Follow-up on corrections·September 7, 2023

On 9/7/23, Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced to conduct a case management visit. LPA met with facility representative Steve Sarine and explained the purpose of the visit. The purpose of the case management visit is to follow up on deficiencies found during a complaint investigation conducted by the Department for complaint dated 9/19/2022, control number: 27-AS-20220919221525 The following deficiencies were identified during the complaint investigation: - Personal Rights - Staff blocked resident (R1’s) doorway with a couch to prevent resident from leaving. This incident was witnessed by facility staff. - Administrator Qualifications - The designated administrator (A1) did not act in their capacity as the Administrator. A1 told the Department that he was hired as a consultant and was working in the facility only until designated administrator (A2) could obtain their Administrator certificate. On 8/4/22, during a non-compliance meeting, A1 was designated as the facility administrator. - Basic Services - Facility did not provide adequate supervision which resulted in R1 sustaining multiple injuries from falls. During the investigation, (A1) stated that the private care agency will provide all the care and supervision to the resident, however per Department guidelines, private agencies are only allowed to provide companion services not care and supervision. Continued on 809-C - Plan of Operation - Observation of resident change in condition, bruises, prohibited condition. Per facility’s Plan of Operation which stated that a condition of combative, dangerous behavior or the inability to get along in a congregate setting is prohibited and would make the resident inappropriate for admission/move in. During the investigation, it was learned that R1 has displayed aggression towards staff on multiple occasions. Moreover, R1’s Physician’s Report also stated that R1 has behavioral disturbance and aggressive condition. As a result, deficiencies were cited on LIC 809-D pursuant to the California Code of Regulations, Title 22, and California Health and Safety Code. An exit interview was conducted, a copy of this report, LIC 809-D and appeal rights were provided. Failure to correct any deficiencies by plan of correction due date(s) may result in civil penalties.