Complaint Investigation Report

157209516-5-13-2026-24-AS-SMOA-DUBLAF-20260522083500

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

This is an official report of an unannounced visit/investigation of a complaint received in our office on

04/21/2026 and conducted by Evaluator Melinda Medina

COMPLAINT CONTROL NUMBER: 24-AS-20260421083453

Staff are not addressing pests at facility

Staff did not prevent resident from smoking while residents use oxygen

Staff do not maintain facility in good repair

Staff do not ensure that residents care needs are met

On 5/13/26 Licensing Program Analysts (LPAs) M. Medina and M. Garza arrived at the facility for an unannounced complaint visit. LPAs met with Activities Director, Taylor Lloyd who contacted, Administrator Brittany Kavanaugh by telephone to advise of complaint visit. Wellness Director, Elizabeth Vasku arrived a short time later ton also conduct visit. Residents were observed in common areas and in their rooms.

During subsequent visit, LPAs conducted additional interviews. Facility provided documentation showing pest control provided treatment in two phases, conducted 2 weeks apart for resident 1's (R1s) room. Facility provided documentation of occurrences with R1 for smoking in unauthorized areas. R1 was provided redirection to the designated smoking area and resident signed acknowledgement for resident smoking policy. Facility had an incident on 4/16/26, for a smell of burning in facility. The fire department was dispatched and facility was cleared with no fires. Invoice provided from the electrician observed no electrical problems at the time of visit. On 4/22/2026, facility ordered 10 additional pendants and 2 walkie-talkies for residents in care. During interviews, it was stated that staff 1 was terminated in February 2026 after complaints of care from both residents and staff.

Although the allegation may or may not have occurred the preponderance of evidence standard has not been met per California Code of Regulations, Title 22. The allegations listed above are UNSUBSTANTIATED. No deficiencies cited during todays visit.

Exit interview completed with Wellness Director, Elizabeth and Administrator, Brittany via telephone. A copy of this report provided.