Caring Hearts for Elderly

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kathleen Banrasavong arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that five (5) clients live at this facility. There were three (3) staff members present. Staff (1) conducted the facility tour. The Administrator, May-Ann Agresor later came to complete the facility tour. There is an Infection Control Plan on file. Client Records-Incident Reports/Clients Rights-Information/Dental- LPA reviewed client records. Five (5) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. Personnel Records/Training/and Staffing- LPA reviewed employee records. Two (2) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrative organization. May-Ann Agresor’s Administrator’s license expiration date is 05/27/2024. (Continued on LIC809C) (Continuation from LIC809) Food Service- Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a locked location for sharps in the kitchen. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The facility is maintained at 76 degrees for the client’s comfort. Lighting is sufficient for safety. Water temperature measured 105.0 degrees F. Laundry is done in the hallway closet. There is a locked cabinet for storing laundry soap and other chemicals. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location. LPA dialed the facility’s landline number, which rang and was operable. The LIC 610, emergency disaster plan is maintained. There are no firearms at this facility. There is one (1) secured fireplace at this facility. There is not a pool at the facility. There are two (2) gates that have a self-latching lock on the northwest and northeast side of the house. The facility performed their last fire and emergency drills on May 18th, 2023. Medications- The medications are centrally stored. There is a locked cabinet allocated for medication storage. Centrally stored medication and destruction logs are maintained separately. LPA would have reviewed medication logs and observed if they were dispensed accurately. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. LPA observed eight (8) fire alarms and three (3) carbon monoxide detectors. The Administrator tested the smoke alarms and carbon monoxide alarms on site. There is two (2) fire extinguisher on site, last charged on May 5th, 2023. Pursuant to the Title 22 of The California Code of Regulations Division 6, there are zero (0) deficiencies observed. An exit interview was conducted, this LIC 809 was reviewed with, and a copy of this report was provided to the Administrator, May-Ann Agresor.the state’s words, verbatim · CDSS document, Aug 7, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced for the purpose of completing the facility's Annual Inspection. LPA Colvin met with Administrator Mary-Ann Agresor and advised her of the purpose of the visit, and that the Annual Inspection will be limited to Infection Control only. Below is a summary of what was observed: Infection Control: LPA Colvin went over COVID-19 best practices for infection control and prevention with Administrator Mary-Ann Agresor, who LPA Colvin found to be successfully incorporating the several aspects of the facility's Mitigation Plan. Residents have hand sanitizer available to them, and the bathrooms were stocked with hand soap and paper towels. While touring the facility, LPA Colvin observed postings throughout the facility for cough etiquette, social distancing, and infection control. LPA Colvin requested to view the facility's PPE supplies (gloves, masks, and sanitizer, and isolation gowns) which LPA Colvin observed to be sufficient for a 30-day supply and is accessible to staff at the front door of the facility, along with sanitizer which visitors are requested to use upon entrance. LPA Colvin went over the various recommended training for facility staff in relation to COVID-19 and confirmed that staff have been trained on various aspects of infection control, recognition of symptoms of COVID-19, and donning/doffing PPE. LPA Colvin inquired as to if staff have been fit tested for N95 masks, and Administrator Mary-Ann Agresor stated that they have not conducted fit testing for staff at this time. LPA Colvin will be issuing a Technical Assistance Advisory Note during today's inspection for staff not being fit tested for N95 masks. LPA Colvin will not be issuing a deficiency for this item due to the facility not currently having any COVID-19 positive residents, and N95 masks only needing to be worn when a resident is COVID-19 positive or under observation while awaiting test results. Administrator Mary-Ann Agresor confirmed that both staff and visitors are screened for COVID-19 symptoms prior to entering the facility. LPA Colvin confirmed this as LPA Colvin's temperature was taken upon entry to the facility, and LPA Colvin signed in on the visitor log. LPA Colvin inquired with Administrator Mary-Ann Agresor if staff were still screening residents daily for COVID-19 symptoms and checking their temperature, which the Administrator confirmed. LPA Colvin went over proper PPE use for caring for a COVID-19 positive resident, as well as what symptoms to contact 911 for (such as shortness of breath and high fever). LPA Colvin additionally confirmed with Administrator Mary-Ann Agresor that all resident emergency contact information was up to date and that the facility has a 30-day supply of medication for the residents. LPA Colvin additionally observed a white board in the dining room/kitchen area which listed all emergency contact numbers such as local hospitals, Department of Public Health, Emergency Medical Transportation, and others. No deficiencies cited during today's inspection. An exit interview was conducted with Administrator Mary-Ann Agresor and a copy of this report and LIC9102-TA Advisory Notes was providedthe state’s words, verbatim · CDSS document, Aug 1, 2022

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced visit to the facility for an annual inspection. LPA met with caregivers Fida Agresor and Segundina Edwards. LPA toured the facility inside and out. The facility has no bodies of water. The facility has charged fire extinguishers, smoke alarms, and carbon monoxide detectors. Cleaning supplies, medications, and sharps were kept safe. Cleaning supplies were kept in the garage. Medications and sharps are kept in locked cabinets. LPA observed at least two (2) days supply of perishable food items and seven (7) days supply of nonperishable food items. The facility menu was available for review. The resident bedrooms had the required furniture and sufficient lighting. Facility had a supply of additional linen and hygiene items. LPA observed that the facility has a mitigation plan to mitigate the spread of COVID-19 in the facility. One central entry point and sign-in policy has been designated for universal entry screening. Routine symptom screening has been initiated at entry for all staff, clients, and visitors. Facility also documents daily temperature and COVID-19 symptom checks, and any change in condition for staff and residents. LPA observed hand sanitizer throughout the facility and a 30 day supply of PPE. All residents have at least a 30 day supply of medications. LPA observed that all emergency contact information is viewable in the kitchen and dining areas. No deficiencies were cited during this visit. An exit interview was conducted where this report was discussed and provided to Agresor.the state’s words, verbatim · CDSS document, Aug 19, 2021