Follow-up on corrections·August 24, 2022

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced at the facility to deliver complaint findings and also issue a citation for a deficiency discovered during the course of a recent complaint investigation. LPA met with Kimberly Hagen, Administrator, and explained purpose of inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols and completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and confirmed there are currently multiple positive Covid cases at the community. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. During the investigation of complaint #25-AS-20220426122233, the Department reviewed documentation entitled "Secured Environment Addendum" for resident (R1) and observed it to be signed by resident's Power of Attorney on 2/25/2022. LPA discussed the document with facility Administrator, Memory Care Director and POA during a phone conference on 4/29/22 and that it does not include resident's signature. Resident's POA stated that resident clearly knew she was moving into a facility with a secured environment and was rejected for Assisted Living. The facility was previously cited on 2/23/2018, for the same deficiency, under Health and Safety Code § 1569.698 (f) which reads : Any person who is not a conservatee and is entering a locked or secured perimeter facility pursuant to this section shall sign a statement of voluntary entry. The facility shall retain the original statement and shall send a copy of the statement to the department. Per California Code of Regulations, Title 22, Division 6, Chapter 8, the following (1) deficiency is cited on the 809-D page. Exit interview. Copy of report and appeal rights provided to the Administrator.