Alameda Board & Care

Allegation investigated: Staff did not ensure a safe and healthy environment by speaking inappropriately to a resident Staff would not allow resident to have personal property

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegations. LPA met with Licensee Vahag Amirjanyan and explained the reason for the visit. The Investigation consisted of the following: LPA conducted interviews with Licensee Vahag Amirjanyan, Administrator Yelena Amirjanyan, Staff 1-2 (S1-2), Residents 1-3 (R1-3) and Kern Medical Emergency Department LVN Discharge Facilitator (LVN DF) by telephone. LPA obtained copies of Staff and Resident Rosters. LPA reviewed R1's facility file and collected copies of the following: Physician's Report for Residential Care Facilities for the Elderly dated 1/10/22, Identification and Emergency Information dated 2/4/21, Preplacement Appraisal Information dated 2/5/21, Resident Appraisal dated 2/5/21, Appraisal/ Needs and Services Plan dated 2/1/21, Kern Medical Emergency Department Discharge Instructions dated 7/3/22, Unity First Hospice Care Inc paperwork, Note signed by R1 dated 7/7/22 and Note signed by R1's (See LIC9099C for continuation) Unsubstantiated Family Member (R1 FM) regarding personal belongings dated 6/30/22. LPA additionally conducted a tour of facility which included observations of living room, dining room, kitchen and random resident rooms which included R1's room. LPA attempted a phone call to Unity First Hospice Care Inc. Investigation revealed the following: Regarding allegation, Staff did not ensure a safe and healthy environment by speaking inappropriately to a resident, it is alleged that facility staff made inappropriate comments to a facility resident and that facility is not providing appropriate physical care to a resident as prescribed. Interviews conducted with facility licensee Mr. Amirjanyan and Administrator Yelena Amirjanya revealed that facility staff provide a safe and healthy environment to all facility residents at all times. They denied that any facility staff have ever spoken inappropriately to any facility resident and stated that staff take very good care of all facility residents at all times. Interviews conducted with S1-2 revealed that staff ensure a safe and healthy environment for all residents at all times and provide the appropriate needed care that each facility resident needs. S1-2 denied ever making any inappropriate comments or speaking inappropriately to any facility resident and stated that they treat all facility residents with dignity and respect at all times. 3 out of 3 residents that were interviewed stated that they are happy at the facility and stated that facility have not spoken to them inappropriately. 3 out of 3 residents stated that they are happy at the facility, feel safe at the facility and do not have any concerns. Interview with R1 revealed that they are happy at the facility and they live at the facility due to their personal choice. LPA observed staff interactions with facility residents and observed staff tending to residents and speaking to them in an appropriate manner. Based on interviews conducted with facility staff, facility residents, and LPA observations, there was not enough supportive evidence to concur with the reported allegation. Regarding allegation, Staff would not allow resident to have personal property, it is alleged that facility staff did not allow resident to take their wheelchair and oxygen machine. Interviews conducted with Licensee Mr. Amirjanyan and Administrator Yelena Amirjanya revealed that R1 FM came to the facility on 6/30/22 and chose to independently remove R1 from the facility to individually care for and take responsibility for R1. R1 agreed to leave with R1 FM and took all their belongings. R1 FM signed a letter indicating that they were taking full responsibility of R1 and was taking all of R1's belongings including all medications. They stated that the only items that the facility did not allow R1's FM to take were the wheelchair and oxygen machine due to the items being property of Unity First Hospice Care Inc and assigned to R1 as Durable Medical Equipment (DME) for use at the facility and R1 FM was relocating R1 to a different county in California. LPA reviewed Unity First Hospice Care Inc paperwork and observed that both items are listed as DME equipment. LPA attempted to contact hospice agency but was not able to reach anyone. LPA also reviewed Note signed by R1FM which listed R1's belongings that were taken on 6/30/22. Interviews conducted with R1-3 revealed that they do not have any concerns regarding their personal property and they stated that they do not have any concerns regarding the facility or the services received at the facility. R1 stated that they want to live at the facility and no longer wish to live with R1 FM. Interview conducted with Kern Medical Emergency Department LVN DF revealed that R1 was left at the hospital by R1 FM due to R1 FM not being able to care for R1 and did not leave any belongings for R1. LVN DF stated that R1 did not have a medical reason to be left at the hospital and stated that R1 told them that they wanted to return to the facility. R1 was transferred from the hospital back to the facility with no belongings as R1 FM left R1 at the hospital with no belongings. LPA toured the facility including R1's room and did not observe anything of concern. Administrator stated that R1 FM came to the facility on 7/10/22 and dropped off some of R1's belongings. Based on interviews conducted with facility staff, facility residents, Kern Medical Emergency Department LVN DF, LPA observations, and LPA review of records, there was not enough supportive evidence to concur with the reported allegation. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview held. A copy of the report was provided to Licensee Vahag Amirjanyan.the state’s words, verbatim · CDSS document, Jul 11, 2022 · control 28-AS-20220705141921

Allegation investigated: Resident is not provided drinking water. Resident's hygiene needs are not being met. Facility does not ensure resident is receiving therapy sessions.

Licensing Program Analyst Alberto Lopez conducted an unannounced site visit to the facility for the purpose of investigating the above complaint allegations. LPA was greeted by Armine Oganesyan DSP, and Administrator Yelena Amirjanyan arrived a short time later. The investigation consisted of interviews with Administrator and two staff S1-S2, three residents R1-R3. LPA also reviewed and obtained staff rooster, resident roster, R1 Admission Agreement, R1 Physician's report, R1 Hospice Care Inc treatment/medication /DME list. R1 medication list. Allegation: Resident is not provided drinking water. R1 is under doctor's orders to thicken all liquids including water in order to prevent aspiration. Administrator and 2 of 2 staff stated they provide resident with water but thicken it with “Thick it Powder” according to Doctor’s orders. 3 of 3 residents stated they get water when they ask. Unsubstantiated Allegation: Resident's hygiene needs are not being met. Administrator and two staff (S1 -S2) stated that all of resident’s hygiene needs are being met and that resident can communicate when he wants his hygiene needs taken care of. Administrator stated resident is under Hospice care and they provide bathing services 2 times per week. Facility does not ensure resident is receiving therapy sessions: Administrator stated that there is no doctor order for any kind of therapy, and they do not provide that service. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the above alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview was conducted with Administrator and care provider Melania Iailoian and Administrator gave Care provider authorization to sign report.the state’s words, verbatim · CDSS document, Jun 23, 2022 · control 28-AS-20220622091836

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(2) · Plan of correction due date: Jun 30, 2022

87468.1(a)(2) Residents in all residential care facilities for the elderly shall have all of the following personal rights 2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. The above was not met by evidence of: Facility staff could not find resident's socks in his possesion or anywhere in the facility.the state’s words, verbatim · CDSS document, Jun 23, 2022

Plan of correction: Licensee will purchase new socks for R1 and will send receipts and photos to LPA by POC date as proof.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nune Margaryan conducted an unannounced Required One (1) year - Inspection to this facility. Upon arrival, LPA met with Staff Armine Oganesyan. Administrator Yelena Amirjanyan arrived shortly after, and assisted with the visit. The purpose of the visit was explained. The facility is licensed to serve 6 (six) ambulatory residents ages 60 and over of which 1 (one) may be bedridden. Facility is approved to retain 2 (two) residents on hospice. The facility cares for elderly residents with dementia. LPA Nune Margaryan inspected the physical plant including but not limited to the kitchen, dining and living room, bedrooms, bathrooms, laundry area, and outside areas of the facility to ensure compliance with Title 22 regulations. LPA also conducted the infection control domain tool. There is only one entrance being utilized at the facility, all required posters were posted at the entrance. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. LPA was screened upon entry. All staff were observed to be wearing mask upon entrance and during visit. LPA inspected the interior and the exterior of the facility with the Administrator including but not limited to: living /dinning room, office / storage room, kitchen, three (3) resident bedrooms, three (3) bathrooms, laundry located outside, backyard and garage. All indoor and outdoor passageways are free of obstruction. Bathrooms and bedrooms were clean and in good repair. There is a locked storages for medications in the kitchen. The common areas including the living / dining room are clean and have the required furniture. The backyard has a shaded area and sitting area. In the back yard right next to shaded / sitting area LPA observed cabinet which contains cleaning supplies / chemicals. It was not locked or inaccessible to residents. The facility has camera in the leaving / dining area only. Continue 809C All residents bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, and sufficient closet space. Both bathrooms were toured. Bathrooms have the required grabs bars and non-skid mats. The hot water was 117.5 and 118.2 degrees which is within the required 105 - 120 degrees. LPA observed fire extinguisher near the kitchen which was fully charged. Smoke detectors were observed throughout the facility. First-aid Kit is complete and located in the kitchen. LPA reviewed residents files to confirm emergency contact is updated. LPA also reviewed staff files to confirm health screenings and fingerprint clearances. All staff files reviewed were fingerprint cleared. Residents' medications were reviewed. Medications are documented properly and stored appropriately. The deficiency cited is documented on the attached 809D. A copy of the report and appeal rights will be provided to Administrator.the state’s words, verbatim · CDSS document, Mar 4, 2022