Follow-up on corrections·November 4, 2025

Licensing Program Analyst (LPA) Angela Hood arrived at the care home today and met with the Executive Director (ED), Dana Stansel, to conduct a case management visit in relation to a separate inspection conducted on today’s date, November 4, 2025. LPA reviewed resident (R1's) documentation. The facility provided R1's progress notes indicating that R1 was sent to the hospital on January 14, 2025, due to increased confusion and hallucinations. R1 was reassessed by the facility on January 22, 2025, which indicated that R1 required assistance three (3) times per day for orientation "mild/moderate impairment of memory, disorientation, and may display anxiety with memory difficulties. May be perceived as oriented, but memory deficits seen over time. Requires some prompting and encouragement 1 to 3 times per day". R1's previous assessment conducted on March 28, 2024 did not indicate that resident required assistance. R1's Physician's Report LIC602A dated January 6, 2022 indicated that R1 had mild cognitive impairment and did not exhibit confusion/disorientation. R1's Physician's Report LIC602A dated January 21, 2025 indicated that R1 had a primary diagnosis of Dementia and exhibits confusion/disorientation. Interview with ED indicated that R1 required additional care due to progression of Dementia diagnosis. The facility implemented additional care for R1. According to R1's Identification and Emergency Information LIC601, R1 is their own responsible party for financial affairs, payment for care, and their own legal guardian. R1's LIC601 also included family members to notify in an emergency. Email correspondence indicated that the facility was aware that R1's family member was attempting to gain Durable Power of Attorney (DPOA) in order to assist R1. According to invoices provided by the facility, R1 was on an automatic payment plan. The automatic payment did not go ************************************************Continued on LIC809-C******************************************** through on February 5, 2025 and was returned on February 8, 2025. R1's automatic payments continued to be returned until April 10, 2025. Due to non-payment, the facility began the 30-day eviction process sending notification to R1 via certified mail on April 28, 2025. The facility did not provide LPA a signed certified mail proof of service for this date. An additional 30-day notice to pay or quit was sent to R1 via certified mail on May 7, 2025 and the certified mail received was signed by R1 on May 13, 2025. The facility filed an unlawful detainer complaint with the Superior Court of California County of Sacramento on July 22, 2025. According to Proof of Service of Summons, R1 was personally served a copy of the summons, complaint, civil case cover sheet, and plaintiff's mandatory cover sheet and supplemental allegations unlawful detainer on July 24, 2025. The Proof of Service of Summons indicated that R1 was served at their home as "a competent member of the household (at least 18 years of age) at the dwelling house or usual place of abode of the party. I informed him or her of the general nature of the papers". R1 has a Dementia diagnosis as of the LIC692A dated January 21, 2025 with confusion/disorientation and also had a family member in the process of obtaining DPOA status who was not sent the 30-day notice or unlawful detainer complaint documentation. Interview with R1 indicated that they do not check their mail frequently and that they have been receiving documents that they do not understand. R1 indicated that they received documents saying they owe something. R1 believed it was for furniture purchased in the 1970s when their spouse was living and expressed they were afraid they could go to jail. R1 indicated that they have not purchased any furniture recently and that their spouse has passed away. Observation of R1 indicated that they were exhibiting confusion. The facility provided LPA with all court documentation pertaining to the unlawful detainer complaint and there were no indication that the court was notified of R1's current primary diagnosis. R1's progress notes indicated that they were sent to the hospital on September 19, 2025 due to increased confusion and strong urine odor. Progress notes also indicated that on September 21, 2025 R1 was noted to have a urinary tract infection and prescription medication was ordered. Interview with ED indicated that the facility had a meeting regarding over reporting and indicated that this incident was not reported to CCLD. CCLD does not have record of the September 19, 2025 incident. LPA had a conversation with ED regarding reporting requirements and ED agreed that the facility will begin reporting all hospitalization incidents to CCLD. As a result of today's inspection, deficiencies are being cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Deficiencies are listed on 809-D pages. Exit interview was conducted. A copy of this report and appeal rights were provided.