Yearling Board and Care

Type of visit: Required - 1 Year

On 9/11/23 at 9:00 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced Annual/Required inspection to Yearling Board and Care. Upon arrival LPA was greeted by Direct Support Professional (DSP) Jean Andrade who contacted the Administrator, Maria Tangonan. The Administrator arrived at 9:10 a.m., and LPA explained the reason for the visit. This home is licensed to serve age range 60 and over. (6) non-Ambulatory of which (1) may be bedridden. The bedridden resident is approved for bedroom #2. Hospice wavier granted for (2) residents. There were (5) resident in care during the time of this visit, the other (1) resident was hospitalized. The last emergency disaster/fire drill was conducted on 9/05/2023. The Administrator Certificate expires on 10/30/2023 #6054015740. During today's visit LPA inspected the physical plant inside and outside, reviewed the food supply, tested the smoke/carbon monoxide detectors, reviewed (3) staff files, (6) resident files, medications, and medication administration records for (6) residents. This home contains 5 resident bedrooms, 1 staff bedroom, 2 bathrooms, 1 staff bathroom, living room, kitchen, dining room and an attached garage. LPA toured the physical plant with the Administrator. and observed all (5) resident bedrooms, contained required furniture, lamps, dresser, chair, and closet space. The three bathrooms contain a working toilet, basin and water faucet, walk in shower with grab bar, shower chair, and bathmat. The temperature measured at 113.5.7*F-117.5*F. The smoke detectors were battery operated and individually tested and observed to be working properly. The carbon monoxide detector was located throughout the facility, tested, and functioning properly. There were (3) fire extinguishers located in kitchen, hallway and the garage fully charged and up to date. The kitchen was toured and contained working appliances; refrigerator, stove, oven and contained dishware, cups, plates, utensils, pots, and pans with knives secured and locked in a cabinet. The toxins and cleaning supplies were locked underneath kitchen sink. The pantry was well stocked with canned goods, pasta, cereals, and the food supply contained a sufficient supply with a two-day supply of perishables and a seven-day supply of non-perishables that met title 22 guidelines. Walls and floors, cabinets and counters were clean and sanitary throughout the home. (Report continued on LIC809C.) The outdoor grounds were toured and inspected, and the patio was well maintained with a shaded seating area accessible for resident use. The garage contained a working washer and dryer, with cabinetry that contained emergency supply kits, bottled water, toiletries, personal care supplies, toxins and cleaning agents stored locked. The dining room contained bingo, coloring supplies, ring toss and activity supplies available to the residents. Exit interview conducted with Maria Tangonan, Administrator, a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 11, 2023

Allegation investigated: Staff did not provide proper notification to increase resident's rates. Staff are charging resident for unnecessary fees.

On 07/20/2023 at 9:31 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted a subsequent 10-day complaint visit, to deliver findings. LPA met with staff (S1) Manuel Torres who contacted the administrator. At 9:50 (Administrator) Maria Tangonan called and LPA explained the reason for the visit. Staff Leonida Namuag arrived at 10:45 a.m. During the initial visit on 7/6/2023, LPA toured the facility with the Administrator. LPA obtained resident roster, staff roster, staff schedule, R1 admissions agreement, R2 admissions agreement, R1 Needs and services plan dated 6/09/22 and 6/22/2023, R1 physicians’ report, and letter of fee increase. LPA also interviewed: Administrator and a total of two (2) staff who shall be referred to as S1, and S2. LPA interviewed a total of three (3) residents who shall be referred to as: R1 through R3. LPA attempted to interview R4 through R6, but due to communication limitation LPA was unable to conduct the interview. LPA also interviewed family member of R4. Report continued on 9099c Substantiated The investigation reveals the following: Regarding " Staff are not able to meet resident's needs due to being short staffed.", it is alleged that the facility wants to evict R1 due to being short staffed. During the tour LPA observed 2 staff on duty. The Administrator denied the allegation stating they have 2 staff working during the day and 1 night staff. LPA observed staff schedule and confirmed administrators interview. 2 out of 2 staff stated the facility have 2 staff working during the day and 1 night staff. 3 out of 3 residents stated the facility has 2 or more staff during the day and 1 night staff. Family member for R4 stated during visitations they always observe 2 staff. Facility member for R1 stated the facility has not given a formal eviction notice but stated they are short of male staff and will not be able to continue caring for R1. The investigation reveals the following: Regarding " Staff did not provide resident with a breakdown of fees due for rate increase.", it is alleged that the facility did not provide a proper breakdown of fees before rate increase. The administrator denied the allegation stating they provided all responsible parties with a breakdown of fee increase. LPA reviewed the document provided and confirmed the breakdown of the fees before rate increase. 2 out of 2 staff stated they are not involved in the financial aspects of the facility. 3 out of 3 residents stated their family members handle their finances. Family member of R4 stated they are unsure if they received a breakdown of fees. Family member of R1 stated they did not receive a breakdown of rates. Based on LPA's interviews, investigation revealed: 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. Exit interview conducted with Leonida Namuag and a copy of this record provided. The investigation reveals the following: Regarding " Staff did not provide proper notification to increase resident's rates.", it is alleged that the facility notified the responsible parties through text. The Administrator denied the allegation stating the families received a 30-day notice and was provided with written notice. 3 out of 3 residents interviewed stated their family members handle their finances. LPA interviewed a told of 2 family members who stated they received a 30-day notice before the rate increased. Per the health and safety code the facility is required to gave no less than 60 days’ notice for a rate increase The investigation reveals the following: Regarding " Staff are charging resident for unnecessary fees.", it is alleged that the facility is going to increase fees during months of major holidays. The Administrator confirmed the allegation stating the increase is used to pay staff time and a half during the holidays. 3 out of 3 residents interviewed stated their family members handle their finances. LPA interviewed a told of 2 family members who confirmed the allegation stating the rate increases during the holidays and decreases after the holiday. Documentation reviewed confirmed the allegation. Based on LPA observation, interviews and file review, the preponderance of evidence standard has been met, therefore, the above allegations is found to be SUBSTANTIATED. California Code of Regulation, Title 22 are being cited on the attached LIC9099D. Exit Interview Conducted with administrator/ Appeal Rights Provided / A Copy of the Report Issued.the state’s words, verbatim · CDSS document, Jul 20, 2023 · control 28-AS-20230629151114

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.655(a) · Plan of correction due date: Aug 4, 2023

1569.655 (a) If a licensee of a residential care facility for the elderly increases the rates of fees for residents or makes increases in any of its rate structures for services, the licensee shall provide no less than 60 days' prior written notice to the residents or the residents' representatives ... This requirement is not being met as evidenced by : Facility administrator confirmed the residents resonsible parties was given a 30 days notice, which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 20, 2023

Plan of correction: The Licensee will ensure the facility provides proper notification of there rate increase and review health and safety code 1569.655 by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.655(b) · Plan of correction due date: Aug 4, 2023

1569.655(b) No licensee shall charge nonrecurring lump-sum assessments. The notification requirements contained in subdivision (a) shall apply to increases specified in this subdivision. For purposes of this subdivision, "nonrecurring lump-sum assessments" mean rate increases due to unavoidable and unexpected costs that financially obligate the licensee. In lieu of the lump-sum payment, all increases in rates shall be to the monthly rate amortized over a 12-month period. The prohibition against a lump-sum assessment shall not apply to charges for specific goods or services provided to an individual resident. This requirement is not being met as evidenced by : Facility administrator confirmed that they requires residents to pay holiday pay only during the holidays, which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 20, 2023

Plan of correction: The Licensee will ensure they do not charge non reaccurring lump sum and review health and safety code 1569.655 by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) V. Maldonado made an unannounced visit to the facility for the required 1 year inspection. LPA was greeted by caregiver Modesto Valentos and he was explained the purpose for the visit. Modesto phoned licensee Maria Tangonan and informed her of the visit. Shortly after, licensee's aunt Leonida Namuag arrived at the facility to assist with the inspection. LPA used the infection control tool to evaluate the facility. During today's visit, LPA toured the physical plant with caregiver Modesto and Leonida, food and PPE supplies were observed, and COVID-19 procedures and residents' medications were reviewed. Licensee Maria Tangonan arrived at the end of the visit to assist with the visit. The facility is a one story home in a residential area that consists of 5 bedrooms, 3 bathrooms, a living room, a kitchen, a dining room, a back patio, and attached garage. The facility is licensed to serve 6 non-ambulatory residents, of which 1 may be bedridden, all of ages 60 and over. The facility also has a hospice waiver for 6 residents. During the tour, LPA observed the living room area with sufficient seating and lighting. Social distancing signs were posted throughout the facility. All 5 bedrooms were observed to have the required bedding, furniture and storage space. The 3 bathrooms were observed to have functional showers, toilets and wash basins. All handwash stations were fully stocked with soap and paper towels for use. The hot water was tested in all bathrooms and measured within the required 105*F - 120*F. All showers were observed to have the required grab bars and non-skid mats. The food supplies was observed in the kitchen and the emergency food supplies was stored in the garage. LPA observed more than the required 2-day perishable and 7-day non-perishable food supplies. All sharps were observed to be stored and locked in a kitchen cabinet next to the sink, and cleaning supplies and toxins were stored and locked under the kitchen sink. The back patio had a shaded seating area for the residents. All walkways and entrances/exits were observed to be clear and free of debris and hazards. A fire extinguisher was observed in the hallway and in the garage- both inspected and fully charged. Sufficient PPE was observed throughout the facility and readily available for resident use. Smoke/carbon monoxide detectors were tested and observed to operate properly. (Report Continued on LIC809-C...) At 11:02AM, LPA reviewed the medication for Residents#1-#4. R1-R3 had prescribed medications that were not properly labeled, per California Code of Regulations, Title 22. At 11:30AM- LPA reviewed the facility staff roster and association list. During the review, it was discovered that (1) staff has a criminal background clearance, but is not associated to the facility. Per California Code of Regulations, Title 22, deficiencies were observed during today's visit and will be cited on the LIC809-D. Additionally, immediate civil penalties in the amount of $500 will be issued today. An exit interview was conducted with Licensee Maria Tangonan and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 12, 2022

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Nune Margaryan, and Glenn Trueman conducted a prelicensing visit. LPA’s met with Maria Tangonan and Laurence Tangonan. Component III was also completed during the visit. The fire clearance has been approved for 6 non-ambulatory residents of which 1 may be bedridden. The applicant has requested to care for dementia residents. A hospice waiver has been requested for 2 hospice residents. The physical plant was toured with the applicant. The following was observed: There are auditory devices on exit doors as required for dementia residents. The auditory devices were operating at the time of the visit. Smoke detectors were observed in common areas and in each resident bedroom. The smoke detectors are also carbon monoxide detectors. The fire extinguishers are fully charged. The common areas were appropriately furnished and lighting was adequate. The resident and staff records will be stored in locked cabinets located in the Administrator's office. The garage was observed. The washer and dryer are located in the garage. Medications are stored in a locked cabinet in the living room. Facility also has a complete first aid kit. Windows and doors are in good condition and there were no obstructions near doors. Windows do not have security bars. There are 5 bedrooms for residents and 0 staff bedrooms. 1 of the resident bedrooms are shared room, and 4 are private rooms. Resident rooms were observed to have the required furniture such as bed frames, dressers, chairs, lamps and sufficient closet space. The bedding was also appropriate. The facility has 3 bathrooms. The bathrooms have sufficient hygiene items. The bathrooms have the required grab bars along with the required non-slip mats. The hot water temperature was between 114.2 to 118.2 degrees, which is within the required 105 - 120 degrees. There is sufficient lighting throughout the home including common areas and resident bedrooms Dining room and kitchen observed to have room for sufficient dining capacity, and the kitchen had all necessary equipment and supplies to meet the needs of six (6) residents. Appliances in the kitchen were clean and all functional. The supply of dishes/cups are adequate. More than 7-day supply of nonperishable foods were observed. Count. 809C The backyard has a shaded patio area with patio furniture. There is no pool or other large bodies of water. The home has all the required posters including but not limited to complaint poster, labor law, Ombudsman, personal rights, emergency disaster plan, and COVID-19 required postings. The facility is in compliance with Title 22 regulations. Exit interview was conducted and a copy of the report was provided to applicant.the state’s words, verbatim · CDSS document, Sep 2, 2021