Bella Care Home

Allegation investigated: Staff is not properly trained Staff left resident in a wheelchair that was positioned in an unsafe manner

On 8/10/2022 Licensing Program Analyst (LPA) M. Garza arrived at facility to complete an unannounced complaint visit to deliver findings. LPA was COVID pre-screened at time of entry. Administrator was contacted and reason for visit was discussed. LPA completed a health and safety check on residents in care. Residents observed in common areas and in rooms. During investigation, LPA completed interviews with RP, staff and residents. LPA reviewed 4 of 4 staff files located at the facility. 4 of 4 files were not complete. LPA observed photo of R3 in an unsafe position in their wheelchair. Wheelchair was observed to be leaning on a chair with the front wheels of the wheelchair in the air. The allegations listed above are found to be SUBSTANTIATED based on LPA’s record reviews and observations. Per Title 22,the state’s words, verbatim · CDSS document, Aug 10, 2022 · control 24-AS-20211101082313

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87707(a)(2) · Plan of correction due date: Aug 19, 2022

87707 Training Requirements If Advertising Dementia Special Care, Programming And/Or Environments (2) Direct care staff shall complete at least eight hours of in-service training on the subject of serving residents with dementia within 12 months of working in the facility and in each succeeding 12-month period... This requirement was not met as evidence by: LPA's observation of 4 of 4 personnel files having incomplete training records. This posess a potential health and safety or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Aug 10, 2022

Plan of correction: Licensee stated training will be completed and record documentation will be updated and maintained accordingly. Licensee to provide updated records by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(d)(3) · Plan of correction due date: Aug 19, 2022

87411 Personnel Requirements - General (d) All personnel shall be given on the job training or have related experience in the job assigned to them...as evidenced by safe and effective job performance:(3) Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents. This requirement was not met as evidence by: LPA's observation of a picture provided during investigation. The picture showing R3 in a wheelchair leaning back with the wheels of the wheelchair in the air. This poses a potential health and safety or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Aug 10, 2022

Plan of correction: Licensee to provide training to all staff on regulations. A sign in sheet and training material to be provided to CCL by POC date.

Allegation investigated: Resident developed a pressure injury while in care Staff yelled at resident Staff did not assist resident with transfers Staff did not assist resident with toileting needs

On 8/10/2022 Licensing Program Analyst (LPA) M. Garza arrived at facility to complete an unannounced complaint visit to deliver findings. Administrator was contacted and arrived a short time later. Reason for visit was discussed. LPA completed a health and safety check on residents in care. Residents observed in common areas and in rooms. During investigation resident files, staff files, hospice records reviewed, and interviews were completed. Review of hospice records showed resident resided at a Skilled Nursing Facility (SNF) and hospital prior to being moved to facility. Records indicated R1 was on hospice at time of move in. Initial intake of resident by hospice showed resident having pressure injuries. LPA completed interviews with staff and residents. R2 stated, “staff spoke loudly but was never observed to be yelling at residents”. R2 reported “staff assisted R1”, “R1 would be in their motorized wheelchair, outside or in the living room watching TV”. CONT... Unsubstantiated Staff interviewed reported " R1 was a two person assist and if one staff were busy it could take a little longer to assist R1”. S1 and S2 both indicated R1 was able to state when they needed assistance and was able to toilet themselves once transferred. S1 and S2 stated that all of R2’s care needs were met. This allegations listed above are UNSUBSTANTIATED. No deficiencies cited during todays visit. Exit interview completed. A copy of this report was given.the state’s words, verbatim · CDSS document, Aug 10, 2022 · control 24-AS-20211101082313

Type of visit: Case Management - Other

On 8/10/2022 Licensing Program Analyst (LPA) M. Garza arrived at facility to complete a case management for a previous visit made on 11/04/21. LPA was COVID pre-screened at time of entry. Administrator was contacted and arrived a short time later. Reason for visit was discussed. LPA completed a health and safety check on residents in care. Residents observed in common areas and in rooms. During visit made on 11/04/2022 Licensing Program Analyst M. Garza arrived at the facility and observed two staff (S1 and S2) outside to the right of the facility smoking. Residents were observed to be in the home unsupervised. This poses a potential health and safety or personal rights risk to residents in care. LPA cited Care and Supervision in correlation to complaint #24-AS-20211101082313. A duplicate citation was not given for this today. On todays visit upon entry, LPA observed the facility front door to be secured with a pin at the bottom of the door. Staff was observed removing the pin and when asked to take a closer look the staff placed the pin in a box. Licensee stated "this was probably old and should not be used anymore". This poses an immediate health and safety or personal rights risk to residents in care. Deficiency cited on the attached LIC809-D An exit interview was completed. Appeal rights and a copy of this report was given.the state’s words, verbatim · CDSS document, Aug 10, 2022

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87203 · Plan of correction due date: Aug 11, 2022

87203 Fire Safety -All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement was not met as evidence by: LPA observation of front door being secured with a pin at the bottom of the door. This poses an immediate health and safety or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Aug 10, 2022

Plan of correction: Staff immediately removed pin. Licensee to dispose of pin. Hole in door will be patched up by POC date.

Type of visit: Required - 1 Year

On 04/25/2022 Licensing Program Analyst, M. Garza arrived at the facility unannounced to conduct the required Infection Control Inspection. Administrator was contacted and arrived a short time later. LPA was greeted by Direct Care Staff, Johanna Lorio and COVID pre-screened. LPA was permitted entry into the facility. LPA observed a central entry point with a supply of hand sanitizer and a sign in policy that includes documented routine symptom screening for resident's, staff and visitors. Resident observed in rooms and common areas. Mitigation plan was received and reviewed. COVID-19 procedures described in the plan include required postings, symptoms screenings (for staff, persons in care and visitors), testing, quarantine/isolation cohorts, infection control plan to include donning and doffing of Personal Protective Equipment. Staffing and sick leave plans are in place for emergency staffing and/or PPE shortages. LPA toured the facility inside and out. Required postings of signs to include hand washing, coughing etiquette and physical distancing were observed. 1 of 2 staff observed wearing face coverings. Facility has designated visitation areas. Covered trash bins were observed. LPA observed residents with a 30-day supply of resident medications. A 30 day supply of PPE not observed. Licensee has available at different location. Licensee to provided additional PPE. Sinks are well stocked and liquid soap for hand washing and paper towels for hand drying were observed. Through LPA observation of documentation and interview with Administrator and staff, the required infection control practices are found to be in compliance. Exit interview conducted.the state’s words, verbatim · CDSS document, Apr 25, 2022