Marconi Villa

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual inspection on 04/07/2023 at 12:30 PM. LPA Martinez met with Jessica Quistgard and stated the purpose of today’s visit. LPA Martinez inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations. Administrator holds current certificate. The facility is licensed for six non-ambulatory resident , and has an approved hospice waiver for four. LPA Martinez toured the facility with Jessica Quistgard on 04/07/2023 at 1:30 PM. The facility is sanitary and furnished. All resident rooms are furnished and in good repair, and the resident bathrooms are sanitary and furnished. The facility kitchen is sanitary and has an adequate food supply. The laundry is room is sanitary and laundry is done daily. All toxins are kept locked and made inaccessible resident in care. The water temperature is 108 degrees, and the facility temperature is 78 degrees. The facility fire extinguishers are in good repair, and the last fire drill was on March 23, 2023. The smoke and carbon detectors were tested and were in good repair. The facility has a call button system, and is in good repair, and the facility has a public telephone in the activities room. The exterior of the facility is in good repair. LPA Martinez reviewed 4 resident files and 5 staff files. All of the files were up to date. The facility has the required posters in the facility. LPA Martinez reviewed two Medication Administration records, which were up to date, and LPA Martinez inspected the first aid kit, which was up to date. The facility has infection control plan, and has an emergency disaster plan. There were no deficiencies cited at today's annual inspection. An exit interview was conducted, and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Apr 7, 2023

Type of visit: POC

Licensing Program Analysts (LPAs) Avelina Martinez and Arielle Pascua arrived at the facility unannounced on 12/20/2022 at 12:10 PM to conduct a POC case management visit. LPA Martinez met with Jessica Quistgard explained the purpose of the visit. The purpose of this visit is to follow-up on plan of corrections that were due on 12/19/2022. During today's visit, LPAs reviewed training documents regarding, basic services, personal rights, and cleaning and disinfecting. Moreover, the LPA Martinez requested the following POC’s to be corrected by: December 19, 2022. The POC's documentation was emailed to LPA Martinez on December 18, 2022. In addition, LPA Martinez and LPA Pascua toured the facility and inspected resident rooms for cleanliness. Based upon this inspection, the LPAs observed the following POC’s to be corrected. The Deficiencies cited have been cleared. Licensee complied with the terms of the plan of correction and corrected the deficiencies by plan of correction due date. An exit interview was held, and a copy of this report was given to the facility at the end of the visit.the state’s words, verbatim · CDSS document, Dec 20, 2022

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Avelina Martinez arrived at the facility unannounced on 11/28/2022 at 9:00 AM to conduct a case management, LPA Martinez met with Manpreet Dhanoa explained the purpose of the visit. The purpose of the visit today, is in response to learned deficiencies during a complaint investigation. LPA Martinez toured the facility on November 17, 2022 and November 28, 2022. During these visit, LPA Martinez observed that residents' rooms were not cleaned. LPA Martinez observed dead pest on window sils, unsanitary floors, and bed sheets missing. As a result it was determined the facility was unsanitary. Moreover, the facility has Administrator changes pending. LPA Martinez Requested the following documents: LIC 200 Facility Application LIC 501: Personnel Record and Application LIC 503: Health Screening LIC 500: Personnel Work Schedule All Administrator documents shall be emailed to LPA Martinez by December 2, 2022 by close of business 5PM. As a result of this visit, the following deficiency was cited, per Title 22 Regulations. The deficiencies were cited on 809-D. An exit interview was conducted, and a copy of this 809 report, 809D Page, and Appeals Rights were given to facility.the state’s words, verbatim · CDSS document, Nov 28, 2022

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Dec 19, 2022

87303(a) Maintenance and Operation: The facility shall be clean, safe, sanitary and in good repair at all times...This requirement was not met as evidence by. Based on observation, the facility floors and window sils were unsanitary. This posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 28, 2022

Plan of correction: Licensee agrees to conduct staff training on disinfecting and cleaning by plan of correction (POC) date 12/19/2022. Licensee agrees to email training documents to LPA Martinez on POC date 12/19/2022.

Allegation investigated: Staff were not meeting residents hygiene needs. Staff did not change the residents sheets timely.

Licensing Program Analyst (LPA) Avelina Martinez arrived at the facility unannounced on 11/28/2022 at 8:30 AM to follow up on a complaint investigation and deliver findings, LPA Martinez met with Manpreet Dhanoa explained the purpose of the visit. Throughout the course of the investigation, LPA Martinez conducted interviews, toured the facility, and reviewed documents. LPA Martinez reviewed resident 1 (R1) daily charting records. LPA Martinez was informed R1 is scheduled to have three baths per week. LPA Martinez reviewed R1's shower log for October 2022, and the log reported R1 had a total of five baths in October 2022. LPA Martinez was also informed resident 2 (R2) did not receive baths. As a result, it was determined the facility was not meeting residents' hygeine needs. Continued... Substantiated Moreover, LPA Martinez toured the facility on November 17, 2022 and November 28, 2022. During these visit, LPA Martinez observed that residents' rooms were not cleaned. LPA Martinez observed dead pest on window sils, unsanitary floors, and bed sheets missing, and pillows did not have pillow casing. Based investigation it was determined facility sheets are being changed timely. As a result of this investigation, the Department finds these allegations to be Substantiated. A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the evidence standard has been met. Deficiencies cited on the LIC 9099-D, per Title 22 Regulations. An exit interview was conducted, and a copy of the 9099 report, LIC 9099-D, and appeal rights were given to the facility.the state’s words, verbatim · CDSS document, Nov 23, 2022 · control 27-AS-20221114143503

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87464(f)(1) · Plan of correction due date: Dec 19, 2022

Basic Services 87464(f)(1): Basic services shall at a minimum include: Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not met as evidence by: Based on observation, interviews, and file review, the licensee did not ensure R1 was received baths. This posed a potential health and safety risk to R1the state’s words, verbatim · CDSS document, Nov 23, 2022

Plan of correction: Licensee agrees to conduct staff training on basic services by plan of correction (POC) date 12/19/2022. Licensee agrees to email training documents to LPA Martinez on POC date 12/19/2022.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(2) · Plan of correction due date: Dec 19, 2022

Personal Rights of Residents in All Facilities 87468.1(a)(2):esidents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidence by: Based on observation, interviews, and file review, the licensee did not ensure facility sheet were changed and clean. This posed a potential health and safety risk to R1the state’s words, verbatim · CDSS document, Nov 23, 2022

Plan of correction: Licensee agrees to conduct staff training on personal rights by plan of correction (POC) date 12/19/2022. Licensee agrees to email training documents to LPA Martinez on POC date 12/19/2022.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced on 5/5/22 at 1:00PM to conduct a Pre-licensing inspection visit. LPA met with Manpreet Dhanoa and explained the purpose of the visit. Administrator certificate expires 11/24/23 for Manpreet Dhanoa.. The licensing fees are current at this time. The facility is licensed for a capacity of 6 non-ambulatory residents. LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed 5 residents during this visit. LPA observed 2-day perishables and a supply of 7-day non-perishables during this visit. Facility has video cameras in the common areas. LPA observed exit alarms during this visit. Administrator demonstrated the use of Medication Administration Record (MAR). The temperature inside the facility was observed to be at 75*F which is within the required range of 68-85*F. The hot water temperature was measured at 114.2*F which is within the required range of 105-120*F. LPA observed fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed the centrally stored medications area to be locked and inaccessible to residents. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. Component III conducted-Licensure pending. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies observed or cited. Exit interview held, copy of report given.the state’s words, verbatim · CDSS document, May 5, 2022

Type of visit: Office

Facility Type: Residential Care Facility for the Elderly Application Type: Change of ownership Capacity: 6 Census (if any clients in care): 5 COMP II Participants: Manpreet Dhanoa Interview Method: Telephone interview On April 19, 2022, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Apr 19, 2022