Santa Barbara Memory Care

Right to sufficient care and qualified staff

87468.2(a)(4) Personal Rights: 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 requirement is not met as evidenced by: Based on interviews conducted and records reviewed, the licensee did not comply with the section cited above when administrator did not protect a safe environment for residents in care resulting in resident(s) being inappropriately touched by another resident which poses an immediate health and safety risk to residents in care.

Private visitor access without prior notice

87468.1(a)(11) Residents...shall have all of the...personal rights: (11) To have their visitors...and advocacy representatives, permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement is not met as evidenced by:Based on observation and interviews conducted, the licensee did not comply with the section cited above when R1 was not allowed visitors which poses an immediate health and safety risk to residents in care.

Freedom to leave and not be locked in

87468.1(a)(6) To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night.This requirement is not met as evidenced by: Based on observation and interviews conducted, the licensee did not comply with the section cited above when R1 was not allowed to leave or depart the facility upon their choice which poses an immediate health and safety risk to residents in care.

Right to sufficient care and qualified staff

87468.2(a)(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 requirement was not met as evidenced by: Based on interview and record review, the licensee did not comply with the section cited above when staff provided inadequate supervision to R2, which posed a potential health, safety, and personal rights risk to residents in care.

87507 Admission Agreement (g) Admission agreements shall specify the following: (3) Payment provisions, including the following:(B) Rate for additional items and services, including: 2.A separate charge for an item or service may be assessed only if that charge is included in and authorized by the admission agreement. By not processing checks revived in the mail when in timely manor when revived, which poses a potential risk to residents in care.

87217(i) Upon discharge of a resident, all cash resources, personal property and valuables of that resident which have been entrusted to the licensee shall be surrendered to the resident, or his responsible person. A signed receipt shall be obtained. This requirement was not met by evidence of Medication Delivery Record date and date specific medication was not provided to R1's representative. Which poses an immanent risk to residents in care.

87508 Register of Residents (b)Registers of residents shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Registers may be removed if necessary for copying. Removal of registers shall be subject to the following requirements: Which is a potential danger to Residents in care. This requirement was not met by evidence of not having Register or Residents (LIC9020) upon demand during complaint visit on 05/21/2025.

87355 Criminal Record Clearance(a) The Department shall conduct a criminal record review of all individuals specified in Health and Safety Code section 1569.17 and shall have the authority to approve or deny a facility license, or employment, residence, or presence in the facility, based upon the results of such review. This requirement was not met by review of current working staff S1 not being cleared in Guardian or LIS at time of visit. Which poses a risk to residents in care.

87705(f)(4)(B) Care of Persons with Dementia (4) The licensee shall maintain either of the following documents in the resident's record, depending on the resident's conservatorship status:(B) A written statement signed by each non-conserved resident that states the resident understands that the facility has locked exterior doors or perimeter fence gates and that the resident voluntarily consents to such upon admission Based on interview and record review, the licensee did not comply with the section cited above when Licensee accepted a non-conserved individual who does not have a dementia diagnosis and does not require the level of care provided by the facility which poses an immediate health and safety risk to residents in care.

87211(a(1)(A) Reporting Requirements: Each licensee shall furnish …(A) Death of any resident from any cause regardless of where the death occurred...This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the section cited above when death of a resident on 3/3/2025 was not reported to CCLD until 3/11/2025 which poses an immediate health and safety risk to residents in care.

Obtain required California clearance or exemption

Record review and interview conducted revealed the licensee did not comply with the section cited above when three (3) staff members were not properly associated to the facility prior to working, residing, and/or volunteering in the facility which poses an immediate health and safety risk to residents in care.

Notification to department after hospice care starts

Record review revealed the licensee did not comply with the section cited above when CCLD was not notified of Resident 1’s (R1’s) placement of hospice on or about 6/11/2024 which poses a potential health and safety risk to persons in care.

Based on observation, the licensee did not comply with the section cited above in that approximately 16 heads of iceberg lettuce were observed in the refrigerator and food storage area are not stored properly which poses a potential health and safety risk to persons in care.

Every facility required to be licensed under this chapter shall provide at least the following basic services: (a) Care and supervision as defined in Section 1569.2. This requirement is not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited when they failed to ensure R1’s medication needs were being met,

Maintain facility in clean, safe, sanitary condition

Maintenance and Operation. The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by: Based on interviews and observations, the licensee did not comply with the section when the facility was not clean or safe, which posed a potential health and safety risk to residents in care.

Private visitor access without prior notice

Personal Rights. To have their visitors…permitted to visit privately during reasonable hours and without prior notice…This requirement was not met as evidenced by: Based on interview and observation, the licensee did not comply with this section when visitors were not let into the facility timely to visit, which posed a potential personal rights risk to residents in care.

Right to access and copy personal medical records

Personal Rights. To have prompt access to review all...records and to purchase photocopies of all their records. Photocopied records shall be provided within two (2) business days… This requirement was not met as evidenced by:Based on interview and record review, the licensee did not comply with this section when F1 was notprovided R1’s record, which posed a

Admission Agreements. A 100 percent refund of a preadmission fee shall be provided…if: The applicant decides not to enter the facility…This requirement was not met as evidenced by: Based on record review and interview, the licensee did not comply with the section cited above when a refund was not issued to prospective residents, which posed a potential personal rights risk to residents in care.

Personal Accommodations and Services. Equipment and supplies necessary for personal care and maintenance of adequate hygiene practice shall be readily available to each resident. This requirement is not met as evidenced by: Based on interviews, the licensee did not comply with the section when the facility could not access toilet paper, towels, hygiene or cleaning products, which posed an immediately health

Maintain facility in clean, safe, sanitary condition

87303(a) Maintenance and Operation. The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by: Based on interviews and observations, the licensee did not comply with the section when the facility was not clean or in good repair, which poses potential health and safety risk to residents in care.

Infection Control Requirements…Staff…shall be required to perform enhanced environmental cleaning and disinfection to maintain a safe and sanitary environment... This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not comply with the section cited above when disinfectants and cleaning supplies were not available during a COVID outbreak,

Certified administrator requirements and substitute coverage

87405(a) Administrator Qualifications and Duties. All facilities shall have a qualified and currently certified administrator. This requirement was not met as evidenced by: Based on interview and record review, the Licensee did not comply with the regulation above when facility has not had certified administrator for months, which posed an immediate health and safety risk to residents in care.

Right to sufficient care and qualified staff

Personal Rights…Residents…have all of the following personal rights: 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 requirement was not met as evidenced by: Based on interview and record review, the Licensee did not comply with the regulation above when there

Maintain facilities for fire and panic safety

Based on observation, the licensee did not comply with the section cited above, as fire inspection service on five out of five fire extinguishers was expired as of 1/5/2023, which poses an immediate heatlh and safety risk to residents in care.

Maintain facility in clean, safe, sanitary condition

Based on observation, the licensee did not comply with the section cited above as out of 14 residents rooms and bathrooms, two residents’ bedrooms and two residents' bathrooms had foul odors which poses an immediate health and safety risk to residents in care.

87211(a)(1) Each licensee shall furnish to the licensing agency such reports as the Department may require,... (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... This requirement is not met as evidenced by:Based on record review, observation, and interviews conducted, the licensee did not comply in the section cited above as the facility staff did not notify R1's responsible party of a hospital visit; nor did the facility notify CCLD of the hospital visit.

Facility personnel sufficiency and competence

Type A 87411(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 interviews, record review, and observation, the licensee did not comply in the section cited above as facility staff were unable to answer telephone calls from R1's responsible party on 8/23/2023, 8/24/2023, and 8/25/2023 which poses an immediate health and safety risk to residents in care.

HSC 1569.652(c) Termination of admission agreement upon death of resident…refund of fees paid…(c) A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual, individuals, or entity contractually responsible for the fees or, if the deceased resident paid the fees, to the resident’s estate, within 15 days after the personal property is removed. This requirement is not met as evidenced by:Based on interviews and records review, the licensee did not comply with the section cited above as Licensee failed to provide R1’s Representative with a refund within 15 days after R1 passed away and personal belongings removed, which posed a potential health, safety, or personal rights to residents in care.

(g) Admission Agreements. Admission agreements shall specify the following: (5) Refund conditions: (E) Preadmission fees shall be refunded according to the following conditions: … (a) A refund of at least 80 percent of the preadmission fee in excess of $500 shall be provided if the applicant does not enter the facility after a preadmission appraisal is conducted, or the resident leaves the facility for any reason during the first month of residency. This requirement is not met as evidenced by: Based on the record review and interviews conducted, the licensee did not comply with the section cited above when PR1’s responsible party did not receive a refund within 15 days after PR1’s responsible party decided not to move PR1 into the facility.

Based on observation, the facility failed to ensure Staff 1 (S1) was wearing a face covering correctly which poses an immediate health, safety and personal rights risk to residents in care.

87211(a)(1)(A) Reporting Requirements:... Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, en route to or from a hospital, or visiting away from the facility.This requirement is not met as evidenced by: Based on records review, the licensee did not comply with the section cited above as CCL has not received notifications of residents’ death since 9/11/2021 which poses an immediate health and safety risk to residents in care.

Notification to department after hospice care starts

87632(d)(2) Hospice Waiver: The licensee shall notify the Department in writing within five working days of the initiation of hospice care services for any terminally ill resident in the facility or within five working days of admitting a resident already receiving hospice care services. This requirement is not met as evidenced by:Based on records review, the licensee did not comply with the section cited above as CCL has not received hospice notifications for residents placed on hospice since 6/18/2021 which poses an immediate health and safety risk to residents in care.

87211(a)(1)(D) Reporting Requirements: (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...(D) Any incident which threatens the welfare, safety or health of any resident.This requirement not met as evidenced by: Based on record review, the licensee did not comply with the section cited above as 21 out of 21 serious injury/incident reports were not received by CCL within 7 days of their occurrence on 11/26/2022 which poses a potential health & safety risk to residents in care.

87211(a)(1)(D) Reporting Requirements: (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...(D) Any incident which threatens the welfare, safety or health of any resident... This requirement is not met as evidenced by:Based on record review, the licensee did not comply with the section cited above as 5 out of 5 serious injury/incident reports were not received by CCL within 7 days of their occurrence on 11/26/2022 which poses an immediate health & safety risk to residents in care.

Safe, healthful, comfortable accommodations

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:(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by:Based on observation, the facility failed to ensure Administrator/staff were wearing face coverings which poses an immediate health, safety and personal rights risk to residents in care.

Comply with all admission agreement terms

87507(f) Admission Agreements: The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments.This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the above cited section by not honoring their admission agreement modification of no rate increase for R1 for at least two years, which posed a potential health, safety, and personal rights risk for residents in care.

§1569.618 Administration and management of residential care facilities; substituted qualifications; employee scheduling : (b) At least one administrator, facility manager, or designated substitute who is at least 21 years of age and has qualifications adequate to be responsible and accountable for the management and administration of the facility pursuant to Title 22 of the California Code of Regulations shall be on the premises 24 hours per day. The designated substitute may be a direct care staff member who shall not be required to meet the educational, certification, or training requirements of an administrator This requirement was not met as evidenced by: Based on interview and record review, the licensee did not ensure a designated substitute on the premises 24 hours per day, which posed a potential health and safety risk to residents in care.

87468.1 (a)(2) Personal Rights of Residents in all Facilities: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.This requirement is not met as evidenced by: Based on LPA’s observation, the licensee did not comply with regulation above when Staff 1 and Staff 2 were present in the facility without wearing masks fully covering the mouth and nose which poses an immediate health, safety, and personal rights risk to residents in care.

Maintain facility in clean, safe, sanitary condition

87303(a) Maintenance and Operation: The facility shall be clean, safe, sanitary and in good repair at all times....This requirement is not met as evidenced by: Based on LPAs observation, the licensee did not comply with the section cited above as LPA observed an abandoned washing machine in front of the facility visible to residents in care, visitors to the facility, staff, and public individuals passing by which poses a potential health and safety risk to residents in care.

H&S 1569.652(c) Termination of admission agreement upon death of resident...(c) A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued...within 15 days after the personal property is removed.This requirement is not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above. Licensee failed to provide R1’s Representative with a refund within 15 days after R1 passed away and personal belongings removed, which posed a potential health, safety, or personal rights to residents in care.

H&S 1569.312(a) Basic services requirementsEvery facility required to be licensed under this chapter shall provide at least the following basic services: (a) Care and supervision as defined in Section 1569.2This requirement is not met as evidenced by:Based on interviews and records review, the licensee did not comply with the section cited above. Licensee failed to provide adequate care and supervision to R1 which attributed to R1’s aggressive, assaultive incidents on 04/25/2020 and 04/26/2020,which posed an immediate health, safety, or personal rights risk to person in care.

Facility personnel sufficiency and competence

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 interviews and records review, the licensee did not comply with the section cited above. Licensee failed to provide adequate staffing to care for thirteen (13) dementia residents, which posed an immediate health, safety, or personal rights risk to residents in care.

Provide copies of signed agreements and amendments

87507(e) Admission Agreements(e)The licensee shall provide a copy of the signed and dated current admission agreement... immediately upon signing the admission agreement or modification...shall provide additional copies to the resident or resident’s representative upon request. This requirement is not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above. Licensee failed to provide R1’s Representative with a copy of R1’s Admission Agreement, which posed a potential health, safety, or personal rights risk to residents in care.

Submit and maintain current mailing address

Based on record review, the LPA found one staff on the facility roster that did not have criminal record clearance. The licensee did not comply with the section cited above in 1 count which poses an immediate health, safety or personal rights risk to persons in care.

87303 - Maintenance and OperationSolid waste shall be stored, located and disposed of in a manner that will not permit the transmission of a communicable disease or of odors, create a nuisance, provide a breeding place or food source for insects or rodents. This requirement was not met as evidenced by: Based on observations, the licensee did not ensure that sufficient measures were taken to keep the area in and around the bird cage free from flies and ants. This poses a potential health risk to all clients in care.