Good Hands Homecare

Allegation investigated: Illegal Eviction Staff did not observe resident had open wound Staff did not disclose to POA resident's health condition

On 09/13/2023 at 8:00 am, Licensing Program Analyst (LPA) David España conducted an unannounced complaint visit at this facility, LPA was greeted by S4 and later Administrator Michelle Porca. LPA explained the purpose of the visit is to investigate the allegation mentioned above. LPA conducted a risk assessment at the entrance of the facility, and there are no COVID-19 cases at this time. The facility is licensed to operate for six (6) non-ambulatory elderly residents ages 60 and above. The facility is approved for six (6) hospice residents. Currently, there are four (4) hospice residents in care. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident's rooms, one (1) staff room, two (2) common bathrooms, a living area, a dining area, a kitchen, and an outside patio area. LPA and licensee toured the physical plant. The investigation consisted of the following: LPA España conducted a tour of the facility grounds. LPA España interviewed staff and noted the reviewed records. LPA España requested and reviewed the following documents, client roster and staff roster. LPA Investigation spans from 08/15/2023; 08/28/2023; and 09/13/2023. Report continued on LIC 9099C Unsubstantiated Allegation: Illegal Eviction At 8:00 am LPA reviewed documentation from past visit(s) 08/15/2023 and 08/28/2023, namely, Staff 1-4 (S1-S4) who were interviewed as S1 had no knowledge of the eviction and referred to case manager (unknown name) and complainant, as being all called and informed. LPA spoke to S1 regarding the alleged illegal eviction. The Administrator stated R1’s POA and case manager were informed. The Administrator further stated R1 was not evicted because R1 had higher level of care requirements. S1 stated there was no eviction issued. LPA noted two different statements on 08/15/2023: (1) Administrator did speak with R1’s POA and case manager about relocating R1 and (2) the Administrator did not provide an eviction notice. Residents 1, 2, 3, 5, 6, 7 (R1-R3 and R5-R7) all have dementia and are nonverbal. Resident 4 (R4) is verbal. LPA on 08/28/2023 and 09/13/2023 did not observe an eviction notice(s) copy as requested. LPA on 08/28/2023 and 09/13/2023 did not observe unlawful detainer action from the Superior Court. LPA on 08/28/2023 and 09/13/2023 observed no written judgment. LPA on 08/15/ 2023 and 08/28/2023 requested from S1 medical discharge, medical records, hospice records, and facility log notes relating to higher level of care (e.g., stage 1, 2, 3, and 4 confirmations of higher level of care). Allegation: Staff did not observe resident had open wound It’s being alleged the facility has not observed “Staff did not observe resident had open wound.” 6 out of 6 residents interviewed goes as follows: Residents 1, 2, 3, 5, 6, 7 (R1-R3 and R5-R7) all have dementia and verbal (Classified: As verbal by S1. LPA could not interview R1-R3 and R5-R7 all have dementia and are classified as "Alert and oriented x1 to name" as referenced by the appraisal/needs and services plan LPA reviewed R2). 4 out of 4 staff denied the allegation, S1-4 denied observing “Staff did not observe resident had open wound.” 1 out of 1 Witness 1 (W1) agreed with the allegation ““Staff did not observe resident had open wound.” Allegation: Staff did not disclose to POA resident's health condition. Regarding the allegation: “Staff did not disclose to POA resident's health condition.” Based on LPA’s observations, interviews with S 1-4 and record reviews, and W1 interviews goes as follows: S1-4 that that facility resident family members/responsible party were notified of all changes relating to resident’s health condition. S1, informed the LPA that all changes of resident’s health were discussed with POA and documented in their case file. S1 also stated that S2-4 makes sure that family members are notified and also arrange for medical appointments. In addition, S1 and S2 inform family of resident incidents that occur in the facility in person, however, not in written form. According to S1 and S2 there has never been an issue with a resident’s family member not being notified of changes to a resident’s condition. According to S1 and S2 the POA was spoke to weekly or biweekly regarding changes of resident’s conditions. Due to R1 terminal illness, W1 provided documentation to the LPA about the assessment process for R1 (placement ending date: 06/12/2022). LPA confirmed that between June 12, 2021, and April 20, 2022, according to W1, that R1 obtained care from Good Hands Homecare. In addition, on May 22, 2022, per W1, R1 was taken to the Torrance Memorial Hospital to treat her injuries. W1 noted that R1 had been taken to Dignity Hospice. W1 stated R1 was in COVID isolation at the Downey Community Health Center. On June 16, 2022, R1 was transferred to the Sunny Day Guest Home, where medical professionals and caregiver detected lesions in the second stage of their development. R1 passed away on August 21, 2022. 6 out of 6 residents interviewed goes as follows: Residents 1, 2, 3, 5, 6, 7 (R1-R3 and R5-R7) all have dementia. LPA could not interview R1-R3 and R5-R7 all have dementia. 4 out of 4 staff denied the allegation, S1-4 denied observing “Staff did not disclose to POA resident's health condition.” 1 out of 1 Witness 1 (W1) agreed with the allegation “Staff did not disclose to POA resident's health condition.” Based on interviews conducted, record reviews and observation, the preponderance of evidence standard has not been met. 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. A copy of this report was provided and discussed and left with Licensee Administrator Michelle Porca whose signature on this form confirm receipt of these documents.the state’s words, verbatim · CDSS document, Sep 13, 2023 · control 11-AS-20230810130243

Type of visit: Case Management - Deficiencies

On 09/13/2023 at 8:00 am, Licensing Program Analyst (LPA) David España conducted an unannounced complaint visit at this facility, LPA was greeted by S4 and later Administrator Michelle Porca. LPA explained the purpose of the visit is to investigate the allegation mentioned above. LPA conducted a risk assessment at the entrance of the facility, and there are no COVID-19 cases at this time. The facility is licensed to operate for six (6) non-ambulatory elderly residents ages 60 and above. The facility is approved for six (6) hospice residents. Currently, there are four (4) hospice residents in care. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident's rooms, one (1) staff room, two (2) common bathrooms, a living area, a dining area, a kitchen, and an outside patio area. LPA and licensee toured the physical plant. Based on LPA(s) observation and inspection the following resident bathroom(s) to have hot water temperature reading of 96.2 degree F. Title 22, Division 6 Chapter 8 Article 05. Physical Environments and Accommodations 87303 Maintenance and Operation is being cited on the attached LIC 809D. Deficiencies 87303(e)(1)(A)(B)(2-6) A copy of this report and appeal rights was provided and discussed and left with Licensee Administrator Michelle Porca whose signature on this form confirm receipt of these documents.the state’s words, verbatim · CDSS document, Sep 13, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(e)(A)(B)(2-6) · Plan of correction due date: Sep 17, 2023

Faucets used by residents for personal care...grooming shall... Hot water temperature controls...regulate the temperature of hot water...a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F... This requirement has not been met as evidenced by: Based on LPA(s) observation and inspection the following resident bathrooms there was hot water temperature reading of 96.2 degree F.the state’s words, verbatim · CDSS document, Sep 13, 2023

Plan of correction: Administrator will have how water temperature reading between 105F and 120F degrees for all facility bathrooms/restrooms by the POC due date. LPA will return to check correction.

Allegation investigated: Staff did not provide records to resident's authorized representative in a timely manner.

On 03/29/23, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced complaint visit at this facility, LPA was greeted by administrator Michelle Porca. LPA explained the purpose of the visit is to investigate the allegation mentioned above. INVESTIGATION REVEALED THE FOLLOWING: The complainant requested an investigation concerning resident #1 (R1) who formerly resided at this facility. According to the complainant, the facility failed to provide the service records requested to (R1's) representatives. These records were requested on 02/15/23 from the facility. According to the complainant, several email communications and phone calls were made to Good Hands HomeCare legal representative on the following dates: 03/09/23, 03/10/23, 03/23/23 and 03/28/23 with no response. Evaluation Report continues LIC 9099-C Substantiated The Department interviewed administrator Michell Porca staff #1 (S1) who recalled receiving a Medical Record request in 02/22/23 and forwarded the request immediately to the facility’s legal representative on 02/24/23. (S1) claimed once it was forwarded to their legal representative, (S1) was no longer involved with any communications with any of the parties once it was handled by legal representatives. An interview with the legal representative witness #1 (W1) verified responding to the request in late February 2023. (W1) requested additional supporting legal documents including a Declaration of Custodian of Records for (R1). The completed documents were received on 03/13/23 according to (W1). (W1) last email communication with the complainant was on 03/16/23 in a statement “working on it”. According to (W1) there have been no follow-up calls or email communications to the complainant regarding the service records and when they will be provided to the complainant. The complainant reported there has been limited update on the request and that the legal representative (W1) failed to provide the day, time, or date when medical records will be available. There is no evidence of (W1) was in communication with the complainant for 13 days since 03/16/23 to explain the reason for the delays. Based on interviews, observations, and supporting documentation, the preponderance of evidence standard has been met; the facility failed to make available upon written consent Title 22 section § 87506(c)(1). Therefore, the allegation of: “Staff did not provide records to resident's authorized representative in a timely manner” is found to be SUBSTANTIATED. According to the California Code of Regulations (Title 22, Division 6, Health and Safety Code), the following deficiency has been observed and a citation issued (ref. LIC 9099-D). An exit interview was conducted with Michelle Porca, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Mar 29, 2023 · control 11-AS-20230327150607

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(c)(1) · Plan of correction due date: Apr 5, 2023

87506-Resident Records (c) All information and records obtained from or regarding residents shall be confidential. … (1) The licensee shall be responsible for storing active and inactive records...licensee… shall reveal or make available confidential information… upon the resident's written consent or… designated representative. This requirement is not met as evidence by: Based on interview, Licensee did not make (R1) service records available on time upon written request. This violation possesses a potential Health and Safety risk to residents in care.the state’s words, verbatim · CDSS document, Mar 29, 2023

Plan of correction: Licensee/Administrator will adhere to the regulations and review Title 22 87506 and will ensure to release resident records upon written request on timely manner. Licensee will ensure to provide proof of correction sent by fax 323-981.1781 to El Segundo Regional office by 04/05/23.

Type of visit: Case Management - Deficiencies

On 03/29/23, Licensing Program Analyst (LPA) Ernand Dabuet conducted a case management inspection visit at this facility. LPA met with Admnistrator Michelle Porca and explained the purpose of the visit. During a complaint investigation visit on 03/29/23 control #11-AS-20230327150607 related to resident #1 (R1), LPA identified former resident #1 (R1) who was admitted at a local hospital on 05/12/22 and was on hospice care was not reported to Community Care Licensing (CCL) in timely manner with a LIC 624. (R1) required a higher level of care with restricted health conditions and did not return to the facility. The licensee violated Title 22 Regulations 82711- Reporting Requirements and 87632 - Hospice Care Waiver California Code of Regulations (Title 22, Division 6, Chapter 8), deficiencies were observed, and citations were issued (ref. LIC 9099-D).the state’s words, verbatim · CDSS document, Mar 29, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(D) · Plan of correction due date: Apr 5, 2023

87211 Reporting Requirements (a) licensee shall furnish to the licensing agency such reports as the Department... (1) A written report shall be submitted to the licensing agency... within seven days..(D) Any or health of any resident.. or unexplained absence of any resident. This requirement is not met as evidence by: Based on interview with licensee, Licensee failed to report incident with R1 admitted to hospital for change of health condition. This violation possesses a potential Health and Safety risk to residents in care.the state’s words, verbatim · CDSS document, Mar 29, 2023

Plan of correction: Licensee/Administrator will adhere to the regulations and will ensure any changes in resident's health condition or death will be reported to CCLD. Licensee will ensure to provide proof of correction sent by fax 323-981.1781 to El Segundo Regional office by 04/05/23. *Corrected during visit 03/2/9/23*

From the deficiency page — Deficiency type: Type B · Section cited: CCR87632(2) · Plan of correction due date: Apr 5, 2023

87632 Hospice Care Waiver (2) The licensee shall notify the Department in writing within five working days of the initiation of hospice care services for any terminally ill resident in the facility or within five working days of admitting a resident already receiving hospice care services... This requirement is not met as evidence by: Based on interview with licensee, Licensee failed to notifiy CCL with resident R1 admitted at this facility who was on hospice care. This violation possess a potential Health and Safety risk to residents in care.the state’s words, verbatim · CDSS document, Mar 29, 2023

Plan of correction: Licensee/Administrator will adhere to Title 22 87632 regulations and will ensure notify CCL of hospice residents in care. Licensee will ensure to provide proof of correction sent by fax 323-981.1781 to El Segundo Regional office by 04/05/23. *Corrected during visit 03/2/9/23*

Type of visit: Required - 1 Year

On 01/21/23, 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 and licensee Michelle Porca and explained the purpose of today’s visit. The facility is licensed to operate for six (6) non-ambulatory elderly residents ages 60 and above. The facility is approved for six (6) hospice residents. Currently, there are two (3) hospice residents in care. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident's rooms, one (1) staff room, two (2) common bathrooms, a living area, a dining area, a kitchen, and an outside patio area. LPA and licensee toured the physical plant. There were no bodies of water or 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 clean and operational. The water temperature measured 105.6 F. A comfortable temperature of 73 degrees was maintained in the facility. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, 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 two (2) fire extinguishers that were charged, smoke detectors, and carbon monoxide was operable. LPA reviewed Medication Administration Records (MAR) revealed accurate and maintained in order. The facility conducted a Fire/Safety Drill on 12/31/22. A working landline telephone remains available. The facility has a current liability insurance on file effective 06/23/22 – 06/23/23. Evaluation Report Continues on LIC 809-C INFECTION CONTROL: During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed staff 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 the resident's and staff vaccination records were conducted. The facility has a Mitigation Plan Report on file with CCLD. All staff had current (CPR/First-Aid) training certificates. No deficiencies cited. Technical Advisory Assistance (see LIC 9102). An exit interview was conducted, and a copy of this report was provided to Michelle Porca.the state’s words, verbatim · CDSS document, Jan 21, 2023

Type of visit: Required - 1 Year

On 1/04/22, Licensing Program Analysts (LPA) Gail Johnson and Ernand Dabuet conducted an unannounced annual required visit with a primary focus on Infection Control measures using the CARE Inspection Tool. LPA Johnson met with the licensee/administrator Michelle Ann Porca. LPA Johnson explained the purpose of today’s visit. The facility is licensed to operate for (6) non-ambulatory clients (60 and older). This facility is licensed as a Residential Care For the Elderly and to service clients with dementia. The facility is a one-story structure located in a residential neighborhood. It consists of the following: four (4) bedrooms (one staff bedroom and four client bedrooms) two bathrooms, living area, dining area, kitchen, and outside patio area. LPA Johnson and LPA Dabuet toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for client 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 clean and operational. The water temperature measured 106.9 F. Storage areas for personal hygiene, cleaning supplies, toxins, and sharp objects were stored and not accessible to clients. The kitchen was inspected and there is sufficient perishable and non-perishable food available and maintained properly. Three fire extinguishers were charged, smoke detectors and carbon monoxide were operable. Evaluation Report Continues on LIC 809-C During the visit, LPA Johnson and LPA Dabuet observed the facility's infection control practices. LPA Johnson observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA Johnson observed staff was wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection 'control posters were posted. There was appropriate signage throughout the facility (encouraging physical distancing on the floors). Staff and resident temperature logs were reviewed. The facility has a Mitigation Plan Report approved by CCLD on file. An exit interview was conducted with Michelle Ann Porca. A copy of this report was printed and provided to Michelle Ann Porca. An LIC-9102 is provided for technical assistance.the state’s words, verbatim · CDSS document, Jan 4, 2022