Follow-up·September 16, 2022

Licensing Program Analyst (LPA) Fernandes-Goes arrived unannounced with the purpose of closing a complaint investigation. During subsequent complaint investigation LPA learned that there are related deficiencies observed during the visit. LPA met with Blaine Lyons - Acting Executive Director. Following item were observed during investigation visits: Department has learned after alarm records review that facility alarm system on 2/17/2022 show that from 100 % of calls 22 % were answered in a time frame of 10 to 29 min and 9.6 % of calls took 30 min to 1 hr 18 min to be answered. Facility on 2/17/2022 had according to records provided by facility 102 Assisted Living residents'. Acting Executive Director email stated that facility had 1 medication technician and 3 agency care staff. However, facility records show that there were only 3 staff on NOC shift counting medication technician and after 4 AM only one staff on shift. (copy of records on file) Records show that call bell alarms in Assisted Living were not answered in a timely matter to ensure that residents' needs were meet. (see LIC 809-D) During visit to facility on 8/1/2022 Department reviewed residents' and staff files and learned that 4 out of 4 residents' files have no updated care plan as required by Title 22 Regulations. Residents R1 & R2 have a diagnosis of dementia and care plans dated 7/25 and 3/16/2021 while residents R3 no care plan found – only has a pre-assessment which dates 10/12/2020 & R4 has a care plan in progress that dated 11/9/2018. In addition, resident R4 has a physical assessment (LIC 602) dated 3/31/2021 however; it is not signed. (see LIC 809-D) Continued 809-C Regarding staff files review, 3 out of 3 staff don’t have proof of enough training according to Health & Safety Code requirements. Staff S1 was hired on 3/2/2021 with no proof of medication training under this facility, CPR, and/or 1 st Aid – only documentation is a Med Tech training from 2016 under facility Nazareth Fairfield. Staff S2 was hired on 11/25/2020 and has proof of a total of 11.5 hours training between 11/26/2020 and 9/29/2021, no proof of CPR and/or 1 st Aid certification. Staff S3 has no proof of training or file at facility. (see LIC 809-D) Timecard for staff S3 was submitted to the Department, however; facility has no file and staff is not associated to the facility. According with a week timecard submitted staff S3 worked on 2/13/2022 and 2/17/2022. (see LIC 809-D, Civil Penalties) In addition, none of the staff mentioned above has criminal record statement on file (see LIC 809-D), and staff names from agency that were provided to the Department by Acting Executive Director had only first names. Department wasn’t able to review fingerprint clearance, association, and/or training for these individuals. Immediate Civil Penalties are being assessed in the amount of $200 due to staff not being associated to the facility. *****Total Civil Penalties issued today in the amount of $200.00. Appeal of Rights Given. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.