Complaint·November 5, 2024

Facility is not adhering to infection control plan: The allegation is that a home care nurse did not receive a notice of 2 resident and 1 staff with COVID positive in the facility until he/she visited the facility on 2/8/2024, at 9:15AM, and observed 2 staff without wearing masks and were not adhering to infection control plan. On 2/15/2024, LPA visit the facility and interviewed Administrator (ADM) Amparo Que Garcia. ADM stated resident R1 tested COVID positive on 2/4/2024 and resident R2 tested positive on 2/5/2024. ADM stated R1 and R2 were isolated at their private rooms. ADM stated staff S1 tested negative and S2 tested positive on 2/5/2024. ADM stated S1 only takes care of COVID negative residents and S2 only takes care of COVID positive residents. ADM stated he/she notified local health department and CCL office. ADM stated he/she notified resident families and affected residents' family doctors. ADM stated he/she encouraged visitors not to visit the facility if not necessary. ADM stated on 2/9/2024, S2 was tested COVID negative and R1 and R2 were tested COVID negative on 2/12/2024. LPA interviewed staff S1. S1 stated he/she only takes care of COVID negative residents during the facility COVID period. LPA interviewed staff S2. S2 stated he/she only takes care of COVID positive residents during the facility COVID period. S2 stated he/she was wearing PPE when he/she entered R1 and R2's rooms. During LPA visit, LPA observed S1, S2 and ADM were wearing masks. LPA observed the COVID screening station with visitor log, mask, and thermometer in the main entrance. LPA checked the facility PPE supplies, and PPE supplies were observed sufficient. LPA interviewed resident R1. R1 just listened to LPA's questions but was unable to answer LPA's question. LPA interviewed resident R2. R2 stated facility staff took care of him/her during his/her COVID positive period but was unable to tell the name of the staff. Continue on LIC9099-C. Page 2 of 3. Based on the record reviewed, the facility notified CCL office on the phone on 2/7/2024 and sent the incident report to CCL office on 2/7/2024. Based on the observation, interview, and records reviewed, no evidence to indicate the facility is not adhering to infection control plan. Facility did not notify residents' family and other agencies of current covid outbreak: On 2/15/2024, LPA interviewed Administrator (ADM). ADM stated he/she notified CCL office and local health department. ADM stated he/she notified residents families for the COVID positive cases in the facility. ADM stated the facility notified visitors, including home heath nurse, not to visit the facility if not necessary. LPA interviewed 4 residents. 2 out 4 residents did not know the facility had COVID cases. On 2/19/2024, LPA interviewed 2 families of residents. 1 Out of 2 stated the facility notified him/her, the other one stated the facility did not notified him/her of the facility COVID positive cases. Based on the records reviewed, On 2/7/2024, two LPAs spoke with ADM and instruct ADM to notified local health department, and ADM stated he/she will notified local health department. On 2/7/2024, CCL office received the facility incident report of 3 COVID positive cases at the facility. Based on documents reviewed, observation, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation did or did not occur. No citations noted for today’s visit. Exit interview was conducted with ADM. A copy of this report was provided to ADM. Page 3 of 3.