Anza Home Care

Type of visit: Case Management - Annual Continuation

On 05/11/23, Licensing Program Analyst (LPA) Mario Leon conducted an unannounced annual required visit with using the full CARE Inspection Tool. LPA met with house manager, Patricia Changco and explained the purpose of today’s visit. The facility is licensed to operate for (1) non-ambulatory and cleared for (5) bedridden elderly residents ages 60 and above. The facility is approved for (6) hospice residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident's rooms, two (2) common bathrooms, living area, dining area, kitchen, and outside covered patio area. LPA toured the physical plant. There were no obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were clean and operational, yet found to be outside Title 22 regulations as the water temperature measured 128.3 F. A comfortable temperature of 74 degrees was maintained in the facility. LPA observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The facility has (1) fire extinguisher that is charged, smoke detectors operable. A working landline telephone remains available. Evaluation Report continues on LIC 809-C There were six (6) deficiencies cited today, one of which is a repeated violation resulting in an immediate civil penalty. See LIC809D and LIC421FC. There was one technical violation observed. See LIC9102AN. An exit interview was conducted. This report, deficiencies and appeal rights have been provided to House Manager, Patricia Changco.the state’s words, verbatim · CDSS document, May 12, 2023

The state marks this report as 7 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 05/01/2023 Licensing Program Analyst (LPA) Mario Leon conducted an unannounced annual inspection visit at the above facility. LPA Leon was met by Patricia Changco, House Manager. During today's inspection a physical plant tour was conducted with Mrs. Changco. LPA conducted facility, staff and resident records review. During today's visit, there were no deficiencies cited. Due to time constraints, an unannounced subsequent annual inspection will be conducted. An exit interview was conducted and a copy of this report was provided to Mrs. Changco, House manager.the state’s words, verbatim · CDSS document, May 1, 2023

Type of visit: Case Management - Deficiencies

On 07/08/22, Licensing Program Analyst (LPA) Ernand Dabuet initiated a Case Management visit. LPA was met by Shalani Ramos the assistant administrator and explained the purpose of today’s visit. LPA toured the physical plant in association with the required annual inspection on 07/08/22. The facility is caring for residents diagnosed with dementia and observed the residents with non-up-to-date medical assessment and reappraisal reports for residents #1- #4 (R1–R4). The physician's reports for (R1) is dated 02/05/21 and (R2) is dated 06/08//21. While (R3) and (R4) are dated 10/06/20. During the inspection, LPA observed that the facility did not have a current administrator on file and did not notify the Department of the change of administrator. During record review, an active administrator was observed for Rodrigo Ramos which is not in compliance with PIN 21-24 CCLD. Based on interviews, observation, and record reviews the licensee violated the California Code Regulations (CCR) of Title 22, Division 6, Chapter 8, Deficiencies are issued and an exit interview is conducted with Shalani Ramos. A copy of this report is provided along with the appeal rights.the state’s words, verbatim · CDSS document, Jul 8, 2022

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(a) · Plan of correction due date: Jul 22, 2022

87405 Administrator - Qualifications and Duties(a) All facilities shall have a qualified and currently certified administrator...The administrator shall have ... other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section... This requirement was not met as evidenced by: Based on observation and interview, the licensee did not have an authorized administrator file with CCLD. This citation poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 8, 2022

Plan of correction: The licensee will adhere to Title 22 Section 87405. The licensee will perform knowledge of and conform to applicable laws, rules, and regulations. Plan of correction will be submitted by POC due date: 07/22/22 with documentation for authorized facility administrator.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87705(5) · Plan of correction due date: Aug 8, 2022

87705 (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. This requirement was not met as evidenced by: Based on observation and interview, the licensee did not have up to date medical assessments and reappraisal for (R1-R4). This citation poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 8, 2022

Plan of correction: The licensee will adhere to Title 22 Section 87705. The licensee will perform knowledge of and conform to applicable laws, rules, and regulations. The licensee will ensure to obtain medical assessments/reappraisals for all residents in care. Plan of correction will be submitted by POC due date: 08/08/22.

Type of visit: Required - 1 Year

On 07/08/22, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit with a primary focus on Infection Control measures using the CARE Inspection Tool. LPA met with administrator Shalani Ramos and explained the purpose of today’s visit. The facility is licensed to operate for (1) non-ambulatory and cleared for (5) bedridden elderly residents ages 60 and above. The facility is approved for (6) hospice residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident's rooms, two (2) common bathrooms, living area, dining area, kitchen, and outside covered patio area. LPA toured the physical plant. There were no obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were operational. The water temperature measured 111.6 F. A comfortable temperature of 64 degrees was maintained in the facility. LPA observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The facility has (1) fire extinguisher that is charged, smoke detectors operable. A working landline telephone remains available. Evaluation Report continues on LIC 809-C DEFICIENCIES: LPA observed at 10:32 am an unpresentable bathroom #1 and #2. At 10:40 am, LPA observed the kitchen area in an unpresentable condition. At 12:00 pm, LPA observed a non-working carbon monoxide. The facility failed to conduct fire drills on a quarterly basis. The facility did not have Medication Administration Records for resident #4 who is receiving PRN medications for July 2022. INFECTION CONTROL: During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of staff tests and residents' vaccination along with daily temperature checks were conducted. The facility has an approved Mitigation Plan Report on file with CCLD. Deficiencies are issued and an exit interview is conducted with Shalani Ramos. A copy of this report is provided along with the appeal rights.the state’s words, verbatim · CDSS document, Jul 8, 2022

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.