A Touch of Serenity Residential Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one year infection control annual visit. LPA was greeted, granted entry by staff and explained the reason for the visit. Staff called the Director/Administrator (AD) Juan Reyes via telephone who arrived and was present for the visit. AD Reyes has a current administrators certificate that expires 12/02/22. At 12:25 PM LPA Haley began the tour of the facility with AD Reyes. There were five residents present for the visit. Right near the entrance of the facility there is a COVID screening station with temperature log books, a thermometer, gloves and hand sanitizer. Right near the entrance of the living room, there's a locked closet with staff files, resident files, and medication. All client bedrooms were clean, well organized, and had all necessary requirements: night stand, chair, lamp and storage space. All bedroom exit alarms were functional. Both client bathrooms were clean and very well organized. The kitchen was clean and organized. All knives and sharp objects were locked under the sink. Hazardous chemicals were also locked under the sink. All burners on the stove were operational. The facility has a two day supply of perishable food items and seven day supply of nonperishable food items. LPA observed a first aid kit with all required elements in a cabinet near the refrigerator. There is a fully charged fire extinguisher mounted on the wall near the refrigerator. LPA also observed a locked cabinet under the kitchen counter that's used to store resident medication. In between the kitchen and the garage there is a laundry room that remains locked. In the laundry room there is a closet that is used by staff for their miscellaneous items. Cleaning supplies are kept in the cabinets above the washer and dryer. Continued on LIC809C Dated October 25, 2022 The garage was clean and organized. Walkways were clear of obstruction and tripping hazards. In the garage LPA Haley observed additional supplies and items: mattresses, chairs, and a dresser to name a few of the items. There is a refridgerator in the garage with an additional supply of perishable food items. LPA Haley observed an emergency container equipped with emergency food, water, and emergency COVID PPE supplies prepared and ready to go. Additional cleaning supplies, and plenty of adult diapers was also observed in the garage. The backyard was clean, very well organized, and free of clutter. Both side exit gates were alarmed, self closing and self latching. A shaded area with a table and chairs was observed. A pool surrounded by a gate that meets regulation guidelines was observed. LPA Haley advised Director Juan Reyes to exchange the lock currently on the pool gate with a child proof lock and showed a picture for reference. Director Reyes understood and agreeded to replace the lock on the pool with a child proof lock. All smoke detectors were tested and are operational. No deficiencies are being cited during todays visit. An exit interview conducted and a copy of the report was provided to Director/Administrator Juan Reyes.the state’s words, verbatim · CDSS document, Oct 25, 2022

Allegation investigated: Resident sustained severe fracture while in care. Staff did not seek medical attention in a timely manner. Staff did not notify resident's authorized representative of incident.

Licensing Program Analyst (LPA) Albert Marin made an unannounced visit to this facility to deliver the final report for the investigation completed for the complaint received last April 22, 2022 against this facility. LPA met with Administrator (AD) Juan Reyes and discussed the findings. Based on the information gathered during the investigation and review of documents obtained for the allegation that resident sustained severe fracture while in care, the following are the findings. Resident 1 (R1) was admitted in the facility in January 2022. R1 was place under hospice care with diagnosis of senile degeneration of the brain, and comorbidities which included Coronary Artery Disease (CAD), hypertension, and congestive heart failure. Per April 2022 Physician’s Report, R1 was evaluated to be confused, disoriented, with wandering behavior, not able to follow instructions and not able to communicate needs and needed maximum assistance with toileting needs. R1 had no reported fall incident until the early morning of April 20, 2022. Staff rushed to Resident’s room and observed R1 was on the floor. R1 was helped and denied having apparent injury. R1 was not in pain and responded well to questions. Fall was witnessed by Resident 2 (R2). (Continuation in Page 1) Unsubstantiated (Continuation from Page 1) Fall incident was reported to hospice agency. R1 was evaluated by hospice nurse. X ray was requested and revealed “slightly displaced impacted subcapital fracture is noted Degenerative Joint Disease (DJD) is present and osteoporosis suggested. Right hip fracture”. R1 remained in the facility and managed with maximum assistance and medication. The Department is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or refute the alleged violation occurred; therefore, this allegation that resident sustained severe fracture while in care is deemed UNSUBSTANTIATED. On allegation that staff did not seek medical attention in a timely manner, the following are the findings. The first fall incident for R1 occurred around 2:00 AM of April 20, 2022. R2 observed R1 got out of bed and began walking unsteadily before the fall. Staff rushed towards the room and observed R1 on the floor. Staff checked R1 and did not observe apparent injuries. R1 stated no pain and responded to questions well. Staff was assisting R1 to get to showers when R1 reported pain. Staff called hospice agency for evaluation. Around 9:00 AM, when hospice nurse arrived in the facility and evaluated R1. After the initial medical assessment was made, R1 remained in the facility and managed with pain medications. Thus, the allegation that staff did not seek medical attention in a timely manner is UNSUBSTANTIATED. On allegation that staff did not notify authorized representative of the incident, the following are the findings. Per interviews, Responsible Party (RP) for R1 confirmed that RP received a report from Administrator (AD) Juan Reyes regarding the fall incident. Staff attempted to contact another authorized representative using the contact information available. Thus, the allegation that staff did not notify authorized representative of the incident is deemed UNSUBSTANTIATED. LPA Marin conducted an exit interview with AD Juan Reyes. Copies of this report were left in the facility.the state’s words, verbatim · CDSS document, Sep 21, 2022 · control 22-AS-20220422100704

Allegation investigated: Licensee did not administer oxygen to resident as ordered. Unlawful eviction of a resident.

Licensing Program Analyst (LPA) Albert Marin made an unannounced visit to this facility. LPA met with Administrator Juan Reyes and stated the purpose of the visit. The purpose of the visit was to deliver the findings on the investigation completed for the complaint filed against this facility last August 23, 2021. On allegation Licensee did not administer oxygen to resident as ordered, the following are the findings. On September 26,2020 4:00 PM, Resident 1 (R1) was seen and evaluated by skilled medical professional. R1 was not in pain nor in distress but confused and agitated. Vital signs were taken and recorded to be within normal limits with respiratory rate of 18 per minute, oxygen saturation at 97% at room air with clear lung sounds but diminished at the bases. An order of 2-5 liters of oxygen per minute via nasal cannula and mask as needed was made on admission. Hospice admission was completed at 7:00 PM. At 3:49 AM of September 27, 2020, the hospice received a report from the facility that R1 had troubled breathing. Via video conference, R1 was on recliner on oxygen therapy. Moments after, R1 was reassessed via video conference and R1 was observed to comfortable, sleeping and with no signs of respiratory distress. (Continuation in page 2) Unsubstantiated (Continuation from Page 2) Based on the information gathered during the investigation and review of documents obtained, the LPA is unable to ascertain if the allegation occurred as reported.Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed UNSUBSTANTIATED. On allegation of unlawful eviction of a resident, the following are the findings. On September 18, 2020, Resident 1 (R1) was admitted in the facility. On the same date, the facility issues two invoice statements. The first statement described the prorated basic services fee for September and the preadmission appraisal fee; and the second statement described the basic services fee for October 2020. Per file review, LPA observed two checks that paid the amount in full as described in the first statement; but no document was provided to support if full payment was made for October 2020. On September 26, 2020, R1 was placed under hospice care and determined that it was necessary to place R1 under 1:1 particularly during night shifts to address R1’s needs. On September 29, 2020, both parties agreed in writing that the services for R1 will end on September 30,2020 and any additional days and services will be pro-rated and charged separately. R1 was transferred to another facility. Thus, the allegation of unlawful eviction of a resident is UNSUBSTANTIATED. LPA Marin conducted an exit interview with AD Juan Reyes, and copies of this report was left in the facility.the state’s words, verbatim · CDSS document, Nov 3, 2021 · control 22-AS-20210823102714

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 conducted an unannounced required annual inspection in this facility. LPA met with Administrators (ADs) Juan and Nayehy Reyes and stated the purpose of this visit. The facility is a single level structure and licensed for 6 non-ambulatory and hospice waiver for four. For this visit, there two residents under hospice care. About 1:45 PM, LPA Marin was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. Facility had 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 1 shared 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, provided with grab bars 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 patio furniture in good repair, and grounds were free of tripping hazards. Facility had a pool feature with steel fence and rendered inaccessible to residents in care. Side exit doors were self-closing and self-latching. LPA 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 Administrator Neyehy Reyes ; and copy of this report was left in the facility.the state’s words, verbatim · CDSS document, Jul 29, 2021