Inspection Reports for The Fountains Skilled Nursing Care

CA, 95991

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Inspection Report Summary

Most inspections found no deficiencies, reflecting a generally compliant facility with appropriate infection control, safety measures, and resident care practices. Several complaint investigations were unsubstantiated, including allegations of inadequate supervision, improper staff conduct, and facility disrepair. The one substantiated deficiency occurred in August 2025 when a medication error was reported involving a substitute technician giving medication to the wrong resident; this was addressed with staff training and improved procedures, and no harm resulted. The most recent report from September 4, 2025, was a complaint investigation that found no deficiencies and unsubstantiated allegations. Overall, the facility’s record shows mostly consistent compliance with isolated issues related to medication management that have been addressed.

Deficiencies (last 5 years)

Deficiencies (over 5 years) 0.2 deficiencies/year

Deficiencies are regulatory violations found during state inspections.

95% better than California average
California average: 4 deficiencies/year

Deficiencies per year

4 3 2 1 0
2021
2022
2023
2024
2025

Census

Latest occupancy rate 70% occupied

Based on a September 2025 inspection.

This facility has shown a steady increase in demand based on occupancy rates.

Census over time

0 20 40 60 80 100 Feb 2021 Jul 2022 Dec 2022 Jan 2024 Aug 2025 Sep 2025

Inspection Report

Complaint Investigation
Census: 56 Capacity: 80 Deficiencies: 0 Date: Sep 4, 2025

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that facility staff did not provide adequate supervision to a resident in care and did not seek medical attention in a timely manner.

Complaint Details
The complaint investigation was unsubstantiated regarding inadequate supervision and unfounded regarding failure to seek medical attention in a timely manner. The findings concluded there was no preponderance of evidence to prove the alleged violations occurred.
Findings
The investigation found that the facility staff checked on the resident at least every two hours and contacted hospice regularly regarding the resident's condition. The written plan of care required frequent checks but did not specify exact frequency. There was insufficient evidence to prove the allegations; therefore, both allegations were found to be unsubstantiated or unfounded.

Report Facts
Capacity: 80 Census: 56

Employees mentioned
NameTitleContext
Kerry HiratsukaLicensing Program AnalystConducted the complaint investigation and authored the report
Brandy StrahlAdministratorFacility administrator met during the investigation
Troy OrdonezLicensing Program ManagerNamed as Licensing Program Manager on the report

Inspection Report

Complaint Investigation
Census: 54 Capacity: 80 Deficiencies: 1 Date: Aug 19, 2025

Visit Reason
An unannounced complaint investigation was conducted due to an allegation that staff mismanaged residents' medication.

Complaint Details
The complaint alleging staff mismanagement of residents' medication was substantiated based on the preponderance of evidence.
Findings
The investigation found that a substitute medication technician accidentally gave medication intended for one resident to another resident with the same first name. The incident was immediately reported and investigated, with no ill effects to the resident. Refresher training for staff and methods to flag residents with the same names were planned.

Deficiencies (1)
Failure to develop and implement a plan for incidental medical and dental care, resulting in a medication pass error posing an immediate health and safety risk to a resident.
Report Facts
Capacity: 80 Census: 54 Deficiency count: 1 Plan of Correction Due Date: Aug 20, 2025

Employees mentioned
NameTitleContext
Kerry HiratsukaLicensing Program AnalystConducted the complaint investigation and authored the report
Brandy StrahlAdministratorFacility administrator interviewed during investigation and responsible for corrective actions
Troy OrdonezLicensing Program ManagerOversaw licensing program and signed report

Inspection Report

Annual Inspection
Census: 54 Capacity: 80 Deficiencies: 0 Date: Jan 22, 2025

Visit Reason
Licensing Program Analysts arrived unannounced to conduct an annual inspection to ensure compliance with Title 22 regulations.

Findings
The inspection found the facility compliant with no deficiencies cited. The facility had adequate food supplies, operational safety detectors, secured medication storage, and reviewed resident and staff files.

Report Facts
Resident rooms: 54 Perishable food supply: 2 Non-perishable food supply: 7 Resident files reviewed: 5 Staff files reviewed: 4

Employees mentioned
NameTitleContext
Brandy StrahlAdministratorMet with Licensing Program Analysts during inspection
Cassandra MikkelsonLicensing Program AnalystConducted the annual inspection
Kerry HiratsukaLicensing Program AnalystConducted the annual inspection

Inspection Report

Monitoring
Census: 56 Capacity: 80 Deficiencies: 0 Date: Nov 14, 2024

Visit Reason
This unannounced case management visit was conducted in response to the facility submitting a death report.

Findings
The licensing program analyst obtained a copy of some documents from the resident's file. No deficiencies were cited during this visit.

Employees mentioned
NameTitleContext
Brandy StrahlAdministrator/DirectorMet with during the inspection visit
Kerry HiratsukaLicensing Program AnalystConducted the unannounced case management visit
Troy OrdonezLicensing Program ManagerNamed in the report

Inspection Report

Annual Inspection
Census: 56 Capacity: 80 Deficiencies: 0 Date: Jan 17, 2024

Visit Reason
This was an unannounced annual visit conducted as a required one-year inspection of the facility.

Findings
The inspection found no deficiencies. Several staff and resident files were reviewed, and multiple topics were discussed during the visit.

Report Facts
Resident rooms: 54

Employees mentioned
NameTitleContext
Brandy StrahlAdministratorMet with during the inspection and toured the facility

Inspection Report

Complaint Investigation
Census: 56 Capacity: 80 Deficiencies: 0 Date: Sep 27, 2023

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that staff forced a resident to take medication.

Complaint Details
The complaint alleged that staff forced a resident to take medication. The investigation found conflicting statements between staff and resident regarding medication administration, resulting in an unsubstantiated finding.
Findings
The Licensing Program Analyst conducted interviews and reviewed medication records but could not prove or disprove the allegation due to conflicting accounts. The allegation was found to be unsubstantiated due to lack of preponderance of evidence.

Report Facts
Capacity: 80 Census: 56

Employees mentioned
NameTitleContext
Kerry HiratsukaLicensing Program AnalystConducted the complaint investigation
Troy OrdonezLicensing Program ManagerNamed in report as Licensing Program Manager

Inspection Report

Complaint Investigation
Census: 56 Capacity: 80 Deficiencies: 0 Date: Sep 27, 2023

Visit Reason
Unannounced complaint investigation visit conducted due to a complaint received on 2023-08-25 alleging that staff spoke inappropriately to a resident.

Complaint Details
The complaint alleged that staff spoke inappropriately to a resident. The allegation was investigated and found to be unsubstantiated.
Findings
The investigation found that the staff denied any ill intent and the resident felt humiliated by the staff's loud and boisterous voice. No witnesses could be contacted, and the Licensing Program Analyst was unable to prove or disprove the allegation. The allegation was found to be unsubstantiated due to lack of preponderance of evidence.

Employees mentioned
NameTitleContext
Kerry HiratsukaEvaluator / Licensing Program AnalystConducted the complaint investigation and authored the report.
Brandy StrahlAdministratorNamed as facility administrator.
Jamie ScottMet with during the investigation.
Troy OrdonezLicensing Program ManagerNamed in report signature section.

Inspection Report

Complaint Investigation
Census: 57 Capacity: 80 Deficiencies: 0 Date: Mar 23, 2023

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint alleging that staff caused a resident to fall while in care and that the facility does not have backup emergency services for residents.

Complaint Details
The complaint investigation was unannounced and conducted by Evaluator Kerry Hiratsuka. The allegation that staff caused a resident to fall was unsubstantiated due to insufficient evidence. The allegation that the facility lacks backup emergency services was found to be unfounded as the facility has appropriate emergency plans and procedures.
Findings
The investigation found the allegation that staff caused a resident to fall while in care to be unsubstantiated due to conflicting accounts and lack of evidence. The complaint regarding lack of backup emergency services was found to be unfounded as the facility has a written emergency plan and complies with regulations.

Report Facts
Capacity: 80 Census: 57

Employees mentioned
NameTitleContext
Kerry HiratsukaEvaluator / Licensing Program AnalystConducted the complaint investigation and authored the report
Carol PickardAdministratorFacility administrator mentioned in the report
Brandy StrahlPerson met with during the investigation
Lauren CrockerLicensing Program ManagerNamed in the report as Licensing Program Manager

Inspection Report

Annual Inspection
Census: 54 Capacity: 80 Deficiencies: 0 Date: Dec 20, 2022

Visit Reason
This was an unannounced annual inspection visit conducted as a required one-year evaluation of the facility.

Findings
The inspection found no deficiencies. The facility was observed to have appropriate infection control measures with staff wearing surgical masks, and the physical environment was described in detail.

Report Facts
Resident rooms: 54 Restrooms: 2

Inspection Report

Complaint Investigation
Census: 54 Capacity: 80 Deficiencies: 0 Date: Dec 16, 2022

Visit Reason
The visit was an unannounced complaint investigation conducted in response to a complaint received on 2022-09-22 alleging multiple issues including improper staff training, unattended residents, untimely response to alerts, retention of residents needing higher care, uncomfortable accommodations, and forced early sleeping.

Complaint Details
The complaint investigation was unannounced and addressed allegations of improper staff training, unattended residents, untimely response to alerts, retention of residents requiring higher care, uncomfortable accommodations, forced early sleeping, denial of restroom use, lack of privacy, residents left soiled, falls, and delayed medical attention. The findings determined the allegations were unfounded or unsubstantiated due to lack of evidence and interviews.
Findings
The investigation found all allegations to be unfounded or unsubstantiated. Staff training met requirements, residents and staff interviews indicated no issues with supervision or care, and no evidence supported the complaint allegations.

Report Facts
Capacity: 80 Census: 54

Employees mentioned
NameTitleContext
Carol PickardAdministratorFacility administrator met during the investigation
Kerry HiratsukaLicensing Program AnalystEvaluator who conducted the complaint investigation
Troy OrdonezLicensing Program ManagerManager overseeing the complaint investigation

Inspection Report

Census: 54 Capacity: 80 Deficiencies: 0 Date: Nov 2, 2022

Visit Reason
This unannounced case management visit was conducted in response to an incident reported to the Licensing Program Analyst (LPA) while conducting an annual inspection at the sister facility. The visit addressed the evacuation of the facility due to smoke in the building earlier that morning.

Findings
The facility was evacuated at approximately 6:30 AM due to smoke, with residents outside for about fifteen minutes. The fire department cleared the building for re-occupation, and all residents returned inside. The licensee's engineering staff checked and cleared the building, and emergency evacuation procedures were properly conducted. No residents or staff were injured during the evacuation. No deficiencies were cited.

Report Facts
Evacuation duration (minutes): 15 Time of evacuation: 630

Employees mentioned
NameTitleContext
Carol PickardAdministratorMet with during the visit and mentioned in the incident report
Kerry HiratsukaLicensing Program AnalystConducted the unannounced case management visit
Troy OrdonezLicensing Program ManagerNamed in the report header

Inspection Report

Census: 51 Capacity: 80 Deficiencies: 0 Date: Jul 13, 2022

Visit Reason
The visit was an unannounced Case Management - Incident visit conducted in response to an incident reported by the Director of Assisted Living Services regarding a resident who died unexpectedly on 2022-07-06.

Findings
The Licensing Program Analyst discussed the incident with the facility representative and determined that no extra documentation was required at this time, but further investigation is needed. No deficiencies were cited during the visit.

Employees mentioned
NameTitleContext
Carol PickardDirector of Assisted Living ServicesReported the incident of a resident's unexpected death.
Kerry HiratsukaLicensing Program AnalystConducted the unannounced Case Management visit.
Troy OrdonezLicensing Program ManagerNamed in the report header.

Inspection Report

Annual Inspection
Census: 22 Capacity: 80 Deficiencies: 0 Date: Jan 4, 2022

Visit Reason
The inspection was an unannounced Required-1 Year Inspection focusing on the infection control domain as part of the annual case management continuation.

Findings
The facility was found to be in substantial compliance with no immediate health, safety, or personal rights violations observed. No deficiencies were cited as a result of the inspection.

Employees mentioned
NameTitleContext
Carol PickardAdministratorMet with Licensing Program Analyst during inspection and involved in infection control domain review.
Dawn KeaneLicensing Program AnalystConducted the inspection and infection control domain review.

Inspection Report

Annual Inspection
Census: 48 Capacity: 80 Deficiencies: 0 Date: Dec 22, 2021

Visit Reason
The inspection was an unannounced Required-1 Year Inspection focusing on the infection control domain to ensure health and safety compliance at the facility.

Findings
The facility was found to be in substantial compliance with no immediate health, safety, or personal rights violations observed. No deficiencies were cited as a result of the inspection.

Employees mentioned
NameTitleContext
Carol PickardAdministratorMet with Licensing Program Analyst during inspection and involved in infection control domain completion.
Dawn KeaneLicensing Program AnalystConducted the Required-1 Year Inspection and infection control domain evaluation.
Rayna L BrysonLicensing Program ManagerNamed as Licensing Program Manager on the report.

Inspection Report

Complaint Investigation
Census: 48 Capacity: 80 Deficiencies: 0 Date: Feb 23, 2021

Visit Reason
An unannounced complaint investigation was conducted following a complaint received on 12/18/2020 regarding the facility being in disrepair.

Complaint Details
The complaint alleged that the facility was in disrepair. After investigation, the complaint was found to be unsubstantiated due to lack of preponderance of evidence.
Findings
The Licensing Program Analyst concluded that the complaint was unsubstantiated after interviews and investigation, finding no evidence of violations. No deficiencies were cited.

Report Facts
Capacity: 80 Census: 48

Employees mentioned
NameTitleContext
Misty ValenciaLicensing Program AnalystConducted the complaint investigation and concluded findings
Carol PickardAdministratorFacility administrator interviewed during investigation

Report

December 17, 2025

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Dec 3, 2025

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Mar 20, 2025

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Mar 20, 2025

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Mar 14, 2025

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Apr 20, 2023

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Mar 23, 2023

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Mar 21, 2023

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May 6, 2021

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