Napa Valley Senior Care

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Alviso conducted a continued Annual visit, on 7/18/2023 at approximately 10:15am, and met with Health & Wellness Director(HWD) Rafael Daatio. The HWD contacted the Administrator Minerva Villegas. The Administrator would arrive within an hour after being contacted. Hospice care waiver approved for ten(10) residents. Facility has an approved dementia plan of operation. Facility has a required Infection Control Plan, which is part of the facility's plan of operation. Fire clearance approval is for 46 nonambulatory residents, of which 10 may be bedridden. All ten(10) smoke alarms were serviced and tagged as required- expires 5/4/24. LPA toured the facility with the HWD. Hot water was checked at 109.8F., which is within regulation. Facility was observed to be at a comfortable temperature with portable air conditioners and fans throughout the facility during the inspection. LPA observed exits free from obstruction. LPA observed residents in the large dining area watching tv, and others at a large table participating in an activity with the Activities Director. Medications were locked up, and inaccessible to residents in care. All medications were stored appropriately within State and Federal Laws during the inspection. All toxins/cleaners are stored and locked up making them inaccessible to residents' in care. The facility had a sufficient supply of food. Facility had a sufficient supply of paper products, soap, hygiene supplies, and personal protective equipment(PPE) supply. Continued on LIC809C... The LPA reviewed five(5) resident files. All files were complete. The LPA reviewed five(5) staff files, including training. All staff have required criminal record clearance. All direct care staff have current First Aid, and CPR as required. The LPA observed during the tour of the facility that there were approximately five(5)resident bedrooms, and shared bathrooms, that smelled strongly of urine. The residents that occupy the rooms are incontinent. There was also a toilet with feces left in it which left the whole room smelling of feces; The resident of this room is incontinent, uses a wheelchair, and needs to be assisted with toileting, cleaning and changing as needed. There was another room that was vacant but had a dirty diaper in a cabinet. This deficiency will be cited, 87625(b)(3) Managed Incontinence -The licensee shall be permitted to accept or retain a resident who has a manageable bowel and/or bladder incontinence condition.the licensee shall be responsible for the following: Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence, see LIC809D. The LPA observed that there were approximately five(5)resident bedrooms, and shared bathrooms, that smelled strongly of urine. Toilets were found to have old caulking around the bottom of the toilet(s) that was peeling off, stained yellow and brown, and in some areas the caulking was missing. This deficiency will be cited,87303(a)(1) Maintenance and Operation The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition, see LIC809D. The LPA observed that resident bathrooms had no paper towels available, and there were no paper towels in the paper towel machine in each restroom. LPA was told by staff (S2) that they don't put any paper towels in the restrooms and just hang a towel up on the bathroom towel bar for residents use. Continued on LIC809C Based on LPA's observation of no paper towels in restrooms checked. The bathrooms are not private but are to be used by residents in rooms that are on each side of the shared bathroom, jack and jill type. HWD stated to the LPA that facility doesn’t put any paper towels in the restrooms and just will hang a towel up in the bathroom for residents use. LPA didn't observe any towels in the bathrooms. Due to physical arrangements of the facility and/or the habits or condition of others in the facility, towels may be used by more than one resident, common towels are prohibited. A resident's bed was checked and when sheets were pulled back the bottom of the sheet had dirt and garbage all in it. This deficiency will be cited, 87307(a)(3)(C)Personal Accommodations and Services -The quantity shall be sufficient to permit changing at least once per week or more often when indicated to ensure that clean linen is in use by residents at all times. The linen shall be in good repair. The use of common wash cloths and towels shall be prohibited, see LIC809D. Administrator will provide copies of the following by 8/18/2023: LIC 308 Designated of facility responsibility, LIC 500 Personnel Summary, LIC 610 Emergency Disaster Plan (if there are any changes), LIC 9020 Register of Facility Client’s/Resident’s, Copy of Administrator Certificate, Copy of Certificate of Liability Insurance Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and appeal of rights provided.the state’s words, verbatim · CDSS document, Jul 18, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alviso conducted a Required- 1 Year visit, on 6/22/2023 at approximately 3:25pm, and met with Health & Wellness Director(HWD) Rafael Daatio. The HWD contacted the Administrator Minerva Villegas. The Administrator arrived to meet with the LPA. Hospice care waiver approved for ten(10) residents. Facility has an approved dementia plan of operation. Facility has a required Infection Control Plan, which is part of the facility's plan of operation. Fire clearance approval is for 46 nonambulatory residents, of which 10 may be bedridden. LPA toured the facility with the HWD. Facility was observed to be at a comfortable temperature. LPA observed exits free from obstruction. LPA observed residents in the large dining area watching a movie. LPA observed that the dinner meal was being prepared for residents. Medications were locked up, and inaccessible to residents in care. The LPA will continue this Required- 1 Year visit at a later date.the state’s words, verbatim · CDSS document, Jun 22, 2023

Allegation investigated: Facility mismanaged resident's medications

Licensing Program Analyst (LPA) Erik Gonzalez Campos arrived unannounced on 02/16/2023 to conduct a complaint inspection regarding the allegation that facility mismanaged resident’s medications. LPA met with administrator, Minerva Villegas. During the inspection LPA conducted interviews, reviewed records and made observations. Medications were locked and secured in a central medication room. Individual resident medications are kept separated in labeled bins. Overflow medication is also kept locked, labeled and separated by resident. LPA was able to review current month’s medication administration record. Previous month’s records are moved to resident files which were also reviewed. Facility logs and dates medications upon receiving them. LPA was shown records for medication destruction. Continued on LIC 9099C Unsubstantiated It is alleged that facility gave Resident 1 (R1) a medication after the physician had ordered it be stopped. Orders were found in R1’s file to stop medication dated 11/03/2022. Last dose was given 11/02/2022. Medication destruction record indicated the remaining medication was destroyed on 12/01/2022. Although the allegation may be valid there is not a preponderance of evidence to prove the alleged violation did or did not occur therefore the allegation is unsubstantiated. No deficiencies cited during today’s inspection. Exit interview conducted with administrator and a copy of this report sent to her email.the state’s words, verbatim · CDSS document, Feb 16, 2023 · control 21-AS-20230104161110

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Erik Gonzalez Campos arrived unannounced to conduct a Post Licensing Inspection. LPA met with executive director, Emil De Guzman. LPA toured the building and grounds with director which were clean and in good repair. Walkways and exits were clear and unobstructed. There are currently 28 residents in care. Medications were locked and inaccessible in medication room. Toxins were locked and inaccessible. LPA observed sufficient perishable and non perishable food. Fir extinguishers were last inspected April 8, 2022. Carbon monoxide detectors were present and functioning. There is a sufficient supply of hygiene products and linens on hand for resident use. LPA reviewed Personnel Policies, Abuse Reporting Procedures, In-Service Training, Medication Procedures, Addendums to Admission Agreements, and Resident Records with executive director during today's inspection. During the inspection LPA reviewed resident file regarding eviction on 08/24/2022. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this inspection: LIC500 Personnel Report LIC308 Designation of Responsibility LIC610 Disaster Plan Evidence of Liability Insurance LIC200 Application for Administrator Change Administrator's Certificate Minutes of Meeting Appointing Administrator No deficiencies cited during today's inspection.the state’s words, verbatim · CDSS document, Oct 14, 2022

Type of visit: Prelicensing

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Nazareth Classic Care of Napa Inc for the purpose of conducting a Pre-Licensing Inspection due to Change of Ownership. Currently, there is 34 residents in care during this Change of Ownership. Facility is approved for 36 non-ambulatory and 10 bedridden residents. LPA was met at the door by Administrator, Shanti Ragland and was granted access into the facility. New licensee, Bobby T. Singh arrived 14 minutes later to introduce himself and participate in the Pre-Licensing inspection. LPA toured the building and grounds with the new Licensee. Facility was found to be clean, in good repair and at a comfortable temperature. LPA observed all walkways and exits to be unobstructed. The amount of fresh and nonperishable foods was within regulation. Food stored in the kitchen refrigerators was properly stored as per regulations at the time of this inspection. Emergency Supplies are locked in a closet in hallway 2. Toxins are stored in a locked closet in the hallway 3. Hygiene supplies are locked in the Nursing Supply closet in hallway 1. A sample tour of 3 empty facility rooms were inspected, water temperature measured within regulation between 105 and 120 degrees F at faucets accessible to residents. Fire extinguishers were last inspected on April 2022. First Aid kit was found to be appropriate during the inspection. Smoke detectors are hardwired into the fire suppression system. Carbon Monoxide detectors were present and were found to be operational during the inspection. Egress Doors were tested and found to be operational during the inspection. Medication is centrally stored and secured. There was a supply of cleaners, hygiene products and paper products available for residents. The bathrooms designated for residents at the facility were supplied with individual paper towels and hand soap dispensers. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present in the bathroom shower. All bedrooms have lighting & appropriate furnishings. Resident’s beds were outfitted with mattress pads as required by Title 22 Regulations # 87307. (Report continued on LIC 809C) Emergency Disaster Plan was discussed and COVID-19 Mitigation Plan was discussed and approved during the Pre-Licensing Inspection. LPA requested the following documents during the Pre-Licensing inspection: -Program Plan of Operation -LIC 308 Designated Facility Responsibility -LIC 500 Personnel Summary -LIC 610 Emergency Disaster Plan -LIC 610E-S Supplemental Emergency Disaster Plan for RCFE -LIC 9020 Register of Facility Client’s/Resident’s -Copy of Certificate of Liability Insurance Component III was completed with the Licensee on April 12, 2022 during the Pre-Licensing inspection. No deficiencies were observed during today's Pre-Licensing inspection. Exit interview was conducted and a copy of this report was emailed to the facility Administrator and new Licensee.the state’s words, verbatim · CDSS document, Apr 12, 2022