Silver Living Home Care

Type of visit: Required - 1 Year

On October 18, 2023, Licensing Program Analyst (LPA), Venus Mixson arrived to the facility unannounced and met with the Administrator, Florina Candidato. The LPA introduced herself, and stated the purpose of the visit, which was in order to conduct the required annual inspection LPA Mixson toured the facility along with the Administrator, and inspected the facility inside and outside. There were no obstructions to the indoor or outdoor passageways at the time of this visit. The facility is a single story home, located at 22590 Temco Street, Moreno Valley, CA. 92553. Physical Plant: The facility phone number is (951) 563-0181, and is operable. The LPA observed the resident bedrooms, and they are equipped with required furniture as per Title 22. The LPA inspected the facility bathrooms, and the hot water temperature tested within regulations. Bathrooms were clean and appliances were operating appropriately at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguisher. The LPA observed required postings such as; the Ombudsman poster, "If you See Something, Say Something" and the "Personal Rights" postings were posted in a common area close to the front door. The cleaning supplies and sharp items were kept locked and inaccessible to the residents. There was a designated storage space for the resident and staff files. Medications: were reviewed, and were locked and inaccessible to residents. The overall facility is clean, the furniture is in good condition. The facility air conditioning and other appliances were operable currently at the time of this visit. Food Service: Non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for the residents. The dishes and utensils were in sufficient supply and stored properly. Care & Supervision: Facility has sufficient staff, three at the time of this visit, and staff were attending to the residents. Records Review: The LPA reviewed four resident files, and three staff files. There were no Title 22, Division 6 Regulation violations observed and/or cited during todays visit. An exit interview was conducted and a copy of this report, along with the LIC 811, was given to the Administrator, Florina Candidator.the state’s words, verbatim · CDSS document, Oct 18, 2023

Allegation investigated: Residents were confined in bed by staff as a form of restraint

Licensing Program Analyst (LPA) Jesse Gardner made an unannounced visit to the facility to initiate a complaint investigation for the allegation listed above. LPA Gardner met with Caregiver Adela Tolentino and toured the facility. LPA informed staff of the purpose of the visit and the elements of the allegation. LPA conducted interviews with residents and staff, and reviewed records. It was alleged that five out of six resident's were laying in bed with bedrails up and legs elevated as a possible form of restraint. And further, residents allegedly were not helped in getting out of bed very often, though they would like to. Interview with residents revealed that those who were able to communicate, stated that they do, in fact, get out of bed by staff, and are not confined. Continued on LIC9099C. Substantiated LPA observed Resident's in Room #1, Room #2, and one resident in Room #3 all had their bed not raised. Resident One (R1), who was in Room #4. R1's bed was elevated at the feet and when questioned, R1 advised that it was due to personal preference. However, Resident Two (R2) in Room #3 was noted to have a cardboard box wedged between the frame at the foot, and the foot of the bed was partially raised. Staff interview revealed that this was done to keep R2 from getting out of bed, or rolling out of bed. LPA also noted that both of R2's bed rails were up extending the length of the bed. The facility was cited per Title 22, and thus, this complaint was 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 where a copy of this report was provided along with copies of the LIC9099D, and Appeal Rights.the state’s words, verbatim · CDSS document, May 30, 2023 · control 18-AS-20230523095508

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87608(a)(1) · Plan of correction due date: May 31, 2023

Postural Supports: (a) Based on the individual's preadmission appraisal, and subsequent changes..provide assistance and care for the resident in those activities... Postural supports may be used under the following conditions. (1) Postural supports.. spring release trays..to improve a resident's mobility.. functioning, or to position rather than restrict movement including, but not limited to, preventing a resident from falling out of bed, a chair, etc. This requirement was not being met as evidenced by: Based on staff interview and LPA observation, R1 had a box wedged between the bed and frame preventing R1 was exiting the bed. This poses an immediate personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 30, 2023

Plan of correction: Licensee agrees to develop a plan to provide supervision for R1 and further agrees to conduct in-service training on personal rights and cited regulation, and provide proof of training by POC date.

Allegation investigated: Resident's needs are not being met

Licensing Program Analyst (LPA) Jesse Gardner made an unannounced visit to the facility to initiate a complaint investigation for the allegation listed above. LPA Gardner met with Caregiver Adela Tolentino and toured the facility. LPA informed staff of the purpose of the visit and the elements of the allegation. LPA conducted interviews with Resident One (R1) and staff. It was alleged that R1 was refused assistance with toileting and staff refused to change R1's soiled diaper. Interview with confidential source indicated that the date on which this incident took place was approximately the week of May 1, 2023, R1 had not been changed in the morning. Substantiated Staff interviews indicated that it is protocol that each resident be changed before breakfast. Other staff interview revealed that if residents do not voice the need to be changed in the morning before breakfast, they do not check their diaper. Record review indicated that R1 is to be assisted with toileting. Thus, this allegation was Substantiated. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. The facility was cited per Title 22. An exit interview was conducted where a copy of this report was discussed and provided along with copies of the LIC9099D, and Appeal Rights. Interview with R1 indicated that R1 has staff help when they voice it. R1 further indicated that they receive 3 meals a day, and their TV is always on and in their control. Thus, this allegation was Unsubstantiated. A finding of UNSUBSTANTIATED means 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. An exit interview was conducted where a copy of this report was discussed with and provided.the state’s words, verbatim · CDSS document, May 17, 2023 · control 18-AS-20230509150545

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87625(b)(3) · Plan of correction due date: May 24, 2023

Managed Incontinence (b) In addition to Section 87611...licensee shall be responsible for the following:(3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement was not met as evidenced by: Based on staff interview, LPA found that staff are to change resident's before breakfast and/or inquire if they need changing. This was not done for R1. This poses a potential personal rights risk for residents in care.the state’s words, verbatim · CDSS document, May 17, 2023

Plan of correction: Licensee agrees to conduct in-service training on the cited regulation, and provide proof of completion by POC date to LPA.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tricia Danielson arrived unannounced to the facility to conduct an annual inspection with emphasis on infection control. LPA met Caregivers Adela Tolentino and Leila Marasigan and explained the purpose of today’s visit. LPA spoke with Administrator Flor Candidato via telephone. The facility has a Mitigation Plan Report as well as an Infection Control Plan posted in the facility however, a copy of each is not on file with the Department. LPA obtained copies of both during today's visit in order to update the file. During the inspection, LPA observed appropriate COVID-19 postings at the facility front entrance and throughout the facility itself. The facility has a COVID-19 symptom and temperature screening process in place which was in accordance with the Department's guidelines. LPA observed that the facility was also equipped with sufficient hand hygiene supplies, sufficient cleaning/disinfecting provisions, and a supply of Personal Protective Equipment (PPE). As documented in the Infection Control Plan, the facility has a designated infection preventionist who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring staff are trained in the facility's infection control procedures, and ensuring infection control measures are implemented. Also, the facility has a plan in place which follows Community Care Licensing Division guidelines for COVID-19 testing, isolation, and properly caring for residents and staff with COVID-19 positive results and/or exposures. Additionally, as documented in the Infection Control Plan, the facility has a plan to monitor residents regularly for any changes in condition and to subsequently notify the resident's physician, emergency personnel, and responsible party in the event the resident presents with any COVID-19 symptoms. Based on today's observations, the facility is following the Infection Control Plan as posted. No deficiencies were cited during today's visit. An exit interview was conducted and a copy of this report was provided along with LIC 9102- Technical Assistance.the state’s words, verbatim · CDSS document, Oct 10, 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.