Cozy Home Care

Allegation investigated: Staff illegally evicted resident

On 9/12/2023, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced to deliver the finding for the allegation listed above. LPA met with caregiver, Khanika Moodie, and explained the purpose of the visit. Caregiver contacted Administrator who stated she is 40 minutes away and visit can be conducted with caregiver. During the investigation of this complaint, the Department conducted interviews and record review for the allegation cited above. Results are as follow, please continue report on LIC 9099-C... Substantiated Allegation: Staff illegally evicted resident The Department conducted records review and interviews to investigate this allegation. Interview conducted on 2/24/2023 with Administrator indicated that R1 has been residing at the facility for approximately three days prior to hospitalization. Administrator stated that during R1’s duration at the facility, R1 refused to eat and/or be changed by caregivers. R1 was sent to Mercy San Juan Emergency Room for evaluation. Administrator reported to hospital social worker that due to concerns of R1’s health and safety, R1 cannot return to the facility until she is conserved. Administrator stated a 30-day eviction notice was not provided to R1. Based on the allegation, staff illegally evicted resident, the allegation is SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Per California Code of Regulations, Title 22, Division 6, Chapter 8, the following deficiency cited on LIC9099D. Exit interview conducted, a copy of the report and appeal right was provided. Allegation: Staff did not ensure resident was adequately fed. The Department conducted records review and interviews to investigate this allegation. Record review indicated that on date of admission R1 was given fruits to eat. It further indicated that R1 was “offered fruits and she ate berries, strawberries, and slices of bananas.” Additionally, record review indicated the following day after R1’s admission, “she only ate a few fruits for breakfast and did not eat lunch. She drank a sip of ensure., Five grapes for dinner.” Interviews conducted indicated that staff continuously offered R1 food, but R1 refused. Allegation: Staff financially abused resident. The Department conducted interviews to investigate this allegation. Interview conducted with S1 indicated that S1 does not have access to R1’s account and/or have S1 taken R1 to the bank to withdrawal money. Interview conducted with S2 indicated since R1’s admission R1 has not vacated the premises until hospitalization. S2 stated staff did not take R1 to the bank. Interview conducted with Licensee indicated Licensee met with R1 and R1’s transporter at the bank, but it was to help R1’s transporter navigate to the facility as money was not withdrawn in her presence. During this investigation, LPA conducted records review and extensive interviews regarding the cited allegations above. LPA found the facility to be compliance with Title 22. Based on interviews conducted, the preponderance of evidence standards have not been met. Based on information obtained during the investigation, LPA finds the allegation to be UNFOUNDED- A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. Exit interview conducted, a copy of the report and appeal right was provided.the state’s words, verbatim · CDSS document, Sep 12, 2023 · control 25-AS-20230216182434

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(a)(4) · Plan of correction due date: Sep 29, 2023

87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5) (4) If, after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted pursuant to Section 87463, and the licensee and the person who performs the reappraisal believe that the facility is not appropriate for the resident. This requirement is not met as evidenced by: Based on records review and interviews, Licensee did not comply with the section cited above, as Licensee did not provide R1 a 30-day eviction notice as Administrator reported R1 cannot return to the facility until R1 has a conservator, which poses a potential health and safety risk for residents in care.the state’s words, verbatim · CDSS document, Sep 12, 2023

Plan of correction: Licensee is to submit a statement of compliance with Eviction Procedures to LPA Yang by close of business Friday September 29, 2023.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced to conduct a case management visit. LPA met with Licensee, Aida Briones, and explained the purpose of the visit. Prior to entering the facility, LPA observed the front metal gate to be in the middle of the driveway. LPA was informed the gate was broken, a result of the storm the night prior. Licensee stated it was too heavy for staff and Licensee to remove, and a third party will be arriving in the afternoon to fix the gate. Additionally, LPA observed a mattress present on the side of the facility at the exit fence. Caregiver informed LPA it has been discarded on the side of the facility for about two weeks. As a result of today's inspection, deficiencies were observed. Please see attached LIC 809-D. Exit interview conducted and a copy of the report and appeal rights was emailed to Licensee.the state’s words, verbatim · CDSS document, Feb 24, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(f)(1) · Plan of correction due date: Mar 3, 2023

87303 Maintenance and Operation (f) Solid waste shall be stored and disposed of as follows: (1) Solid waste shall be stored, located and disposed of in a manner that will not permit the transmission of a communicable disease or of odors, create a nuisance, provide a breeding place or food source for insects or rodents. This requirement is not met as evidenced by: Based on observation and interview, Licensee did not ensure solid waste was disposed appropriately as LPA observed a mattress discarded on the side of the facility and was infromed it has been there for approxiamtely (2) weeks, which posed a potential risk to the health and safety of residents in care.the state’s words, verbatim · CDSS document, Feb 24, 2023

Plan of correction: Licensee moved the mattress immediately and placed the mattress in the back of the facility for Monday trash pick up. Licensee is to submit a photo proof that mattress has been picked up by March 3, 2023.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Cassie Yang arrived announced at the facility on 12/01/2022 to conduct a Pre-licensing inspection. LPA met with Licensee, Aida Briones, and explained the purpose of the visit. Prior to initiating the 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 she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA was screened by Licensee upon entering the facility. LPA and Licensee toured the interior and exterior of the facility to ensure the health and safety of residents in care. Areas toured included but are not limited to: common areas, resident bedrooms, bathrooms, laundry room, staff room and kitchen. LPA observed toxic, sharps and medications to be locked and secured. LPA observed the fire extinguisher to be last serviced 3/7/2022. LPA observed bathrooms to have soap, hand washing sign, trash can with lid, and paper towels in all shared bathrooms. LPA observed the exterior of the facility to have a clear pathway. Facility observed to have at least 2+ days of perishable and 7+ days of non-perishable foods. LPA observed the facility to have a working carbon monoxide detector, and smoke detectors located in all rooms. LPA advised Licensee staff door should have a lock to prevent residents from entering the room. During this visit, deficiencies were observed. LPA informed Licensee fire doors cannot be opened with door stoppers. Licensee corrected the deficiencies immediately. Pre-licensing inspection completed, Licensee waived Comp III as she is the Licensee at another RCFE. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Dec 1, 2022

Type of visit: Office

On 11/4/2022, 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/CPMB associations & 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, Nov 4, 2022