In Loving Hands Care Home II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Tetyana Hankevych, Co-Administrator/caregiver and explained purpose of inspection. LPA also met with Adina Sbingu, assistant staff person. LPA observed (2) residents in the common area and (3) residents in their rooms at the start of the inspection. LPA was advised that (1) resident is currently in the hospital. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (2). Currently, there are (0) residents on hospice. Prior to initiating today's inspection, LPA completed required COVID-19 Department protocols, wore a surgical mask and was screened per Covid-19 precautionary measures upon entering the facility. LPA and the Co-Administrators toured the interior of the facility including the common areas, (4) resident bedrooms with private bathrooms, (1) shared bedroom with bathroom in hallway, kitchen, staff room and laundry area. The upstairs area is used by staff only. LPA observed the facility to be clean, in good repair and odor-free. LPA observed the bathrooms to have the necessary grab bars, non-skid flooring, paper towels and hand-washing posters posted. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food, and locked sharps and daily medications in the kitchen. LPA observed locked toxins in the laundry room and locked medications in a closet. LPA observed the inside temperature to be 72*F. Fire extinguisher was last serviced 6/30/22. Discussed vaccination status of residents/staff, eligibility for boosters, and booster flyer provided. LPA observed multiple Covid posters throughout as well as other required postings. LPA observed (1) unlocked gate from the inside back patio. LPA observed the front and back concrete areas being power washed during the inspection. There are no bodies of water or a pool. LPA observed sufficient incontinent products and PPE products on hand. Discussed PIN 22-28.1 issued 11/29/22 regarding visitation protocols. LPA was advised that Tetyana Hankevych will be the official Administrator on/around 1/1/23. Additional paperwork to be submitted to CCLD for the change. LPA obtained an updated copy of LIC500, LIC308 copy of the current liability insurance. There are no deficiencies issued during today's inspection. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Nov 29, 2022

Allegation investigated: Facility is retaining a resident beyond their level of care

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to open allegations listed above. LPA met with Administrator Florica Sferdian during today's 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. LPA ensured they applied hand sanitizer before entering the facility and Personal Protective Equipment (PPE) was worn. LPA investigated the allegation, “Facility is retaining a resident beyond their level of care”. R1 moved into the facility in August 2021. R1’s LIC602 dated 12/14/2021 states resident “has chronic left medial ankle wound”. LPA reviewed R1’s medical documents which shows R1 was being treated from September 2021 for cellulitis by a podiatrist. Medical documents indicate follow up appointments with podiatrist occurred however wound care referral was not needed. Continuation on 9099-C. Unfounded In November 2021 R1 was sent out to the emergency department due to a change of condition and was diagnosed with a stroke. Upon admission to the hospital resident was noted to have left ankle cellulitis. R1 remained in the hospital and then a skilled nursing facility (SNF) until returning to the facility on 12/21/21. LPA reviewed discharge paperwork from SNF which documented several skin conditions on R1 upon being discharged. R1 was sent out to the emergency department again on 1/4/22 due to change in condition. LPA reviewed hospital documentation, and there was no documentation indicating resident had an injury. Relevant Party indicates on 1/5/22 a bedsore was discovered. LPA spoke to a Homehealth representative, in which they stated R1 did not have a stageable wound and the skin tear was healing. Due to the information gathered LPA finds allegation to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted. In November 2021 R1 was sent out to the emergency department due to a change of condition and was diagnosed with a stroke. Upon admission to the hospital resident was noted to have left ankle cellulitis. R1 remained in the hospital and then a skilled nursing facility (SNF) until returning to the facility on 12/21/21. LPA reviewed discharge paperwork from SNF which documented several skin conditions on R1 upon being discharged. Skin conditions documented are not a prohibited health care condition. LPA spoke to R1’s homehealth in which they stated client did not have a prohibited healthcare condition. R1 was sent out to the emergency department again on 1/4/22 due to change in condition. LPA reviewed hospital documentation, and there was no documentation indicating resident had a prohibited healthcare condition. LPA interviewed R1 in which they stated they feel facility staff are caring for them properly and indicated they have had skin issues on and off for many years. Due to the information gathered LPA finds 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.the state’s words, verbatim · CDSS document, Mar 30, 2022 · control 25-AS-20220105145658

Allegation investigated: Staff is appointed as resident's power of attorney

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to continue investigation into allegation listed above. LPA met with Administrator, Florica Sferdian and Adina Sbingu, during today's 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. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Masks. LPA conducted interviews and obtained resident documentation. LPA obtained R1's Advanced Health Care Directive, in which it states a staff member is one of R1's Durable Power of Attorney for Health Care. LPA interviewed Administrator in which she stated staff member is one of R1's Durable Power of Attorney for Health Care. As a result of this investigation, LPA finds allegations to be (S) Substantiated - A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.the state’s words, verbatim · CDSS document, Jan 11, 2022 · control 25-AS-20211228150217

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87217(d)(2) · Plan of correction due date: Jan 28, 2022

87217 Safeguards for Resident Cash, Personal Property, and Valuables. (d) Except as provided in approved continuing care agreements, no licensee or employee of a facility shall:(2) accept any general or special power of attorney for any such person; This requirement is not met as evidenced by: Based on record review the licensee staff had Medical POA for R1 which poses a potential health and safety risk to resident's in care.the state’s words, verbatim · CDSS document, Jan 11, 2022

Plan of correction: Administrator and staff have begun the process of dissolving the POA agreement and R1 will have another individual outside of the facility as medical POA. Administrator agrees to send new medical POA paperwork by 1/28/22.

Type of visit: Annual/Random

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct an annual inspection. LPA met with Administrator Adina Sbingu during today's 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. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Masks. LPA toured facility with staff to ensure health and safety of residents in care. LPA toured 5 resident rooms, 1 staff rooms, bathrooms, kitchen, common living spaces, and backyard. There is an upstairs area however no one is living upstairs. In the areas toured no immediate health, safety, or personal rights violations were observed. Staff stated there are no positive COVID cases at the facility, but have an isolation room and sufficient amount of PPE. LPA and staff completed the infection control domain and facility was found to be in substantial compliance at this time. Staff provided LPA a copy of a current administrator certificate, and current liability insurance. No deficiencies are being cited as a result of todays inspection. Exit interview conducted.the state’s words, verbatim · CDSS document, Dec 8, 2021