Connected Living Oakland

Type of visit: Required - 1 Year

On 12/9/2022 starting at 9:00 a.m., Licensing Program Analyst (LPA) Catherine Lin arrived unannounced to conduct Infection Control Inspection. LPA met with the Administrator and disclosed the purpose of the visit. Upon entry, LPA’s temperature was checked by the staff, and requested to wash hands. LPA toured facility including but not limited to front entrance, screening station, hand washing stations, bedrooms, bathrooms, kitchen, common areas, and outdoor areas. 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 and hand washing posters were observed. Facility staff were observed to be wearing proper PPE. Facility has a sufficient 2-day perishable and one-week non-perishable food supply. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. Facility has Mitigation Plan, Emergency Disaster Plan, and maintains record of routine screening for residents, staff, and visitors. No deficiency cited during visit. Exit interview conducted with Administrator, and a copy of this report provided.the state’s words, verbatim · CDSS document, Dec 9, 2022

Type of visit: POC

On 11/18/22 approximately at 3:40pm, Licensing Program Analyst (LPA) C. Lin arrived unannounced to conduct a proof of correction (POC) visit for the deficiencies cited on 11/3/2022. LPA met with Administrator and explained the purpose of the visit. During visit, water temperature was observed at 112.4 degree F. Deficiency cleared. Civil penalty is discontinued at today's date. No deficiencies are being cited on this date. Exit interview conducted with Administrator and a copy of this report provided.the state’s words, verbatim · CDSS document, Nov 18, 2022

Type of visit: POC

On 11/17/22 approximately at 8:30 am, Licensing Program Analyst (LPA) C. Lin arrived unannounced to conduct a proof of correction (POC) visit for the deficiencies cited on 11/3/2022. LPA met with Administrator and explained the purpose of the visit. During visit, LPA observed knives were locked, fire extinguisher was new purchased on 11/9/2022, completed physician's report, pre-admission appraisal, and admission agreement were observed. Deficiency of water temperature (87303(e)(2) was observed 124.7 degree F today. A civil penalty has been assessed from 11/11/2022 to 11/17/2022 at $100 x 7 = $700. Plan and proof of correction was discussed with Administrator. Civil Penalties will continue to be assessed daily until corrected. No deficiencies are being cited on this date. Administrator was not available while conducting exit interview and authorized staff member Richard Felix to sign on this report and civil penalty page (LIC421FC), and a copy of this report and appeal rights provided.the state’s words, verbatim · CDSS document, Nov 17, 2022

Type of visit: Post Licensing

On 11/3/2022 starting at 9:00 a.m., Licensing Program Analyst (LPA) Catherine Lin arrived unannounced to conduct a post-Licensing Inspection after facility accepted the 1st resident in October 2022. LPA met with Administrator and staff and disclosed the purpose of the visit. Administrator was not available and authorized staff to sign on the report. During the inspection, LPA toured facility including but not limited to front entrance, screening station, hand washing stations, bedrooms, kitchen, common areas, and backyard. There is one central entry point for universal screening for staff, residents and visitors. Facility has a sufficient 2-day perishable and one-week non-perishable food supply. Facility has Infection Control Plan, Emergency Disaster Plan, and maintains record of routine screening for residents, staff and visitors. THE FOLLOWING DEFICIENCIES WERE OBSERVED: · Approximately 9:20 a.m., LPA observed 10 knives and 1 scissor in the kitchen drawer without being locked. Staff locked them up during visit. · Approximately 9:30 a.m., LPA observed water temperature was 137.2 degree F. · Approximately 9:40 a.m., LPA observed the fire extinguisher was last purchased on 8/1/2021. · Approximately 9:45 a.m., LPA observed gardening tool, paint, and gardening chemical supplies located in the backyard were observed unlocked. Staff locked all items during visit. · Approximately 10:00 a.m., based on record review, LPA observed that there has no Physician's Report, Pre-Admission Appraisal, and Admission Agreement on resident's file. The above deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations. Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted with staff. LIC809D, Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Nov 3, 2022

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Allegation investigated: Facility does not have enough food for residents in care Resident had an altercation with another resident in the home Staff spoke inappropriately to resident Staff did not safeguard resident's personal property Staff left residents unattended Staff yelled at residents Staff did not allow resident to eat

On 9/30/22 at 9:00am, Licensing Program Analyst (LPA) Catherine Lin conducted an announced subsequent complaint investigation regarding the above allegations and delivered investigation findings. LPA met with Administrator and explained the purpose of the visit. Facility does not have enough food for residents in care – Unfounded The Department has investigated this allegation and per record review and interviews found that the current census in facility was zero. There was no requirement to maintain adequate food supply in facility with zero census. During the subject time period, there were 2 individuals residing at the facility. It was found that R2 (subject of the complaint) was a general renter not receiving any services; and R1 and been accidentally placed at the facility by another agency (Family Home Agency), and was immediately transferred when it learned that the facility is an RCFE. Neither individual was jurisdictional to CCLD. Continue on LIC9099-C (page 1) Unfounded Resident had an altercation with another resident in the home – Unfounded The Department has investigated this allegation and per record review and interviews found that R1 was referred by Family Home Agency (FHA) which was contracted with the Mentor Network. R1’s social worker W1 had no knowledge that the facility had been licensed by CCL, and W1 moved R1 to an appropriate facility. R2 was a non-resident who was found to be a general renter of the facility. It had been alleged that R2 had been subjected to an assault by R1, however, it has been found that neither individual was jurisdictional to CCLD. Staff spoke inappropriately to resident – Unfounded The Department has investigated this allegation and per record review and interviews found that R2 (subject to this complaint) was a general renter and not an admission to the licensed facility. Staff denied speaking inappropriately to R2 with no witnesses identified, and R2 was not jurisdictional to CCLD. Staff did not safeguard resident’s personal property – Unfounded The Department has investigated this allegation and per record review and interviews found that R2 (subject to this complaint) was a general renter and not an admission to the licensed facility. Staff denied holding any personal belongings of R2, none were found at the facility during investigation, and there were no identified witnesses – in addition to R2 not being jurisdictional to CCLD. Staff left residents unattended – Unfounded The Department has investigated this allegation and per record review and interviews found that R2 (subject to this complaint) was a general renter and not an admission to the licensed facility. The facility was under no obligation to supervise R2, and R2 was not jurisdictional to CCLD. Staff yelled at residents – Unfounded The Department has investigated this allegation and per record review and interviews found that while staff denied yelling at the residents – with no identified witnesses – R2 (subject to this complaint) and R1 were not jurisdictional to CCLD. Continue on LIC9099-C (page 2) Staff did not allow resident to eat – Unfounded The Department has investigated this allegation and per record review and interviews found that R2 (subject to this complaint) was a general renter and not an admission to the licensed facility. Therefore, the facility was under no obligation to provide food per Title 22 and R2 was not jurisdictional to CCLD. The Department has investigated the complaint alleging the above complaint allegations and have found that the complaint was UNFOUNDED, meaning that the allegations are false, could not have happened and/or is without a reasonable basis. No deficiency cited. Exit interview conducted with Administrator and a copy of this report provided. (page 3, ended)the state’s words, verbatim · CDSS document, Sep 30, 2022 · control 15-AS-20220215153035

Type of visit: Prelicensing

On 11/19/2021 at 9:00 AM, Licensing Program Analyst (LPA) C. Lin arrived announced to conduct Pre-licensing Required inspection. LPA met with Administrator, Sara Trail and explained the purpose of the visit. The facility currently has no clients. LPA toured facility including but not limited to 5 bedrooms, 4 bathrooms, 1 office, kitchen, common areas and backyard. Bedrooms and living rooms were equipped with the proper furniture. Bathrooms were equipped with non-skid mats. Linens and hygiene supplies were observed inside a cabinet. There is sufficient lighting throughout facility. Room temperature was maintained at 69 degrees F and hot water temperature was maintained at 110 degrees F. First-aid kits were observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was purchased on 08/01/2021. LPA observed the facility had the necessary posters in posted in common areas (i.e. Complaint poster, Personal Rights, Rights to Council, Visitation policy, Emergency Disaster Plan). No deficiencies cited during the pre-licensing inspection. LPA observed the facility is ready to be licensed. However, this report will be submitted to the central application unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Nov 19, 2021

Type of visit: Case Management - Other

On 11/19/2021 at 10:45 AM, Licensing Program Analyst (LPA) C. Lin conducted a Component III presentation with Administrator. LPA provided the Administrator sufficient information on how to operate the facility within substantial compliance as well as how to avoid common problem areas of facility operation. Items discussed were clients refusing medications, AWOLs, engaging in inappropriate behaviors, money management, staffing, personnel records, clients' records, criminal record clearances, association to facility, centrally stored medications, locked toxic chemicals, Special incident reporting (LIC 624s), emergency/disaster plans/fire drills, in-service training for staff, first aid/CPR certifications, prohibited & restricted health conditions, universal precautions for staph infections, Personal rights, etc. Administrator is appreciative of information shared during this presentation.the state’s words, verbatim · CDSS document, Nov 19, 2021