complaint·April 7, 2022

continuation of allegation: " Facility has an insect infestation." Administrator and staff interviews revealed that the cockroach infestation problem has been going on for months. Ms. Duenas stated that they were not able to contract pest control services due to COVID-19 pandemic. However, pest control service companies continued to provide services to facilities; except for incidence of active COVID-19 cases in the facility. Resident interviews were attempted, but due to cognitive impairment the residents were unable to be interviewed. All staff acknowledged the cockroach infestation. During today’s visit, LPA observed live cockroaches, and dead cockroaches throughout the facility in the pest baits. Allegation: “Foods are not properly stored.” The findings indicate that dry goods were observed to be stored in cockroach infested kitchen cabinets/storage areas. Holes in food packaging and evidence of cockroach consumption was observed. When staff was questioned by visitor about the observation the staff responded, “we do not use these cabinets.” Administrator stated the facility has different style of storing food. Staff interviews confirmed food packaging has been observed to be contaminated by cockroach infestation. LPA observed food storage in the garage, where there were cockroaches on the floor. Allegation: “Facility is storing expired food.” Based on interviews conducted the findings indicate that on 3/30/22, the facility had expired canned goods on the shelves. Administrator and staff confirmed that the facility had expired canned goods and stated that they may have been misplaced, but that residents are not given expired food. LPA o bserved canned goods in the kitchen counters and garage. The expired food cans have not been discarded yet. Allegation: “Facility is hazardous.” Based on observation and picture evidence the findings indicate that the wood ramp to enter the facility is warped and poses a tripping/fall hazard. Staff have placed a rug on top of the warped wood to prevent a tripping hazard. All staff acknowledged the disrepair of the ramp poses a tripping hazard. LPA observed and confirmed the ramp is a hazard to residents in care, staff, and visitors. Discarded bed springs and wheelchair was observed in the backyard. In addition, the facility floors were observed unswept, dirty, and not recently mopped; which poses potential health, See LIC 9099C for report continuation. Allegation: “Facility lawn is not maintained.” Based observation and picture proof evidence the findings indicate the front and backyard lawns are not maintained and may be a vector to additional infestation. The grass/weeds are overgrown. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. Staff acknowledged the lawns were not maintained because the gardener did not show up. Administrator stated the gardener visits twice a month. Allegation: “Medication cabinet is not locked.” On 3/30/2022 a visitor observed that the medication cabinet was not locked. Staff were asked multiple times to lock the medication cabinet, but staff refused, was not able to demonstrate the lock worked, or that they had a key to the medication storage. Administrator stated that it was unlocked because noon medications were going to be given out. Staff interviews confirmed the medication cabinet was unlocked on 3/30/22. During today's visit the cabinet was observed locked. LPA reviewed and provided a copy of regulation “Care of Persons with Dementia”. Due to cognitive impairment residents were not interviewed. Allegation: “Facility is utilizing full length bed rails for resident's that are not on hospice.” Based on interviews conducted the findings indicate that on 3/30/22, all resident beds had full-length bedrails that were not securely attached to the bed. Administrator stated there are currently no residents receiving hospice services. Therefore, under no circumstances shall bed rails that extend the entire length of the bed be used, except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. During today’s visit, LPA observed all beds had bedrails. One bed had a full length bedrail, and two beds had two half rails installed making it into a full rail. No physician orders are in place. Allegation: “Facility is not storing an adequate amount of food.” On 3/30/2022, a visitor did not observe two days’ worth of meals in fresh food. Per Title 22, supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. Staff stated that on 3/30/2022 they did not have much fresh food. LPA observed 2-day supply of food today. However, the two refrigerators were dirty. Based on observation, picture proof, and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED . Deficiencies are being cited according to California Code of Regulations, Title 22, Division 6. See LIC 9099D. Exit interview was conducted with Administrator Ana Duenas. A copy of the report and appeal rights were provided.