Nunez Care Home #2

Type of visit: Required - 1 Year

On 08/15/2023 at 12:05 PM, Licensing Program Analyst (LPA) Pang Lee arrived at the facility to conduct an unannounced annual inspection. LPA Lee knocked on the door and no one was home. LPA Lee called administrator, Leonil Nunez, (916) 753-7094 and spoke to administrator. Administrator stated that administrator will send a staff shortly. Care staff Salvacion Santos arrived 33 minutes later. Administrator arrived approximately two hours later and joined the annual inspection. Care staff Salvacion Santos assisted with today’s visit. Administrator certificate # is 6002516735 and will expire on 11/17/2023. The current census is 3 with 2 facility staff. This facility is a single story building licensed to serve three (3) ambulatory only developmentally disable clients. LPA Lee inspected the physical plant including but not limited to the common area, kitchen, dining area, client bedrooms, client bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA Lee observed the facility to be free of odor, clean and in good repair. LPA Lee observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA Lee observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 116.3 degrees Fahrenheit in client bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers, smoke and carbon monoxide detectors are in compliance with fire safety. Fire extinguisher was last serviced on 03/14/2023. The last fire drill was conducted on 07/04/2023. LPA Lee observed the facility has a has a public telephone in the dinning area. The facility has infection control plan and has an emergency disaster plan. Facility thermostat observed at 73 degrees Fahrenheit. LPA Lee checked medication storage and found medication to be locked away and inaccessible to clients. Continued LIC 809-C LPA Lee reviewed 3 out of 3 medication administration record (MAR) and it was complete. First aid kit was checked and is complete. LPA Lee requested client and staff files for review. LPA Lee reviewed 3 out of 3 client files and 5 out of 6 staff files and they were complete. LPA Lee reviewed staff criminal record clearances and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared and associated to the facility. The following documents will be email to LPA Lee (pang.lee@dss.ca.gov) by 08/18/2023 by 5:00 PM by end of day: (1) LIC 308 Designation of Administrative Responsibility (2) LIC 500 Personnel Report (3) Copy of Administrator Certificate (4) LIC 610 Emergency Disaster Plan (5) Proof of Current Liability Insurance Per California Code of Regulations, Title 22, no deficiencies were observed during today’s visit. A copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Aug 15, 2023

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to the facility to conduct a case management due to receiving an incident report. LPA met with facility staff and explained the purpose of the visit. LPA was later met by Administrator Leonil Nunez. Facility staff Lionel Nunez self reported an incident that occurred with a resident on 12/27/2022. On 12/27/22, Resident 1 (R1) mistakenly took another resident's medication. "Staff reported that after [S1] initially administered [R1's] AM medications ... Staff then began to prep for another resident’s medication administration at the homes medication prep area. During staff’s preparation of the other residents medication, 1 pill for the resident bubble pack was put into a pill cup. As staff turned to get the residents other pill bubble pack, [R1] walked by and noticed the single pill in the cup, and proceeded to take it. When staff noticed this error, [S1] immediately asked [R1] why [R1] took the medication, [R1]replied, “I took it because it was my Multi-Vitamin pill.” Staff immediately called the administrator and instructed staff to call 911. Resident was taken to the emergency room for observations. Resident was then later admitted for other health related issues. According to the administrator, the resident is currently doing well and has returned to the facility. LPA interviewed Administrator Leonil and facility staff regarding policies and procedures. Administrator stated a training was conducted with all staff. The training focused on medication administration and was led by a Registered Nurse. Per California Code of Regulations (CCR), Title 22, deficiencies were cited due to the above information. Appeal rights were provided. An exit interview was held with Leonil, and a report was provided.the state’s words, verbatim · CDSS document, Jan 23, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 80075(k)(1) · Plan of correction due date: Jan 30, 2023

80075 Health Related Services(k)The following requirements shall apply to medications which are centrally stored:(1) Medication shall be kept in a safe and locked place that is not accessible to persons... This requirement was not met as evidenced: Based on records review and interviews, the facility did not ensure resident 1 did not have access to another resident's medication, which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jan 23, 2023

Plan of correction: Licensee stated an all staff training was held on 01/21/23 to go over medication administrator. Licensee to send LPA a copy of the in-service sign in sheet by POC due date.

Type of visit: Required - 1 Year

On 9/26/22 at 2:35pm Licensing Program Analyst (LPA) Chris Hopkins arrived at Nunez Care Home #2 for the purpose of conducting a required 1 year annual inspection. LPA met with caregiver, Salvacion Santos and together conducted a tour of the facility. Administrator Leonil Nunez showed up at a later time. LPA and caregiver evaluated the physical plant to ensure the health and safety of the residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor, clean and in good repair. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA measured the water temperature, temperature measured at 110 degrees F which meets the 105-120 degree Fahrenheit regulation. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications and toxins secure from residents. LPA Requested the following documents for facility file: LIC 308 Designation of Facility Responsibility, LIC 500 personnel report, LIC 610E Emergency Disaster Plan, Current Administrator Certificate and Liability Insurance. Per California Code of Regulations, Title 22 there were no deficiencies cited during today's inspection. An exit interview was conducted, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Sep 26, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Anthony Tuck arrived to conduct an unannounced annual/random inspection on 09/03/2021. LPA met with Lionel Nunez and explained the purpose of the visit. Leonil Nunez is the Administrator and holds certificate #6053124735 that expires on 02/26/2022 This facility is a single story building licensed to serve three (3) ambulatory residents. LPA toured the physical plant including but not limited to two resident bedrooms, two resident bathrooms, garage and backyard area. LPA observed the facility to be free of odor, clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 118.2 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers and smoke and carbon monoxide detectors are in compliance with fire safety. Fire extinguisher last serviced 10/31/2020 Thermostat observed at 74 degrees Fahrenheit. LPA observed centrally stored medications, toxins and sharp knives kept locked and inaccessible to clients. LPA reviewed staff associations to the facility. First aid kit was checked and is complete. The following forms were received during today's visit on 09/03/2021: LIC 308 copy of administrator certificate LIC 500 copy of liability insurance LIC 610 Per California Code of Regulations, Title 22 Division 6, Chapter 8, no deficiencies were cited during today's visit. Exit interview held with Lionel Nunez and a copy of report given at the conclusion of the visit.the state’s words, verbatim · CDSS document, Sep 3, 2021

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.