Joy Senior Center

Allegation investigated: Staff is financially abusing resident

On 08/21/2023 at 09:25 AM, Licensing Program Analysts (LPA), J. Clancy-Czuleger arrived unannounced to deliver complaint findings for the above allegations. LPA met with Rose Constastino, Caregiver and explained the reason for the visit. Administrator Gupreet Matharu authorized Rose Constastino, to sign off on the report as he was not able to come to the facility. During the course of investigation, Department conducted interviews with staff, resident’s family, and reporting party. Records were reviewed and obtained, including audit report. It was alleged that resident’s (R1) bank accounts had been closed and that new bank accounts for R1 had been opened with staff’s (S1) name. The Auditor’s investigation revealed that S1 financially abused R1. According to R1’s Physician’s Report dated 2/19/2020, R1 was non-ambulatory, and only able to manage his cash resources with assistance from the licensee. Continued on 9099C.... Substantiated ...Continued from 9099 According to R1’s physician’s report dated 12/3/2022, R1 had dementia and was unable to manage his own cash resources. According to records, on 10/7/2022, S1 took R1 to Bank of the West and closed R1’s old checking account and savings account. The remaining balance was transferred to a new checking and savings account. S1 used R1’s debit card to make unauthorized purchases. The auditor obtained R1’s bank statements from January 2021 to December 2022 detailing the unauthorized purchases by S1. The transactions included purchases from Amazon, Chevron, ARCO, Safeway Grocery, Walmart, CVS, 7-Eleven, T-Mobile, Costco, Door Dash, Pizza Guy, Optavia Weight Control, Family Pet Care Center etc. The auditor determined that the total unauthorized purchases on the resident’s card was $31,727.10. Based on all the information gathered, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiencies are cited per California Code of Regulations, Title 22, Division 6 and Chapter 8 on the attached LIC9099-D. Exit interview conducted and a copy of this report and Appeal Rights provided.the state’s words, verbatim · CDSS document, Aug 21, 2023 · control 15-AS-20221207141510

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87217(b) · Plan of correction due date: Aug 21, 2023

Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff… This requirement is not met as evidenced by: R1’s medical assessment dated 12/3/2022 stated R1 had dementia and was unable to manage his own cash resources. Administrator possessed R1’s debit card but did'nt keep any records of purchases made. Licensee failed to protect R1’s from financial abuse from S1.the state’s words, verbatim · CDSS document, Aug 21, 2023

Plan of correction: A mandatory meeting will be held at a later date.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) J. Clancy-Czuleger conducted this unannounced visit where Administrator Gupreet Matharu was called to address violations that were found during an investigation conducted by the Department. Gupreet authorized Rose Constastino, Caregiver,to sign off on the report as he was not able to come to the facility. As part of an investigation related to Complaint Control No. 15-AS-20221207141510, filed on 12/07/22, the Department's Audit Division conducted an Audit for this facility. The Auditor’s investigation revealed that S1 financially abused R1. On 10/7/2022, S1 took R1 to Bank of the West and closed R1’s old checking account and saving account. The remaining balance was transferred to a new checking and savings account. S1 used R1’s debit card to make unauthorized purchases. The auditor obtained R1’s bank statements from January 2021 to December 2022 detailing the unauthorized purchases by S1. The auditor determined that the total unauthorized purchases on the resident’s card is $31,727.10. In addition, Administrator did not have any Policies and Procedures in place to safeguard residents’ funds R1 who was only able to manage his cash resources with the help of the licensee. The licensee kept R1’s check books but did not secure R1’s debit card. S1 obtained R1’s debit card and used it for in store and online purchases, utility payment, and cash withdrawals. Continued on 809-C... ...Continued from 809 In an interview with the Auditor S2 stated R1’s monthly rent is $3,500 of which $3,087.70 is paid by the VA and R1 paid remaining balance for $412.30. S2 stated “I fill out the check for about $400. R1 signed the checks. R1 can’t write checks. His hands, he can’t brush his teeth. So, I wrote check amount, and he signed it.” Raised the rate without proper 60-day notice, on 12/1/2022, the licensee sent R1 a rate increase notice. The rate was increased to $4,000 per month effective on 1/1/2023. A licensee is required to provide no less than 60 days’ notice prior to an increase to the basic services rate. The licensee did not follow the rate increase requirement. Documents that were reviewed by the department show that licensee filed SOC 341 on 08/06/2018 which stated S1 tried to marry R1 and had taken $500 dollars from R1 using his debit card. On 8/7/2018, licensee gave S1 a warning notice and asked S1 to return R1’s debit card. The facility was not aware of the whereabout of the residents and R1’s outgoing and incoming log stated that R1 did not have activity 08/16/21, 09/13/21, 03/31/22, 10/07/22, when bank statements showing in branch withdrawals from R1 on those dates. Along with 11/14/22 when S1 took R1 to Santa Clara County to legally marry him. Deficiencies are cited per California Code of Regulations, Title 22, and begins on the next page. Failure to correct deficiencies may result in civil penalties. Exit interview conducted and a copy of this report and Appeal Rights provided.the state’s words, verbatim · CDSS document, Aug 21, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(a)(8) · Plan of correction due date: Aug 21, 2023

In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential… or sexual abuse. This requirement is not met as evidenced by: S1’s actions of abusing R1’s cash resources. S1 used R1’s debit card to make personal purchases in the amount of $31,727.10.the state’s words, verbatim · CDSS document, Aug 21, 2023

Plan of correction: A mandatory meeting will be held at a later date.

From the deficiency page — Deficiency type: Type A · Section cited: HSC1569.655(a) · Plan of correction due date: Aug 21, 2023

If a licensee of a residential care facility for the elderly increases the rates of fees for residents or makes increases in any of its rate structures for services, the licensee shall provide no less than 60 days' prior written notice... This requirement is not met as evidenced by: The Licensee gave R1 a rate increase notice on 12/1/22 effective 1/1/23.the state’s words, verbatim · CDSS document, Aug 21, 2023

Plan of correction: A mandatory meeting will be held at a later date.

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.312(d) · Plan of correction due date: Aug 21, 2023

Every facility required to be licensed under this chapter shall provide at least the following basic services: (d) Being aware of the resident's general whereabouts, although the resident may travel independently in the community. This requirement is not met as evidenced by: The facility not having accurate logs of the resident’s ingoing and outgoing activities.the state’s words, verbatim · CDSS document, Aug 21, 2023

Plan of correction: A mandatory meeting will be held at a later date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87405(d)(3) · Plan of correction due date: Aug 21, 2023

The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7)... (3) Ability to maintain or supervise the maintenance of financial and other records.This requirement is not met as evidenced by: Based on record review and interviews by the Department's Auditor, Licensee did not comply with the above regulation by mishandling R1's finances which poses a personal rights issue to residents in care.the state’s words, verbatim · CDSS document, Aug 21, 2023

Plan of correction: A mandatory meeting will be held at a later date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87205(a) · Plan of correction due date: Aug 22, 2023

The licensee, whether an individual or other entity, shall exercise general supervision over the affairs of the licensed facility and establish policies concerning its operation in conformance with these regulations and the welfare of the individuals it serves. This requirement is not met as evidenced by: Based on record review by the Department's Auditor, Licensee did not comply with the above regulation by having knowledge of the staffs intents back in 2018 and still allowed S1 to work with R1.the state’s words, verbatim · CDSS document, Aug 21, 2023

Plan of correction: A mandatory meeting will be held at a later date.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) J. Clancy-Czuleger arrived today to deliver Order for Immediate Exclusion Letters for S1. LPA meet with caregiver Rose Constastino and explained the purpose of the visit. Licensee, Gurpreet Matharu was called and designated Rose Constastino to sign off on the report. An Audit Report dated 04/03/2023, shows that S1 misappropriated R1's cash resources. Licensee, and other care staff confirmed that S1 was not present at facility today. Licensee stated that S1 last worked at facility on 12/17/2022. LPA delivered an Order for Immediate Exclusion Letter today to Rose Constastino for S1. An Order for Immediate Exclusion Letter will be sent to S1 via certified mail. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 1, 2023

Type of visit: Case Management - Health Checks

On 07/21/2023, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct a health and safety check as a result of a Priority 2 complaint. Upon entering, LPA explained purpose of the visit to staff member Meledel "Mel" Sumaylo, who called the Licensee and Administrator Gupreet "Bobby" Matharu, with whom LPA spoke briefly to explain purpose of the visit. At approximately 2:00 PM, the ADM arrived LPA toured facility, including but not limited to, the bedrooms, bathrooms, common areas, kitchen, patio, trash disposal, parking, and outdoor areas. Facility temperature was maintained at 77.6 degrees F. Hot water temperature was measured at 118 degrees F in kitchen sink. 7-days of non-perishable and 2-days of perishable food supplies were sufficient. Resident medications were kept locked in the cabinet. Smoke and Carbon monoxide detectors tested and were functional. Fire extinguisher was observed to be full and last serviced on 12/02/2022. There are no accessible bodies of water observed.. 1 Type-B citation issued for incomplete first aid kit (refer to LIC 809-D for details). Exit interview conducted. A copy of this report was provided via email.the state’s words, verbatim · CDSS document, Jul 21, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(a)(9) · Plan of correction due date: Jul 31, 2023

... a complete first aid kit shall be maintained and be readily available in a specific location in the facility. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above, which poses a potential health, safety, or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 21, 2023

Plan of correction: The licensee shall: (1) label the cabinet as "First Aid", (2) ensure that within it is a kit that contains at least the following: (A) A current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency. (B) Sterile first aid dressings. (C) Bandages or roller bandages. (D) Scissors. (E) Tweezers. (F) Thermometers.

Allegation investigated: Questionable death Lack of supervision resulting resident sustained unexplained fractured leg while in care Facility serves low quality food to residents Facility does not provide planned activities for residents Staff did not provide sufficient care for residents needs Resident wheel chair is in disrepair

On 4/3/2023 at around 9:35AM, Licensing Program Analyst (LPA) L. Ibo arrived unannounced to deliver complaint findings for the allegations above. Upon arrival, LPA met with S3 and explained the reason for the visit. LPA called Administrator Gurpreet Matharu and explained the purpose of the visit, Administrator stated that he is not available to meet LPA today and gave permission to LPA to discuss the report and provide a copy of the report to S3. During the course of the investigation, the Department conducted interviews with staff, residents, health providers, and complainant. Medical records and facility file, incident report, and facility’s correspondence with health providers were obtained and reviewed. Continue to LIC9099C.. Unsubstantiated Allegation: Questionable death Based on records review, On May 18, 2022, R1 was sent to the hospital due to leg pain, R1 was transferred then to a post-acute facility. Records review revealed that on 7/25/2022 R1 passed away with caused of death of vascular dementia. Allegation: Lack of supervision resulting resident sustained unexplained fractured leg while in care On August 16, 2022, department reviewed hospital medical records and records from the ambulance services (American Medical Response). On October 13, 2022, department conducted staff and resident interviews; licensee was interviewed via phone on January 17, 2023. Based on interviews and record review, on May 18, 2022, at around 05:30AM Resident (R1) complaint of leg pain to the night staff but staff said there was no pattern in the way R1 was acting that prompted an emergency response. Staff (S1) stated R1 was normal because by 9AM, she changed her diaper without any issues or complaints. At around 01:42PM, R1 complaint of pain so staff called 9-1-1. Based on documents review, paramedics arrived and found R1 on supine position with no signs of distress. Medical records revealed that R1 was diagnosed of hip fracture with notes of unwitnessed fall, however it was not indicated the cause of injury and only noting that R1 had hip replacement surgery on 2012. R1’s Appraisal/Needs and Service Plan dated June 6, 2021, does not identify fall risk as an issue, R1 was non-ambulatory and wheelchair bound. Allegation: Facility serves low quality food to residents Based on interview and records review, facility has variety of food. LPA conducted interview with four residents (R2, R3, R4, & R7) in care, based on interview, and the residents are satisfied with the food that was being served, Allegation: Facility does not provide planned activities for residents Based on LPA’s observation and residents’ interview. Facility has a planned activities. During LPA’s visits, it was observed that staff are conducting different activities with the residents in care, at least 5-6 residents were observed to be attending the activities. Resident’s interview revealed that there are activities at the facility, however, sometimes residents want to join sometimes resident prefer to watch TV or stay in their rooms. Allegation: Staff did not provide sufficient care for residents needs Based on residents’ interview, facility is providing sufficient care for the residents. Residents stated that the staff are taking care of them and providing the care that they need. Allegation: Resident wheelchair is in disrepair Based on LPA’s observation on residents that are using wheelchairs. The wheelchairs was clean, functional and in good condition. Based on the investigation, above allegations are deemed unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted and copy of this report provided.the state’s words, verbatim · CDSS document, Apr 3, 2023 · control 15-AS-20220729140627

Type of visit: Required - 1 Year

On this day 03/28/2023 at around 9:30AM, Licensing Program Analyst (LPA) L. Ibo arrived at the facility to conduct annual required inspection. LPA was met by caregiver S2. Administrator Gurpreet Matharu arrived around 12:30PM. LPA inspected the facility inside and out including but not limited to bedrooms, bathrooms, kitchen, dining and living areas. The facility has 11 bedrooms , 7 bathrooms and two shower rooms. There were 13 residents observed during the visit, some of them were in the living room, some of them were walking around the facility and some stayed in their own rooms. Two fire extinguisher was observed with service date December 2022. Facility has sufficient supply of perishable and non-perishable foods. There were 3 staff working during the visit. Bathrooms and shower rooms were observed with grab bars and nonskid mats. LPA reviewed 5 residents files and 3 staff files and interviewed 5 residents and 3 staff. Facility has wired carbon monoxide and smoke detector that were observed functional. LPA observed the following: At 10:00AM, LPA observed that S4’s fingerprint clearance was not associated to the facility. At 12:10PM, LPA observed that R2 and R5 does not have updated needs and services plan. At 12:15PM, LPA observed that R2 and R5 does not have updated LIC602A. Deficiencies are being cited today in violation of California Code of Regulations and follows on 809D. Failure to submit proof of corrections (POC's) along with LIC9098 by plan of correction due dates may result in civil penalty. Exit interview was conducted with Administrator and Appeal Rights was provided.the state’s words, verbatim · CDSS document, Mar 28, 2023

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

On 12/9/2022, Licensing Program Analyst (LPA) L. Ibo arrived unannounced to conduct a Case Management regarding a report received from the facility alleging former staff (S2) married current resident (R1). LPA met with Caregivers S3 & S4. The staff called the Administrator and informed him the purpose of the visit. Administrator stated to provide copy of report to S3. During the case management visit, LPA conducted staff interview and attempted to interview R1. LPA requested copy of R1’s file including but not limited to admission agreement, R1’s physician’s report, R1’s incident report for the last six months, R1’s financial documents document, six months facility’s residents outgoing and incoming log, three months staffing schedule and S2’s staff file; these documents needed to be submitted on or before 12/12/2022 Due to insufficient information at this time, LPA will conduct additional interviews and documents reviews. LPA will return to the facility. Exit interview conducted with S3, copy of report was provided.the state’s words, verbatim · CDSS document, Dec 9, 2022

Type of visit: Case Management - Other

On 8/1/2022 starting at 2:10PM Licensing Program Analyst (LPA) L. Ibo conducted a health and safety check as a result of department receiving a priority 1 complaint. LPA met with S2 , Administrator arrived at the facility at around 3:50PM . LPA observed 5 Residents watching TV at the living room, 6 residents observed at their bedrooms. During the health and safety check, LPA toured the building with S2, including but not limited to common areas, bathrooms, bedrooms and outdoor area. LPA observed smoke detectors and carbon monoxide detector throughout facility. Water temperature was observed at 120 degrees Fahrenheit. LPA observed sufficient food supplies for residents in care. Facility appear to be safe and there are no imminent health/safety concerns on today's date. Facility is maintained at a comfortable temperature for the residents in care. No deficiencies were cited today.the state’s words, verbatim · CDSS document, Aug 1, 2022

Allegation investigated: Staff left resident in soiled diapers for extended period of time resulting in pressure injuries Staff are not meeting resident's hygiene needs Staff did not notice residents decline in health Staff are not meeting resident dietary needs

On 6/15/2022, Licensing Program Analyst (LPA), L. Ibo arrived unannounced to investigate and deliver complaint findings of the above allegations. LPA met with S2 and explained the reason for the visit. LPA called Administrator Gurpreet Matharu, Administrator gave permission to LPA to provide copy of report to one of facility staff. LPA called Administrator to discuss and deliver findings. LPA conducted interview with residents at the facility, based on the interview, residents are comfortable living at the facility, staff are helping residents with their needs. Allegation: Staff left resident in soiled diapers for extended period of time resulting in pressure injuries; LPA reviewed daily logs it was indicated that residents was being change on regular basis however there were few times that residents refused to be change. …Continue to lic9099c.. Unsubstantiated Allegation : Staff are not meeting resident's hygiene needs; LPA reviewed residents records and logs, RP stated that R1 had dandruff, based on records review there was a dandruff shampoo ordered to address the issue, LPA interviewed staff, the staff stated and documented that staff offered to trim R1’s nails but residents refused staff assistance. Allegation: Staff did not notice residents decline in health; LPA conducted records review, R1 was admitted at the facility on 11/2020 and left the facility on May 2021, there is no records of new needs and appraisal services regarding change of condition, staff does not recall any change in condition. Allegation: Staff are not meeting resident dietary needs; LPA interviewed 6 residents, no concern of food, and residents stated that facility offer different kind of food, based on records review R1 do not have special dietary needs. Based on all information gathered during the course of investigation, the allegations are close as unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted and copy of this report provided.the state’s words, verbatim · CDSS document, Jun 15, 2022 · control 15-AS-20210614164530