Care Janella

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose to conduct a Case Management visit. LPA met with Administrator (Admin) Leonora Amorsolo and explained the reason for the visit. It was established during the staff interviews in connection to Complaint Control Number: 22-AS-20230714131828 that the live-in Staff #1 (S1) does not provide assistance to residents in their Activities of Daily Living (ADLs) in the evenings. During the course of today's visit, LPA verified on the Personnel Report and through three out of three staff interviews confirming the presence of an additional staff in addition to S1 during the nocturnal hours. Based on the observations and interviews made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 Chapter 8 of the California Code of Regulations. Due to the Administrator's time constraints, Admin authorized House Manager to sign the report on her behalf. An exit interview was conducted with House Manager Verigilio Galang, and a copy of this report was provided to the HM at exit.the state’s words, verbatim · CDSS document, Oct 10, 2023

Allegation investigated: Facility failed to provide a safe & comfortable environment for the residents due to construction. New Staff does not treat residents in care with respect.

Licensing Program Analyst (LPA) Jessica Cho arrived unannounced to continue the investigation and deliver the findings. LPA explained the nature of the visit and reviewed the allegations with Administrator Leonora Amorsolo. On July 21, 2023, LPA initiated the complaint investigation visit consisting of resident and staff interviews. Pertinent records were previously obtained during the complaint investigation into Complaint Control #: 22-AS-20230630115900. On today’s date, LPA attempted to interview two remaining residents, however could not be interviewed as one individual was asleep and other recently passed away. The following was revealed during the course of the investigation: It is alleged that the facility failed to provide a safe environment for the resident due to construction. The construction to build a staff bedroom began on June 27, 2023 and was completed on July 10, 2023. Unfounded Four out of the four staff interviewed indicated that three meals and snacks are offered to the residents daily. Due to conflicting details, LPA is unable to corroborate with the allegation. Therefore, 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 allegation: Residents are not provided proper food services is deemed UNSUBSTANTIATED. An exit interview was conducted with Administrator Leonora Amorsolo, and a copy of the complete report was emailed to the administrator at the end of the visit. Four out of the six residents indicated that they were not affected by the construction noise and felt safe and comfortable. Two out of the six residents could not be interviewed during the two subsequent visits. Two out of the four staff indicated that there were no concerns expressed by the residents. One out of the two staff indicated that they were employed after the room was built, and the last remaining staff indicated that they were employed the last few days when the final touches were being completed and did not hear loud noise that could be disruptive at the time. It is alleged that the new staff does not treat resident in care with respect. Four out of the six residents stated that they had no concerns with the treatment by all staff, and two remaining residents could not be interviewed. Four out of the four staff indicated that the residents are treated with dignity and respect. This agency has investigated the complaint and based on the observations made, interviews which were conducted, and the records that were reviewed, the following allegations: Facility failed to provide a safe & comfortable environment for the residents due to construction, New Staff does not treat residents in care with respect are deemed UNFOUNDED. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint. An exit interview was conducted with Administrator Leonora Amorsolo, and a copy of the complete report was emailed to the administrator at the end of the visit.the state’s words, verbatim · CDSS document, Aug 31, 2023 · control 22-AS-20230714131828

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Jessica Cho continued the visit after delivering the findings into Complaint Control #: 22-AS-20230714131828. The purpose of this subsequent visit was to issue a citation after initially observing a deficiency on July 7, 2023 while conducting the complaint investigation in connection to Complaint Control #: 22-AS-20230630115900. LPA met with Administrator Leonora Cheryll Amorsolo and explained the reason for the case management visit. The following was reviewed: The purpose of this visit is to discuss new construction within the facility. On July 7, 2023, LPA discovered facility constructing a staff bedroom. Construction began on June 27, 2023 and was completed on July 10, 2023. As of today, facility now has five bedrooms instead of four. Licensees Janella Cervania and Karmian Calangi stated that the addition of the new staff bedroom was not reported to the Department prior to the construction. On today's date, facility is operating outside the limits of the approved fire clearance, therefore the preponderance of evidence standard has been met. Admin will follow up with the Fire Marshall, or the local fire authority, to schedule a fire clearance for the addition of the new bedroom. A deficiency is being cited as per Title 22, Division 6, Chapter 8 of the California Code of Regulations. See the attached LIC809D. An exit interview was conducted with Administrator Leonora Amorsolo, and a copy of this report was sent electronically to Administrator Amorsolo at the end of the visit.the state’s words, verbatim · CDSS document, Aug 31, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87305(b) · Plan of correction due date: Sep 1, 2023

87305 Alterations to Existing Building or New Facilities (b) The licensing agency may require the facility to acquire a local building inspection where the agency determines that a suspected hazard to health and safety exists. This requirement was not met as evidenced by: Based on LPA's observations and interviews, the addition of the staff bedroom was not cleared by the local fire authority which poses an immediatel Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 31, 2023

Plan of correction: Administrator to submit the LIC200, updated facility sketch, a letter requesting a fire clearance along with $25 check payable to DSS mailed to the Department by POC due date.

Allegation investigated: Resident developed pressure injuries while in care due to neglect.

Licensing Program Analyst (LPA) Jerome Haley made unannounced visit to begin the investigation into the complaint received against this facility on August 3, 2023. LPA Haley was greeted by staff and explained the reason for the visit. Administrator (AD) Leonora Amorsolo arrived a short time later. During the visit, LPA Haley conducted 8 interviews and collected relevant documentation during the visit. Regarding the allegation: Resident developed pressure injuries while in care due to neglect. 5 of 8 witnessed denied the allegation above. Interviews revealed residents are rotated every two hours by caregivers on duty. Regarding Resident 1 (R1), it was discovered, R1 receives Palliative care and is seen by a nurse on a weekly basis. R1 was sent to the hospital due to general weakness July 26, 2023 and returned to the facility the same day. After review of the After Visit Summary from Kaiser dated July 26, 2023, there was not mention of a pressure injury. Continued on LIC 9099C Unfounded During interviews it was discovered redness was observed on the buttocks area of R1 due to shingles, diarrhea, and R1 being difficult with caregivers and not allowing them to provide the proper care. R1 was prescribed Lidocaine-Prilocaine to apply to the affected areas 2 times a day as needed. During the visit LPA Haley observed the visible portions of R1's back with assistance from 2 caregivers and no pressure wound was observed. Based on the information gathered during the investigation through interviews, record review, and observation, the following allegation: Resident developed pressure injuries while in care due to neglect, is deemed Unfounded, meaning the allegation is false, could not have happened and/or is without a reasonable basis. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 10, 2023 · control 22-AS-20230803092428

Allegation investigated: Facility staff abuses residents. Staff is not providing an adequate amount of food to residents. Staff are unable to communicate with the residents due to language barrier.

Licensing Program Analyst (LPA) Jessica Cho made an unannounced complaint visit for the purpose to investigate into the above allegations. LPA was greeted by Caregiver Rolly Trio and was granted entry after explaining the reason for the visit. LPA initially observed Caregivers #1, #4 (C1 & C4), and Visitor #1 (V1) supervising the residents while Caregiver #3 (C3) was at the market. Two other caregivers, Caregiver #2 (C2) and C3 arrived shortly thereafter to assist with the investigation. Administrator (Admin) Karmian Calangi arrived at the facility approximately 3:35pm. During the course of the investigation, LPA obtained copies of pertinent resident/staff records, and conducted interviews with residents and staff. The following was determined based on observations, record review, and interviews: It was alleged that the facility staff abuses residents. Five out of the six residents stated that they are treated well and feel safe living in the facility. One out of the six residents could not be interviewed due to resident being non-responsive, and five out of the five staff stated that they have not abused nor witnessed the abuse to a resident. Unsubstantiated It was alleged that the staff is not providing an adequate amount of food to residents. LPA observed the residents were served soup and sandwich for lunch and crackers as snack. Five out of the six residents stated that they receive three meals per day and felt that the meals are in good portion. Five out of the five staff also confirmed the residents having three meals daily and their meals being sufficient in quantity. It was alleged that the staff are unable to communicate with the residents due to a language barrier. Although LPA observed during the interview that two out of the five staff spoke minimal English, fIve out of the six residents stated that they did not have any issue communicating and understanding the caregivers. Three out of the five staff aknowledged that two out of the four caregivers are not fluent in English however stated that they are able to converse using key words and body languages to relay their message. Due to the residents not having any concerns with communication, LPA is unable to corroborate the allegation. Therefore, 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 above allegations are deemed UNSUBSTANTIATED. An exit interview was conducted with Administrator Karmian Calangi, and a copy of this report including the LIC9099C, and the LIC811 were provided during this visit.the state’s words, verbatim · CDSS document, Jul 7, 2023 · control 22-AS-20230630115900

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Jessica Cho made a subsequent visit for the purpose to issue a citation after observing a deficiency while conducting a 10-day complaint investigation into complaint control number: 22-AS-20230630115900. Approximately 3:35pm, LPA explained the reason for the Case Management visit to Co-Licensee/Administrator (CL/Admin) Karmian Calangi and Interim Administrator (IA) Leonora Cheryll Amorsolo Librada. LPA explained the following: During the 10-day visit conducted on July 7, 2023, LPA was greeted and granted entry by Staff #1 (S1) followed by Staff #2 (S2), and Visitor #1 (V1). Per review of the Department's Licensing Information System (LIS) Facility Personnel Report Summary printed on July 3, 2023, S1, S2, and V1 were not listed on the roster. LPA verified that S1 was fingerprint cleared however was not associated at the time LPA arrived for the 10-day visit. S2 completed the live scan process, however was not fingerprint cleared and also not associated to the facility. V1 stated that they were visiting their friend, Staff #3 (S3), who was at the market. LPA observed V1 assisting in the kitchen prepping food. Upon review of the Department's Guardian Background Check with CL/Admin Calangi and IA approximately 4:45pm, four additional names were added on July 7, 2023 which includes S1 and S2 with S2 determined to be "In Process." CL/Admin acknowledged associating four names after receiving a phone call from the LPA at 10:55am and 11:13am and were added prior to coming to the facility to meet with LPA. Per Title 22 Regulation 87355 Criminal Record Clearance, all individuals subject to a criminal record review shall prior to working, residing, or volunteering at a licensed facility obtain a California clearance and request a transfer of a criminal record clearance, therefore the preponderance of evidence standard has been met for S1, S2, and V1. Based on the observations, interviews conducted, and the records reviewed, deficiencies are being cited as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. See LIC809D. An immediate CIVIL PENALTY (LIC421BG) is being assessed. An exit interview was conducted with Co-Licensee/Administrator Karmian Calangi, and a copy of this report along with the LIC809C, LIC809D, LIC421BG, LIC811, and the appeal rights were provided during this visit.the state’s words, verbatim · CDSS document, Jul 7, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(1) · Plan of correction due date: Jul 8, 2023

87355 Criminal Record Clearance (e) "All individuals subject to a criminal record review...(b) shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department..." This requirement is not met as evidenced by: Based on observations, interviews, and record review, two out of three individuals, S2 & V1, were not fingerprint cleared prior to working or visitng the facility which poses an immediate Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 7, 2023

Plan of correction: Licensee to provide S2's proof of clearance to LPA via emaill by POC due date and to submit an Acknowlegement of Understanding regarding the said deficiency and for visitors assisting with the operation of the facility without proper clearance.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87355(e)(2) · Plan of correction due date: Jul 8, 2023

87355 Criminal Record Clearance (e) "All individuals subject to a criminal record review...(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance..." This requirement is not met as evidenced by: Based on observations, interviews, and record review, one out of the three individuals, S1, was not associated prior to working at the facility which poses an immediate Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 7, 2023

Plan of correction: Licensee to associate S1 and to provide proof to LPA via email by POC due date and to submit an Acknowlegement of Understanding regarding the said deficiency. S1 was assoicated on today's date.

Allegation investigated: Loud parties at the facility all the time.

Licensing Program Analyst (LPA) Jerome Haley made unannouced visit to intiatate the investigation for the complaint received against this facility on April 20, 2023. LPA Haley was allowed into the facility and explained the reason for the visit upon entry. Before entering the facility, LPA Haley conducted several interviews in the neighborhood (on Saga Drive) to gather additional information on the complaint allegation. LPA Haley discussed the complaint allegation and interviewed Staff 1 (S1), Staff 2 (S2) and Resident 1 (R1). Resident 2 (R2) was not in the facility and could not be interviewed. Administrator (AD) Karmian Calangi was interviewed over the telephone. Regarding the allegation, “Loud parties at the facility all the time” The investigation revealed the following: Unsubstantiated During the initial complaint investigation, LPA Haley interviewed 5 individuals who live or work on Saga Drive near the facility to gather additional information regarding the complaint allegation. LPA Haley attempted to interview 2 additional individuals on Saga Drive, but they both declined to be interviewed. 4 of 5 people that did take the time to be interviewed did not provide any information that supports the complaint allegation. LPA Haley interviewed two facility staff, one resident and the facility Administrator Karmian Calangi over the phone. 2 of 4 interviews conducted with facility staff and the resident revealed there was a gathering in the garage a few months back (February 2023), but there was no party. The majority of the information gather from the final four interviews was consistent with the information provided by the individuals from the neighborhood that were interviewed. Based on the information gathered during the investigation, document review and interviews, 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 evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Apr 25, 2023 · control 22-AS-20230420142620

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Jerome Haley conducted a case management visit to address a deficiency observed during a complaint investigation (complaint control # 22-AS-20230420142620). During the 10-day visit for the complaint listed above, LPA Haley was touring the facility with staff. Around 11:50AM LPA Haley inspected the garage area and observed a man laying on the couch in the garage. LPA Haley, and both facility staff members were present when the unassociated individual (UI) was observed in the garage sleeping on a couch. LPA Haley asked the man for his full name, his birthday and how long he's been here at the facility. The man said he arrived last night and House manager (HM) Virgilio Galang said he was there to "shadow." HM Galang told the UI to get his ID (passport) and fingerprints. LPA Haley asked HM Galang for a copy of the passport and fingerprint information, and copies were provided (Passport and LIC9163). LPA Haley explained to the unassociated individual, HM Galang and Staff 2, the UI is not associated and not allowed to be inside the facility until he's fingerprint cleared and associated to the facility. The individual was asked to leave and escorted out by House Manager Galang. Deficiencies are being cited under California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Apr 25, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87411(g)(2) · Plan of correction due date: Apr 25, 2023

Personnel Requirements - General (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c). This reguirement was not met as evidenced by a unassociated individual present during a visual inspection of the garage are. LPA Haley, the House manager, and Staff 2 observed the unassociated individual in the garage around 11:50AM. This poses an immmediate safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 25, 2023

Plan of correction: Licensee/Administrator, and all staff will read and review regulation sections: 87411 - Personnel Requirements 87355 - Criminal Record Clearance Licensee/Administrator will email LPA Haley a signed statement of understanding that the regulations have been read and understood (signed by all staff). Licensee/Administrator will associate the unidentified individual before they're allowed back into the facility. POC due date: April 27, 2023 at 12 noon.

Allegation investigated: Staff cannot effectively communicate with residents. Staff does not clean facility.

Licensing Program Analyst (LPA) Jerome Haley made an unannouced visit regarding the complaint allegations listed above. LPA Haley was greeted and granted entry by staff. LPA Haley met with Licensee Janella Cervania and explained the reason for the visit. Before getting started, Licensee Janella Cervania led LPA Haley on a tour of the facility. The interior of the facility was clean and well organized as well as the backyard area and the garage. After the tour of the facility, LPA began interviewing facility staff and residents: Licensee Cervania, Administrator Karmian Calangi via telephone, Resident 1 (R1), Resident 2 (R2), and Resident 3 (R3) was sleeping and could not be interviewed. Regarding the allegations: (1) Staff cannot effectively communicate with residents and (2) Staff does not clean the faciltiy Continued on LIC9099C Unfounded Through interviews with the Licensee, Administrator, staff, and residents the investigation revealed the following: Staff and residents communicate effectively with each other. During the time of the visit LPA Haley observed effective communication between staff and residents. LPA observed a white board in R2s room that's used to communicate with the R2 who's hard of hearing. Staff write down what they're saying and R2 will read the white board and respond. Furthermore, effective communication between residents and staff was confirmed during interviews with staff and residents. The facility was observed to be clean and organized. At the beginning of the visit Licensee Janella and LPA Haley toured the inside, outside, and garage area of the facility. Everything was clean, and neatly organized. The bathroom areas were clean as well. Furthermore, during interviews LPA Haley received information that contradicts the allegation staff does not clean facility. Based on the information gathered during the investigation, observation, and review of all documents obtained, the following allegations: (1) Staff cannot effectively communicate with residents and (2) Staff does not clean the facility is deemed Unfounded, meaning the allegation is false, could not have happened and/or is without a reasonable basis. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jan 24, 2023 · control 22-AS-20230120102448

Type of visit: Prelicensing

Licensing Program Analyst (LPA), Kathrina Chin made an announced visit for a second pre-licensing evaluation. LPA met with Janella Cervania, Applicant and Karmian Calangi, Administrator. The first pre-licensing inspection was made on September 13, 2022 and several corrections were needed. The facility has four bedrooms and two full bathrooms and one half bath. This is a single story with a two car garage. A fire clearance was granted on August 23, 2022 for 5 non-ambulatory and 1 bedridden. The facility is requesting for a hospice waiver for 4 residents. The following items have been corrected. 1) The air conditioning was fixed. 2) A fire protective screen was placed in front of the fire place. 3) The facility posted an Ombudsman poster and the Let Us Know poster. 4) The facility posted activity calendars, theft and loss policy, residents rights, admission agreement, and emergency plans. 5) The hot water temperature was measured at 112 degrees F. 6) The facility has a COVID-19 screening station by the entrance. 7) The facility has more than a 30 day supply of PPE. 8) There is a tweezer inside the first aid kit and a first aid manual by the first aid kit. 9) There are two outdoor patio tables with umbrellas for shade. 10) Each bathroom has hand washing signs posted. 11) Remove all debris by the exit and side gate (Continued on LIC 809C) 12) All six beds have mattress pads and blankets. 13) The large holes in the bedframes have been covered. 14) The trash and debris in the garage have been cleared. 15) Karmian Calangi, Administrator is now associated to the facility. The Pre-Licensing evaluation has been completed. It appears this facility meets the requirements for licensure. The license will be granted upon completion of a final review and approval from the Application Specialist. An exit interview was conducted with Janella Cervania, Applicant and Karmian Calangi, Administrator and a hard copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 20, 2022

Type of visit: Office

A second Component II completed due to change in administrators. Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): None Method: Telephone call with CAB COMP II Participants: Janella Cervania, Applicant; Karmian Calangi, Administrator Applicant/administrator participated in COMP II via telephone call with the analyst at CAB. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, Sep 22, 2022

Type of visit: Prelicensing

Licensing Program Analysts (LPAs), Kathrina Chin and Jessica Cho made an announced visit for a pre-licensing evaluation. LPAs met with Janella Cervania, Applicant and Karmian Calangi, Applicant/Administrator. The facility has four bedrooms and two full bathrooms and one half bath. This is a single story with a two car garage facility. The inspection is as follows: A fire clearance was granted on August 23, 2022 for 5 non-ambulatory and 1 bedridden. The facility is requesting for a hospice waiver for 4 residents. LPAs toured the facility, interior and exterior, including all resident bedrooms. The hot water temperature was tested in the resident bathrooms and observed to be 79.8 degrees Fahrenheit. One fire extinguisher was mounted and charged. Smoke detectors were centrally wired throughout and have been checked by the fire department. Carbon monoxide detectors are operational. There is sufficient supply of linens. There are non-skid mats in the showers. There was one locked medication closet and one first aid kit. There were several locked closets for storage of toxins and cleaning equipments. All exits have auditory devices. The kitchen area was checked. Karmian Calangi stated that she will post activity calendars, theft and loss policy, residents rights, admission agreement, and emergency plans. The facility needs to post an Ombudsman and Let Us Know posters. LPA reviewed the outdoor area and there were outdoor furniture but no umbrella for shade. (Continued LIC 9099C) A second pre-licensing will be scheduled. The following items need to be corrected prior to licensure: 1) Air conditioning is broken. Karmian Calangi stated that she will have an air conditioning installed. 2) A fire protective screen for the fire place is needed. 3) The facility needs to post an Ombudsman and Let Us Know posters. 4) The facility needs to post activity calendars, theft and loss policy, residents rights, admission agreement, and emergency plans. 5) The facility does not have hot water. The hot water temperature was measured at 79.8 degrees Fahrenheit in all three bathrooms. 6) The facility does not have a COVID-19 screening station. 7) The facility does not have 30 day PPE supplies 8) A tweezer for the first aid kit and first aid manual are needed. 9) A patio umbrella is needed for shade. 10) Post hand washing signs in all bathrooms. 11) Remove all debris by the exit and side gate 12) Mattress pads and blankets are needed for the six beds. 13) Cover up the two holes on the bedframes. 14) Remove all trash and debris in the garage. 15) Please associate Karmian Calangi, Administrator to the facility. A Component III was completed during the visit with Janella Cervania and Karmian Calangi, Applicants. LPAs reviewed Personnel Policies, Prohibited Health Conditions, Fingerprinting, Abuse Reporting Procedures, In-Service Training, and Medication Procedures. It appears that this facility does not meet the requirements for licensure. A second pre-licensing visit will be scheduled. An exit interview was conducted with Janella Cervania and Karmian Calangi, Applicants and a hard copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 13, 2022

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): None Method: Telephone call with CAB COMP II Participants: Janella Cervania, Applicant; Adriel Pao, Administrator Applicant/administrator participated in COMP II via telephone call with the analyst at CAB. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, Apr 5, 2022