Enjoycare-Poplar

Allegation investigated: Staff handled resident in a rough manner Staff made inappropriate comments towards resident

Licensing Program Analyst (LPA) Magda Malcore and Licensing Program Manager (LPM) Karen Clemons made an unannounced visit to the facility to conduct a complaint investigation regarding the above allegations. LPA Malcore and LPM Clemons met with Licensee Nirmala Boling and discussed the purpose of the visit. The investigation consisted of direct observations and interviews with residents and staff. Regarding the allegation that staff handled resident in a rough manner, LPA Malcore interviewed licensee, one staff and four residents in care. Interviews conducted with the licensee and staff person both deny handling residents in a rough manner. Interviews conducted with the four residents all deny that staff have mishandled them in a rough manner they also deny witnessing or hearing from other residents that staff has mishandled them. Unsubstantiated Regarding the allegation that staff made inappropriate comments towards residents, LPA Malcore interviewed the licensee and facility staff person whom both deny ever making inappropriate comments towards residents. Interviews with four residents in the facility all deny that staff has made inappropriate comments towards them and have not heard staff making inappropriate comments toward other residents. Based on evidence obtained during the investigation, the above allegations are Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. No deficiencies cited during this visit. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Nirmala boling at the conclusion of the visit.the state’s words, verbatim · CDSS document, Mar 7, 2023 · control 56-AS-20230301100425

Allegation investigated: Staff are mismanaging residents medications.

Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to initiate a complaint investigation for the allegation(s) above. LPA Allen met with Susan Fries who was informed of the purpose of the visit. Allegation- Staff failed to dispense medication as prescribed by physician. During the investigation LPA observed that the resident’s medications were removed from the original package and placed in a medication dispensary and documents were signed by the administrator not by the staff member who dispensed the medication.LPA interviewed staff members S1, S2, and S3 and staff stated that the medications are separated prior to giving medications to the resident but they are always given on time. Substantiated LPA interviewed residents (R1), (R2), (R3),( R4) and (R5) and the residents in care stated that their medications are provided to them on a daily basis. The interviews conducted with staff (S1), (S2) and (S3) confirmed that medications are removed from the original package and then dispensed to the resident’s and later signed by the administrator. Based on interviews, observation and documentation gathered during the investigation, the above allegation is found 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. A deficiency is being cited on the attached LIC 9099-D for mismanaging residents medications. LPA conducted an exit interview where this report was discussed with Susan Fries and a copy of this report LIC9099, 9099-C and LIC 9099-D with appeal rights were provided at the conclusion of the visitthe state’s words, verbatim · CDSS document, Jan 27, 2023 · control 56-AS-20221209161254

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)1-6 · Plan of correction due date: Jan 27, 2023

Incidental Medical and Dental Care-The following requirements shall apply to medications which are centrally stored:Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement is not met as evidenced by: This requirement is not met as evidenced by: During LPA visit observations were made and the residents medications were not in its original packaging and documents/MAR's are not signed by the staff member providing medication. interviews also confirmed that medications are not in original packaging at the time of dispensingthe state’s words, verbatim · CDSS document, Jan 27, 2023

Plan of correction: The licensee has agreed to read the cited regulation entirely including all staff members and provide a written statement of understanding signed by all staff members. This document will be forward to CCL by the POC date of 1/28/2023.

Allegation investigated: Resident engaged in inappropriate behavior with another resident in care. Staff are not providing adequate food service.

Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to deliver the findings for the allegation(s) above. LPA Allen met with Susan Fries who was informed of the purpose of the visit. During LPA Allen investigation interviews were conducted with five (5) residents and three (3) staff members. Interviews were conducted with (R1),(R2),(R3),(R4) and (R5) and based on the interviews the residents said that no one has been inappropriate with them. The residents were also asked about adequate food service and they said that the food was to their satissfaction. The three (3) staff members were interviewed (S1),(S2) and (S3) and they inform LPA of the types of food provided along a menu. LPA observed that there was a 7day supply of non-perishables and 5days suppy perishables. Based on interviews and observations the during the investigation the above allegations are unsubstantiated. Unsubstantiated A finding of Unsubstantiated means although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. LPA conducted an exit interview was conducted where this report with appeal rights was discussed with Susan Fries and a copy was provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jan 27, 2023 · control 56-AS-20221209161254

Type of visit: Required - 1 Year

Licensing Program Analyst, Amber Coleman (LPA) arrived at the Enjoyable Care Facility to conduct an Annual Inspection with a focus of Infection Control. LPA introduced self and stated the purpose of the visit. Staff Member, Olivia Aguilar (S1) greeted LPA and invited LPA inside facility. LPA was asked to sign in and have temperature taken. S1 reports there were no current residents diagnosed with COVID at the time of visit and has a census of 6. The facility was observed to be comfortable in temperature and free of any obstructions. LPA walked throughout facility interior and exterior. Staff and visitors observed wearing PPE. LPA observed a COVID station upon walking inside and signing in. The station offers visitors and staff hand sanitizer, disinfectant, PPE and posted information for Infection Control. LPA inquired about resident charts, S1 phoned the Administrator, who later arrived to the facility to provide LPA access to resident charts. The facility staff has a plan in place to manage Covid-19 symptoms, which includes staff monitoring residents regularly for any changes in condition, includes daily temperature checks. The facility will contact the resident's physician in the event of any COVID-19 related illnesses. The facility staff are responsible for cleaning and disinfecting the highly touched surfaces during their shift. LPA observed no health and safety concerns while walking through facility. The client rooms had the required furniture and sufficient lighting. The facility had a supply of additional linen and extra hygiene items and paper supplies for the residents. Fire and carbon monoxide alarms were tested and found operational. Fire extinguisher last inspected 7/27/22. Medications, chemicals and sharp objects were observed being kept in secure locations. Fire and carbon monoxide alarms tested and operational. Adequate amount of Emergency Rations were observed in the garage. Inspection Tool was utilized, Mitigation plan was reviewed. Facility was further inspected, and no deficiencies were noted. Copy of this report was provided to the Administrator.the state’s words, verbatim · CDSS document, Dec 14, 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.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Javier Prieto made an unannounced visit to the facility to conduct an annual inspection with an emphasis on infection control. LPA explained the purpose of the visit. There are currently no cases of COVID-19 within the facility. During today's visit, LPA toured the facility and made observations pertaining to the facility's infection control measures. LPA observed proper signs throughout the facility, sufficient hand hygiene supplies, sufficient cleaning and disinfecting provisions, and proper use of face coverings. The facility has a designated infection control lead person who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring PPE supplies are maintained, cleaning and disinfection provisions are in adequate quantities, and that staff are trained in the proper use and disposal of PPE and overall infection control. The facility has a plan in place which follows Community Care Licensing guidelines for when and how long to test staff and residents for COVID-19, when and how to isolate/quarantine residents, and when to schedule cleaning and disinfection times of high traffic and frequently touched areas. The facility also has a plan in place to monitor residents regularly for any changes in condition and to subsequently notify the resident's physician and to notify all emergency agencies in the event of any COVID-19 related and/or suspected illnesses. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code or Regulations. An exit interview to review this report was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Nov 8, 2021