Sunriver Senior Care

Type of visit: Required - 1 Year

On 5/12/23 at 9:35am Licensing Program Analyst (LPA) Kevin Gould arrived at Sunriver Senior Care LLC. for the purpose of conducting a required 1 year annual inspection. LPA met with Licensee, Suzie Dizon and together conducted a tour of the home. LPA and Administrator 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 rooms 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 118 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 secure from residents. LPA conducted file review of staff records and was not able to review all documents as staff files are being organized off site and will review as part of the plan of correction. Per California Code of Regulations, Title 22 the following deficiency is cited during today's inspection. An exit interview was conducted, and a copy of this report and appeal rights were left at the facility.the state’s words, verbatim · CDSS document, May 12, 2023

Allegation investigated: ) Resident’s diapering needs are not being met while in care. 2) Staff did not make sure resident had enough oxygen in his oxygen tank for his appointment

Licensing Program Analyst (LPA) Kevin Gould made an unannounced inspection to the Sunriver Senior Care, LLC (RCFE) on 9/22/22 at 1:15pm to conclude the investigation of the above allegations and to deliver the findings. LPA met with Administrator and together discussed the investigation details. Based on the interviews and statements obtained during the investigation process, the allegations have been corroborated because LPA Gould obtained statements from staff, residents and reporting party to confirm that the resident was placed in adult diapers that were either intended for an individual of the opposite sex or were sized too small for the resident. LPA was also able to corroborate that stall allowed resident to depart for a hospital appointment with an oxygen tank that did not have enough oxygen to meet the needs of the resident for the entire outing and a staff member had to meet resident a the hospital to provide another oxygen tank. The Department has determined, based on the preponderance of the evidence obtained during this investigation, that the allegation of Personal Rights and Medication are substantiated but if any additional information is received this complaint can be amended and the finding can be changed. Substantiated The following deficiencies are cited per California Code Regulation, TITLE 22. Exit interview was conducted with the facility administrator. Appeal Rights were issued, and a copy of this report was left at the facility. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegations of Medication are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There are no deficiencies noted or cited per California Code Regulation, TITLE 22. Exit interview was conducted with the facility administrator. Appeal Rights were issued, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Sep 22, 2022 · control 27-AS-20220608080255

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(1) · Plan of correction due date: Sep 23, 2022

Incidental Medical and Dental Care:The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement was not met as evidenced by Statements obtained from staff, family and reporting party that the facility did not provide an oxygen tank with enough oxygen to last the resident's doctor appointment and a staff member had to bring another oxygen tank to the hospial to resident while away from the facility which poses an immediate health safety and peronal rights rick to resident in care.the state’s words, verbatim · CDSS document, Sep 22, 2022

Plan of correction: Facility has agreed to and has already obtained an additional suppy of travel tanks that the facility agreed to inventory bi-weekly to ensure there is always an oxygen tank available to meet the residents needs for an outing or appointment. inventory to begin 9/26/22

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Sep 26, 2022

Personal Rights of Residents in All Facilities: To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by statements obtained from staff, residents and reporting party corroborating allegations resident was placed in briefs intended for a member of the opposite sex and or was a size too small which poses a potential health, safety or personal rights risk to residents in carethe state’s words, verbatim · CDSS document, Sep 22, 2022

Plan of correction: Facility has agreed to and has already obtained additional suppies for residents and will conduct bi-weekly inventory of diaper supplues for all residents to ensure the supplies meet the needs of the residents in care. inventory to begin 9/26/22

Type of visit: Case Management - Deficiencies

On 5/18/22 Licensing Program Analyst (LPA) Kevin Gould conducted an unannounced Case Managed inspection to ensure the previously cited deficiency has been corrected and staff were accurately documenting medication administration. LPA arrived at the facility and was greeted by staff. LPA immediately reviewed the medication administration logs and observed that staff had not documented any morning medications administered to residents on 5/18/22. LPA was unable to clear the POC. The following deficiency was cited per California Code of Regulations Title 22. Exit interview was conducted and a copy of this report and appeal rights were left at the facility.the state’s words, verbatim · CDSS document, May 18, 2022

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(1) · Plan of correction due date: May 19, 2022

Incidental Medical and Dental Care Services: The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement was not met as evidenced by LPAs review of all resident's medication administration logs where LPA observed errors in documenting medication administration logs on 5 of 5 resident logs with no documentation of morning medications administered for all five residents in care which poses an immediate health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 18, 2022

Plan of correction: The facility will conduct additional medication administration training for all staff who administer medications from an outside source. Facility administrator will conduct daily inspections of the medication administration logs and will send weekly copies of medication administration to LPA and will report any observed errors via an incident report.

Type of visit: Required - 1 Year

On 5/13/22 at 1:15pm Licensing Program Analyst (LPA) Kevin Gould arrived at Sunriver Senior Care LLC. for the purpose of conducting a required 1 year annual inspection. LPA met with Licensee, Shirley Dizon and together conducted a tour of the home. LPA and Administrator 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 rooms 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 111 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 secure from residents. LPA conducted file review of resident records and observed four of the five medication administration logs for residents with errors and missing documentation for several days. Facility staff had documented and retained documentation on separate notes but had not logged them as required. Per California Code of Regulations, Title 22 the following deficiency is cited during today's inspection. An exit interview was conducted, and a copy of this report and appeal rights were left at the facility.the state’s words, verbatim · CDSS document, May 13, 2022