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Type of visit: Case Management - Annual Continuation

On 08/09/2023, Licensing Program Analysts Walton and Flores arrived unannounced to conduct a case management - annual continuation inspection. LPAs introduced themselves, stated the purpose of the visit and were granted entry to the facility. Facility staff contacted Administrator, Luz Newell-Parangalan, who arrived a short time later. During today's visit LPAs reviewed resident medications and personnel records. Upon entry to the facility, LPAs observed medication, that had been pre-poured into a dispensing cup, placed on the table near a R1. The medication was meant for R2. Per facility staff, R2 "was on the way" to the dining table. Review of medication revealed that the facility has been administering over-the-counter medication to residents in care. Administrator was unable to provide a physician's order prescribing the medications to residents. Review of personnel files revealed that staff have not received annual training. Deficiencies are being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. Exit interview conducted and a plan of correction was reviewed and developed with Administrator. A copy of this report and appeal rights were discussed and provided to Administrator, Luz Newell-Parangalan, whose signature on this form confirms receipt of these documents. LPAs are requesting the following documents be submitted to the Fresno CCL office by 08/23/2023: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E ) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond**the state’s words, verbatim · CDSS document, Aug 9, 2023

Type of visit: Required - 1 Year

On 07/19/2023, Licensing Program Analyst (LPA) Walton arrived at the facility unannounced to conduct an Annual Required Inspection. LPA introduced self, stated the purpose of the visit and was allowed entry to the facility by facility staff. Facility staff contacted Licensee, Larry Newell, who arrived a short time later. LPA conducted a tour inside and outside of facility. Facility observed to be clean, odor free and at a comfortable temperature. Common areas were furnished well with adequate seating and lighting available. LPA observed furniture blocking the exit in the living room near the main entrance. Resident rooms appeared clean and had required furnishings. LPA observed chair blocking the exit in bedroom 3, facility staff moved the chair during the inspection. LPA observed an adequate supply of linen. Resident bathrooms were properly equipped with securely fastened grab bars in toilet and shower areas, non-skid mats were observed. LPA observed a bottle of disinfectant under the sink in bathroom 2, facility staff removed the bottle and placed the bottle in a locked cabinet.. Hot water measured at 112.4 degrees F in bathroom 1 and 109.7 degrees F in bathroom 2. Kitchen toured, appeared clean. Upon entry to the facility, LPA observed multiple knives on top of container in the kitchen, facility staff removed the knives and placed the knives in a locked cabinet. LPA observed an adequate food supply. Exterior tour conducted, LPA observed various equipment on the patio blocking an exit leading to the living room near the main entrance. Side gate was observed to be self-latching. Fire extinguisher serviced on 08/15/2022. Smoke detectors and carbon monoxide detectors observed operational during today’s inspection. Last fire drill conducted in April 2022. LPA reviewed resident records. LPA will return at a later date to review medications and personnel files. Deficiencies are being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. Exit interview conducted with Licensee. A copy of this report and appeal rights were discussed and left with Licensee, whose signature on this form confirms receipt of these documents.the state’s words, verbatim · CDSS document, Jul 19, 2023

Type of visit: Case Management - Other

On 11/18/22 at 8:00 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a case management - other inspection. LPA explained reason for inspection and was granted entry into the facility. Licensees Larry and Luz Newell arrived a short time later. LPA returned to verify correction for deficiency CCR 87303(a) issued on 10/7/22 with a Plan of Correction (POC) due date of 10/28/22. LPA observed new lock installed for door to garage requiring use of a key from the interior of the facility (kitchen) to be able to access the garage. LPA observed all excess furniture, medical equipment, and miscellaneous items from area outside on north side of facility had been removed. POC cleared. During this inspection, LPA observed the following deficiencies: 1. S1 does not have a completed transfer of criminal record clearance. S1 was present and working. S1 has been working in the facility since 11/3/22 and has worked three days. 2. S2 did not have fingerprint criminal clearance and was present and working. S2 advises this is S2's first day of work and had not yet started the fingerprint clearance process. Deficiencies are being cited based on LPA observations, interviews, and record review in accordance with the California Code of Regulations, Title 22, see LIC809Ds. Civil penalties are being assessed in the amount of $100 per day for S1, for 3 days, and in the amount of $100 per day for S2, for 1 day, for a total of $400. See LIC421BG for more details. A civil penalty is being assessed for a repeat violation within 12 months for CCR 87355(e)(2) in the amount of $1000. See LIC421IM for more details. Exit interview conducted and Plan of Corrections were reviewed and developed with Licensee Luz Newell. A copy of this report and appeal rights were given to Licensee Luz Newell, whose signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Nov 18, 2022

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Nov 19, 2022

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working... (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or This requirement is not met as evidenced by: S1 does not have a completed transfer of criminal record clearance. S1 was present and working. S1 has been working in the facility since 11/3/22 and has worked three days which poses an immediate health, safety, or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Nov 18, 2022

Plan of correction: Licensee will submit written plan about changes Licensee will make to ensure transfer of criminal record clearances are completed before working new staff to CCL by POC due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87355(e)(1) · Plan of correction due date: Nov 19, 2022

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working... (1) Obtain a California clearance or a criminal record exemption as required by the Department or This requirement is not met as evidenced by: S2 did not have fingerprint criminal clearance and was present and working. S2 advises this is S2's first day of work and had not yet started the fingerprint clearance process. This poses an immediate health, safety, or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Nov 18, 2022

Plan of correction: Licensee will submit written plan of using checklist to ensure new staff is being processed for criminal record clearance prior to working and include checklist, to CCL by POC due date.

Type of visit: Case Management - Other

On 10/7/22 at 8:20 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a case management inspection. LPA explained reason for inspection and was granted entry by staff. Licensee Larry Newell and Licensee/Administrator Luz Newell-Parangalan arrived an hour later. LPA returned to inspect the facility for correction of deficiencies CCR 87303(a) and 87307(d)(6) issued during an annual inspection on 8/12/22. LPA observed both baby gates were removed. LPA observed hallway and master bathroom tile shower walls and floors cleaned, sliding screen doors for both master bedroom and living room replaced, pull chain installed for exterior fire exit gate, and excess electric cords in dining room were secured. The following deficiencies were observed: 1. S1 did not have a completed transfer of criminal record clearance. S1 was present and working. S1 has been working in the facility since 9/20/22. 2. Blender blade still in blender on counter and one steak knife observed in kitchen sink and accessible. 3. Excess furniture, medical equipment, and miscellaneous items observed stored in area outside on the north side of the facility and also in the garage. Deficiencies are being cited based on LPA observations, interviews, and record review in accordance with the California Code of Regulations, Title 22, see LIC809Ds. A civil penalty is being assessed in the amount of $100 per day, for a maximum of 5 days, for a total of $500. See LIC421BG for more details. Exit interview conducted and Plan of Corrections were reviewed and developed with Administrator Luz Newell. A copy of this report and appeal rights were given to Administrator Luz Newell, whose signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Oct 7, 2022

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87533(e)(2) · Plan of correction due date: Oct 8, 2022

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working... (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or This requirement is not met as evidenced by: S1 did not have a completed transfer of criminal record clearance, S1 was present and working, S1 has been working in the facility since 9/20/22, which poses an immediate health, safety, or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Oct 7, 2022

Plan of correction: Licensee removed S1 from the facility. Licensee will submit written statement that the facility will not have staff work in the facility until the LIC9182, LIC508, and copy of proper ID is submitted to CCL and confirms completion of criminal record clearance or transfer of criminal record clearance is completed on Guardian website, to CCL by POC due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87309(a) · Plan of correction due date: Oct 7, 2022

87309 Storage Space (a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Blender blade observed still in blender on counter and one steak knife observed in kitchen sink and accessible, which poses an immediate safety or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Oct 7, 2022

Plan of correction: Licensee immediately removed and made blender with blades and steak knife inaccessible. POC cleared during inspection.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Oct 28, 2022

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Excess furniture, medical equipment, and miscellaneous items observed stored in area outside on the north side of the facility and also in the garage, which poses a potential health, safety, or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Oct 7, 2022

Plan of correction: Licensee states a new lock will be installed for the door to garage so that entry from kitchen will not be accessible without a key and Licensee will remove all excess furniture, medical equipment, and miscellaneous items from area outside on north side of facility by POC due date. LPA will return for POC visit.

Type of visit: Required - 1 Year

On 8/12/22 at 10:30 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection and was granted entry by staff. Administrator Luz Newell and Licensee Larry Newell arrived about 30 minutes later. LPA toured inside and outside of facility. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common and dining areas. Hand washing posters were observed by the bathroom sinks. Bedrooms were checked and no residents share a room. LPA checked residents’ medications and observed the month's supply. Food supply was observed in adequate supply. Cleaning and PPE supplies were checked. Staff records were reviewed for good health. Administrator certification is valid. The following deficiencies were observed: 1. Fire extinguishers were last serviced 9/21/2020. 2. LPA observed a rusted shovel outside by fire exit gate; a shovel inside garage by side exit door; a steak knife and a pair of scissors on kitchen counter; hall closet where toilet cleaner, a can of Comet cleaner, a bottle of cleaner, and a can of disinfecting spray was unlocked and accessible; a bottle of Pine Sol cleaner, spray bottle of cleaner, bottle of toilet cleaner, and can of tung oil finish were observed accessible and sitting on top of washing machine in laundry area that was accessible; and an open can of Comet cleaner, spray bottle of cleaner, large bottle of weed killer, bottle of stain odor remover, and a bottle of charcoal lighter fluid was observed accessible in garage. 3. LPA observed an open can of Comet cleaner, two large bottles of Pine Sol cleaner, a bottle of charcoal lighter fluid, and a spray bottle of cleaner stored in open area below a small table in garage where several bags of spaghetti, a medium sized plastic container filled with white rice, and several canned food items were kept. Continue on LIC809-C. Continued from LIC809. 4. Six bottles of prescribed medications were observed accessible on top of kitchen counter. 5. LPA observed hallway and master bathroom tile shower walls and floors with mold and soap scum, sliding screen doors for both master bedroom and living room observed in disrepair and not sliding with ease, molded lemons and tomatoes observed in bottom drawer in refrigerator, fire exit gate observed with stiff metal wire as pull chain, excess electric cords in dining room strewn about in fireplace corner, and excess furniture, medical equipment, mattresses, and miscellaneous items observed in back patio and in garage. 6. Baby gate is installed between dining room and kitchen, and passageway between foyer and kitchen. Treadmill observed stored in passageway between foyer and kitchen. 7. On 6/28/22, all four residents tested positive for COVID-19 and the Administrator did not submit an incident report to CCL. Deficiencies are being cited based on LPA observations and interviews in accordance with the California Code of Regulations, Title 22, see LIC809Ds. The following documents are to be submitted to CCL within the next 2 weeks: LIC308 LIC500 LIC610E An exit interview was conducted and Plans of Corrections were reviewed and developed with the Licensee. A copy of this report and appeal rights were discussed and given to Administrator Luz Newell, whose signature on this form confirms receipt of this report and these documents.the state’s words, verbatim · CDSS document, Aug 12, 2022

The state marks this report as 14 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 7/27/21 at 9:00 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA was greeted by staff and granted entry. Licensee (LIC) Larry Newell and Administrator Luz Newell-Parangalan arrived an hour later. Facility was observed clean and without any obstructions or fire clearance issues. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common and dining areas. Hand washing posters were observed by the bathroom sinks. Bedrooms were checked and no residents share a room. LPA checked residents’ medications and observed the month's supply. Food supply was observed in adequate supply. Cleaning and PPE supplies were checked. Staff records were reviewed for good health. Residents files have updated emergency contact information. Administrator certification is valid. No deficiencies cited during inspection. Exit interview was conducted. A copy of this report was emailed to Administrator Luz Newell-Parangalan at luznewell1@aol.com with read receipt to confirm receipt of this report.the state’s words, verbatim · CDSS document, Jul 27, 2021

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.