Non-compliance follow-up·November 4, 2025

At approximately 11:30 AM Licensing Program Analyst (LPA) Stevenson arrived unannounced for the purpose of conducting a quarterly Case Management-Legal/Non-compliance (NCC) Inspection and met with caregiver Martha Reyes who has Designation of Facility Responsibility (DFR). Administrator Madonna Martinez was called to advise of NCC inspection, but was not able to attend as she was at a sister facility. LPA was advised that there were five (4) residents in care, one (1) of which is on hospice. This facility was placed on a non-compliance (NCC) on 06/26/2024 for a two-year term by Community Care Licensing (CCL); Concerns addressed in NCC meeting on 06/26/2024 were: Administrator Duties and Qualifications Active Administrator in place for facility oversight per regulation Clearing Plans of Correction (POCs) Reporting Requirements Timely response to CCL when communication is engaged DFR was advised that on 08/27/2025 and again on 10/13/2025, LPA left voice mail messages with licensee that an update was needed as to the status of Triune, INC with the Franchise Tax Board (FTB). LPA advised DFR that Triune,INC is currently indicated as in suspended status with the FTB. In addition LPA advised DFR That this LPA did not receive a update response from the licensee regarding their efforts with the FTB and that this was in violation of the NCC goal of Magnolia Gold Home Care having more, "Timely responses with CCL when communication is engaged" Continued on LIC809C Continued from LIC809 At approximately 12:00 PM, five (5) staff files were reviewed and one staff member (S1) of five (5) were found to have just ten (10) hours of the required 40 hours of education and shadow training required for all caregivers within the first four (4) weeks of work at a Residential Community For the Elderly (RCFE) (Type B violation was issued and Plan of Correction (POC) developed.) Licensee was given a copy of educational requirements for staff and volunteers at RCFEs. Five (5) of 5 Resident files were reviewed and 5 of 5 were found to have all required documentation including recently attained Consents for Emergency Medical Treatment (LIC627C) At approximately 1:00 PM LPA and caregiver/DFR conducted a wellness and safety walk-through of facility, finding it at a comfortable temperature, clean, odor free, exits free from obstructions and well organized. Residents were clean and dressed appropriately. There was an ample supply of hygiene products for residents' care. There was also an ample supply of healthy perishable and non-perishable food as required by Title 22. Left-over foods were observed to be labeled appropriately. A new fire extinguisher in the kitchen purchased 08/10/2025 was observed to be fully charged, Smoke detectors/carbon monoxide detectors are centrally wired and tested to be functional. The front and back yards are well maintained and the back yard pool is fenced and secured as required by regulation. There is also a covered patio with seating for outdoor activities and visits. There are comfortable couches and chairs in the living room with television and simple games available. Soaps and toxins, as well as sharps were locked securely and inaccessible to residents. Medications were kept secured in a closet in hallway. LPA obtained copy of letter indicating the 2022 Income Tax Return for Triune, INC was submitted to the IRS. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report was reviewed with Martha Reyes (DFR) in person and Licensee Madonna Martinez by phone and and Appeal rights were given.