Casa Doctora III

Type of visit: POC

Licensing Program Analyst (LPA) Celine De Perio made an unannounced visit to the facility for the purpose of a Plan of Correction (POC) visit, based upon the deficiencies cited in LIC 809D on 10/17/2022. LPA De Perio explained reason for visit and was greeted by staff on duty, who contacted facility administrator (AD) Estela Kramer about visit. AD Kramer was unable to be present during time of visit, but provided consent for staff on duty, Denmark Mangova to receive and sign report. For today's visit, LPA De Perio verified that there are currently 6 residents in care, and 2 staff on duty. On 10/17/2022, licensee failed to lock disinfectants, cleaning solutions, poisons, and other items which could post a danger. LPA De Perio observed cleaning supplies and disinfectants stored in an unlocked cabinet located under the kitchen sink. This poses an immediate health, safety or personal rights risk to persons in care. Licensee has secured noted items and now has placed a new lock for disinfectants, cleaning solutions, poisons, and other items. Licensee has complied with the terms of the POC. *Deficiency cited under Title 22 Regulation 87309(a) pertaining to Storage Space has been CLEARED. On 10/17/22, facility failed to keep the centrally stored medication in a safe and locked place that is not accessible to residents in care, other than employees responsible for the supervision of centrally stored medication. LPA De Perio observed an unlocked mini refrigerator under the kitchen island that had bottles of liquid medications and pills. LPA De Perio also observed an unlocked medication cabinet located by the staff desk. AD locked refrigerator and cabinet. Threat reduced. This poses an immediate threat on the health and safety of the residents in care. Licensee has secured and locked noted items and medications are made inaccessible to residents in care. Licensee has complied with the terms of the POC. *Deficiency cited under Title 22 Regulation 87465(h)(2) pertaining to Incidental Medical and Dental Care has been CLEARED. For this visit, no deficiencies were issued at this time. No citations issued at this time. LPA De Perio conducted an exit interview with staff on duty and AD Kramer via phone call and a copy of this report and Letter of Cleared Deficiencies has been provided to the facility.the state’s words, verbatim · CDSS document, Nov 4, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced required annual inspection focusing primarily on the Infection Control. LPA De Perio explained reason for visit and was greeted and granted entry by staff on duty who checked temperature prior to entering facility. During the visit, 4 staff were on duty, who contacted facility administrator (AD) Estela Kramer about visit. As of 10/17/22, there are 0 active COVID-19 cases in the facility as verified. LPA De Perio observed the COVID-19 precautionary signs posted at the entrance of the facility. The PUB475 "See Something, Say Something" poster was also observed at the facility entrance and by the staff desk located by the kitchen. LPA De Perio observed the Administrator's Certificate for Paul Kramer which expires on 10/27/23. AD E. Kramer submitted renewal for certificate on 7/12/22 and provided proof of payment and documentation to LPA De Perio stating that renewal fee was received on 8/2/22. Pending renewed certificate. LPA De Perio toured the interior and exterior portions of the facility with AD Kramer. The facility is a single level structure and is licensed for 4 non-ambulatory residents of which 2 may be bedridden and 6 may be on hospice. For this visit, there are a total of 6 residents in care, of which 1 is on hospice and 0 bedridden. There are a total of 7 bedrooms, of which 5 are private resident rooms, 1 shared resident room and 1 for staff. LPA De Perio toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 2 restrooms of which were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured to be at 109.9 degrees Fahrenheit and hand washing signs were also posted in each restroom. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Facility had a fire extinguisher located in the kitchen and is mounted and charged. LPA De Perio observed the emergency disaster and evacuation plan, which is posted at the entrance of the facility. Facility had back-up emergency food and water supply, located in the kitchen pantry. LPA De Perio observed that First Aid Kit had all the required components. The facility had an adequate supply of PPE that was located in the facility hallway. Toxins in the bathroom were also observed to be locked and inaccessible to residents. For the exterior portion, LPA De Perio observed patio furniture under shading, and the grounds were free of any hazards. There are 2 gates in the backyard, which was self-closing and self-latching. No bodies of water were observed. LPA De Perio verified the Coronavirus 2019 (COVID 19) mitigation plan of the facility with AD Kramer. LPA De Perio discussed Assembly Bill 665 requires that a licensee of any adult or senior care residential facility that has internet service provide at least one internet access device, such as a computer, smart phone, tablet or other device, that: can support real-time interactive applications; is equipped with video conferencing technology, including microphone and camera functions; and is dedicated for client or resident use. LPA De Perio discussed with AD Kramer to review, and subscribe for emails regarding the Provider Information Notices (PINs) as well as to attend the CCLD Informational Calls to ensure that facility and staff are up to date. The PINs can be accessed at: www.ccld.ca.gov. LPA De Perio discussed the California Code of Regulations Section 87466 Observation of the Resident and Section 87211 Reporting Requirements with AD Kramer. For today's visit deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. LPA De Perio advised AD Kramer to use the general email address: CCLASCPOrangeCountyRO@dss.ca.gov for any inquiries and to specify attention to the assigned LPA. LPA De Perio conducted an exit interview with AD Kramer and a copy of this report, LIC809D, Appeal Rights copies of the regulations discussed were provided to the facility.the state’s words, verbatim · CDSS document, Oct 17, 2022

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Albert Marin made an unannounced required annual inspection. Administrator (AD) Estela Kramer arrived in the facility shortly after being notified about the presence of LPA in the facility. LPA met with AD and stated the purpose of this visit. The facility is a single level structure and licensed for six non-ambulatory of which two may be bedridden; and with hospice waiver for six. There was no resident under hospice care. About 11:35 AM , LPA Marin was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. For this visit, there were five residents in care and two staff members on the floor. LPA toured the interior and exterior portions of the facility. There were four private and one shared resident's rooms. Rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Hardwired smoke, carbon monoxide, and auditory exit alarms were tested to be operational. Bathrooms were observed to be in good repair; and provided with handrails and nonskid-floor mats. Hot water was measured at 115 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food stock requirements. Medications, cleaning supplies and sharp items were inaccessible to residents in care. Fire extinguisher was mounted and charged. For the exterior portion, facility had outside furniture in good repair. Grounds were free of tripping hazards. Side exit doors were self-latching and self closing. LPA Marin reviewed the COVID 19 mitigation plan of the facility. For this visit, the facility was observed to be in substantial compliance with Title 22 Division 6 of the California Code of Regulations. LPA Marin conducted an exit interview with AD Estela Kramer and copy of this report was left in the facility.the state’s words, verbatim · CDSS document, Jan 6, 2022