Summerfield of Roseville

Type of visit: Case Management - Deficiencies

On 05/31/2023, Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced to follow up on a Case Management- Incident visit conducted on 05/04/2023. LPA met with Executive Director (ED), May Tate, and explained the purpose of the visit. During the course of investigation, the Department interviewed residents, facility staff, and obtained pertinent documents relevant to the complaint investigation such as, resident’s (R1) physician’s report, medication administration records (MAR), receipt of medications, and medication list. The Department requested for R1’s physician’s report from the facility for review. The Department obtained an outdated physician’s report that was completed on 12/16/2021. According to physician’s report, R1 is diagnosed with Dementia and is unable to administer own prescription medications. On 04/27/2023, LPA Keosavang received an email from ED stating the facility was conducting an internal investigation on R1’s medication error. LPA and ED scheduled a telephone call to go over findings of the internal investigation on 04/28/2023. On 04/28/2023, ED stated R1’s MAR indicates that the facility are giving medications to R1, however, if the facility is giving R1 medication they should have refilled those medications by the dates they were supposed to be refilled, but per facility’s nurse, R1’s RP dropped off medications at the facility, but the facility do not have records of when the medications were dropped off and how many medications were dropped off. The Department received R1’s May 2022 through March 2023 MAR for review. According to R1’s MAR from May 2022 to July 2022, R1’s medications were given to R1. MAR for August of 2023 indicated, staff did not provide R1 Latanoprost on 08/07/2023 and 08/16/2023. On 09/25/2023, MAR indicates staff did not provide R1 Latanoprost. On 10/25/2023, MAR indicates staff did not provide R1 with Dorzolamide, Brimonidine, and Latanoprost. MAR for February of 2023 indicates all 4 medications were provided to R1. MAR for March of 2023 indicates staff did not provide R1 Dorzolamide, Brimonidine, and Rhopressa. MAR does not indicate a reason why medications were not provided to R1. According to R1’s responsible party (RP), there are four (4) medications that are not given to R1 per doctor’s orders. Medication for Dorzolamide last filled date was on 08/26/2022 with a 3-month supply duration. Refill fate for Dorzolamide was on 11/26/2022. Medication instruction is to instill1 drop in both eyes 2 times a day for Glaucoma. Medication for Brimonidine last filled date was on 05/24/2022 with a 3-month supply duration. Refill for Brimonidine was on 08/24/2022. Medication instruction is to instill 1 drop in both eyes 3 times a day for Glaucoma. Medication for Latanoprost last filled date was on 12/26/2022 with a 75-day supply duration. Refill for Brimonidine was on 03/11/2023. Medication instruction is to instill 1 drop in both eyes daily at bedtime for Glaucoma. Medication for Rhopressa last filled date was on 12/26/2022 with 25-day supply duration. Refill for Rhopressa was on 01/20/2023. Medication instruction is to instill 1 drop in both eyes once a day for Glaucoma. On 05/02/2023, an office meeting was conducted with R1’s RP to discuss medications concern. LPA Keosavang went over R1’s MAR and medication list with R1’s RP. R1’s RP provided LPA with boxes of the 4 medications listed above. RP stated RP was at the facility and had notified ED of concerns regarding medication not being given to R1. RP stated RP went over medication with the facility and observed medications to be full and unopened. RP took medications from the facility. RP stated if the facility is providing medications to R1 why are there boxes of unused medications. LPA confirmed the dates on the box of each medications matches the filled dates. LPA observed all 4 medications to be full and appears to not be given to R1. Deficiencies are cited on the attached LIC 9099-D. Appeal rights were provided. An exit interview was conducted, and a copy of the report left at the facility.the state’s words, verbatim · CDSS document, May 31, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(c)(2) · Plan of correction due date: Jun 1, 2023

Incidental Medical and Dental Care (c ) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication ... requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Based on observation, the facility did not ensure medication was given according to physician directions. During the review of medications, the LPA found that for R1’s medications were found to be full and not given to R1.the state’s words, verbatim · CDSS document, May 31, 2023

Plan of correction: Administrator agrees to audit centrally stored medication. The facility will hold training with staff concerning medication management. The facility will send the staff sign in sheet and training syllabus. These documents will be due by the POC date of 06/01/2023.

From the deficiency page — Deficiency type: Type B · Section cited: HSC87705(c)(5) · Plan of correction due date: Jun 30, 2023

87705 Care of Persons with Dementia (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. This requirement is not met as evidenced by: Based on records review, the facility did not comply with he section cited. R1 did not have updated medication assessment which poses a potential health, safety, or personal rights risk to person in carethe state’s words, verbatim · CDSS document, May 31, 2023

Plan of correction: Facility agrees to schedule R1 by 6/09/2023 to get updated Medical Assessment and submit in updated Medical Assessments by 6/30/2023

Type of visit: Case Management - Incident

On 05/04/2023, Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced to conduct a Case Management- Incident to obtain information regarding an incident that occurred at the facility on 04/13/2023. LPA met with Executive Director (ED), May Tate, and explained the purpose of the visit. The Case Management visit is in response to a telephone call and incident report that was submitted to CCLD. The report indicates resident (R1) responsible party (RP) was present at the facility on 04/13/2023. RP notified the facility that R1 is going blind in left eye due to staff not giving eye drops to R1. RP indicated R1’s eye drops have not been refilled in a while. The facility conducted an internal investigation. The facility reviewed R1’s medication administration records (MAR) to see if staff had been signing off, checked medication cart to see how many eye drops are currently in use, and how many backups are left. Facility had contacted R1’s pharmacy and confirmed refill dates. Facility interviewed Med Techs and confirmed they have been giving eye drops to R1. The facility reported the incident to CCL and Local Long Term Care Ombudsman. According to facility, RP refilled all 4 eye drops and dropped them off to the facility on 04/18/2023. LPA Keosavang requested for R1’s physician’s report, doctor's orders for medications, medication list, and MAR for review. LPA conducted interviews with facility staff. The ED was advised that at this time possible follow-up telephone calls or visits are necessary for further investigation. At this time, deficiencies are not being cited. An exit interview conducted and report provided.the state’s words, verbatim · CDSS document, May 4, 2023

Type of visit: Required - 1 Year

On 4/12/2023 at 9 AM, Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced to conduct a Required- 1 Year inspection utilizing the inspection tool. LPA met with Community Relations Director (CRD), Jane Scapparo, and explained the purpose of the visit. At 9:20 AM, LPA toured the interior and exterior of the facility together with CRD to ensure the health and safety of residents in care. Areas toured include but are not limited to: residents' bedrooms, bathrooms, common areas, maintenance room, kitchen, courtyard, and medication room. LPA observed required furniture, and lighting throughout the residents' bedrooms. Bathrooms are clean, sanitary, and in good repair. Toxic and cleaning supplies are locked in the maintenance room and is inaccessible to residents in care. LPA observed fire extinguishers, fire detectors, and carbon monoxide present at the facility. LPA observed food supplies of non-perishable for a minimum of one week and perishable foods for a minimum of two days. LPA observed medications were locked in medication carts and inaccessible to residents in care. Licensing posters are posted as required. At 10:20 AM, LPA reviewed a total of five residents' files and five staff files. Five out of five residents' files contain signed Admission Agreements, Identification Sheet, Releases, Preplacement Appraisals, and Resident's Rights. Physician's Report for two out of Dementia residents did not have an updated annual medical assessment. Two (2) residents' Physician's Report were completed in 2021. Staff have training in Dementia, First Aid and CPR, and other various care provision. Med Tech have received required training in medications. At 1:20 PM, medications were reviewed for five residents. Medications are centrally stored, locked, and appear to be given per doctor's order. LPA requested for ED to submit documents for review and records keeping. Updated LIC500 Change of Administrator Request There were deficiencies found in today's inspection. Deficiencies are cited from California Code of Regulations, Title 22, and citations are listed on LIC809-D. If the deficiencies are not corrected by the noted due date civil penalties may be assessed. Exit interview conducted and appeal rights were provided.the state’s words, verbatim · CDSS document, Apr 12, 2023

Type of visit: Case Management - Incident

On 4/12/2023, Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced to conduct a Case Management- Incident inspection. LPA met with Community Relations Director (CRD), Jane Scapparo, and explained the purpose of the visit. The purpose of the visit is to follow-up on two unusual incident/injury reports that was submitted to Community Care Licensing (CCL) on 03/31/2023. Incident report indicated on 03/28/2023, a quarterly audit was conducted by Omnicare Pharmacy, per community request. During the audit, it was found that residents (R1 and R2), had not been receiving their medications for administration. The facility requested for R1's and R2's medication refills. R1 and R2's physician's were notified. R1 and R2 were observed by staff for 48 hours for any changes related to missed medications. On 4/5/2023, all of the medication technicians will receive mandatory training on the process of reordering medications and procedures to follow when a medication does not have any refills. LPA interviewed CRD regarding the two incident reports. CRD stated facility is currently switching over to use online eMARS which will be easier to staff to track medications. LPA requested for audit documents for review. At this time no deficiencies are being cited. Exit interview conducted and report provided.the state’s words, verbatim · CDSS document, Apr 12, 2023

Allegation investigated: - Resident forced to take medication against her will. - Resident Restrained.

This report was amended on 03/07/2023. Administrator listed above is not the facility's administrator. Current administrator is Harumi Hurrianko. Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced 02/3/2023 to deliver final finding for a complaint Community Care Licensing (CCL) received on 11/04/2022. LPA met with Resident Service Director, Jasmine Juchniewicz, and explained the purpose of the visit. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA was screened by facility staff upon entering the facility. Throughout the course of the complaint investigation the Department conducted interviews and obtained pertinent documents, such as resident’s (R1) physician's report, identification, and emergency information, needs and services plan, SOC 341, medication list, admission agreement, unusual incident/injury report, facility’s abuse policy training for staff, and written statements from agency staff. Continued on page LIC-9099C. Substantiated According to complainant, caregivers from Bright Star agency forced R1 to take medication against R1’s will. The Department reviewed R1’s physician’s report which indicated R1 ‘s primary diagnosis is Alzheimer’s disease. R1 is able to administer own medication and able to administer own PRN medication when handed directly to R1. An unusual incident/injury report was submitted to CCL for review. Incident report indicated a registry Med Tech notified the facility that two other registry staff were assisting Med Tech with providing medication to R1 in the evening of 10/25/2022. According to Med Tech, the two staff were assisting R1 and the Med Tech was inappropriate. The Department requested and reviewed written statement from two (2) registry staff provided by Bright Star Agency. Written statement from S1 indicated R1 refused to take medication twice. S1 assisted by holding R1’s face and S2 held on R1’s shoulders. Written statement from S2 indicated, S2 gently held on to R1's shoulders while S1 got R1 to open her mouth. S2 denied restraining resident. Interview statement gathered from S1 indicated, S1 had put her hand under R1's chin and S2 hands were on R1's forehands. S1 stated R1 did not fully take the medication only a portion of it. S1 indicated if a resident refuses to take medication sometimes staff would just put "medication with apple sauce." Interview statement gathered from S2 indicated, S2 suggested for Med Tech to indicate on R1’s Medication Administrator Records (MAR) that R1 refused, but Med Tech insisted that R1 needed to take medication for agitation to prevent R1 from lashing out at staff and other residents. S2 confirmed that S2 held on R1’s arms and shoulders while S1 was holding R1’s mouth. S2 indicated staff were partially success in providing medication to R1. The Department requested for S3's Med Tech credentials and medication training for review. The facility did not have records of S3's credentials or any medication training provided to S3. Due to this information CCL finds the allegation to be SUBSTANTIATED. – A finding that the complaint is substantiated means that the allegations is valid because the preponderance of the evidence standard has been met. Deficiencies are cited on the attached LIC 9099-D. Appeal rights were provided. An exit interview was conducted, and a copy of the report left at the facility. The Department received and reviewed R1's physician's report. According to R1's physician's report, R1's primary diagnosis is Alzheimer's Disease. R1 is able to feed self. According to R1's assessment completed on 11/09/2022, R1 requires reminders for meals and eats independently with no meal adjustments. According to complainant, R1 was forced to eat against will. The Department interviewed and gathered statement from a total of five (5) facility staff. All five (5) facility staff denied witnessing or being involved in forcing R1 to eat against will. Interview statement received from R1 confirmed staff did not force R1 to eat against will. CCL finds the allegation to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, and the findings are unsubstantiated. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Feb 3, 2023 · control 25-AS-20221104151132

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(3) · Plan of correction due date: Feb 10, 2023

Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3)To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement was not met as evidenced by: Based on interviews and documentation reviewed, R1 refused medication twice and three (3) facility staff restrained R1 physicially when assisting with medication. This poses an immediate health and safety risk to resident in care.the state’s words, verbatim · CDSS document, Feb 3, 2023

Plan of correction: Resident Service Director, Jasmine Juchniewicz, agrees to conduct staff training on resident's personal rights. ED is to submit proof of training and indicate what topics were discussed and staff to sign off on training, by POC due date, 02/10/2023.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(5)(D) · Plan of correction due date: Feb 10, 2023

87465(a)(5)(D) Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed... include forcing a resident to take medication, hiding or camouflaging medications in other substances without the resident's knowledge and consent, or otherwise infringing upon a resident's right to refuse to take a medication. This requirement was not met as evidenced by: Based on interviews and documentation reviewed, R1 refused medication twice and facility staff had physically restrained R1 and insisted for R1 to take medication. This poses an immediate health and safety ricks to resident in care.the state’s words, verbatim · CDSS document, Feb 3, 2023

Plan of correction: Resident Service Director, Jasmine Juchniewicz, agrees to conduct staff training on medication refusal and submit proof of training on POC due date, 2/10/2023.

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.69(a)(1) · Plan of correction due date: Feb 10, 2023

§1569.69 Employees assisting residents with self-administration of medication; training requirements. (a) Each residential care facility ... the employee shall complete 16 hours of initial training. This training shall consist of eight hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and eight hours of other training or instruction, as described in subdivision (f), which shall be completed within the first two weeks of employment. Based on interviews, facility does not have records of S3's medication training or credentials. This poses an immediate health and safety ricks to resident in care.the state’s words, verbatim · CDSS document, Feb 3, 2023

Plan of correction: Resident Service Director, Jasmine Juchniewicz, agrees to review Health and Safety Code 1569.69 and submit letter of understanding to CCL by POC due date, 02/10/2023.

Allegation investigated: - Staff have not followed emergency disaster plan. - Facility gates are locked to the residents. - Residents rooms have not been properly maintained while in care.

Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility and met with Executive Director (ED), Jane Scaparro, to deliver complaint findings. LPA wore Surgical mask and was screened by facility upon entry. Throughout the course of the complaint investigation the Department conducted interviews with facility staff and obtained pertinent documents relevant to the complaint allegations listed above. Allegation: Staff have not follow emergecny disaster plan. - Unbsubstantiated. The Department requested for facility's Fire Drill Training documents for review. According to ED, the facility was under a different management in 2021 and switched to a new management in October 2021. ************* Continue on LIC 9099-C. ***************** Unsubstantiated Fire Drill Training records indicated the facility conducted monthly Fire Drill Training on 01/30/2021, 02/11/2021, 03/31/2021, 04/30/2021,06/05/2021, and 06/26/2021. Maintenance Director, Jay Brown, conducted training on topics such as fire equipment functional, visual/audio devices checked, fire panel performed properly, follow-up corrective action- employee education/training, follow-up corrective action- disciplinary action, and head count of staff. Facility does not have records of Fire Drill Training from July 2021 through December 2021. Documents revealed that the facility has continued to conduct Fire Drill Training on 02/17/2022, 02/28/2022, and 06/29/2022. Interviews with a total of four (4) facility staff revealed that the facility's trainer went over facility's emergency disaster plan and conducted fire drills with staff. Allegation: Facility gates are locked to the residents. - Unsubstantiated. According to Complainant, facility has locked doors to prevent resident from using the courtyard. The Department interviewed a total of four (4) facility staff. Interview statements received from the four (4) facility staff indicated that doors used to go to the courtyard is locked. Residents would have to ask staff permission to use the courtyard for their safety. If a resident is out in the courtyard resident is able to enter the building at any time because the door is unlocked from the outside. On 7/6/2022, LPA and ED toured the courtyard together. LPA observed ED unlocked courtyard door with a key to go out into the courtyard, however, when going back into the the facility the door from the outside is unlocked. According to Complainant, the gates located at each sides of the building is locked to residents and staff which poses a threat to staff and residents incase of an emergency evacuation. LPA observed two different locks on both sides of the gates. One lock requires a key to open the gate. According to ED, the Fire Department is the only one that has the key to unlock and open the gate. ED stated she had a conversation with the Fire Marshall who indicated that if there was an emergency the Fire Department is able to get the facility on time to cut lock and get everyone out if necessary. The other lock is a combination code lock which requires someone to enter numbers to unlock gate. According to staff and ED, staff has the numbers to unlock the gate. Allegation: Staff do not properly maintain the kitchen. - Unfounded. On 2/15/2022, LPA Keosavang toured the interior and exterior of the facility together with ED. Areas toured include but are not limited to: common areas, five (5) resident bedrooms, three (3) bathrooms, and kitchen. LPA observed kitchen area kept clean and free of litter, rodents, vermin and insects. Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises. Soaps, detergents, cleaning compounds or similar substances stored in areas separate from food supplies This agency has investigated the complaint allegations listed above. The Department have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conduct and report provided to ED. Allegation: Residents rooms have not been properly maintained while in care. - Unsubstantiated. According to ED, Care staff are maintaining residents' bedrooms on a daily basis. Care staff's responsibility is to rinse the sinks, take out trash, and put everything away. On 02/15/2022, LPA toured the facility together with ED and observed five (5) residents rooms. LPA observed all residents rooms to be properly maintained. Interview statement received from care staff (S2) indicated, when regular care staff is not working at the facility because it's their days off and agency staff is covering, resident's rooms is unkempt. LPA finds the allegation to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, and the findings are unsubstantiated. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Jul 6, 2022 · control 25-AS-20220209091103

Allegation investigated: - Facility has mold. - Kitchen equipment is in disrepair.

Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility and met with Executive Director (ED), Jane Scaparro, to open a complaint investigation into the allegations listed above. LPA wore Surgical mask and was screened by facility upon entry.LPA toured the interior of the facility together with ED to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, three (3) resident bedrooms, two (2) bathrooms, and kitchen. LPA observed mold on the kitchen ceiling. Kitchen equpiment such as ice machine, mixer, and oven is in disrepair. Due to this information CCL finds the allegation to be SUBSTANTIATED. – A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Deficiencies are cited on the attached LIC 9099-D. Appeal rights were provided. An exit interview was conducted, and a copy of the report left at the facility. Substantiatedthe state’s words, verbatim · CDSS document, Apr 20, 2022 · control 25-AS-20220419135522

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(a) · Plan of correction due date: Apr 21, 2022

87303 Maintenance and Operation (a) 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. This requirement is not met as evidenced by: Based on observation the licensee did not ensure that facility kitchen is free from mold which poses an immediate health and safety risk to residents in care. LPA also observed kitchen equipment such as ice machine, mixer, and oven to be in disrepair.the state’s words, verbatim · CDSS document, Apr 20, 2022

Plan of correction: Executive Director agrees to schedule an appointment for a mold remediation company to come out to facility to inspect the kitchen by POC date, 04/21/2022. Executive Director agrees to get the oven and the ice machine repaired by 04/27/2022.

Allegation investigated: Staff spoke inappropriate to resident in care.

Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced on 3/16/2022 to deliver complaint findings. LPA met with Executive Director, Jane Scaparro, and explained the purpose of the visit. Prior to initiating the complaint visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and LPA completed a facility risk assessment at the facility. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA were screened by facility staff upon entering the facility. Allegation: Staff spoke inappropriate to resident in care. – Unsubstantiated. Throughout the course of the complaint investigation the Department conducted interviews and obtained pertinent documents such as staff roster, resident roster, Resident’s Physicians Report (R1), Admission Agreement, Identification and Emergency Information, Level of Care Assessment, and Grievance/Concern Report relevant to the allegation listed above. Unsubstantiated The facility had submitted relevant party’s Grievance/ Concern report to CCL for review. According to the Grievance/ Concern report, R1 was on a video chat call with family when R1’s son heard caregiver state that an incontinence issue was “nasty.” Resident Care Director, Snehal Lata, had conducted internal investigation. It was discovered, the two caregivers that assisted R1 on 10/16/2022 were agency staff from Allure Care Agency. Resident Care Director had questioned the agency caregivers which both denied anything was ever said to R1. Resident Care Director stated the facility is no longer using Allure Care Agency and any new agency care staff will go through in-service training on dementia residents on their first day assisting at the community. Interview statement received from Allure Care Agency Manager indicated that the company conducted an internal investigation and resolved the issue by not sending S2 to assist residents at Somerford Place. Allure Care Agency Caregiver (S1) denied speaking inappropriately to R1. LPA finds the allegation to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, and the findings are unsubstantiated. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Mar 16, 2022 · control 25-AS-20211029094754

Type of visit: Annual/Random

Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced on 2/15/2022 to conduct an Annual/Random Inspection utilizing the infection control domain. LPA met with Executive Director (ED), Jane Scaparro, and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA completed a facility risk assessment at the facility. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Mask. Additionally, LPA were screened by ED upon entering the facility. LPA toured the interior and exterior of the facility together with ED to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, five (5) resident bedrooms, three (3) bathrooms, and kitchen In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and ED completed the infection control domain and facility was found to be in substantial compliance at this time. No deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Feb 15, 2022

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.