Sacred Hands Living

Type of visit: Required - 1 Year

On 09/05/2023 at 12:35 PM, Licensing Program Analyst (LPA) P. Watson arrived unannounced to conduct Required 1 Year Annual inspection. Administrator arrived at approximately 1:50 PM. LPA met with Administrator, Rajwant Panesar and explained the purpose of the visit. The facility’s fire clearance was approved for 6 Non-Ambulatory which 1 may be Bedridden. LPA toured facility with Rajwant including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 5 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathrooms was measured between 105 degrees Fahrenheit and 120 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum 7 day supply of nonperishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was purchased on 04/04/2023. First aid kit was observed to be complete. Report continues on 809 C At 3:30PM, LPA reviewed 3 of 3 residents records. At 3:10 PM, LPA reviewed 4 of 6 staff records and 4 of 4 have current first aid training and associated to the facility. At 3:00 PM, LPA reviewed a sample of 3 of 3 resident’s medications. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 09/26/2023: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Sep 5, 2023

Allegation investigated: Staff engaged in an inappropriate act with an adult on the facility premises

On today's date 9/14/2022, at around 10:10 AM, Licensing Program Analyst (LPAs) L. Ibo and L. Fici arrived announced to conduct a complaint investigation for the above allegation. LPAs was greeted by care staff (S3) and explained the purpose of the visit. LPAs called Administrator (ADM) Raj and explained the purpose of the visit. At 12:33 PM, ADM arrived at the facility and met with LPAs. During the investigation, LPAs conducted interviews and record reviews with staff. ADM stated that S2 does not work at the facility and has not been to the facility for several months. ADM stated she was not aware of the inappropriate act that happened at the facility premises not until she received an exclusion letter for S2. …Continued on LIC9099C… Unfounded Based on interview and records review, there was no residents involved on the inappropriate act by S2. The incident was between former staff (S2) and a visitor (V1). This agency has investigated the complaint alleging Staff engaged in an inappropriate act with an adult on the facility premises. We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted and a copy of this report provided. Based on interviews conducted and records reviewed, the preponderance of evidence standard has not been met, therefore the allegation is found to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it did or did not occur. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Sep 14, 2022 · control 15-AS-20220909172652

Type of visit: Case Management - Other

On 9/14/2022 Licensing Program Analysts (LPAs) Leslie Ibo and Liridon Fici conducted unannounced case management visit while conducting a complaint investigation. LPAs was greeted by care staff (S3) and explained the purpose of the visit. LPAs called Administrator (ADM) Raj and explained the purpose of the visit. At 12:33 PM, ADM arrived at the facility and met with LPAs. LPA’s toured the facility inside and outside. LPAs observed the following: · At 10:51AM LPA observed unlocked chemicals at the laundry room that are accessible to residents in care. · During the course of complaint interview, LPAs found out that Administrator (ADM) did not report incident that happened at the facility Deficiencies are cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due dates, and any repeat violations within 12-month period may result in civil penalties. Deficiencies and plan and proof of corrections were discussed with Rajwant Panasar.the state’s words, verbatim · CDSS document, Sep 14, 2022

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(f)(2) · Plan of correction due date: Sep 15, 2022

Care of persons with Dementia: (f) The following shall be stored inaccessible to residents with dementia: (2) Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances... This requirement is not met as evidence by: Based on observation, the licensee did not comply with the section cited above by having Lysol accessible to residents in care located in the unlocked laundry room , which poses a immediate health and safety risk for persons in care.the state’s words, verbatim · CDSS document, Sep 14, 2022

Plan of correction: Facility staff locked the laundry room. Administrator agreed to conduct in-service training for all the staff regarding the citation cited. A copy of training with staff name and signature is needed to be submitted to CCL office by 9/19/2022.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87211(a)(1) · Plan of correction due date: Sep 19, 2022

Reporting Requirements: (a) Each licensee shall furnish to the licensing agency such reports as the Department may require... (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events... This requirement is not met as evidence by: Based on interview and record review, the licensee did not comply with the section cited above by not submitting incident reports to CCL within seven days, which poses a potential health and safety risk for persons in care.the state’s words, verbatim · CDSS document, Sep 14, 2022

Plan of correction: Administrator agreed to conduct in-service training for all the staff regarding the citation cited. A copy of training with staff name and signature is needed to be submitted to CCL office by 9/19/2022.

Type of visit: Required - 1 Year

On 1/21/2022 Licensing Program Analyst (LPA) Leslie Ibo arrived unannounced to conduct an infection control annual required inspection. LPA met with Rajwant Panesar, Administrator .Facility has census of 6. LPA and Administrator Rajwant inspected the physical plant, but not limited to the kitchen, dining area, resident bedrooms, bathroom, laundry room, and backyard. LPA observed there is sufficient furniture and lighting throughout the facility. LPA observed there is a seven-day non-perishable and two day perishable food supply, and cleaning supplies and toxins were locked. Medications are centrally stored in a locked area that is inaccessible to clients and refilled every at least 30 days. Smoke detectors and carbon monoxide were in operating condition during visit. Facility has enough PPE supplies, paper supplies and hygiene supplies,. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Facility staff were observed to be wearing proper PPE. Facility has a mitigation plan and maintains record of routine screening for residents and staff. No deficiency cited during the visit, technical assistance provided. Exit interview conducted copy of this report provided.the state’s words, verbatim · CDSS document, Jan 21, 2022

Allegation investigated: Facility staff did not notice a change in the resident's condition Facility staff did not seek medical attention in a timely manner Facility staff did not provide resident's records to emergency medical personnel

On 12/7/2021 starting at 9:50 AM, Licensing Program Analyst (LPA) L. Francisco arrived unannounced to deliver findings for the above allegation. Upon arrival, LPA was greeted by Care Staff, Amanda Lopez. Administrator, Rajwant Panesar later arrived at 9:15 AM. During the course of the investigation, LPA obtained information, collected documents, toured facility, interviewed 2 staff and 2 residents. According to 2 of 2 staff, residents are observed every couple of hours. S1 stated in April 2020, R1 was exhibiting an increase in behavioral issue, so facility called 9-1-1. According to S1, R1 is not diabetic. Upon EMS arrival, EMS requested a copy of R1's POLST sheet. However, since it was the only copy facility had, S1 suggested for EMS to take a photo of POLST sheet and according to S1, EMS agreed. REPORT CONTINUES ON 9099C Unsubstantiated Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview conducted. Due to technical difficulties, a copy of this report is provided via email.the state’s words, verbatim · CDSS document, Dec 7, 2021 · control 15-AS-20200408083147

Allegation investigated: Staff failed to keep an accurate medication log

On 12/7/2021 starting at 9:50 AM, Licensing Program Analyst (LPA) L. Francisco arrived unannounced to deliver findings for the above allegation. Upon arrival, LPA was greeted by Care Staff, Amanda Lopez. Administrator, Rajwant Panesar later arrived at 9:15 AM. During the course of the investigation, LPA obtained information, collected documents, toured facility, interviewed 2 staff and 2 residents. During record review, LPA observed R2 and R3’s Medication Administration Record is incomplete. Based on interview with S1, medications were administered to the residents on 10/6/21 and 10/7/21. However, staff did not initial MAR. REPORT CONTINUES ON 9099C Substantiated During an interview with S1, LPA discovered that when R1 was throwing items around, S1 took a picture to provide “proof” to responsible party of the change of behavior. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview conducted. Due to technical difficulties, a copy of report provided via email. Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC9099D. Exit interview conducted. Due to technical difficulties, Appeal Rights and a copy of this report provided via email.the state’s words, verbatim · CDSS document, Dec 7, 2021 · control 15-AS-20200422152439

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(a) · Plan of correction due date: Dec 17, 2021

87506(a) RESIDENT RECORDS (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff This requirement is not met as evidenced by: Based on record review and interview, Licensee did not comply with the regulation above. R2 and R3's medication were administered, but staff did not initial MAR which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Dec 7, 2021

Plan of correction: By POC date, Administrator will submit proof of training to CCL.

Type of visit: Case Management - Other

On 12/7/2021 starting at 11:15 AM, Licensing Program Analyst (LPA) L. Francisco conducted a Case Management while at the facility for another matter. LPA met with Administrator, Rajwant Panesar. During a complaint investigation (#15-AS-20200408083147) on 10/11/2021, LPA discovered facility's protocol is to contact resident's responsible party before calling 9-1-1 due to cost of co-pay. LPA went over Title 22 regulation, 87465(g) Incidental Medical and Dental Care with Administrator and requested Administrator to provide LPA a copy training with staff on when to call 9-11 and procedure no later 12/20/2021. No deficiencies cited during visit. Due to technical difficulties, a copy of this report provided via email.the state’s words, verbatim · CDSS document, Dec 7, 2021

Allegation investigated: Licensee did not assist resident with medications as needed.

On 10/11/2021 Licensing Program Analyst (LPA) L.Ibo conducted unannounced visit to deliver findings on the above allegations. LPA spoke with Administrator, Rajwant Panesar. During the course of the investigation, LPA interviewed staff (S1-S2) and residents (R1, R3, R5). In addition, LPA conduct facility tour inside and outside. LPA conducted records review, based on Medication Administration (MAR) there are days that signature spot left blank without documentation of reason why the MAR was blank, LPA interviewed S1 and she was not sure if staff gave those medication or intentionally left the MAR. LPA interviewed S2 and, and she said the staff might forgot to document or did not give the medication. The above-mentioned allegation is deemed substantiated. ...Continue to LIC 9099C... Substantiated A finding that the complaint is substantiated means that the allegation are valid because the preponderance of the evidence standard has been met. The following deficiencies was observed (see LIC 9099D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview was conducted. Appeal rights was giventhe state’s words, verbatim · CDSS document, Oct 11, 2021 · control 15-AS-20210226085526

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(c)(2) · Plan of correction due date: Oct 22, 2021

INCIDENTAL MEDICAL AND DENTAL CARE (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Based on records review, licensee did not comply with regulation above, there are blank signature page on Medication Administration record (MAR) log and S1 & S2 is not sure if medications were given to residents in care, this is pottential health risk to residents in care.the state’s words, verbatim · CDSS document, Oct 11, 2021

Plan of correction: Adminsitrator needs to conduct in-service training for all staff regarding the regulation that was cited from, proof of training need to be submitted to CCL office by POC date.

Allegation investigated: Facility staff did not assist resident with hygiene needs Facility staff did not assist resident with dressing needs Facility staff did not ensure that resident had clean clothing Resident was left in soiled bedding for an extended period of time Facility staff did not provide an adequate amount of food to resident

On 10/11/2021 Licensing Program Analyst (LPA) L.Ibo conducted unannounced visit to deliver findings on the above allegations. LPA spoke with Administrator, Rajwant Panesar. During the course of the investigation, LPA interviewed staff (S1-S2) and residents (R1,R3 & R4) . In addition, LPA toured the facility inside and outside. For the allegation, facility staff did not assist resident with hygiene needs, facility staff did not assist resident with dressing needs, facility staff did not ensure that resident had clean clothing, resident was left in soiled bedding for an extended period of time. LPA interviewed 3 current residents at the facility. All 3 residents indicated that their needs are being met, the resident appears to have clean clothing and groomed. Therefore, this allegation is unsubstantiated. ....Continuation on LIC 9099 C .... Unsubstantiated For allegation, facility staff did not dispense medications as prescribed , LPA conducted records review, based on Medication Administration (MAR) there are days that signature spot was left blank without documentation of reason why the MAR was blank, LPA interviewed S1 and she was not sure if staff gave those medication or intentionally left the MAR. LPA interviewed S2 and, and she said the staff might forgot to document or did not give the medication. The above-mentioned allegation is deemed substantiated. For allegation, facility did not issue a refund in a timely manner – Based on records review and interview the resident’s family paid rent on April 1,2020 , financial responsibility ended on April on April 8,2020 and refund was issued on September 2, 2020, therefore the allegation was substantiated. A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the evidence standard has been met. The following deficiencies was observed (see LIC 9099D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview was conducted. Appeal rights was given. For the allegation, Facility staff did not provide an adequate amount of food to resident facility has pre-schedule breakfast, lunch, and dinner list on a monthly calendar. LPA interviewed 3 current residents, residents did not have any issue on food or is on a special diet. R6 passed away and cannot be interviewed to verify allegation. Therefore, this allegation is unsubstantiated. Based on interviews conducted and observations, LPA has found these allegations to be 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. Exit interview conducted with Administrator, Rajwant Panesar, and a copy of report provided.the state’s words, verbatim · CDSS document, Oct 11, 2021 · control 15-AS-20200731154710

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Oct 22, 2021

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... This evidence is not met as evidence by: Based on LPA’s records review, Licensee did not comply with the regulations cited above. LPA gathered pictures from RP based on the evidence it appeared that facility floor was dusty, there are cereals on the floor, bathroom sink was stained, and dusty, resident closet was unorganized with resident’s clothing on the floor and not folded which poses a potential health, safety or personal rights risk to persons in care. which posed a potential Health & Safety risk to residents in care.the state’s words, verbatim · CDSS document, Oct 11, 2021

Plan of correction: Administrator will conduct in-service training for all staff reviewing the regulation that was cited from. Proof of inservice training need to send to LPA on POC date.

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.652(c) · Plan of correction due date: Oct 22, 2021

Health and Safety Code section 1569.652 provides in part:(c) A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual... This evidence is not met as evidence by: Based on record review and interview, Licensee did not comply with the regulations above. R6's personal property was removed on April 8,2020 and a refund was not issued until 9/2/2020 which poses a potential personal rights to residents in care.the state’s words, verbatim · CDSS document, Oct 11, 2021

Plan of correction: Administrator agrees to review regulation and send a self-certification letter to CCL by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(c)(2) · Plan of correction due date: Oct 22, 2021

INCIDENTAL MEDICAL AND DENTAL CARE (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Based on records review, licensee did not comply with regulation above, there are blank signature spot on Medication Administration record log and S1 & S2 is not sure if medications were given to residents in care, this is pottential health risk to residents in care.the state’s words, verbatim · CDSS document, Oct 11, 2021

Plan of correction: Adminsitrator needs to conduct in-service training for all staff regarding the regulation that was cited from, proof of training need to be submitted to CCL office by POC date.