Better Living and Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA's) Gina Saucedo, Michael Cava and Angela Panushkina arrived at the facility at 10:30 am to conduct an annual. LPA's met with Natalya Sadovskaya and explained the purpose of this visit. She then called the administrator Stella Ezros whom arrived about ten minutes after. Stella Ezros walked us through the facility for our physical plant inspection. A tour of the physical plant was conducted at 10:55am and the following was observed: The facility has six (06) bedrooms and (06) bathrooms located in the bedrooms currently occupying (1) one residents. The facility has one main entrance being used, there are required Covid-19 prevention signage (handwashing, coughing etiquette, and physical distancing) posting in the entrance. The PPE screening station is located on a table at the entrance equipped with sufficient PPE readily accessible, a thermometer, hand sanitizer, gloves, mask, and sign in sheet at the time of visit. The facility maintains an overall temperature at 75 degrees Fahrenheit. Kitchen: The LPA's observed the kitchen to be clean and an adequate supply of perishables and non-perishable food. There is a pantry storing dry food, condiments, and can goods above the refrigerator. Food was properly labeled and stored. All appliances observed to be operational and in good repair. Fire extinguisher observed to be under the kitchen sink fully charged. Sharps and chemicals were observed to be stored in the kitchen pantry inaccessible to residents in care. LPA's observed (6) bedrooms to be appropriately furnished with sufficient lighting. LPA observed appropriately bed linen and comforters on all beds. All bedrooms are single occupancy. All bedrooms observed to be clean and clear from obstruction. LPA's observed (6) bathrooms which are located inside of the bedrooms to be clean and in proper operation. Water temperature measured at 115.2 degrees Fahrenheit. LPA's observed appropriate grab bars in shower and toilet area with appropriate non-skid mats in six (6) out of (6) bathrooms. Bathrooms are stocked and equipped with soap and private towels use. Medications: LPA's observed the locked medication cabinets in the medication room located in the hallway. LPA's observed the first aid kit and manual located and stored in the medication room. Living, dining room and common areas: LPA's observed these areas to be appropriately furnished with tables and chairs and adequate lighting. Observed to be neat and clean. The smoke detector was tested and observed to be working, it is not hard wired and interconnected throughout facility. The facility has does not have a carbon monoxide detector a Type A citation was issued. Backyard: LPA's observed the outside area and surrounding the facility it was clean and clear from obstruction and debris. The facility has a covered area with a table and chairs for seating, and additional table and chairs for lounging. LPA's observed a swimming pool with a self-latching gate measured a pad lock that requires a key located on the premises to be locked during the visit. LPA's observed a detached garage that is separated into two sections to be locked and storing extra personal care items, incontinent supplies, PPE in one section, and the laundry machines and toxins, extra wheelchairs, walkers, and mattresses on the second section of the garage. Exit interview conducted. Copy of report, Type A citation issued.the state’s words, verbatim · CDSS document, Oct 19, 2023

Allegation investigated: Facility did not seek timely medical treatment for resident's injuries

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced subsequent complaint visit at this facility to deliver the findings for the above allegations. LPA met with Administrator Stella Ezros and explained the reason for the visit. On 01/24/22, a complaint was received by the Woodland Hills Adult and Senior Care Regional Office. The complaint was referred to and accepted by Community Care Licensing Division’s Investigations Branch (IB) and assigned to IB investigator Tiffany Brunelli. On 01/25/2022 at 9:02 AM, LPA Tan initiated the complaint visit. LPA Tan interviewed the administrator and staff and obtained copies of the facility records relevant to the investigation. (continued to LIC 9099-C) Substantiated (continued from LIC 9099) During the course of the investigation, LPA Tan interviewed the administrator and staff on 01/25/2022 between 11:15 AM to 1:00 PM. Investigator Brunelli interviewed the administrator, staff, family member, hospital and fire department and law enforcement staff on different dates and time from 03/14/22 to 07/18/22. IB Investigator Brunelli also reviewed hospital record, Los Angeles Police Department (LAPD) and Los Angeles Fire Department (LAFD)’s record on 05/6/22 and 05/27/22. Regarding the allegation that the Facility did not seek timely medical treatment for resident's injuries, it was alleged that Resident #1 (R1) was being burned for two (2) hours prior to anyone from the facility calling 911. IB Investigator Brunelli’s interview with staff on 03/24/22 at 2:05 PM and 03/25/22 at 11:15 AM and LPA’s interview with staff on 01/25/22 at around 10:30 AM revealed that the incident occurred between 4:50 PM to 5:10 PM. IB Investigator Brunelli’s record review of the 911 call record on 05/27/22 however, revealed that the first 911 call regarding the incident was at 7:07:31 PM. IB Brunelli’s interview with the administrator on 3/14/22 at 12:11 PM and LPA’s interview on 01/25/22 at around 11:45 PM also revealed that R1 and R1’s family member (FM) refused to be sent to the hospital initially. Overall investigation concluded that although R1 and their family member refused to send R1 to the hospital, the staff should have immediately call 911 as R1’s injuries has resulted in an imminent threat to resident’s health and safety. Therefore, based on the information gathered during the course of the investigation, the allegation is deemed substantiated at this time. Citation issued. Appeal rights discussed and given. Exit interview conducted. Copy of this report issued. (continued from LIC 9099-A) During the course of the investigation, LPA Tan interviewed the administrator and staff on 01/25/2022 between 11:15 AM to 1:00 PM. Investigator Brunelli interviewed the administrator, staff, family member, hospital and fire department and law enforcement staff on different dates and time from 03/14/22 to 07/18/22. IB Investigator Brunelli also reviewed hospital record, Los Angeles Police Department (LAPD) and Los Angeles Fire Department (LAFD)’s record on 05/6/22 and 05/27/22. Regarding the allegation that Resident sustained major injuries while in care, it was alleged that R1 sustained significant burns 30% to 40% of R1’s body. IB Investigator Brunelli’s interview with staff on 03/24/22 at 2:05 PM and 03/25/22 at 11:15 AM and LPA’s interview with staff on 01/25/22 at around 10:30 AM revealed that R1 had been living at the facility since 04/12/18 and had a daily routine of smoking after every meal at the same place in the residence, which is just outside by the gated swimming pool. There were two (2) care staff on duty at the time of the incident and they were checking R1 periodically every five (5) to ten (10) minutes. Investigator Brunelli’s interview with FM on 03/14/22 at 12:11 PM also revealed that the FM noticed that it was on the day of the incident and thought of calling the facility to notify the staff about the windy condition as FM was aware that R1 usually smokes outside of the house but was not able to, for some reason. FM also expressed that FM did not suspect any foul play or negligence on the part of the staff. Regarding the allegation that Staff did not have adequate knowledge of first aid to properly treat injuries, it was alleged that while the staff attempted to treat R1’s injuries it was the incorrect treatment. LPA record review on 01/25/22 revealed that both staff on duty on the night of the incident had a current first aid certificate on file. LPA’s interview also revealed that the staff applied what they learned from their training and do the best that they can to assist R1 given the circumstances. Based on the information gathered during the course of the investigation, there is insufficient information to support the allegations and therefore deemed unsubstantiated at this time. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Aug 24, 2022 · control 31-AS-20220124115111

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(g) · Plan of correction due date: Aug 26, 2022

The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis except as specified in Sections 87469(c)(2), (c)(3), or (c)(4). This requirement is not as evidenced by: Based on IB Investigator record review and interview, the llicensee did not immediately call 911 after the incident regarding R1 which poses an immediate health risk to the resident in care.the state’s words, verbatim · CDSS document, Aug 24, 2022

Plan of correction: Licensee agreed to submit a written statement understanding section 87465(g) of the regulation and to formulate a new policy in the facility to abide by this regulation, to be submitted to CCL on or before the POC date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) LaQueena Lacy arrived at the facility at 1:37pm on 07/07/2022 to conduct a One (1) year Required Infection Control visit. LPA meet with Stella Ezros and explained the purpose of this visit. The facility has an approved mitigation plan on file. A tour of the physical plant was conducted at 1:55am and the following was observed: The facility has six (06) bedrooms and (06) bathrooms located in the bedrooms currently occupying (6) residents. The facility has one main entrance being used, there are required Covid-19 prevention signage (handwashing, coughing etiquette, and physical distancing) posted. The PPE screening station is located on a table at the entrance equipped with sufficient PPE readily accessible, a thermometer, hand sanitizer, gloves, mask, and sign in sheet at the time of visit. The facility maintains a temperature at 76 degrees Fahrenheit which is controlled by an application on the administrators cell phone. The facility has a fire clearance for (06) non-ambulatory. Kitchen: At 2:06pm LPA observed the kitchen to be clean and an adequate supply of perishables and non-perishable food. There is a pantry storing dry food, condiments, and can goods. Food was properly labeled and stored. All appliances observed to be operational and in good repair. Fire extinguisher observed to be under the kitchen sink with an inspection tag of March 2022. Sharps observed to be stored in the kitchen pantry inaccessible to resident in care. Contuinued on LIC809C Bedrooms: At 2:17pm LPA observed (6) bedrooms to be appropriately furnished with sufficient lighting. LPA observed appropriately bed linen and comforters on all beds. All bedrooms are single occupancy. All bedrooms observed to be clean and clear from obstruction. Bathroom: At 2:17pm LPA observed (6) bathrooms which are located inside of the bedrooms to be clean and in proper operation. Water temperature measured at 111.6 – 112.4 degrees Fahrenheit. LPA observed appropriate grab bars in shower and toilet area with appropriate non-skid mats in three (3) out of (6) bathrooms. (3) out of (6) residents received bed baths therefore no non-skid mats are located in those bathrooms. Bathrooms are stocked and equipped with soap and private towels use. Medications: LPA observed at 2:32pm the locked medication cabinet located in the hallway by the entrance of the facility. LPA observed the first aid kit and manual located and stored in the medication cupboard. Living, dining room and common areas: At 2:39pm LPA observed these areas to be appropriately furnished with tables and chairs and adequate lighting. Observed to be neat and clean. Activities are stored in a cupboard near the entrance of the facility. At 2:51pm the smoke detector was tested and observed to be working, it is not hard wired and interconnected throughout facility. The facility has a carbon monoxide detector located in the hallway it was tested and observed to be operational and functioning. Backyard: At 3:02am LPA observed the outside area and surrounding the facility it was clean and clear from obstruction and debris. The facility has a covered area with a table and chairs for seating, and additional table and chairs for lounging. LPA observed a swimming pool with a self-latching gate measured at 5ft with a pad lock that requires a key located on the premises to be locked during the visit. LPA observed a detached garage that is separated into two sections at 3:09pm to be locked and storing extra personal care items, incontinent supplies, PPE in one section, and the laundry machines and toxins, extra wheelchairs, walkers, and mattresses on the second section of the garage. Exit interview conducted. Copy of report, Technical Assistance issued.the state’s words, verbatim · CDSS document, Jul 7, 2022

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.