Bella Care Home LLC-Matus

Type of visit: Required - 1 Year

On 10/18/2023, Licensing Program Analyst (LPA) V. Gorban arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility. LPA toured facility with Administrator (AD) Marilen Gonzales and Phillip Gonzales, who was notified of Licensing visit over the phone and was able to attend the visit shortly. AD certification number 6055102740 and expiration date 8/12/2024. Facility has one entrance/exit point. LPA toured facility with Administrator inside and out. LPA observed back yard fenced and the emergency exit gate was unlocked for safety of residents. The facility was observed to be at a comfortable temperature, of 75 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPA observed residents in common area after breakfast, others in their rooms resting. Department phone number and infection prevention information signs were posted thought the facility. Inspecting kitchen LPA observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. Fire extinguisher was observed with a service date of 10/18/2023. All 5 residents’ bedrooms were observed to be with comfortable temperature. Bathroom water temperature was tested and recorded reading of 105 degrees F. Report continues on LIC809-C Medications observed to be locked in a cabinet in the kitchen. LPA reviewed medication records appears to be administered properly. Cleaning supplies were observed to be in a locked cabinet in the laundry room. An outdoor seating area was observed for residents in care. LPA reviewed Staff and Resident files. Resident files observed to have updated information. No deficiencies were observed and cited. Exit interview conducted. Report was signed and copy of this report was provided for facility records.the state’s words, verbatim · CDSS document, Oct 18, 2023

Allegation investigated: Violation of Personal Rights of residents in care

On 10/13/2022, Licensing Program Analyst (LPA) A. Walton arrived unannounced to deliver findings on the above allegation. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Administrator, Marilen Gonzales was not available during this inspection. LPA received verbal permission via telephone to meet with Facility Staff, Erick Khio. During the investigation, LPA conducted a facility tour and interviewed residents and staff. Based on interviews conducted, the allegation: Violation of Personal Rights of residents in care is UNSUBSTANIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. No deficiencies issued during this inspection. An exit interview was conducted. A copy of this report was discussed and provided to Facility Staff, Erick Khio, whose signature on this form confirms receipt of this document. Unsubstantiatedthe state’s words, verbatim · CDSS document, Oct 13, 2022 · control 24-AS-20220831150226

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.

Type of visit: Required - 1 Year

On 09/19/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Facility staff contacted Administrator via telephone. Administrator stated she is unavailable to attend this inspection and gave verbal permission to meet with facility staff. LPA met with Caregiver, Martin Salcedo and Caregiver, Johanna Lorio. Facility tour was conducted with Caregiver, Salcedo. All entrances, exits, and pathways were free from obstructions. No fire clearance issues observed during today's inspection. LPA observed signs at the entrance promoting social distancing, cough/sneeze etiquette, and hand-washing. LPA observed reminders to wash hands in facility bathrooms. 4 bedrooms are single occupant, 1 bedroom is shared. LPAs observed beds in the shared bedroom to be at least 3 feet apart with head to toe orientation. Bathrooms were stocked with paper towels and liquid soap. LPA observed a trash can with lid in 1 out of 3 bathrooms. LPA observed a 30 day supply of medications. Medications are locked and inaccessible to residents in care. Food supply checked. LPA observed a 2-day supply of perishable foods and a 7-day supply of non-perishable foods. Facility has a 30 day supply of cleaning supplies. LPA did not observe a 30 day supply of PPE supplies. Resident records were reviewed for updated emergency contact information. Staff records were reviewed for good health. CONTINUED TO 809C LPA is requesting the following documents be submitted to the Fresno CCL office by 10/03/2022: 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 No deficiencies issued during today's inspection. Exit interview conducted. A copy of this report was discussed and provided to Caregiver, Martin Salcedo, whose signature on this form confirms receipt of this document.the state’s words, verbatim · CDSS document, Sep 19, 2022

Allegation investigated: Staff do not have required training

On 08/25/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to commence a complaint investigation. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Administrator is not present in the facility. Facility staff contacted Administrator, Marilyn Gonzales, via telephone. LPA spoke with Administrator and received verbal permission to meet with Caregiver, Malou Simpson. LPA reviewed records and interviewed staff during today's inspection. LPA observed required training to be documented in the personnel files. LPA confirmed with facility staff that staff have the required annual training. This agency has investigated the complaint alleging: Staff do not have required training. We have found that the complaint was UNFOUNDED, meaning the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted with Caregiver. A copy of this report was discussed and provided to Caregiver, Malou Simpson, whose signature on this form confirms receipt of this document. Unfoundedthe state’s words, verbatim · CDSS document, Aug 25, 2022 · control 24-AS-20220819111313

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.

Allegation investigated: Staff yells at residents in care Centrally stored medications are accessible to residents in care Staff do not have appropriate training Facility is unkempt

On 10/18/2021, Licensing Program Analyst (LPA) A. Walton arrived unannounced to deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Marilen Gonzales. During this investigation, LPA reviewed records, conducted a facility tour, and interviewed residents and staff. Interviews with staff revealed that S1 can speak in a tone that “may be seen as rude”. Per Administrator, S1 “can get excited and speak in a high tone”. S1 does not yell or verbally abuse residents in care. Interviews with residents revealed that there were no concerns with staff. CONTINUED TO LIC9099C Unsubstantiated Based on record review and interviews with staff, it was determined that staff have received the required training prior to working with residents. Interviews revealed that the Licensee instructs staff training. New hires are trained for approximately 2 weeks, training includes shadowing other caregivers. During the facility tour, LPA observed medications to be stored inaccessible to residents in care, in a cabinet in the kitchen. LPA did not observe medications in the resident bedrooms. Facility floors appeared to be clean during the inspection, no residue or dirt was observed on the floors. Faucets were observed to be operational, LPA observed faucets to be in good repair. Resident bedrooms were observed to be kempt, with no obstructions to pathways. Resident bathrooms were observed to be clean and free from odors. Based on observation, interviews and records review, the above allegations are UNSUBSTANTIATED. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. No deficiencies issued. An exit interview was conducted with Administrator. As a COVID-19 precautionary measure, copy of this report was discussed and provided to Administrator via email and an electronic read receipt confirms receiving this document. Report was signed on-site by Facility Representative.the state’s words, verbatim · CDSS document, Oct 18, 2021 · control 24-AS-20210810143633

Type of visit: Required - 1 Year

On 08/03/2021, Licensing Program Analysts (LPAs) A. Walton and M. Yang arrived unannounced to conduct an Annual Inspection - Infection Control. LPAs met with Administrator, Marilen Gonzales and stated the purpose of the visit. Facility has one central entry and exit. Upon entry to the facility, LPAs observed visitor log-in/temperature check. Facility staff observed to be wearing facial coverings. Residents wear facial coverings will out in the community. Facility tour was conducted with Administrator. All entrances, exits, and pathways were free from obstructions. No fire clearance issues observed during today's inspection. LPAs observed signs at the entrance promoting social distancing, cough/sneeze etiquette, and hand-washing. LPAs observed reminders to wash hands in facility bathrooms. 4 bedrooms are single occupant, 1 bedroom is shared. LPAs observed beds in the shared bedroom to be at least 3 feet apart with head to toe orientation. Bathrooms were stocked with paper towels and liquid soap. LPAs did not observe trash cans with a lid. LPAs observed a 30 day supply of medications. Medications are locked and inaccessible to residents in care. Food supply checked. LPAs observed a 2-day supply of perishable foods and a 7-day supply of non-perishable foods. Facility has a 30 day supply of cleaning supplies. LPAs did not observe a 30 day supply of PPE supplies. Resident records were reviewed for updated emergency contact information. Staff records were reviewed for good health and infection control training. No deficiencies observed during this inspection. Exit interview conducted with Administrator. As a COVID-19 precautionary measure, a copy of this report will be provided via email and an electronic read receipt confirms receiving this document. Facility Representative signature on file.the state’s words, verbatim · CDSS document, Aug 3, 2021