Jasmin's Care Home

Allegation investigated: Facility staff member is not giving resident medication according to the label Facility was not allowing resident to use the commode located in the bathroom

Licensing Program Analyst (LPA) Patricia Velazquez conducted an unannounced subsequent complaint visit to deliver the findings of the investigation regarding the above allegations. LPA Velazquez was allowed entry into the facility and met with Administrator Manuel Perez. On today's visit LPA Velazquez conducted interviews with residents and staff. LPA Velazquez also reviewed and obtained copies of facility, resident, and staff records. During the course of the investigation the following was revealed: LPAs Ruth Martinez and Patricia Velazquez conducted interviews with residents and staff. Six of six individuals interviewed could not corroborate the above allegations. LPA Velazquez also reviewed facility, resident, and staff records. The records reviewed included Physician's Reports, Resident Appraisals, Appraisal Needs and Services Plans, Centrally Stored Medication and Destruction Records (CSMDRs), Resident (R) #2's Progress Notes by Mark Abramson, M.D. dated September 27, 2022 at 9:28 AM, and staff training records. Unsubstantiated Regarding the allegation: Facility staff member is not giving resident medication according to the label the following was revealed: R2's page 7 of 8 Progress Notes by Mark Abramson, M.D. dated September 27, 2022 at 9:28 AM documented Hydrocodone - Acetaminophen (NORCO) 5-325 mg be administered 1 tablet by mouth every 6 hours as needed for severe pain. Two of two individuals interviewed indicated they provided R2 with NORCO medication as prescribed by the doctor and could not corroborate the allegation: Facility staff member is not giving resident medication according to the label. Four of four individuals interviewed stated they received their medications as prescribed by their doctors. Administrator Manuel Perez stated he spoke with R2's doctor and that the doctor stated they would not refill the NORCO prescription for fear resident would become addicted to NORCO. Per Administrator Perez, R2's doctor advised the facility to administer Over The Counter (OTC) Acetaminophen 500 mg for pain whenever possible and to provide the NORCO when resident was experiencing severe pain. Regarding the allegation: Facility was not allowing resident to use the commode located in the bathroom the following was revealed: Two of two individuals interviewed indicated facility staff provided R2 with a bedside commode to facilitate going to the bathroom especially at night. R2 also indicated that at times it was easier to use the bedside commode than going to the bathroom. R2 currently uses the bathroom whenever they need to use the bathroom and is no longer using a bedside commode. The 2 staff interviewed stated the bedside commode was only utilized when R2 came home from the hospital after R2 underwent surgery for a fractured hip. Based on the observations made, interviews which were conducted and the records that were reviewed, 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 following allegations: Facility staff member is not giving resident medication according to the label and Facility was not allowing resident to use the commode located in the bathroom are deemed UNSUBSTANTIATED. An exit interview was conducted with Administrator Manuel Perez and a copy of this report along with the LIC 811 was provided at the time of this visit.the state’s words, verbatim · CDSS document, Jan 24, 2023 · control 22-AS-20221010092541

Allegation investigated: Facility staff physically abused resident while in care

Licensing Program Analyst (LPA) Patricia Velazquez conducted an unannounced initial 10 day complaint visit to initiate the investigation into the above allegation as well as to deliver the findings of the investigation. LPA Velazquez was allowed entry into the facility and met with Administrator Manuel Perez. On today's visit LPA Velazquez conducted interviews with residents and staff. LPA also reviewed and obtained copies of facility, resident, and staff records. During the course of the investigation the following was revealed: LPA Patricia Velazquez conducted interviews with residents and staff. Six of six individuals interviewed could not corroborate the above allegation. LPA Velazquez also reviewed facility, resident, and staff records. The records reviewed included Physician's Reports, Resident Appraisals, Appraisal Needs and Services Plans, Centrally Stored Medication and Destruction Records (CSMDRs), Resident (R) #1's discharge documents from Hoag Hospital Newport where R1 was hospitalized from January 16, 2023 until discharge on January 20, 2023, Unsubstantiated and staff training records. Six of six individuals interviewed could not corroborate the allegation. Four of four individuals interviewed felt they were well-cared for at the facility and denied ever being physically abused by anyone at the facility. The residents appeared clean, well-groomed with no visible injuries observed. Based on the observations made, interviews which were conducted and the records that were reviewed, 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 following allegation: Facility staff physically abused resident while in care is deemed UNSUBSTANTIATED. An exit interview was conducted with Administrator Manuel Perez and a copy of this report along with the LIC 811 was provided at the time of this visit.the state’s words, verbatim · CDSS document, Jan 24, 2023 · control 22-AS-20230119145353

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Patricia Velazquez conducted an unannounced visit to Jasmin's Care Home. The purpose of today's visit was to conduct a Required 1 Year inspection. LPA Velazquez was allowed entry into the facility and met with Caregiver Laura Perdomo. Administrator (AD) Manuel Perez arrived shortly after LPA's arrival. The facility is licensed for 6 non-ambulatory residents. There are currently 5 residents living in the facility. The last emergency disaster drill was conducted on April 3, 2021. At 2:53 PM LPA Velazquez conducted a tour of the physical plant along with AD Perez. The 1 story home consists of 4 resident bedrooms with 2 bathrooms. There are no staff bedrooms as AD Perez indicated he employs awake staff at night from 10:00 PM to 7:00 AM. The facility also has a living room, dining area, and kitchen. LPA and AD observed 4 bottles of medications were stored on top of a cabinet in the dining room easily accessible to residents. Two of the 4 bottles had prescription Amlodipine Besylate belonging to a resident which AD verified. At LPA's direction AD immediately removed the medications and locked them in the medication cabinet. The 5 residents in the facility appeared well-groomed and well cared-for. The resident bedrooms had the required furnishings, bed linens, and closet/drawer space to accommodate each resident comfortably. LPA Velazquez observed a postural support bar on one of the resident beds. AD Perez indicated he did not have a written physician's order for the postural support bar. LPA and AD observed an exit door in a resident's room did not have an auditory alarm and the facility has residents with Dementia. AD verified the sliding glass door did not have an auditory alarm pursuant to Title 22 regulation. The sliding glass in the living room also had an inoperable auditory alarm which AD verified. Resident bath towels and personal hygiene supplies were adequately stocked. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, showers were free of mold/mildew and a non-skid surface or mat was in place. LPA Velazquez tested the hot water temperature in the resident bathrooms and the temperature measured at 109.0 degrees Fahrenheit in the first bathroom and at 115.3 degrees Fahrenheit in the left sink and at 114.0 degrees Fahrenheit in the right sink of the second bathroom. LPA Velazquez inspected the kitchen along with AD Perez. LPA and AD observed the right front burner of the electric stove was inoperable which AD verified. Perishable and non-perishable food supply was checked and adequately stocked at the time of the visit. The fire extinguisher was fully charged. The smoke and carbon monoxide detectors were tested and found to be operational. Toxins and sharps were locked and inaccessible to residents. First aid kit was checked and found to be in order. The facility did have a First Aid guide dated 1989 and LPA Velazquez advised AD Perez to obtain an updated First Aid manual. LPA Velazquez along with AD Perez toured the outside grounds and observed a jacuzzi that was surrounded by a locked gate. LPA and AD observed the jacuzzi had standing water which AD indicated was from the recent rains. AD indicated he would empty out the jacuzzi by tomorrow. There was shading and sufficient seating for residents. LPA and AD also observed the umbrella that provides shading had a large tear which AD verified. AD indicated he had already order another umbrella and will email LPA a copy of the receipt by tomorrow. LPA and AD also observed broken wooden fencing and a worn wooden bench. AD indicated he would remove the wooden bench and repair the wooden gate enclosure. AD indicated he an insurance claim that is pending. There was also a large rusted metal pole with rusted screws protruding from the pole which AD verified. Walkways around the home were clear of hazards and the exit gates were operational. There were no security bars or weapons on the premises. No resident or staff files were reviewed at the time of this visit but LPA did verify 2 of the 5 residents in the facility were diagnosed with Dementia which AD verified. LPA Velazquez informed AD Perez to ensure a written physician's order for bed rails is present in a resident's file pursuant to Title 22 Regulation Section 87608 Postural Supports Deficiencies cited under California Code of Regulations Title 22, Division 6, Chapter 8. An exit interview was conducted with Administrator Manuel Perez and a copy of this report along with the appeal rights and a copy of the LIC 9098 were provided at the time of this visit.the state’s words, verbatim · CDSS document, Feb 23, 2022