Copper Canyon Senior Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced annual required visit. LPA was granted entry and met with Licensee, Telecia Cooke, who was informed of the purpose of the visit. At the time of the visit there was two (2) staff and eight (8) residents present. The facility is a two story home with seven (7) bedrooms and four (4) bathrooms with an attached garage. Three (3) bedrooms and two (2) bathrooms upstairs are designated for live in staff/family and four (4) bedrooms and two (2) bathrooms downstairs are designated for residents. The facility does not have any bodies of water or firearms and ammunition on the premises. The residents served are elderly adults 65 years of age and older. LPA conducted a tour of the interior and exterior, reviewed facility documents and conducted a interviews. LPA observed the following: Infection Control: LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies and hand washing signs. Facility had PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan which met department requirements. LPA reviewed staff records and found that all staff had infection control training. Physical Plant: LPA observed the resident bedrooms and staff office. Physical plant, floors, windows, and doors were observed to be clean. Fixtures and furniture were in good repair were present. The outdoor area was observed to be free of hazards and facility had outdoor furniture and shaded area for residents. Laundry equipment was observed to be in good working condition. The sharp and dangerous objects were observed to be locked and inaccessible to residents. The smoke detector and carbon monoxide was operational, and the hot water temperature 114F. Food Service: LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. Care & Supervision/Administration: Adequate staff are present for the supervision of clients during the visit. Facility sketch, exit routes, personal rights, complaint information and emergency phone numbers were found posted in the facility. The listed administrator possesses a current administrator's certificate. Record Review and Resident/Staff Files: LPA reviewed three (3) staff files and training. All staff have criminal clearance and updated training along with CPR/First Aid Certification. Four (4) resident files were reviewed and possessed all required paperwork. Health Related Services/ Incidental Medical Services: All medications were locked in a hallway closet. LPA reviewed medications for four (4) residents and found all medication listed on MARS and all required labeling was found to be in place. Disaster preparedness: LPA reviewed the facility's emergency and disaster plan. LPA reviewed documentation showing the facility's last fire and earthquake drills was conducted on 06/23/2023 which met the department requirements. LPA observed all facility exits were clear from obstructions. LPA observed emergency supplies in the garage and first aid kit with all required items. No deficiencies were cited at the time of the visit. An exit interview was conducted where a copy of this report was provided to Licensee, Telecia Cooke.the state’s words, verbatim · CDSS document, Sep 7, 2023

Type of visit: Case Management - Other

At 11:00am on the date noted above an office meeting was held. In attendance was Licensing Program Analyst (LPA) Javina George, Licensing Program Manager (LPM) Joel Esquivel and Regional Manager Reyna Lacey who met with the Licensee Telecia Cooke. The following was discussed: - substantiated findings given on March 21, 2023, and the details regarding - ombudsman visit that was made to the facility on December 8, 2021. -Appeal rights when/after substantiated findings have been issued An exit interview was conducted, and a copy of this report, and appeal rights were provided to the Licensee Telecia Cooke.the state’s words, verbatim · CDSS document, Apr 17, 2023

Allegation investigated: Licensee created a hostile environment. Licensee prevented a visitor from leaving. Licensee made unnecessary law enforcement contact.

***The following report is an amended complaint report for the findins orignigally delivered on 12/10/2021. Regarding the allegation of Licensee created a hostile environment. LPA conducted interviews and reviewed documentation. The evidence collected revealed that on December 8, 2022, The Riverside County Long-term Care Ombudsman (LTCO) representative attempted a visit to the facility. According to interviews conducted the administrator Telecia Cooke made a request for the representative to step outside, so that the caregiver on duty could complete the required Covid screening protocol. A video collected shows the Administrator already on the phone speaking with Law Enforcement (LE). Administrator can be heard stating to LE that the LTCO representative was being non-cooperative. Administrator continued to state to LE that the LTCO representative did not identify self prior to entering and would not comply with request to have their temperature checked. LPA observed the LTCO representative with a badge hanging from the neck that is clearly visible. *** Continued on 9099c. Substantiated In addition, the administrator made inferences that the LTCO representative “could have been under the influence”. While the administrator was on the phone with LE, the LTCO representative received a call from the LTCO supervisor. The administrator hung up the phone with LE and directed her attention to the LTCO supervisor, stating that the representative would not exit the home and comply with request to be screened. After several back and forth between the administrator and the LTCO supervisor, no clear directions were provided. As the representative is receiving final instructions by the LTCO supervisor, the administrator can be heard stating over and over, for the representative to “step outside the home”. The representative did as instructed, by the administrator and step outside the home, confirming that LE was on their way to the facility and that she would wait outside. The representative exits and leaves the home and tried to sit in their vehicle that is parked in front of the facility. The administrator made the decision to leave the home and follow the LTCO representative to the parked vehicle. LPA can hear the administrator repeatedly, asking the LTCO representative for the supervisor’s number and approaches the vehicle. The administrator places herself between the open door of the vehicle, preventing the LTCO representative from closing the door. LPA can observe that the representative makes several attempts to close the door, but is unable to do so, because of the administrator standing between the door. Based on observation the allegation of the licensee created a hostile environment, the allegation is SUBSTANTIATED. Regarding the allegation of Licensee prevented a visitor from leaving. On December 8, 2022, The Riverside County Long-term Care Ombudsman (LTCO) representative attempted a visit to the facility. According to interviews conducted the administrator Telecia Cooke made a request for the representative to step outside, so that the caregiver on duty could complete the required Covid screening protocol. A video collected shows the Administrator the representative is receiving final instructions by the LTCO supervisor, the administrator can be heard stating over and over, for the representative to “step outside the home”. The representative did as instructed, by the administrator and step outside the home, The representative exits and leaves the home and tried to sit in her vehicle that is parked in front of the facility. The administrator made the decision to leave the home and follow the LTCO representative to the parked vehicle. LPA can hear the administrator repeatedly, asking the LTCO representative for the supervisor’s number and approaches the vehicle. The administrator places herself between the open door of the vehicle, preventing the LTCO representative from closing the door. LPA can observe that the representative makes several attempts to close the door, but is unable to do so, because of the administrator standing between the door. After several attempts the representative is finally able to close the door and the incident ends. Based on observation the allegation of the licensee created a hostile environment, the allegation is SUBSTANTIATED. Regarding the allegation of Licensee made unnecessary law enforcement contact. On December 8, 2022, The Riverside County Long-term Care Ombudsman (LTCO) representative attempted a visit to the facility. According to interviews conducted the administrator Telecia Cooke made a request for the representative to step outside, so that the caregiver on duty could complete the required Covid screening protocol. A video collected shows the Administrator already on the phone speaking with Law Enforcement (LE). Administrator can be heard stating to LE that the LTCO representative was being non-cooperative. Administrator continued to state to LE that the LTCO representative did not identify self prior to entering and would not comply with request to have her temperature checked. LPA observed the LTCO representative with a badge hanging from the neck that is clearly visible. The video also shows the LTCO showing and making the statement of “here is my credential”. Based on observation the allegation of Licensee made unnecessary law enforcement contact is SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. An exit interview was conducted, and a copy of this report, 9099c, 9099d, and appeal rights were provided to Licensee Telecia Cooke. A finding that the complaint is UNSUBSTANTIATED means 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, therefore the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report was provided to Licensee Telecia Cooke.the state’s words, verbatim · CDSS document, Mar 21, 2023 · control 18-AS-20211208114153

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(11) · Plan of correction due date: Apr 4, 2023

87468.1 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: (11) To have their visitors, including ombudspersons and advocacy representatives, permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement is not met as evidenced by: one out of one time the licensee did not permit the LTCO to enter the facility. This poses a potential personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 21, 2023

Plan of correction: The licensee agrees to provide a statement of staff expectations with the Ombudsman. Proof of the POC is due by 5pm on the due date indicated.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(d) · Plan of correction due date: Apr 4, 2023

87405 Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (5) Good character and a continuing reputation of personal integrity. This requirement is not met as evidenced by: the licensee creating a hostile environment at least one time. This poses a potential personal rights risk to person’s in care.the state’s words, verbatim · CDSS document, Mar 21, 2023

Plan of correction: The Licensee agrees to have a staff training on the Ombudsman and their rights to visit the facility.. Proof of the POC is due by 5pm on the due date indicated.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87504(h)(8) · Plan of correction due date: Apr 4, 2023

87405 Administrator - Qualifications and Duties (h) The administrator shall have the responsibility to: (8) Have the personal characteristics, physical energy and competence to provide care and supervision and, where applicable, to work effectively with social agencies. This requirement is not met as evidenced by: on at least one occasion the Licensee made unnecessary law enforcement contact. This poses a potential personal rights risk to person’s in care.the state’s words, verbatim · CDSS document, Mar 21, 2023

Plan of correction: The Licensee agrees to provide her statement on why it was deemed necessary to contact law environment. Proof of the POC is due by 5pm on the due date indicated.

Type of visit: Required - 1 Year

On September 9, 2022, Licensing Program Analyst (LPA), Venus Mixson arrived at the above facility for an unannounced required annual with emphasis on infection control. LPA Mixson was greeted and granted entry by Lead Caregiver, Monique Nicanor introduced self and stated the purpose of the visit. Present in the facility were 5 residents and 1 staff. There are currently no cases of COVID-19 within the facility. LPA Mixson toured the facility and made observations pertaining to the facility's infection control measures. LPA Mixson observed sufficient hand hygiene supplies, sufficient cleaning and disinfecting provisions, and the 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, and cleaning and disinfection provisions are in adequate quantities. LPA Mixson later discussed infection control practices and procedures with Lead Caregiver. An exit interview was conducted and a copy of this report, along with the LIC 811, was given to Lead Caregiver.the state’s words, verbatim · CDSS document, Sep 9, 2022

Allegation investigated: Licensee wilfully created an act of isolation by denying access to the residents/facility from an authorized representative. Licensee created a hostile environment. Licensee prevented a visitor from leaving. Licensee made unnecessary law enforcement contact.

Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to investigate and deliver findings for the allegations (s) listed above. LPA met with Administrator Telecia Cooke and explained the purpose of the visit and elements of the allegations. The investigation consisted of observation, interviews, and record review. Allegation: Licensee willfully created an act of isolation by denying access to the residents/facility from an authorized representative. LPA conducted interviews and documentation review, which revealed that the representative arrived at the facility and refused to comply with the facility’s covid-19 screening protocol. Per Administrator Telecia and Caregiver Vicky the screening is conducted right outside the front door, prior to entering inside the facility. When the request was made by the caregiver on duty at the time of the incident, the representative refused and stated that they were exempt from being screened as they had a right of entry. Therefore, the allegation of is Licensee willfully created an act of isolation by denying access to the residents/facility from an authorized representative. UNFOUNDED. Unfounded Allegation: Licensee created a hostile environment. LPA conducted interviews and reviewed documentation. The documentation reviewed revealed the administrator Telecia making a reasonable and common request of asking for the representative to step outside, so that the caregiver on duty could complete the covid screening for visitors. The administrator attempted to explain the reason, but the representative began to raise their voice. The representative got out their cell phone and began recording the Administrator, and the administrator in turn did the same. The documentation reviewed does not support the administrator creating a hostile environment. Therefore, the allegation is UNFOUNDED. Allegation: Licensee prevented a visitor from leaving. LPA reviewed documentation which revealed the representative was instructed by their Supervisor via telephone to go to their car. At that time the representative stated that they were going to go to their car and wait for the police to arrive. Additionally, the documentation did show the Administrator walking outside, at a reasonable distance and was requesting the representative’s supervisor’s contact information. The representative attempted to close their car door and began honking their horn with the Administrator standing there. The Administrator moved out of the way. Additionally, the Administrator had requested for the representative to leave the premises multiple times. Therefore, the allegation is UNFOUNDED. Allegation: Licensee made unnecessary law enforcement contact. LPA interviewed Administrator Telecia stated that she did contact law enforcement via the non-emergency line because the representative became aggressive, did not comply with being screened and refused to exit her home, so that proper covid protocols could be followed. Administrator stated that the facility has not had any positive covid cases and would like to keep it that way. Administrator could not see the harm in asking a few questions and taking a temperature. Additionally, documentation reviewed supported what administrator reported to LPA George as well as the on duty LPA. the allegation is UNFOUNDED. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. The department investigated and therefore dismissed the complaint. An exit interview was conducted, and a copy of this report was provided to administrator Telecia Cooke.the state’s words, verbatim · CDSS document, Dec 10, 2021 · control 18-AS-20211208114153