SK Marathon Home Care

Type of visit: Required - 1 Year

At 11:35 p.m. on 10/06/2022, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual visit. LPA met with Administrator and disclosed the reason for the visit. LPA and Administrator toured the facility inside and out. The facility was last visited on 06/13/2022 for a complaint visit. It is a single story building with 4 bedrooms, 2 bathrooms, kitchen, common areas, and outdoor areas. It has an approved fire clearance for 5 nonambulatory residents, of which 1 may be bedridden in Bedroom #3. Approved hospice waivers for 2. Cameras are used in common areas. Upon entry, LPA a resident sitting outside in a maintained front yard. The front yard is gated. The ramp leading up to the main entrance was in good condition. Signs posted at the main entrance indicated the facility’s masking and visitation policies. LPA was screened for infectious disease upon entry. The screening station contained a digital thermometer, surgical masks, sanitizing wipes, hand sanitizer, and a visitor log. The visitor log tracked temperatures, and the Administrator stated vaccination status and symptoms are documented and retained. Other postings inside included Ombudsman contacts, confidential complaint contact, personal rights, emergency contacts, rights of resident councils, COVID precautions, activity calendar, facility sketch, and facility menu. Walls, floors, ceilings, windows, screens, and blinds were clean and in good repair. At 11:50 p.m. LPA measured the room temperature to be 79 degrees Fahrenheit. The fireplace was appropriately grated. Living room furniture was in good repair. Medications were locked near the dining room. 2 residents were observed eating lunch. LPA observed an adequate supply of perishable and non-perishable food in the kitchen. The stove hood was clean. Appliances were functional. Surfaces were sanitary. Sharps and cleaning solutions were locked above the counter top. Patio furniture was in good condition and shaded. The facility kept a pet dog outside. The laundry shed was behind the kitchen. It contained an operable washer and dryer, and detergents were locked in the shed. The facility had 4 bedrooms. 1 was private and 2 were shared. 1 bedroom was designated for staff. The staff bedroom was free of hazards and inaccessible. All bedrooms contained a chair, nightstand, nightlights, storage, and bed with adequate bedding. All furnishings were clean and in good condition. Emergency exit paths were free from obstruction and unlocked. 3 out of 3 auditory alarms were on and functioning. The facility had 2 bathrooms. All bathrooms contained liquid soap, paper towels, handwashing instruction sign, trash can with a tight fitting lid, grab bars near the toilet and shower, assistive devices, and a non-skid mat in the shower. At 11:56 a.m. LPA measured the water temperature in Bathroom #1 to be 116 degrees Fahrenheit. At 11:59 a.m. LPA observed a fully charged fire extinguisher in the kitchen It was purchased on 01/02/2022. At 12:06 p.m. LPA tested the dual function smoke and carbon monoxide detector to be operational. 2 out of 2 detectors functioned simultaneously, and an additional verbal alert sounded. During today's inspection, the facility is in compliance with Title 22 regulations. No citations issued. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Oct 6, 2022

Allegation investigated: Facility is unsanitary. Facility is not following Covid-19 screening protocols. Facility appliances are in disrepair Resident(s) have access to harmful chemicals while in care. Doorknobs are obstructed to keep residents from moving freely throughout facility and leaving the facility Ombudsman Poster is not visible to residents at the facility. Facility has bugs Facility staff is not allowing residents to speak with visitors privately Residents are not being provided activities while in care.

Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced complaint visit to investigate the allegations above. LPA met with the administrator and explained the reason for this visit. LPA conducted a physical plant tour of the facility from approximately 10-10:40am to ensure no immediate health and safety issues were present. Regarding the allegations above LPA went over the allegations with the administrator. Facility is unsanitary It is alleged that the facility is dirty and unkempt in some areas of the facility. During the physical plant walk through LPA did observed there clutter and debris in some areas of the facility. In the bathroom LPA observed a pair of dirty shoes in the bathtub. LPA also observed spider webs in the corner of some areas in the facility. Based on information obtained through observation this allegation is deemed Substantiated at this time. Substantiated Facility is not following Covid-19 screening protocols. It is alleged that facility staff are not screening visitors for Covid-19 symptoms by taking visitor's temperatures and that facility staff is not wearing mask around the facility. Upon entry to the facility, facility staff did not take LPA's temperature and staff were observed to not be wearing mask during the initial part of the visit. After approximately five minutes into the visit staff put their mask on. Based on the information obtained through observation this allegation is deemed Substantiated. Facility appliances are in disrepair It is alleged that during a visit by a verified witness on 5/6/22 that the facilities dryer and the toilet in the resident bathroom to not be working properly. It was also noted that there were several cords on the ground throughout the facility that were a tripping hazard for the residents. LPA spoke with facility staff regarding this allegation. Administrator stated that the toilet and dryer have been fixed since 5/6/22. LPA observed facility staff pick up cords that were laying on the ground around the facility. Based on the information obtained through interview and observation this allegation is deemed Substantiated. Resident(s) have access to harmful chemicals while in care. It is alleged that facility has cleaning supplies that are not locked up and are accessible to residents. During the physical plant walk through LPA observed cleaning supplies accessible to residents and not locked away. Based on the information obtained through observation this allegation is deemed Substantiated at this time. Doorknobs are obstructed to keep residents from moving freely throughout facility and leaving the facility. It is alleged that facility has a device on the doorknobs entering the facility and in some resident bedrooms which stop residents from opening the doors. During the physical plant walk through LPA observed a device on the door to stop residents from opening the door. LPA also observed a device on a resident's door which stopped them from opening the door. LPA spoke with the administrator about this allegation and was told that they had it on there to stop residents from wandering in the middle of the night. Based on the information obtained through interviews and observation this allegation is deemed Substantiated at this time. Ombudsman Poster is not visible to residents at the facility. It is alleged that the facility did not have an Ombudsman poster visible to the residents in the facility. LPA spoke with the administrator regarding this allegation. Administrator stated that they did not have an Ombudsman poster for a period of time but after speaking with an Ombudsman the facility was able to obtain a poster and have it posted in a visible place for the residents. During the visit LPA observed the ombudsman poster posted by the entry of the facility. Based on the information obtained through interviews this allegation is deemed Substantiated. Facility has bugs It is alleged that the facility had cockroaches in the facility. LPA received photos of cockroaches throughout the facility. LPA during the physical plant walk through observed spider webs on the ceiling inside the facility. LPA also spoke with staff regarding this allegation. Staff indicated they have not had pest control come out but they have been spraying the facility for insects. Based on the information obtained through observation and interviews this allegation is deemed Substantiated. Facility staff is not allowing residents to speak with visitors privately It is alleged that facility staff was not allowing residents to meet privately with a visitors on 5/6/22. LPA spoke with a verified witness who confirmed that on 5/6/22 residents did have visitors who came to speak with the residents and confirmed residents were not allowed to speak privately with their visitors. LPA spoke with the administrator regarding this allegation. Based on the information obtained through interviews this allegation is deemed Substantiated at this time. Residents are not being provided activities while in care. It is alleged that residents are not being provided activities while in care. LPA conducted interviews with facility staff regarding this allegation. LPA attempted to interviews the residents but the residents were not able to understand what was being asked. During the visit LPA observed one resident to be sitting alone at the table, while another resident was just sitting on the couch, while another resident was in their bedroom. LPA interviewed staff regarding this and they stated only one person was able to do activities. Based on the information obtained through observation and interviews this allegation is deemed Substantiated. All deficiencies are cited on LIC 9099 D. Appeal Rights explained. Exit Interview conducted.the state’s words, verbatim · CDSS document, Jun 13, 2022 · control 31-AS-20220610145602

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(f)(2) · Plan of correction due date: Jun 13, 2022

Care Persons with Dementia-Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. This requirement was not met as evidenced by Based on observation during the physical plant walk through LPA observed disinfectants to be accessible to residents in care which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jun 13, 2022

Plan of correction: Corrected during the visit. Cleaning supplies were locked away during the visit.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(6) · Plan of correction due date: Jun 13, 2022

Personal Rights of Residents in All facilities-To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night. This requirement was not met as evidenced by: Based on observation LPA observed a device on the front door of the facility and a resident bedroom which stopped residents from opening the door and would stop them from leaving the facility which poses an immediate health and safety risk to all residents in care.the state’s words, verbatim · CDSS document, Jun 13, 2022

Plan of correction: Corrected during the visit. The devices on the doors were removed during the visit.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87470(c) · Plan of correction due date: Jun 15, 2022

87470(c) An Infection Control Plan shall be developed by the licensee... (1) The Infection Control Plan shall include: (F) Staff shall demonstrate knowledge... appropriate to the job assigned and as evidenced by safe and effective job performance. This requirement was not met as evidenced by: Based on observations the licensee/staff did not comply with the cited section by not screening LPA"s for symptoms of COVID 19 upon entry and facility staff were not observed to be wearin gmask which poses and immediate Health and Safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 13, 2022

Plan of correction: Administrator shall submit statement that all visitors will be Covid-19 screened before entering the facility and that facility staff shall wear mask while working. Statement shall be submitted to LPA by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Jun 15, 2022

Maintenance and Operation-The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by: Based on observation the facility was not observed to be clean and sanitary during the visit. Facility also had an issue with roaches being present in the facility.The toilet and dryer were not working for a time which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jun 13, 2022

Plan of correction: Administrator shall have a pest control company come and treat the facility. Administrator shall also have the facility cleaned and send a self certifying statement when this is done. Proof of pest control services obtained need to be submitted to LPA.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(1) · Plan of correction due date: Jun 15, 2022

Additional Personal Rights of Residents in Privately Operated Facilities-To have a reasonable level of personal privacy in accommodations, medical treatment, personal care and assistance, visits, communications, telephone conversations, use of the Internet, and meetings of resident and family groups. This requirement was not met as evidenced by: Based on interviews conducted residents were not able to meet privately without interruptions with visitors on 5/6/22. This poses as a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jun 13, 2022

Plan of correction: Administrator shall submit statement that residents will have privacy when meeting with any visitor and their visitation will not be impeded by facility staff. Statement is due by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(1) · Plan of correction due date: Jun 13, 2022

Additional Personal Rights of Residents in Privately Operated Facilities- The licensee shall post the telephone numbers and addresses for the local offices of the State Department of Social Services and ombudsman program conspicuously in the facility foyer, lobby, residents’ activity room, or other location easily accessible to residents and their representatives. This requirement was not met as evidenced by: Based on interviews for a period of time facility did not have a poster which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jun 13, 2022

Plan of correction: Corrected before visit. Facility obtained a LTCO poster and it is posted for residents to see.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87219(a) · Plan of correction due date: Jun 15, 2022

Planned Activities-Residents shall be encouraged to maintain and develop their fullest potential for independent living through participation in planned activities. This requirement was not met as evidenced by Based on interviews conducted and observation residents did not have planned activities which posed a personal rights violation to residents in care.the state’s words, verbatim · CDSS document, Jun 13, 2022

Plan of correction: Administrator shall submit a planned activities calendar and signed statement that activities will be provided to residents.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jackson and Licensing Program Analyst (LPA) Shanahan arrived at the facility in order to conduct an annual infection control visit. LPAs were greeted by facility staff and after temperature checks were allowed to enter the facility. LPAs completed infection control tools and inspection. The home was checked for fire safety and observed that the smoke alarms, carbon monoxide detector and all door alarms were functioning properly. The facility is following their approved mitigation plan and no deficiencies were cited on today's visit. Exit interview conducted and report issued.the state’s words, verbatim · CDSS document, Oct 4, 2021