Best Life Home Care

Type of visit: Required - 1 Year

LPA Tryon visited the facility to do an annual review. LPA was greeted by licensees Helen Tan and Chris Butts. LPA toured the house including common areas, kitchen, food storage, bedrooms, bathrooms, hallways. The facility is clean and in good repair, nicely furnished. Smoke detectors and carbon monoxide detectors are installed, fire extinguisher present. Food supplies are appropriate to meet the requirement of 2 days perishable and 7 days non-perishable. Medications are centrally stored and locked. LPA reviewed 2 residents files which included required information. Staff have appropriate classes, clearances, etc. LPA reviewed the CARE Tool with licensees. At this time, the home appears to be in substantial compliance with the regulations. No deficiencies were cited at this visit. Exit interview conducted.the state’s words, verbatim · CDSS document, Aug 17, 2023

Allegation investigated: Facility staff member verbally abused resident while in care.

Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced 02/08/2023 to deliver final finding for a complaint Community Care Licensing (CCL) received on 10/13/2022. LPA met with Administrator, Helen Tan, and explained the purpose of the visit. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA was screened by facility staff upon entering the facility. Throughout the course of the complaint investigation the Department conducted interviews and obtained pertinent documents, such as resident’s (R1) physician's report, identification, and emergency information, assisted living waiver program individual service plan, preplacement appraisal information, and SOC 341. Continued on page LIC-9099C. Substantiated According to complainant, staff (S1) verbally abused resident while in care. R1 had soiled on self and S1 was attending to R1. R1 was confused and S1 was becoming more agitated accusing R1 of being argumentative. S1 was using course language and raising S1’s voice to yell while addressing R1. The Department reviewed R1’s physician’s report. Physician’s report indicated R1 has mild cognitive impairment. Physical health status indicated R1 has bowel impairment and bladder impairment. The Department received statement from two (2) witnesses that confirmed S1 verbally abused resident while in care. Witness (W1) stated R1 had defecated on self and S1 was assisting R1. W1 heard S1 yell “Take off your clothes!” W1 stated S1 was being demeaning towards R1. W2 witnessed R1 nude standing in front of S1 while R1 was being berated. W2 stated S1 was yelling “Cut the attitude!” “I don’t want to hear it!” “Stop arguing and do it!” “Because it got crap all over it, there’s crap all over your shirt!” “Because I told you to stop arguing. I’m tired of you arguing with me!” “When I tell you keep your mouth shut!” “Quiet your ass!” “Good, leave.” W2 heard R1 asking S2, “Why are you talking to me this way!” “You are not nice; I am going to leave.” Other residents in care overheard S1 and R1’s interaction which added further humiliation to R1. Due to this information CCL finds the allegation to be SUBSTANTIATED. – A finding that the complaint is substantiated means that the allegations is valid because the preponderance of the evidence standard has been met. Deficiencies are cited on the attached LIC 9099-D. Appeal rights were provided. An exit interview was conducted, and a copy of the report left at the facility.the state’s words, verbatim · CDSS document, Feb 8, 2023 · control 25-AS-20221013123708

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Feb 10, 2023

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by: Based on interviews, Administrator did not ensure resident was accorded dignity in their relationship with staff which posed an immediate and safety risk to residents in care.the state’s words, verbatim · CDSS document, Feb 8, 2023

Plan of correction: Administrator to review regulation 87468.1 concerning resident rights. Administrator to write a statement of understanding concerning resident rights. Statement of understanding to be sent into CCL by POC due date,

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(3)) · Plan of correction due date: Feb 17, 2023

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination.This requirement was not met as evidenced by: Based on interviews, , Administrator did not ensure resident was free from humiliation during incontinence incident which posed an immediate and safety risk to residents in care.the state’s words, verbatim · CDSS document, Feb 8, 2023

Plan of correction: Administrator agrees to have an outside vendor conduct an in-service training regarding personal rights of residence in care. Licensee agrees to provide CCL proof of training by POC due date, 2/17/2023.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 7/15/2022 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with Administrator, Chris Butts, and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols and the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured to apply hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Mask. LPA toured the facility to ensure the health and safety of the residents in care. Areas toured include but are not limited to: 4 bedrooms and 2 bathrooms for residents, common area, dining room, food supply, office, and outdoor area. LPA and Administrator completed the infection control domain. Upon entry of the facility, LPA observed cleaning solutions and knives unlocked and accessible to residents in care. LPA also observed multiple food items that were expired and missing labels. As a result of today's inspection, deficiencies are cited pursuant to California Code of Regulations, Title 22, Section 87309(a) regarding unlocked chemicals and knives, and Section 87555(b)(8) regarding expired and unlabeled food items. Deficiencies are listed on 809-D. Exit interview was conducted with Administrator. A copy of this report and appeal rights were provided. The Administrator’s signature on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Jul 15, 2022

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Michael Hood met with Administrator, Chris Butts, to conduct a case management visit. During inspection conducted on 10/28/2021, LPA requested all incident reports regarding resident (R1). LPA obtained what Unusual Incident Reports (SIRs) the Administrator supplied. On 5/18/2022, the Department received 2 SIRs regarding R1 dated 9/8/2021 and 9/29/2021. Due to facility not supplying the Department with all requested documents during inspection conducted on 10/28/2021, a deficiency is being cited pursuant to California Code of Regulations, Title 22, Section 87506(a) regarding complete resident records. Deficiencies are listed on 809-D. Exit interview was conducted with Administrator. A copy of this report and appeal rights were provided. The Administrator’s signature on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Jul 15, 2022

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(a) · Plan of correction due date: Jul 29, 2022

87506 Resident Records (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement is not met as evidence by: Based on oberservation made by LPA during prior inspection, facility did not ensure that all documents requested by the department were received when requested, which poses an potential health, safety, and personal rights risk to the residents in care.the state’s words, verbatim · CDSS document, Jul 15, 2022

Plan of correction: Facility will complete a statement of understanding regarding regulation 87506 and submit statement to Department by POC due date of 7/29/2022.

Allegation investigated: Resident sustained fracture while in care Staff did not assist resident with their medication Staff are not following resident's mobility care plan Resident was left on soiled linens for an extended period of time

On 5/10/2022, Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Administrator, Helen Tan, to conclude a complaint investigation into the allegations listed above. LPA wore an N-95 mask. Facility staff wore masks while on the premises. During the investigation, the department conducted interviews and reviewed documentation pertinent to the investigation. The results of the investigation are as follows: Allegation: Resident sustained fracture while in care ** Report continued on 9099-C ** Unsubstantiated Interviews with relevant parties indicated that R1 experienced surgery prior to admission at the facility. Admission Agreement for R1 states that R1 was admitted to the facility on 1/17/2019. Interviews with relevant parties indicated that R1 had a hip and ball replacement in December of 2018. Interviews with relevant parties indicated that R1’s hip fracture occurred prior to admission at the facility. R1’s Preplacement Appraisal Information states that R1 had “recent hip surgery” and that, on 11/18/2018, R1 had “surgery to replace hip ball.” Allegation: Staff did not assist resident with their medication Interviews with staff members S1 and S2, and relevant parties indicated that PRN medications for R1 were administered as needed for R1 during their time at the facility. During interview conducted with R1 on 10/28/21, R1 stated that staff provide "good" care and treat the residents well. R1 stated that they have been taken care of well. R1 stated that they were not experiencing any pain and that care staff help with R1’s pain management “just fine.” Allegation: Staff are not following resident's mobility care plan R1’s California Assisted Living Waiver (ALW) Program Individual Service Plans (ISPs) dated for 12/11/2018, 3/18/2021, and 12/9/2021 state that facility will encourage member to continue daily exercises, assist in obtaining mobility devices as needed, evaluate the use of assisted devices, check member every 2 hours for falls, and encourage member to continue compliance with using cane. Interviews with S1 and S2 indicated that R1 receives transfer assistance when moving from bed to wheelchair. Interviews with relevant parties indicated that facility follows R1’s mobility plan as indicated in R1’s ISPs. Allegation: Resident was left on soiled linens for an extended period of time ** Report continued on 9099-C ** R1’s ISPs dated 12/11/2018, 3/18/2021, and 12/9/2021 states that facility will offer toileting every 2 hours for R1. Interviews with S1 and S2, and relevant parties indicate that the facility is checking on R1 every 2 hours to see if R1 needs assistance with incontinence care. Based on interviews conducted by the Department and records reviewed, the preponderance of evidence standards have not been met. Therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted with Administrator and a copy of this report was provided to the facility. The signature of the Administrator on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, May 10, 2022 · control 25-AS-20211021160943

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Angela Hood and Michael Hood arrived at the facility unannounced on 8/19/2021 to conduct a Required-1 Year Inspection utilizing the infection control domain, LPAs met with Chris Butts, Administrator, and explained the purpose of the visit. Prior to initiating the annual inspection, LPAs completed required COVID-19 testing protocols, the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms, and contacted facility and completed a facility risk assessment. LPAs ensured to apply hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Masks. Additionally, LPAs were screened by staff upon entry and signed visitor log with temperatures. LPAs toured the facility to ensure the health and safety of residents in care. Areas toured include but are not limited to: 4 bedrooms and 2.5 bathrooms for residents, common area, dining room, kitchen, outdoor area, and viewed PPE supplies. In the areas toured no immediate health, safety, or personal rights violations were observed. LPAs and Administrator completed the infection control domain and facility was found to be in substantial compliance at this time. No deficiencies are being cited. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Aug 19, 2021