Health check·July 31, 2021

7/31/21 at 11:00 AM Licensing Program Analyst (LPA) Jaclyn Avila arrived at the facility unannounced to conduct a case management regarding staffing. LPA met with Executive Director Eric Perry, Administrator Darren Trisal and explained the purpose of the visit. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted administrator and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Mask. LPA completed facility screening Currently, there are 2 staff scheduled for day shift, 2 scheduled for PM shift and 1 scheduled for night shift. Per ED, this is normal staffing, the difference is that he is filling shifts and there is no cook. Food is being transported from Roseleaf Gardens to Roseleaf Senior Care. Currently there is not a designated activities person and scheduled activities are taking place twice a week. Activities are not posted. ED has reached out to local registries to assist with staffing to no unveil. LPA confirmed ADLS of residents are being met. At 1:07 PM, LPA walked into the common area of the facility where residents were sitting after their lunch. LPA noted that the kitchen door was left open and did not observe staff in the kitchen or in the common area with 8 residents. Accessible to residents in care were 7 knives. 1 knife was left on the counter top just to the left as you enter into the kitchen. The remainder of the knives were on a magnetic board above the gas stove. At 1:27 PM, LPA observed that staff had not returned to the area and the knives were still accessible. LPA knocked on the administrator's office door which was closed and retrieved Administrator Darren Trisel to advise him. Darren immediately locked up the kitchen making the knives inaccessible. The facility will provide the LIC 500 (personnel roster) to Community Care Licensing (CCL) by 6:30 PM today (7/31/21). The facility will immediately e-mail CCL with any changes to the staff schedule. If there is a call out, the facility will e-mail CCL and notify CCL as to what their plan is to fill the shift. These updates will take place until further notice. On 7/30/21, CCL held a meeting with Peer Services INC regarding staffing. CCL cannot grant a waiver or exception to the following regulation: 87224 Eviction Procedures- (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5) Change of use of the facility. (A) The licensee may, upon no less than sixty (60) days written notice, evict a resident due to change of use of the facility. 1. In addition to written notice to quit requirements specified in Section 87224(d), written notice to evict due to change of use of the facility shall be made to the resident or the resident’s responsible person and shall include all requirements specified in Section 1569.682(a)(2)(A) through (F) of the Health and Safety Code. Administrator Darren Trisal is requesting it be documented that he will be appealing administrator qualifications. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted and appeal rights provided.