Inspection visit

Incident investigationMarch 27, 2026

BALANCE ASSISTED LIVING AND MEMORY CARELicense 3927013889 citations on this visit

9 citations recorded

Inspector’s narrative

What the inspector wrote

Today Licensing Program Manager Liza King and Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to follow up on incident reports received from the facility and documentation requested by the Department. LPA and LPM met with the Administrator Carolyn Appeal. The purpose of the visit was explained. Current census is 67 in hospital 5 on hospice 5 The Regional Office (RO) received an LIC624 on 03/17/26 re an incident that occurred on 3/16/26 for R1 and R2 in which an altercation between the two had occurred. The following documents were reviewed. Admissions Agreement, Emergency Contact Sheet, LIC602, Preplacement appraisal and any reappraisal, Needs and Services Plans, MAR for Jan 2026 to current , Any incident reports Jan 2026 to current , Any Service Notes for Jan 2026 to current, Any discharge summaries for Jan 2026 to current , Resident Roster, Staff Roster with telephone numbers. The incident resulted in R1 being injured. A review of the records revealed there was no update to the care plan. R1 had not been administered any pain medication, since return from the hospital more than a week ago. When LPM asked R1 how they were doing they expressed pain and were able to identify where. Additionally the RO conducted a follow up visit re LIC 624 received for R3, R4, R5, R6, R8 in which falls occurred and residients were hospitalized. Similar documentation was requested from the licensee to be submitted to the RO by 03/26/26, proof of email was observed and documents were printed and provided during visit. The RO will review the documentation, conduct interviews and return at a later date to address any concerns. Documented on several LIC624 was that the caregiver contacted another staff, hospice or a family member prior to calling emergency services (R7, R8). During todays visit three caregivers were interviewed and the all reported that if a resident falls and hits their head on the wall they are to call for a med tech to assess the individual. The caregivers reported they are not to call for emergency services that is the duty of the med tech. A request for the fall policy and emergency protocols was requested which documents any staff may call 911. A tour of the facility was conducted of Memory Care (MC) the door to the laundry room and fire room were unlocked, as well as AL leaving the area with toxins accessible to residents. Additionally several rooms in Memory Care had personal care supplies accessible to residents in care. A review of the LIC602s revealed one or more of the residents were not allowed access to these items. A discussion with the Administrator confirmed that these areas should not have accessibility to personal care supplies, best practices were discussed. Staff were prompted to remove the items. Three doors were tested in MC one released with no alarm after the 15 second delayed egress standard. 2 rooms in MC were observed to have O2 with no warning sign and 1of2 were were improperly stored. More than 10 resident rooms in Al and MC were observed to not have hand soap for residents to wash their hands. A tour of the outside was conducted the water heater closet smelled of gas the Administrator was prompted to call gas service, however Maintenance Director reported that a new water heater is being installed on Monday 03/30/26. Several screen doors were tested, some were unable to move freely. A screen was missing from a window. Hot water was tested ranging from 77 degrees to 125 degrees outside of the acceptable range. Various theromostats were observed at 66 degrees prior to 8am which is outside of the acceptable range. A tour of the AL revealed the floor coming up in room 67, and in the med tech room, in MC with tape over the carpet. In AL a resident was observed with full bedrails. Broken washers and dryers were observed and being cited on a complaint 20260108144201. A tour of the kitchen, adequate food present, breakfast and lunch service were observed with no concern. One broken freezer observed. Currently food is orders twice per week. Citations and civil penalties are being issued today as a result of the visit. A review of the report is being provided and reviewed with Administrator Carolyn Appeal. Appeal rights were provided.

Citations

10 citations recorded^*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

87224(d)Type B
87224(d) Eviction Procedures(d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons.This requirement was not met as evidence by: Based on interview, R1 was not served a lawful eviction notice, which poses a potential health, safety, and/or personal rights risk.
87303Type A
(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 was not met as evidenced by: 2of2 resdient rooms water tested at 77 and 76 degrees, kitchen sink water temperature tested at 125 degress. Flooring in the AL med Tech office, carpet in MC and flooring in AL rm 49 were all in need of repair. This poses an immediate threat to the health and safety of resients in care.
87307(a)(3)(D)Type A
(D) Hygiene items of general use such as soap and toilet paper. This was not met as evidenced by the absense of a hand soap in resdietn rooms. This poses an immediate health and safety risk to clients in care.
87309(a)Type A
(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage... This was not met as evidenced by bleach and laundry supplies asscessible in both memory care and assisted living; all doors were open and accessible to resdients in care. This poses an immediate threat to the health and safety of resients in care.
87463(g)Type A
(g) The licensee shall ensure corresponding changes are made in the care and supervision provided to the resident. This poses an immediate threat to the health and safety of resients in care. This was not met as evidenced by R1 was discharged with a fracture and prn pain medication. A review of the records revealed there was no update to the care plan. This poses an immediate threat to the health and safety of resients in care.
87465(a)(4)Type A
(4) The licensee shall assist residents with self-administered medications as needed. This was not met as evidenced by R1 sustained a fracture. A review of records showed no Pain mangement medication provied for over 7 days. Interview with the resdietn revealed pain when asked how they were doing today. This poses an immediate threat to the health and safety of resients in care. This poses an immediate threat to the health and safety of resients in care.
87468.1Type A
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This was not as evidenced by R1 being forcefully grabbed by R2 resulting in a fracture. This poses an immediate health and safety rsik.
87608(5)(B)Type B
(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This was not met as evidenced by a resdient being observed by the LPM and Admin with full bedrails and no physicans order, exception or hospice services.
87618(b)Type A
(3) Ensuring that the use of oxygen equipment meets the following requirements:...(B) "No Smoking-Oxygen in Use" signs shall be posted in the appropriate areas...(E) Oxygen tanks that are not portable shall be secured in a stand or to the wall. This regulation was not met as evidenced by O2 canisters were not stored poperly in a stand and oxygen signs were not posted on the bedroom doors. This poses an immediate threat to the health and safety of resients in care.
87309(b)Type A
(b) Residents may have access to items specified in subsection (a) for personal use unless there is documentation, as specified in Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, that indicates the resident's or other residents’ safety would be at risk if allowed access. This was not met as evidenced by several resident rooms in memory care had personal care supplies such as soap, shampoo, body wash, toothpaste. 2 of 6 files reviewed showed the residents were not allowed access based on physician documentation. This poses an immediate threat to the health and safety of resients in care.

FAQ · About this visit

Common questions about this visit

What happened during the March 27, 2026 inspection of BALANCE ASSISTED LIVING AND MEMORY CARE?

This was a other inspection of BALANCE ASSISTED LIVING AND MEMORY CARE on March 27, 2026. 9 citations were issued: 8 Type A (serious) and 1 Type B.

Were any citations issued to BALANCE ASSISTED LIVING AND MEMORY CARE on March 27, 2026?

Yes, 9 citations were issued (8 Type A, 1 Type B). The first citation was for: "87224(d) Eviction Procedures(d) The licensee shall set forth in the notice to quit the reasons relied upon for the evict..."

What type of inspection was this?

This was a other inspection. other inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLD View original report

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Data from CCLD public records. Last updated May 25, 2026. If you believe any information is inaccurate, report it here.

Incident investigation·March 27, 2026