Splendor Oaks Senior Living #3

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 12/28/2022 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with Facility Manager, Ann Williams, and explained the purpose of the visit. LPA ensured to apply hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. LPA toured the facility to ensure the health and safety of residents in care. Areas toured include but are not limited to: 9 bedrooms and 5 bathrooms for residents, common areas, kitchen, outdoor area, laundry room, garage, and PPE supplies. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Facility Manager completed the infection control domain. No deficiencies are being cited. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Dec 28, 2022

Allegation investigated: Staff threw an item at a resident while in care

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conclude investigation and deliver complaint findings to a complaint received on 8/22/22. LPA met with Ann Williams, lead caregiver, and explained purpose of inspection. LPA observed caregivers, Paulina and Alicia. Currently there are (10) residents and (0) residents are on hospice. LPA observed (3) residents to be watching television in the common areas during the inspection. Prior to initiating today's inspection, LPA completed required COVID-19 Department protocols and was wearing a surgical mask. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. During the investigation, LPA interviewed Administrator, House Manager, Lead caregiver, (1) caregiver, resident (R1) who is the subject of the complaint, (4) additional residents and family member of R1. LPA reviewed documentation pertaining to R1 including: physician's report, pre-appraisal, and care plan. The results of the investigation are as follows: cont on 9099D(1)... Unsubstantiated 9099A(C)(1).. Allegation: Staff placed a soiled diaper in a resident's face. Complaint alleges that staff placed a soiled diaper in resident's face when assisting her in the bathroom. Interviews with staff and Administrator/managers revealed that no care staff would place a soiled diaper in a resident's face. Lead caregiver stated she was at the facility on Sunday, 8/21/22 when the sheriff conducted a wellness check on R1, and stated the Sheriff stated he didn't see any concerns with care or supervision. Additionally, the Ombudsman visited R1 just after the Sheriff's visit and indicated he didn't see any issue with R1's care, but requested staff document any unusual or recurring incidences. Lead care staff was not aware of staff allegedly putting a soiled diaper in R1's face until the Sheriff's came out on 8/21/22. Also, Lead care staff did not hear R1 mention anything about staff placing a soiled diaper in her face but did her complain about the diaper being thrown at her in a bag. LPA also heard R1 discuss the diaper being thrown and did not hear R1 mention anything about a soiled diaper being placed near her face. Based on information obtained, LPA finds the allegation to be UNFOUNDED. Allegation: Staff do not provide adequate food service. Complaint alleges that resident is served soup when she does not eat soup and when she requests a sandwich, she is told they do not have peanut butter. R1 stated she "doesn't want soup and a half sandwich" and she likes peanut butter and jelly sandwiches and "sometimes staff will give her that". All staff interviewed stated that if a resident doesn't like the menu item served, staff will prepare an alternative dish for the resident. LPA observed the facility to have sufficient food, including peanut butter and jelly, on 8/26/22 and again on 10/25/22. (3) other residents interviewed stated that there are no concerns with the food service with (1) resident stating that the food is served in "small portions that are not proportionate". Based on information obtained, LPA finds the allegation to be UNFOUNDED. Allegation: Staff are not providing comfortable accommodations to a resident. Complaint alleges R1 feels dogs are treated better than she is, staff gather in the area outside of her door and speak loudly to each other, and sometimes early in the morning, staff wake her up early and take her to the table before breakfast preparations have started. cont on 9099A(C)(2)... 9099A(C)(2)... (4) other residents interviewed stated they receive very good care and receive assistance when it's requested. Residents stated staff will wake them up and give them a bed bath before taking them to the dining area at 8:30 when breakfast is served. Staff interviews revealed that starting at 7:00 am, all residents get a sponge bath and their hair combed to prepare them for breakfast which is served at 8:30 am. Lead caregiver stated that staff will wake R1 up in the morning around 7:00 and R1 will do her own hair and is ready around 8:10 am every morning, but will wait in her room until breakfast is served at 8:30 am. Lead caregiver stated she has never heard R1 say that she is "treated worse than a dog". Lead care giver stated that staff will talk loudly only so resident can hear better and also due to the caregiver's accent so it is clearer to understand. Also, the television nearby is often turned on which could be adding to the noise level. Based on information obtained, LPA finds the allegation to be UNFOUNDED. Based on information obtained, LPA finds the above (4) allegations to be UNFOUNDED- meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview. Copy of report left at facility. Allegation: Staff threw an item at a resident while in care Complaint alleges that resident placed the soiled diaper in a bag after being assisted in the bathroom by staff, placed the bag by the door of her room, and then the staff member then threw the bag at her. Physician's report dated 3/5/22 notes resident (R1) has a diagnosis of Dementia, can be confused or disoriented, can follow simple instructions and communicate needs and needs assistance with toileting and/or using incontinent products. Physician's report and interviews confirmed R1 has a visual impairment and is considered legally blind. Lead caregiver stated that R1 is "very independent and is doing well". R1 was interviewed on 8/26/22 stated she is not sure which night shift staff it was but recently a staff threw a diaper in a bag at her. R1 stated the bag didn't hit or hurt her and "the lady that threw the diaper might not work at the facility anymore". Facility staff interviewed stated that R1 is capable of taking her diaper off but needs assistance also with toileting and staff will ask her to call for assistance, never requesting she put a soiled diaper in a bag by the door. Lead caregiver stated she observed a tied bag containing a diaper that was found inside R1's door prior on/around 8/21/22 when the incident allegedly occurred and was reported to local authorities. A copy of the sheriff report was not available. LPA was unable to interview any NOC shift staff and another staff (S1) was no longer working at the facility. Based on information obtained, LPA finds the allegation to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview. Copy of report left at the facility.the state’s words, verbatim · CDSS document, Oct 25, 2022 · control 25-AS-20220822154340

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Rowan "Ann" Williams, , lead caregiver, who contacted Maria Cucicea, House Manager/Co-Administrator by phone. LPA explained purpose of inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols and confirmed the facility does not currently have any positive Covid-19 diagnoses. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Facility currently has (9) residents and (1) resident is on hospice. LPA observed (4) residents to be in the front room watching television and (5) residents to be in their room, sleeping, reading or with a physical therapist. The facility is licensed for (12) non-ambulatory residents and has a hospice waiver for (6) residents. Facility has live-in caregiver staff. LPA confirmed there are (3) caregivers scheduled for all day shifts and (1) awake staff during the nights. LPA observed (3) caregivers presednt and lead careagiver- all caregivers were wearing a mask. LPA and caregiver, Ann, toured the interior of the facility. LPA observed it to be clean, in good repair and to be odor free. LPA observed various Covid posters throughout the facility. Rooms toured include (10) private bedrooms, (1) shared resident bedroom, (3) bathrooms, kitchen, laundry, and common areas. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and lead caregiver completed the infection control domain and facility was found to be in compliance at this time. Inside temperature was observed to be 75 F. Fire extinguishers last serviced 5/28/2021 and smoke/monoxide alarms are in working order, LPA observed sufficient 2+day perishable and 7+day non-perishable food and PPE supply. LPA observed paper towels, soap and sanitizer in the bathrooms. LPA recommended to post 12 -step hand-washing posters by each sink. Sharps, toxins and medications are secured appropriately. Vaccination status of residents and staff and PIN 21-40 issued 8/27/2021 regarding visitation protocols was discussed. . All staff are cleared and requested to be associated to the facility. Administrator Iana Voitehovschi #6056473740- exp 7/12/2022- posted during inspection since Kevin Lee's renewal is pending. cont on 809C.. LPA observed required postings including LTCO, See Something Say Something and Resident Rights, LIC308's (for multiple staff), Non-Discrimination notice and menu. LPA requested an updated copy of LIC500 and current liability insurance to be emailed/faxed to the Department by 11/30/2021. There were no deficiencies observed during today's inspection. Exit interview with lead caregiver, per House Manager. Copy of report to be e-mailed to Administrator following inspection.the state’s words, verbatim · CDSS document, Nov 22, 2021