA was informed by (1) staff that the new facility owner is S2. LPA called the licensee and S2 who informed S2 is managing the facility as the new administrator, however the licensee stated they are still involved in over seeing the facility. The licensee and S2 both confirmed that S2 is now leasing the property and that S2 will be applying for a change in ownership application. A copy of the current lease agreement was reviewed and revealed S2 is the leasing the property. The licensee revealed they did not send a notification of change in ownership to the department and entrusted this task to S2. Therefore, the facility is being cited for lack of reporting the intent to change ownership of the facility. *LPA was off site from 12:20pm to 1:20pm in order to prepare today's report.