Better Living & Care II

Type of visit: Required - 1 Year

On 09/16/2023 at 12:00 NOON, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Better Living & Care 2 Facility. LPA Calderon was allowed entry into the facility by Staff Violetta Khalilova. Staff Violetta Khalilova asked infection control questions and took LPA Calderon temperature prior to entrance into the facility. The facility is licensed for six (6) adult clients with developmental disabilities. Currently, there are four (4) residents residing in the facility with developmental disabilities. LPA Calderon explained to Staff Violetta Khalilova, the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: (PENDING) four (4) resident service records, (PENDING) four (4) resident medication records, (PENDING) two (2) staff records. LPA Calderon inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on (PENDING). The one-story residential home consists of four (4) resident bedrooms, three (3) resident bathrooms, living room, dining room, family room, kitchen, office area, washer and dryer/ storage area, backyard with table and chairs. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water supply is found in the garage area. LPA Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Calderon observed the following during inspection of resident’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Calderon observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 109 degrees Fahrenheit, and bathroom #2 hot water temperature properly measured at 107 degrees Fahrenheit, Bathroom #3 hot water temperature properly measured at 105 degrees Fahrenheit. Kitchen hot water temperature properly measured at 117 degrees Fahrenheit. Facility two (2) carbon Monoxide and seven (7) Smoke Detectors hard wired and connected were tested and are working properly. The facility three (3) Fire Extinguishers were checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. All toxins and knifes are locked/secured and inaccessible to residents. Medications are centrally stored and in a locked storage cabinet. Facility first aid kit is fully stocked with manual was checked and in order. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to residents. (PENDING) Four (4) resident files were reviewed and found to be complete. LPA Calderon reviewed (PENDING) four (4) resident medications and they were all found to be administered according to doctor's orders. (PENDING) Two (2) staff files were checked and have the required documents. LPA Calderon noted the Administrator Lucien Ezros Certification # PENDING expiration date of 00/00/2024 was UNCLEAR valid at time of visit. The facility does NOT handle resident's money/cash resources and a NO Surety bond is needed. General Lability Policy #PENDING policy period from 00/00/2023 to 00/00/2024 underwritten by PENDING Insurance Company Inc, coverage 1,000,000/3,000,000 is PENDING valid at time of inspection. LPA Calderon spoke to Administrator Lucien Ezros who will email valid insurance contact to LPA Calderon on 10/09/2023. All the required documents are posted in the facility in a clearly visible area. LPA Calderon reviewed LIC500 and noted all staff associated to facility. During the visit, LPA Calderon observed the facility infection control practices. LPA Calderon observed screening protocols for visitors, staff, and residents, sanitizing stations (Located in common areas and restrooms). LPA Calderon observed staff and residents were NOT wearing face coverings and required postings throughout the facility. LPA Calderon observed the facility has a thirty-day (30) supply of Personal Protective Equipment (PPE). LPA Calderon advised the Staff Violetta Khalilova to continuously monitor the Centers for Disease Control (CDC) website and Community Care Likening Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Calderon did not observe any deficiencies therefore NO citations were issued at this time. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Staff Violetta Khalilova.the state’s words, verbatim · CDSS document, Sep 16, 2023

Allegation investigated: Staff unlawfully evicted resident.

Licensing Program Analyst (LPA) Ana Soto conducted a subsequent complaint investigation to deliver findings and decisions for the allegation listed above. Today’s complaint investigation was conducted with Violette Khalilova, Care Giver. The investigation consisted of following: Interviews and Record reviews. On 10/24/2022, LPA Soto interviewed S#1-Lucien Ezros and S#2-Stella Ezros, administrators, S#3, (S#4 - S#6 via telephone), R#1 - R#3. The LPA also requested copies of the following documents on 10/24/2022, Face sheets, Resident and Staff rosters, R#1’s-( Admissions agreement, Resident Telecommunication Device Notification, Appraisals, Dual power of attorney, ID/Emergency information, vaccination-booster, consent to photograph and medical treatment, Personal rights, Physician's Report, Medication list. Dietary Menu, and Skilled nursing (Guardian) documents.) Unsubstantiated Based on the LPA's investigation, the investigation revealed the following. For Allegation – Staff unlawfully evicted resident. Interviews conducted with S#1 & S#2, communicated that R#1, was admitted to the facility on 10/06/22 and R#1 came to the facility from a skilled nursing facility. Administrator #2 evaluated R#1 at the skilled nursing facility and seemed like a good fit for the facility. The same night R#1 arrived, R#1 exhibited behaviors not disclosed to the facility. R#1 was exhibiting Dementia behaviors, such as: Sun downing, taking pamper off completely, and hanging out of the bed. R#1’s family took R#1 to a Urology doctor because R#1 came from the skilled nursing facility with a UTI. Family member claiming that R#1 behaviors were likely from the UTI R#1 had. The doctor communicated that R#1’s nightly behavior was from Dementia not the UTI. On 10/12/22, S#1, texted R#1 family member, let family member know that R#1 needed a higher level of care which the facility could not provide and R#1 needed to go to the hospital for the UTI. They volunteered to help find a new appropriate facility for R#1, were R#1 could be properly cared for because of R#1 Dementia extreme behaviors. Interviews conducted with S#3 – S#6, communicated that R#1 needed a lot of care. The staff had to be looking in on R#1 every hour to make sure R#1 was not falling or hanging from the bed, still had R#1 pamper on, and not trying to fall from R#1 wheelchair. R#1 would sleep during the day and slump over R#1 wheelchair because R#1 did not sleep during the night. Interviews conducted R#1 & R#3, could not communicate with LPA, R#1 was not able to communicate verbally and R#3, was not available for interview. R#2, communicated that R#2 has no issues with the facility. LPA reviewed R#1 - Physician’s report dated 10/03/22, it stated that R#1, needed basic assistance for bathing, eating, and help with changing clothes and diapers. The physician’s report also indicated that there was no sun downing or any other behavior which needed a higher level of care. Skilled nursing documents dated 10/03/22, showed that R#1 did have a UTI when R#1 was admitted to the facility. R#1 was admitted to the hospital on 10/17/22 and never returned to the facility per family member decision, R#1 was not illegally evicted. The interviews and records review did not concur with the above allegation. 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, therefore the allegation is unsubstantiated An exit interview was conducted with Violetta Khalilova, Care giver and a hard copy of report was provided.the state’s words, verbatim · CDSS document, Mar 9, 2023 · control 11-AS-20221018134543

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ana Soto conducted an unannounced Annual required visit and an infection control inspection to the above facility. LPA was met by Ekaterina Bagirova, and later met with Stella Ezros, Licensee and the purpose of today’s visit was explained. There are currently (5) residents in the facility. (1) residents are ambulatory and (3) are non-ambulatory, (1) on hospice. The facility is a single-story yellow structure located in a residential neighborhood. It consists (4) bedrooms, (3) full bathrooms, shaded back yard, front yard, laundry room and a 2 car detached garage. LPA and Stella toured the entire facility inside and out. Documents are posted as mandated. Bedrooms 1 - 4 are occupied by residents and contain the mandated furniture. 1 resident has recliner as a bed, resident chooses to have the recliner as a bed, due to fact that the recliner is easy to get up from. The (3) bathrooms are clean and operational. First aid kit complete with manual; smoke detectors and carbon monoxide detector were in compliance and operational. No firearms are stored at facility and no bodies of water present. Medications are stored, locked and inaccessible to residents. 1 staff and 1 resident file and medications are current. Ample supply of perishable and nonperishable food, hot water temperature is 118 degrees Fahrenheit, linens and personal hygiene supplies are adequate, hazardous toxins and/or sharp items are inaccessible to residents, 1 fire extinguishers are fully charged. Exit, walkways and/or passageways, front and back yard are free of debris and/or hazards. The facility is in good repair. During the visit, LPA observed the facility infection control practices. LPA observed a sanitizing station at the facility entry, visitors are logged, and temperature checked, sanitizer/soap in the kitchen and additional sanitation supplies are locked in the garage and in living room. LPA observed staff and clients wearing masks, residents’ private rooms will be converted to isolation rooms (if needed) and required postings throughout the facility. The facility has an approved Mitigation plan. The resident’s temperatures are checked and logged twice a day. PPE's are enough for 30 days. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe any deficiencies, therefore no citations were issued at this time. An exit interview conducted with Stella Ezros, Licensee and copy of report provided.the state’s words, verbatim · CDSS document, Sep 23, 2021