Atwater Residential Care Facility

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced facility visit to deliver findings on the allegations listed above. LPA met with facility Facility staff Arlene Ferguson and explained the purpose of today's visit. Licensee Jessica Johnson was not present at the facility during this visit, but did contact LPA Hurt via phone. Regarding the allegation Staff are denying the residents from going outside due to loose animals. LPA's interviewed facility staff 1 on 03/13/2024 who stated the residents do not normally go in the facility backyard because the goats are loose in the area. LPA's observed several goats along with some goat feces, in the backyard loose on the patio near the back facility door. Based on LPA's interviews conducted, and observation the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. The following Deficiencies are being cited Per Title 22 Regulations, Exit interview conducted with facility stRead the full finding— CDSS inspection report, December 12, 2024 · control 24-AS-20240311224521

Licensing Program Analysts (LPA's) Sarah Hurt and Brianna Miranda conducted an unannounced visit to the facility to deliver investigation findings. LPA’s met with Assistant Administrator, Airen Miro and explained the purpose of today’s visit. Regarding the allegation the facility is not adequately staffed resulting in the facility calling the fire department for assistance. Emergency Medical Personnel provided a log with more than 21 dates listed where they have been asked to assist Residents in the facility that have fallen, and residents who need assistance getting up from being seated in a recliner to different areas of the facility. Based on interviews conducted during this investigation, and call logs reviewed the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED at this time. Continued... SubstantiatedRead the full finding— CDSS inspection report, January 10, 2024 · control 24-AS-20230612142552

Licensing Program Analysts (LPA's) Sarah Hurt and Brianna Miranda conducted an unannounced visit to the facility to deliver investigation findings. LPA’s met with Assistant Administrator, Airen Miro and explained the purpose of today’s visit. Regarding the allegation Illegal Eviction. Resident 1 was taken to the hospital on 12/17/23 and was denied admission back to the facility upon release. Based on LPA's interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. Regarding the allegation Residents’ conservator not provided Admission Agreement within seven days. Resident 1’s conservator was not provided an Admission Agreement within seven days of admission to the facility. Based on LPA’s interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. The following deficiencies arRead the full finding— CDSS inspection report, January 10, 2024 · control 24-AS-20231219084413

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced facility visit to open a complaint on the allegations listed above. LPA met with facility staff Andrene Lowe and explained the purpose of today's visit. Licensee Jessica Johnson was not present at the facility during this visit, but did contact LPA Hurt via phone. Regarding the allegation Staff refused to allow resident to return to facility after hospital stay. Licensee stated Resident 1 did not sign an Admission Agreement and no money was collected therefore was never a resident at this facility.LPA Hurt observed Resident 1 not to be present at the facility during visit on 12/08/2023. 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. No deficincies cited Per Title 22 Regulations. Exit interview conducted with Administrator Jessica Johnson vis phone, and a copy of this reportRead the full finding— CDSS inspection report, December 8, 2023 · control 24-AS-20231204154208

Licensing Program Analysts (LPA's) Sarah Hurt and Brianna Miranda arrived unannounced to deliver findings on the above allegatuons on 12/01/23 at 10:00 a.m.. LPA's met with facility Assistant Administrator Airen Miro and stated the purpose of the visit. Regarding the allegation Staff did not issue a refund. Resident 1 provided proof of two paid fees to Licensee totaling $1,855.00 in two separate payments dated on 08/01/2022 (Admission fee $500), and on 08/16/2022 (holding fee $1,355.00.) Resident 1 never moved into the facility. Licensee refunded Resident 1 $500 of the fees paid. The Admission Agreement does not speak to any non refundable "holding" fees. Based on records reviewed during this investigation, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED at this time. The following deficincies are being cited Per Title 22 Regulations. Exit interview conducted with Assistant Administrator Airen Miro, and a copy of this reRead the full finding— CDSS inspection report, December 1, 2023 · control 24-AS-20230511143721

Licensing Program Analysts (LPA's) Sarah Hurt and Darius Williams conducted an unannounced visit to the facility to deliver investigation findings. LPA’s met with Licensee Jessica Johnson over the phone and explained the purpose of today’s visit. Regarding the allegation, Staff did not meet a resident's incontinence needs while in care. LPA Hurt observed several photos documenting Resident 1’s buttocks area to be extremely red and irritated. Medical records document Resident 1 had erythema and pain in the buttocks area. Based on records reviewed during this investigation, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED at this time. Continued.... SubstantiatedRead the full finding— CDSS inspection report, October 25, 2023 · control 24-AS-20230320135406

Licensing Program Analysts (LPA's) Sarah Hurt and Lisa Salazar conducted an unannounced facility visit conduct a Case Management visit. LPA's met with facility staff Octavia Mcvea and explained the purpose of today's visit. Regarding the allegation Staff are not trained medication management. The Licensee was not able to provide medication training for Staff 1 to LPA's Hurt and Salazar for review. Based on LPA's observation during this investigation, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED at this time. Substantiated— CDSS inspection report, September 1, 2023 · control 24-AS-20230831094129

On 07/28/2023, Licensing Program Analysts(LPA's) Sarah Hurt and Lisa Salazar arrived at the facility unannounced to conduct an initial 10-day complaint inspection. LPAs met with facility Licensee Jessica Johnson announced the purpose of the inspection. Regarding the allegation Staff was unable to communicate due to language barrier.LPA's observed facility Staff 1 present during visit is unable to communicate with licensing staff or facility residents as she does not speak English. Based on LPA's observation during this investigation, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED at this time. Continued on 9099C.. SubstantiatedRead the full finding— CDSS inspection report, July 28, 2023 · control 24-AS-20230725122932

Licensing Program Analyst (LPA) Sarah Hurt and David Ayers conducted an unannounced facility visit to open a complaint investigation. LPA's met with facility Licensee Jessica Johnson and explained the purpose of today's visit. During the course of the investigation, the department conducted interviews, reviewed documentation, and toured the facility. Based on interviews and documentation, Resident 1(R1) was admitted to the facility on 11/23/2022. Based on records review, R1 was admitted without a complete pre-admission appraisal. R1's Needs and Services Plan was also incomplete. Based on interviews, the facility did not have proper eqipument to meet R1's needs. The allegation is Substantiated. See attached 9099D for citation issued in accordance with California Code of Regulations Title 22. Exit iterview conducted with Licensee. SubstantiatedRead the full finding— CDSS inspection report, March 24, 2023 · control 24-AS-20221201135742

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced facility visit to conduct a complaint investigation. LPA Hurt met with Administrator Jessica Johnson and explained the purpose of today's visit. Regarding the allegation Staff did not provide the resident’s representative written notice of the rate increase within two business days after initially providing services at the new level of care. The facility Admissions Agreement documents under section "Notice of Rate Changes." We shall provide the resident or the representatives a written itemized explanation of the additional services provided. Resident 1's responsible party stated they were given the written description through email on 11/18/2022 after the verbal notification of increased rate on 11/04/2022. Based on facility records reviewed, and interviews conducted the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Continued on 9099C.... SubstantiatedRead the full finding— CDSS inspection report, February 27, 2023 · control 24-AS-20221115100653

This is an amended report. On 09/21/2022, Licensing Program Analyst (LPA) Walton conducted an unannounced complaint investigation visit. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Facility staff contacted Administrator via telephone, and she was unable to attend but gave LPA verbal permission to meet with Caregiver, Arlene Angeles. LPA delivered findings of the complaint, whose signature on the original report, confirms receipt. Today, 11/16/2022, LPA Walton and Licensing Program Manager (LPM) Melinda Hoffmann contacted Administrator via telephone and informed her that the report is being amended as follows. CONTINUED TO 9099C SubstantiatedRead the full finding— CDSS inspection report, September 21, 2022 · control 24-AS-20220914194055