Eclipse Home Care II

Allegation investigated: Staff neglect resulted in resident developing worsening pressure injuries.

On 11/8/23, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Administrator Magdalena Saeger. During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation. The results of the investigation are as follows: **Report continued on 9099-C** Substantiated Staff neglect resulted in resident developing worsening pressure injuries. Interviews and records review indicated that over a nine-day period (9/16/2023 - 9/25/2023), facility staff failed to seek medical care intervention, until a Nurse Practitioner came to the facility on 9/25/2023. During the nurse visit to R1 on 9/25/2023, the nurse examined and described R1’s wound as unstageable. Interviews and documentation indicated Nurse Practitioner instructed Administrator on getting Home Health and Hospice involved, which Administrator verbalized understanding. Due to R1’s insurance not taking effect in California, the facility waited a couple more days before sending R1 to the Emergency room on 9/28/23. Facility staff did not contact 911 as soon as the wounds were noticed, nor did they get immediate care for R1 as soon as the wounds were observed. The Nurse Practitioner felt R1’s pressure wounds required immediate medical attention and advised the facility to get Home Health out as soon as possible. Since R1 was documented as being frail with limited ability to move on their own, facility staff should have observed R1’s pressure wounds worsening and contacted a doctor or the Emergency room as soon as possible, but facility failed to do that. It has been concluded that facility staff did not seek timely medical attention for R1. Based on interviews conducted by the department and records reviewed, the preponderance of evidence standards has been met. Therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22 Division 6, Chapter 8, a deficiency is cited on the attached 9099-D page. Exit interview conducted. Appeal Rights and copy of this report has been provided to facility.the state’s words, verbatim · CDSS document, Nov 8, 2023 · control 59-AS-20231010090536

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87466 · Plan of correction due date: Nov 9, 2023

87466 Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This was not evidenced by: The facility failed to ensure that the resident’s medical needs were met in that R1 developed unstageable ulcers while under the care of the facility; the facility failed to seek timely medical care for the condition between 9/16/2023 to 9/28/2023 which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 8, 2023

Plan of correction: Licensee agrees to provide CCL a statement of understanding stating facility has reviewed Title 22, Division 6; Chapter 8, Article 8 by POC Date- 11/9/23. Failure to submit Proof of Correction (POC) by Plan of Correction date may result in civil penalties.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Lavinia Muscan arrived on 10/4/23 to conduct the annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed resident (3) and staff files (2). All resident files contained the required paperwork. All staff files contained the required paperwork. All staff have current first aid and CPR training. Facility was clean and well organized. Facility is current on fire drills. All required posting were observed. Staff training contained the required initial training. LPA and Administrator Magdalena Saeger toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, kitchen, and common areas and outside area. The food supply is within compliance, 2 days of perishable and 7 days worth of non-perishable food items. Grab bars were present at the toilet and in the shower. All exits were unobstructed. The administrator's certificate is current. There is a side gate for emergency access. LPA checked the kitchen area for the ability to prepare and store food. Knives and Sharp objects found to be locked . LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detector at the care home are operational. Fire extinguisher is ready for emergency use. Water temperature is within compliance. In the areas toured, there were no health or safety violations observed. LPA requested a copy of the LIC 500, LIC610E and current liability insurance to be sent to the Department by end of the month. No deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Oct 4, 2023

Type of visit: Required - 1 Year

On 11/9/2022 Licensing Program Analyst (LPA) Lavinia Muscan, arrived at the facility unannounced to conduct an annual visit using the infection control tool visit. LPA met with Facility Administrator, Magdalena Saeger and explained the purpose of the visit. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured hand sanitizer was used shortly before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA was screened by Caregiver. LPA and Administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, outside area and common restrooms. Facility has a 2 day perishable and a 7 day non-perishable amount of food. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Administrator completed the infection control domain and facility was found to be in substantial compliance at this time. Facility has 6 residents 1 of which is on hospice. Administrator agrees to send in LIC500 and liability insurance. No deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Nov 9, 2022

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced on 11/16/2021 to conduct a Prelicensing inspection. LPA met with Licensee and Administrator, Magdalena Saeger and Garbriel Bercea, and explained the purpose of the visit. Prior to initiating the Prelicensing inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and contacted licensee and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA were screened by facility staff upon entering the facility. LPA was allowed entry into the facility that will be licensed for a capacity of six (6). LPA toured the interior and exterior of the facility with Licensee and Administrator. The indoor and outdoor passageways were free of obstruction. Upon entering the facility LPA observed COVID-19 signages. Areas toured include but are not limited to: common areas, six (6) resident bedrooms, two (2) bathrooms, kitchen, garage, medication room, and backyard. LPA observed knives/sharps were locked in the kitchen by sink. LPA observed the require furniture, and lighting throughout the facility. Bathrooms are clean, sanitary, and in good repair. Hot water temperature was measured in residents' bathroom at 102 degrees Fahrenheit. First aid kit was completed with bandages, tweezers, scissors, and thermometer located in the medication room. LPA observed one (1) fire extinguisher in the kitchen. Licensee and Administrator stated the facility has a fire sprinkler system set up at the facility as well. LPA observed fire detectors and carbon monoxide. Component III presentation conducted with Licensee and Administrator. LPA observed that the facility is ready to be licensed. This report will be submitted to the Centralized Application Bureau (CAB) and final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required. An exit interview was conducted with Licensee and this report will be provided to the facility via email.the state’s words, verbatim · CDSS document, Nov 16, 2021

Type of visit: Office

COMP II by CAB successfully completed. Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 6 all non-ambulatory COMP II Participants: Magalena Saegar, Administrator/Licensee Interview Method: Telephone interview On November 10, 2021 at 2:00 PM, Administrator participated in COMP II via telephone with Analyst, Celia Phomphachanh from CAB. Identification of the Licensee was verified by providing California Driver License number verbally. During COMP II, Applicant confirmed the understanding of Title 22 and Health and Safety Codes. Component II was successfully completed. Administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB Analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility Operation: License type, client/resident populations, and program 2. Staff Qualifications and responsibilities 3. Applicant and Administrator Qualifications 4. Program Policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical Plant and Food Service 7. Application Document Review and Technical Assistance: Criminal Record Clearance, Health Screening, Fire Clearance, First Aid/CPR Certificate, Administrator Certificate, Financial Verification, Pre-licensing Inspection, Compliance History and Control of property. Interviewed concluded with Administrator. LIC 809 will be sent via email PDF to Administrator.the state’s words, verbatim · CDSS document, Nov 10, 2021