Abundant Love and Care for the Elderly

Type of visit: Case Management - Legal/Non-compliance

On 10/27/2023, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced to conduct a required quarterly case management visit in accordance with the Stipulation and Waiver; And Order, effective date 02/07/2022 to 02/07/2025. LPA met with Administrator, Virginia Bonite, and explained the purpose of the visit. LPA and Administrator conducted a tour of the facility to ensure the health and safety of residents in care. LPA observed five residents to be present in their rooms. LPA and Administrator discuss facility's previously submitted request for probational term reduction. LPA informed Licensee the request is still under review by the Department. Administrator was informed LPA will update Licensing Program Manager Anthony Perez of today's visit. LPA observed the stipulation to be posted in a conspicuous space. LPA conducted a file review of facility's Stipulation binder. LPA observed monthly training documentation for August 2023, September 2023 and October 2023. LPA observed staff certificate of completion for the following training topics: - August 2023: Wandering Within and Outside of the Facility - September 2023: Memory Behavior - October 2023: Special Needs of Persons With Alzheimer's Disease and Dementia. At this time, LPA found facility to be in compliance with the Stipulations and Waiver; And Order. No deficiencies observed. Exit interview conducted and a copy of report was provided to Administrator.the state’s words, verbatim · CDSS document, Oct 27, 2023

Type of visit: Case Management - Legal/Non-compliance

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced to conduct a required case management inspection. LPA met with caregiver, Nellie Morate, who contacted Licensee, Virginia Bonite, and explained purpose of inspection. LPA observed the stipulation to be posted in a conspicuous space. LPA observed monthly training documentation for March 2023, April 2023, May 2023, June 2023, and July 2023. LPA observed last training was conducted by Licensee/Administrator on 07/03/2023 for S1 and S2. LPA observed July 2023's training topic to be "Special Needs of Persons With Alzheimer's Disease and Dementia and Approaches to Dementia Care & Pathogens Airborne". LPA was informed training materials are from Relias Learning. LPA confirmed training vendor is listed in CCLD's approved vendor. LPA and Licensee discussed staffing at the facility. Licensee explained that there are two (2) staff that are on-call, and three (3) full-time staff on schedule. LPA and Licensee further discuss the possibility of a probation term reduction. LPA informed Licensee the request is still under review. At this time, LPA found facility to be in compliance with the Stipulations and Waiver; And Order effective February 7, 2022. Exit interview conducted and a copy of report was provided to Licensee.the state’s words, verbatim · CDSS document, Jul 26, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kevin Mknelly arrived at the facility unannounced on 1/18/23 to conduct a Annual Inspection utilizing the infection control domain. LPA met with staff and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed the Department's required COVID-19 protocols.LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA were screened by facility staff upon entering the facility. Administrator is present at the facility to conduct an annual inspection. LPA toured the interior and exterior of the facility together with staff to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, bathroom, kitchen, laundry room, and backyard. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA, Administrator, and Infection control Leader completed the infection control domain and facility was found to be in substantial compliance at this time. LPA advised working with residents who delay medication that they are not left out, repair the back yard gate swollen by rain, to operate properly, more robust screening and documentation and establish procedures for non-perishable food rotation and clean/ disinfect surfaces. LPA received LIC 500, resident roster and liability certificate. LPA reviewed Probation conditions and observed compliance. No deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Jan 18, 2023

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required case management inspection. LPA met with Virginia Bonite, Administrator, and explained purpose of inspection. LPA observed caregiver, Maria Maciuca, also present during today's inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, contacted the facility to confirm there are currently no positive Covid-19 diagnoses, completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. There are (4) residents at the facility and no residents are currently receiving hospice services. LPA toured the facility and observed all residents to be in their rooms and the facility to be clean and in good repair. LPA and Administrator reviewed the training binder containing documentation of monthly trainings pursuant to the order dated 2/7/2022. LPA observed monthly trainings completed for (3) staff for June, July and August 2022. Each training lasts 2 hours. Training agenda is signed by each staff and printed certificates are also in the binder. Staff will typically complete their training from 1-3:00 pm after lunch is concluded. There are no deficiencies issued today. LPA advised there will be a subsequent quarterly case management inspection on/around December, 2022. LPA provided some individual bottles of sanitizer and a package of disposable gowns from CCLD during today's inspection. LPA also provided a flyer for information on how to obtain a Covid-19 booster vaccination. Exit interview. Copy of report printed for Administrator.the state’s words, verbatim · CDSS document, Aug 31, 2022

Type of visit: Case Management - Legal/Non-compliance

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required case management inspection. LPA met with Virginia Bonite, Administrator, and explained purpose of inspection. LPA observed caregiver, Maria Maciuca, also present during today's inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, contacted the facility to confirm there are currently no positive Covid-19 diagnoses, completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N95 Mask. There are (5) residents at the facility and no residents are currently receiving hospice services. LPA and Administrator reviewed the training binder containing documentation of the initial (6) hours completed by the Administrator pursuant to the order dated 2/7/2022. Training was completed with (2) different outside companies on 3/19/2022 and on 3/30/2022, within 60 days of the order dated 2/7/2022. LPA observed monthly training documentation for April 2022, conducted by the Administrator on 4/7/2022 for (3) of (3) staff members (S1, S2 and S3). The training materials were taken from an approved vendor source. LPA observed monthly training documentation for May 2022, conducted by the Administrator on 5/3/2022 for the same (3) staff members. June training is scheduled to be completed by 6/15/2022. LPA observed documentation that (2) payments have been submitted to the Department. A probationary license was printed during today's inspection and posted by the Administrator. LPA received documentation that was mailed on 3/4/2022 with a summary of night time care and supervision for residents with dementia per the order. There are no deficiencies issued today. LPA advised there will be a subsequent quarterly case management inspection on/around September, 2022. Exit interview. Copy of report printed for Administrator.the state’s words, verbatim · CDSS document, Jun 6, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection. LPA met with Caregiver, Nellie Morate, who contacted Virginia Bonite, Administrator, and explained purpose of inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, contacted the facility to confirm there are currently no positive Covid-19 diagnoses, completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: KN95 Mask. There are (5) residents at the facility and no residents are currently receiving hospice services. LPA and Administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, (2) shared resident bedrooms, (1) private bedroom, (1) restrooms, kitchen, dining room, laundry area and staff room . In the areas toured no immediate health, safety, or personal rights violations were observed. LPA observed sufficient food and PPE supply. LPA and caregivers completed the infection control domain and facility was found to be in compliance at this time. Inside temperature was observed to be 74* F. Fire extinguisher was last serviced 12/6/2021. LPA's observed required postings in the facility. LPA's and Administrator discussed vaccination status of residents and staff and LPA observed documentation of either vaccination status or exemption on file, as well as testing documentation. Discussed visitation protocols per PIN 21-40 issued 8/27/2021. LPA's observed current Administrator certificates posted. Updated LIC500 and LIC308 were provided in August 2021. There were no deficiencies observed during today's inspection. Exit interview. Copy of report provided to Administrator.the state’s words, verbatim · CDSS document, Jan 6, 2022

Allegation investigated: Resident illegally evicted from facility

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to deliver findings to a complaint the Department received on 10/20/2021. LPA met with Virginia Bonite, Administrator, and explained purpose of inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols and confirmed the facility does not currently have any positive Covid-19 diagnoses. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. During the course of the investigation, LPA interviewed Administrator, (1) caregiver, (2) residents, and individual who assisted resident (R1). LPA reviewed pertinent documentation for resident (R1) including Admission Agreement, eviction letter issued on 5/1/2021, Unusual Incident/Injury report (LIC624), documentation related to move out, and other documentation. The results of the investigation are as follows: Substantiated Health and Safety Code §1569.683(a)(4) Eviction notices; reasons for eviction contents; service reads as follows: (4) The following statement: "In order to evict a resident who remains in the facility after the effective date of the eviction, the residential care facility for the elderly must file an unlawful detainer action in superior court and receive a written judgment signed by a judge. If the facility pursues the unlawful detainer action, you must be served with a summons and complaint. You have the right to contest the eviction in writing and through a hearing." The facility issued resident a 60-day eviction notice on 5/1/2021, with an effective date of 7/1/2021; however, the eviction notice does not mention an unlawful detainer, as required, and interview with the Administrator confirmed the facility did not pursue an unlawful detainer after resident did not move out by 7/1/2021. Resident's admission agreement, dated 7/13/2020, page 10 (items #5 and 6), notes that the eviction notice must include: (item 5) "A statement that informs the resident that the licensee cannot evict a resident who remains in the facility after the effective date of the eviction unless the licensee files an unlawful detainer action in superior court and receives a written judgment signed by a judge" and (item 6) "A statement that if a licensee pursues an unlawful detainer action, the resident must be served with a summons and complaint". Resident was sent out to the emergency room on 8/25/2021 for low oxygen and was approved by resident's home health and physician; however, the resident was not able to return to the facility when she called from the hospital. Interviews revealed that Administrator stated that she was not able to care for the resident due to having a fever but she could assist her in finding another care home. In addition, the hospital care coordinator stated she would facility back if she couldn't find placement for the resident. Interviews confirmed that resident did not return to the facility after being sent out on 8/25/2021, was hospitalized through 8/31/2021 or longer, and resident's personal belongings were retrieved from the facility on 9/3/2021. Resident prepaid rent through 8/31/2021. The Admission Agreement discusses the facility's refund policy when a resident leaves temporarily or becomes deceased. The resident was not charged; however, for the period 9/1/2021- 9/3/2021 when her personal belongings remained at the facility. Based on information obtained, the Department finds the allegation to be 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 following deficiency was cited on 9099-D, per Title 22 Regulations, Division 6. Exit interview. Copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Nov 2, 2021 · control 25-AS-20211020145032

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.683(a)(4) · Plan of correction due date: Nov 16, 2021

§1569.683 Eviction notices; reasons for eviction contents; service (4) The following statement: "In order to evict a resident who remains in the facility after the effective date of the eviction, the residential care facility for the elderly must file an unlawful detainer action in superior court and receive a written judgment signed by a judge. If the facility pursues the unlawful detainer action, you must be served with a summons and complaint. You have the right to contest the eviction in writing and through a hearing." This requirement is not met as evidenced by: Based on documentation reviewed and interviews conducted, the Licensee did not ensure that the eviction notice issued to resident (R1) on 5/1/2021 included all of the required elements, which posed a potential health and safety risk to resident in care.the state’s words, verbatim · CDSS document, Nov 2, 2021

Plan of correction: Licensee/Administrator agree to read Health and Safety Code §1569.683 (copy provided during inspection on 11/2/2021) and provide a signed statment to CCLD by fax by 11/16/2021.

Type of visit: Case Management - Legal/Non-compliance

On August 27, 2021, Licensing Program Analysts (LPA's) Sabrina Calzada and Michael Hood met with Licensee of Abundant Love and Care for the Elderly, Virginia Bonite, at approximately 2:15 pm. Administrator confirmed there are (5) residents present and (1) resident is currently at the hospital. Prior to initiating today's inspection, LPA's completed required COVID-19 testing protocols, contacted the facility to confirm there are currently no positive Covid-19 diagnoses, completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and completed a facility risk assessment. Additionally, LPA's were screened per Covid-19 precautionary measures upon entering the community. LPA's ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: double surgical mask and an N95 mask. This report is for a case management visit to follow up on deficiencies cited during an inspection conducted on September 5, 2018, which determined that the facility did not have adequate staff to care for residents with dementia and did not ensure resident (R1) was accorded dignity. On September 5, 2018, the Department concluded a complaint investigation and substantiated an allegation that a resident (R1) was sexually assaulted by another resident (R2) due to a lack of supervision. The allegation was substantiated, and the licensee was cited for violating California Code of Regulations (CCR) Title 22, § 87705(c)(4)(A) Care of Persons with Dementia – (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. (A) In addition to requirements specified in Section 87415, Night Supervision, a facility with fewer than 16 residents shall have at least one night staff person awake and on duty if any resident with dementia is determined through a pre-admission appraisal, reappraisal or observation to require awake night supervision. continued on 809(C)... The licensee was also cited for CCR Title 22 Section 87468(a)(1) Personal Rights - Residents in residential care facilities for the elderly shall have personal rights which include, but are not limited to, those listed in § 87468.1, Personal Rights of Residents in All Facilities, and 87468.2, Additional Personal Rights of Residents in Privately Operated Facilities, as applicable to the facility. (1) "Privately operated facility" means a residential care facility for the elderly that is licensed to an individual, firm, partnership, association, or corporation During the investigation, the Department conducted interviews and reviewed records pertinent to the reported incident. The local County Sheriff’s Department obtained an account of the incident from R1 regarding the sexual assault. R2 corroborated R1’s account to the local County Sheriff’s and admitted to sexually assaulting R1. The Department obtained video surveillance footage from May 30, 2018. The recording showed R2 entering R1’s bedroom and remaining in the bedroom for eight minutes. Based on the facility’s plan of operation, the facility is required to have awake overnight staff for clients with dementia if the resident’s appraisal indicates such care as necessary. R2’s pre-placement appraisal dated September 27, 2017 identified R2 as a resident with a diagnosis of dementia in need of special observation and supervision due to confusion and wandering. Interviews with facility staff and R1 indicated that overnight facility staff are not awake at night. On the date of the incident, May 30, 2018, there was one staff on duty who was sleeping at the time of the incident. Based on observation, interviews, and records, the licensee did not ensure facility staff provided awake night supervision for R2 that resulted in R2 sexually assaulting R1. At the time of the visit on September 5, 2018, the issuance of an immediate civil penalty for $500 was issued and the licensee was informed that an additional civil penalty might be assessed based on Health and Safety Code § 1569.49. The Department has concluded an analysis and has determined that a civil penalty is warranted for physical abuse based on Penal Code §243.4(e)(1). "Physical abuse" is defined in Welfare and Institutions Code section 15610.63(e)(1) as: "sexual battery, as defined in Section 243.4 of the Penal Code". Penal Code §243.4(e)(1) defines sexual battery as "Any person who touches an intimate part of another person, if the touching is against the will of the person touched, and is for the specific purpose of sexual arousal, sexual gratification, or sexual abuse, is guilty of misdemeanor sexual battery". continued on 809C (2)... Today, August 27, 2021, the Department will be issuing a civil penalty per Health and Safety Code § 1569.49, for a violation that the Department constitutes as physical abuse in the amount of $10,000. However, since an immediate civil penalty of $500 was issued on September 5, 2018, the amount of the civil penalty today will be $9,500. A copy of the LIC 421D was given to the licensee. Exit interview conducted. Appeal Rights provided. A copy of the report issued. Virginia Bonite's signature on this report acknowledges receipt of these rights, found on page 2 of LIC 421D. Administrator stated to LPA's on 8/27/2021 that she plans to file an appeal on the penalty being issued today.the state’s words, verbatim · CDSS document, Aug 27, 2021

Type of visit: Case Management - Legal/Non-compliance

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection to ensure facility is in compliance with Health and Safety Code §1569.38 Posting of licensing reports; disclosure to new residents following the department serving an Accusation on 8/4/2021. LPA met with Virginia Bonite, Administrator, and explained purpose of inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, contacted the facility to confirm there are currently no positive Covid-19 diagnoses, completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and completed a facility risk assessment. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical Mask. Administrator showed LPA the posted notice dated 8/10/2021 displayed in the living/dining room. LPA observed the notice to contain the required elements. Also posted was a copy of the notification sent to the Ombudsman. Administrator stated that all (6) residents/resident representatives were informed verbally and received a notice. LPA observed a signed copy of the notice given to each resident/resident representative. LPA and Administrator confirmed with (2) residents receipt of a letter from the facility regarding the pending legal matter. LPA confirmed with R1 and R2 that a notice was received recently, within the last week, regarding a licensing matter. Also discussed was that the appeal response mailed on 11/6/2018 was not received by Administrator at the facility mailing address or at the licensee mailing address (PO Box). There are no deficiencies being cited today. Exit interview. Copy of report left with Administrator.the state’s words, verbatim · CDSS document, Aug 16, 2021

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection. LPA met with Virginia Bonite, Administrator, and explained purpose of inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, contacted the facility to confirm there are currently no positive Covid-19 diagnoses, completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and completed a facility risk assessment. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical Mask. There are (6) residents at the facility and no residents are currently receiving hospice services. LPA observed a resident to be finishing eating breakfast in the main room at the start of the inspection. LPA observed that (4) residents were napping during the inspection and (2) were watching television in their rooms. LPA and caregivers toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, (2) shared resident bedrooms, (1) private bedroom, (1) restrooms, kitchen, dining room, laundry area and staff room . In the areas toured no immediate health, safety, or personal rights violations were observed. LPA observed sufficient food and PPE supply. LPA and caregivers completed the infection control domain and facility was found to be in compliance at this time. Inside temperature was observed to be 74* F. Copy of current insurance liability policy obtained. Staff (2) that are not vaccinated will be tested weekly per new department guidance. Administrator to provide confirmation of staff testing by Friday, 8/20/2021. Administrator and LPA discussed contacting public health for testing information and the Ombudsman regarding a non-compliant resident. There were no deficiencies cited as a result of todays inspection. Exit interview conducted with Administrator, caregiver, and copy of report left at the facility.the state’s words, verbatim · CDSS document, Aug 16, 2021