Casa Mia

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrator Lilibeth Samson and was granted entry to the facility. The facility is an (11) bedroom, five (5), bathroom home, with a kitchen/dining area, living room, and no garage. Licensed capacity is (20) current census (14). LPA was accompanied by Facility Administrator Lilibeth Samson to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The hot water temperature tested within regulation at 124 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated storage space for client/staff files. Medications are kept inside kitchen cabinet inaccessible to clients. Overall, the facility is clean, in good repair, and operating in safe conditions for clients in care. Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed four (4) client files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. P & I fund were counted and matched with the ledger. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Administrator Lilibeth Samson.the state’s words, verbatim · CDSS document, Jul 27, 2023

Allegation investigated: Staff do not keep an adequate food supply. Staff do not allow resident to have access to the telephone.

This unannounced visit by Amy Goldenberg, Licensing Program Analyst (LPA), is to initiate the 10 day visit to investigate the above-mentioned complaint allegations. LPA met with Lilibeth Samson and explained the elements of the allegations. During the course of the investigation LPA reviewed the facility menu and assessed the food supply. LPA took photographs of the food located in the pantry and in three (3) refrigerator and freezers. Interviews were conducted with four (4) staff. Interviews were conducted with nine (9) of seventeen (17) residents. A review of resident records was completed and copy of pertinent documents obtained. Investigation revealed the following: In regard to the staff do not keep an adequate food supply, LPA tour of the kitchen and review of the food stores and menu refute the allegation. LPA verified supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days are being maintained on the premises. Unfounded Four (4) of four (4) employees interviewed deny verbally abusing or not treating residents with dignity and respect. It is reported that R1 increasingly demanded staff's attention and would cry and yell if demands were not met immediately by four (4) of four (4) employes interviewed. We have found the complaint allegation is unsubstantiated, although the allegation may have happened or is valid: there is not a preponderance of the evidence to prove that the alleged violation occurred. A copy of this report is being reviewed with and furnished to the facility representative. Nine (9) of nine (9) residents interviewed state they receive enough food at each meal and that snacks and drinks are also provided. In regard to the allegation that staff do not allow resident to have access to the telephone, nine (9) of nine (9) residents interviewed report that they have access to a facility telephone or have their own phone. Four (4) of four (4) employees report that R1 was always on the phone. We have found the complaint allegations are unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint. A copy of this report is being reviewed with, and furnished to the facility representative.the state’s words, verbatim · CDSS document, Dec 5, 2022 · control 56-AS-20221128115349

Allegation investigated: Facility staff do not ensure that resident medication is inaccessible to residents. Resident is forced to have medicatons dispensed by facility staff.

This unannounced visit by Amy Goldenberg, Licensing Program Analyst (LPA), to initiate the 10 day visit to investigate the above-mentioned complaint allegations. Investigation revealed that R1 does not reside at this address. During this visit LPA learned that this licensee is an operator of a room and board facility at the address located next door where R1 resides. We have found the complaint allegation is unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint. A copy of this report is being reviewed with, and furnished to the facility representative. Unfoundedthe state’s words, verbatim · CDSS document, Nov 22, 2022 · control 56-AS-20221118090620

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Allegation investigated: Staff not serving nutritional meals to meet the resident’s medical needs Facility heating system is in disrepair

This unannounced visit conducted by Amy Goldenberg, Licensing Program Analyst (LPA), is being conducted to conclude this agency’s investigation into the complaint allegations mentioned above. During the course of this investigation LPA reviewed R1s medication and diet orders, reviewed menus, assessed food supply, interviewed three (3) staff and eight (8) of fifteen (15) residents. LPA tested resident pull alarm system and heaters. Investigation revealed the following: It is alleged that R1 was not serving nutritional meals to meet the residents needs. LPA review of diet orders revealed that R1 had a diet order for a low carbohydrate diet. LPA review of menu and food storage indicate that a low carbohydrate diet can be provided. Interview with R1 revealed their satisfaction with the food items being served. Unfounded It is alleged that staff did not respond to R1 call bell. LPA tested the call system and verified that the call system is working in the bedroom of R1. LPA notes that the alarm system rings loudly and is heard through out the facility. Interview of residents revealed that one (R1) of eight (8) interviewed responds that staff did not respond to their call bell. Staff interviewed deny the allegation. There is no evidence available to confirm or refute that staff did not respond to R1's call for assistance. We have found the complaint allegation is unsubstantiated, although the allegation may have happened or is valid: there is not a preponderance of the evidence to prove that the alleged violation occurred. A copy of this report is being reviewed with and furnished to the facility representative. Eight (8) of eight (8) residents interviewed described the food being served as nutritious and that their needs are being met. Interviews with staff providing food service revealed their knowledge of R1's nutritional needs as related to their medical status and diet order and are able to inform LPA on how those needs are being met through appropriate meal substitutes. Review of the food storage and menus revealed that the facility has the availability of food options to meet the needs of R1s diet order. It is alleged that the facility heating system is in disrepair. LPA toured 10 bedrooms to assess the heaters efficacy. LPA found in ten (10) of ten (10) bedrooms that the heater was functioning. Seven (7) of eight (8) residents interviewed state that their heater works to their satisfaction. One (1) of eight (8) interviewed was unable to provide a response in regard to the heater. The facility thermostats are maintained at a temperature of 73 degrees F. Based on review of the information we have found the complaint allegations are unfounded, meaning that the allegation was false, could not have happened and is without a reasonable basis. We have therefore dismissed the complaint. A copy of this report is being reviewed with, and furnished to the facility representative.the state’s words, verbatim · CDSS document, Jun 9, 2022 · control 56-AS-20220308132028

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Amy Goldenberg made an unannounced visit to the facility to conduct an annual inspection with an emphasis on infection control. LPA arrived and observed a hand sanitation and sign in station. The facility has a screening procedure in place for visitors. LPA learned there are (15) residents residing in the home at this time. There are no cases of COVID-19 in the facility. The facility has an approved mitigation plan in place which follows Community Care Licensing guidelines. During today's visit, LPA toured the facility and made observations pertaining to the facility's infection control measures. LPA observed sufficient hand hygiene supplies, sufficient cleaning and disinfecting provisions. Adequate personal protective equipment is on hand. Staff are wearing masks and residents are encouraged to participate in hand washing and wearing masks. LPA does not observe any issues that pose immediate harm to the residents of the home. During this visit the requirement of LIC 9282 was discussed. Based on the observations made during today’s visit, there are no deficiencies being cited per Title 22, Division 6, of the California Code or Regulations. LPA reviewed this report and a copy was provided to the facility representative.the state’s words, verbatim · CDSS document, Jun 9, 2022