Mountain View Cottages VII

Type of visit: POC

Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Mountain View Cottages VII unannounced to conduct a case management visit. This case management visit is being made to confirm that the plan corrections has been carried out. LPA rang the door bell. LPA greeted and granted entry by Caregiver, Myra Guaratato. LPA introduced self and stated purpose of the visit. LPA signed in and completed a walk through of the facility. There were 5 residents present during the visit. At approximately, 1:50pm LPA completed a walk through of the facility's backyard. LPA observed three, (3) stray cats outside of the door. These cats appeared small. 1. Orange and White. 2. Black and Brown, 3 all Brown. On the left side of the patio, LPA observed a bucket of water, seemingly left for the cats to partake. Staff interviews revealed that is a resident's behavior to continue putting water outside for the cats. According the Administrator, animal control has been contacted to assist with having the cats removed from the property. At approximately 1:55pm LPA observed the unattached storage building. The roof appeared to be fixed. Staff showed LPA the inside of the structure. LPA observed that the structure is secure and used for extra storage space. LPA observed the rest of the outside of facility, the roof was addressed for both the facility and the unattached garage. Based on observations and interviews, no deficiencies are being cited. An exit interview was conducted where this report was reviewed, discussed then provided the facility representative.the state’s words, verbatim · CDSS document, Sep 13, 2023

Allegation investigated: Staff do not assist resident with ambulating. Facility has pests. Staff speak inappropriately to resident.

Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Mountain View Cottages VII Facility unannounced to initiate a complaint investigation into the allegations listed above. LPA rang doorbell, Caregiver answered the door, greeted LPA and granted entry. LPA introduced self and stated purpose of the visit. Staff identified themselves as Helen Nova, then contacted Administrator, Jasbinder Singh who arrived to the visit shortly there after. Today's visit included, gathering pertinent documents, review of staff, facility and resident files, staff and resident interviews and a walk through the facility in and out. It is alleged that staff do not assist residents with ambulating. During staff interviews, it was discovered that the residents are relatively independent and rarely ask for assistance. According to resident files, the facility cares for residents with memory impairment and mild cognitive impairment. Resident interviews revealed that resident's who need assistance ask or call out for help. Assistance comes in a timely manner. Residents report staff members do offer help to the residents, on a regular basis. Please see LIC9099C Unsubstantiated It is alleged that the facility has pests. LPA toured the facility in and out and made no observations of pests; or evidence of a pest control problem. LPA did tour resident rooms and observed that residents do keep open containers of food in their rooms. Staff interviews revealed that they see pests, but not very often as the staff regularly spray the facility with pesticides; both inside and outside. Residents shared that they may have seen a few insects, but not enough to say it is an issue, because staff spray. It is alleged that staff speak to residents inappropriately. During staff interviews, LPA observed that staff do have heavy accents. All staff denied experiencing difficulty speaking to residents. Staff denied ever speaking to or having knowledge of staff speaking inappropriately to one another. All residents, deny witnessing any staff speak to residents inappropriately. Based on observations, interviews and review of records, we have found the complaint allegation is unsubstantiated, although the allegation may have happened or is valid: there is not a preponderance of the evidence to prove that the alleged violation occurred. A copy of this report is being reviewed with and furnished to the facility representative.the state’s words, verbatim · CDSS document, Aug 4, 2023 · control 56-AS-20230802121927

Type of visit: Case Management - Deficiencies

Licensing Program Analyst, Amber Coleman, (LPA) made an unannounced complaint visit for complaint 56-AS-20230802121927. It was during this visit, LPA observed deficiencies not related to the complaint allegations. Upon LPA's arrival, LPA met with staff to discuss the residents in care. LPA asked a number of questions to staff. Staff's response to questions was limited and did not provide LPA with enough information. Staff expressed, that she doesn't know a lot of English and needs assistance with interpretation. At approximately 10:15am, while observing the facility's backyard. LPA observed a third party contractor making repairs to the facility's unattached garage roof. LPA observed materials from the roof were being pulled from the roof and dropped onto the ground. Some of the materials had nails still attached. LPA spoke with Administrator and learned that no report was sent to Community Care Licensing to notify about construction taking place at the facility. The contractor reported that he is repairing the roof of the garage and the facility itself. The expected date they will finish is over the weekend (August 5th and 6th, 2023) The materials, power tools out and ladders are not secure, allowing residents access; which poses a potential threat to residents in care. At approximately 10:17am, while observed the facility's backyard, LPA observed open containers of chemicals and toxins. LPA observed a bottle of pesticides sitting on the ground near the sliding door to access backyard. On the patio, LPA observed a standing barbecue. Adjacent to the barbecue, LPA observed an open container of lighter fluid. Please see LIC809C At approximately 10:19am, while observing the walkways outside facility. LPA observed a cat seated on the patio. Next to the cat was a bowl of animal food. LPA walked to the right of the facility to observe a staff member placing cat food outside the bedroom. Next to the food, stood an animal crate. When LPA inquired about the stray cats. Staff denied that they put food out for stray cats; stating that the residents feed stray cats. LPA had a discussion with staff and the Administrator to address the concern for stray cats in or around the facility and the impact the stray cats may have on residents in care. Administrator and staff stated they understood. At approximately 11:57am, LPA reviewed staff files and observed that there was no valid Administrator on file for the facility. Based on observations and interviews made during today’s inspection, deficiencies will be cited per Title 22, Division 6, of the California Code of Regulations CCR). An exit interview was conducted and a copy of this report, LIC 809D, and Appeal Rights were given to the Licensee.the state’s words, verbatim · CDSS document, Aug 4, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87305(a) · Plan of correction due date: Sep 4, 2023

Alterations to Existing Building or New Facilities: (a) Prior to construction or alterations, all facilities shall obtain a building permit. This requirement was not met as evidenced by: Based on observations and interviews, the Administrator failed to notify Community Care Licensing that the facility roof was damaged and required repairs. This poses a potential health, safety, or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Aug 4, 2023

Plan of correction: Administrator agrees to complete a Special Incident Report to report the damages to the facility, what should be fixed and the projected date of completion to the Community Care Licensing Office within the next 30 days. Administrator will also submit a statement of understanding by way of a LIC9098.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87411(d)(3) · Plan of correction due date: Sep 4, 2023

87411 (d)(3) Personnel Requirements (3) Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents. This requirement is not met as evidenced by: Based on observations and interviews, the Administrator did not ensure that all staff have skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents, which poses a potential health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 4, 2023

Plan of correction: Administrator will seek and hire staff members who have the skills and knowledge to effectively communicate with staff and residents alike. Administrator agrees to do so within the next 30 days and submit proof of correction to the Community Care Licensing.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Aug 7, 2023

87309 Storage Space (a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement was not met as evidenced by: Based on observations, the Administrator failed to ensure that all toxins and chemicals are kept inaccessible. This poses a potential health, safety or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Aug 4, 2023

Plan of correction: Administrator instructed staff to locate all chemicals left out and place them in a secure place inaccessible to resident's. LPA observed the staff collect all containers and place them in a secure place. The plan of correction has been completed during visit.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87405(a) · Plan of correction due date: Aug 7, 2023

87405 Administrator - Qualifications and Duties (a) All facilities shall have a qualified and currently certified administrator. This requirement was not met as evidenced by. Based on record reviews and interviews, the Administrator failed to designate an Administrator for the facility when her Administrator Certificate expired. This poses a potential health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Aug 4, 2023

Plan of correction: Administrator agrees to locate documentation that the Administrator Certification course has been completed and awaiting the certificate. Administrator will submit verification to community care licensing no later than Monday 8/7/23 by close of business.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ryan Gardner made an unannounced visit to the facility. The purpose of the visit was to conduct a required annual inspection, with an emphasis on infection control due to the COVID-19 pandemic. LPA Gardner met with Administrator Jasbindar Singh and was granted entry to the facility. At the time of visit there were two (2) staff and four (4) clients present. LPA Gardner toured the facility inside and out and went over COVID-19 best practices for infection control and prevention with Jasbindar Singh. The facility has a plan in place which follows Community Care Licensing Division guidelines for COVID-19 testing, isolating/quarantining clients and properly caring for clients with COVID-19 positive results and/or exposures. The facility has a designated infection control lead person who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring PPE supplies are maintained, cleaning and disinfection provisions are in adequate quantities, and that staff are trained in the proper use and disposal of PPE. The entrance of the facility has a check in process for visitors, clients, and staff that includes a vaccination verification/negative COVID test check, a temperature check, and a symptom check. The clients have hand sanitizer available to them throughout the facility, and the bathrooms were stocked with hand soap and paper towels. LPA Gardner observed the facility to have multiple postings throughout the facility for proper cough etiquette, proper hand washing procedure, and social distancing guidelines. LPA Gardner requested to inspect the facility's Personal Protective Equipment (PPE) supply, which was located in garage and staff room. The facility has a full thirty (30) day supply of PPE items such as gloves, face shields, gowns, N95 masks, disinfectant, and hand sanitizer. All clients and staff are practicing all other COVID-19 precautions, which minimize the risk of them contracting COVID-19. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to Jasbindar Singh.the state’s words, verbatim · CDSS document, Jul 19, 2022

Type of visit: POC

Licensing Program Analyst (LPA) Anna Bueno conducted a Plan Of Correction (POC) visit to address an issue LPA Bueno observed during a previous visits on 5/6/22, 4/25/22, and 4/19/22. LPA met with care provider Monica Cepena who was informed of the purpose of today's visit. LPA Bueno visited the property on 4/19/22 on a separate case management concern and observed dead roaches in the facility. Administrator stated that the facility was fumigated the day before, 4/18/22. On 4/25/22, LPA conducted another unannounced visit to the property and observed live roaches in the kitchen and roach traps in the kitchen cupboards. On 5/6/22, LPA observed live roaches in the facility. Administrator Singh confirmed that the facility was fumigated in February 2022 and on 4/18/22. Administrator sent a photo of a pest control treatment invoice dated 5/11/22 to LPA Bueno's cell phone on 5/24/22 During today's visit LPA Bueno toured the outside and LPA and staff toured the inside of the facility. LPA and staff observed no live pests in the facility. An exit interview was conducted with Ms. Cepena and this report was discussed and a copy provided.the state’s words, verbatim · CDSS document, Jun 1, 2022

Type of visit: POC

Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced plan of correction (POC) visit to the facility. This POC was conducted to verify compliance from deficiency citations that were issued on 4/19/2022. Health & Safety Code 1569.38 requires the licensee to provide written notification to a resident, the residents' responsible party, if any, and the local long-term care ombudsman within 10 days from the date indicated on the accusation. The licensee is also required to post the accusation in a conspicuous place in the facility. The date the Accusation was delivered was on 4/8/2022. The licensee had 10 days from this date to notify, in writing, the residents, their responsible parties, and the ombudsman. The 10th day was 4/18/2022. During today's visit, LPA observed Accusations posted by the front door. Two of four resident and/or responsible parties deny receiving a written notice regarding the Accusations. On 4/19/2022, LPA issued a deficiency under Health & Safety Code 1569.38. POC was that Licensee shall post accusations: 8219211401, 8219211401B, 8219211401C and 8219211401D in a conspicuous place and provide written notification to the residents and/or resident's responsible party and local long-term care ombudsman. The following deficiency was not corrected by the POC due date nor at the time of this visit. Civil penalties are being assessed and will continue to accrue until correction has been submitted. Civil penalties assessed today at the rate of $100 per day. Today's civil penalty assessment of $2100 is for the period of 4/26/22 through 5/16/22. Civil penalties will continue to accrue at rate of $100 until the violation is corrected. *******LIC809-C******* This assessment will not exceed $100 per day regardless of the number of notices the licensee fails to send. The total civil penalty for a continuous violation shall not exceed $5,000. The civil penalty assessment starts on 04/19/2022 and continues until Licensing has received proof that all required parties have received written notification of the revocation action. Refer to LIC 809D issued on 4/19/2022 for deficiency cited. Civil Penalties assessed today total $2100. An exit interview was conducted where this report, LIC 421A (civil penalty assessment forms) and appeal rights were discussed. A copy of all reports and forms were provided to care provider Mayra Guardado.the state’s words, verbatim · CDSS document, May 16, 2022

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Anna Bueno conducted a case management visit to address issues LPA observed during previous visits on 4/19/22 and 4/25/22. LPA met with care provider Maria Alvarado. Administrator Jasbinder Singh was phoned during the visit. LPA Bueno visited the property on 4/19/22 for another case management and observed dead roaches in the facility. Administrator stated that the facility was fumigated the day before, 4/18/22. On 4/25/22, LPA conducted another unannounced visit to the property and observed live roaches in the kitchen and roach traps in the kitchen cupboards. During today's visit, LPA Bueno observed live roaches in the sitting areas near the fireplace and printer tables, and under the kitchen sink. Per call with Administrator Singh, two types of traps were left by the pest control representative from 4/18/22. Per Administrator, one trap is scheduled to be switched out monthly while the other is changed quarterly. This is a potential health and safety risk to residents in care. Refer to LIC-809D for deficiency cited. An exit interview was conducted with Ms. Alvarado where this report, appeal rights, and LI-809D were discussed.the state’s words, verbatim · CDSS document, May 6, 2022

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87307(d)(2) · Plan of correction due date: May 25, 2022

PERSONAL ACCOMODATIONS/SERVICE: The following space and safety provisions shall apply to all facilities: The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment. This requirement was not met as evidenced by: LPA observed live roaches in the facility. Interviews with staff and residents LPA interviewed residents confirmed that roaches remain present in the facility.the state’s words, verbatim · CDSS document, May 6, 2022

Plan of correction: Licensee will have the entire home fumigated for roaches. Licensee will send proof of pest control treatment and plan to CCL by the end of POC date, 5/25/22.

Type of visit: POC

Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced plan of correction (POC) visit to the facility. This POC was conducted to verify compliance from deficiency citations that were issued on 4/19/2022. Health & Safety Code 1569.38 requires the licensee to provide written notification to a resident, the residents' responsible party, if any, and the local long-term care ombudsman within 10 days from the date indicated on the accusation. The licensee is also required to post the accusation in a conspicuous place in the facility. The date the Accusation was delivered was on 4/8/2022. The licensee had 10 days from this date to notify, in writing, the residents, their responsible parties, and the ombudsman. The 10th day was 4/18/2022. During today's visit, LPA observed Accusations posted by the front door. Two of four resident and/or responsible parties deny receiving a written notice related to the Accusations. The following deficiency was not corrected by the POC due date nor at the time of this visit. Civil penalties are being assessed and will continue to accrue until correction has been submitted: On 4/19/2022, LPA issued a deficiency under Health & Safety Code 1569.38. POC was that Licensee shall post accusations: 8219211401, 8219211401B, 8219211401C and 8219211401D in a conspicuous place and provide written notification to the residents and/or resident's responsible party and local long-term care ombudsman. ***LIC809-C*** Civil penalties assessed today at the rate of $100 per day. Today's civil penalty assessment of $700 is for the period of 4/19/2022 through 4/25/2022. Civil penalties will continue to accrue at rate of $100 until the violation is corrected. This assessment will not exceed $100 per day regardless of the number of notices the licensee fails to send. The total civil penalty for a continuous violation shall not exceed $5,000. The civil penalty assessment starts on 04/19/2022 and continues until Licensing has received proof that all required parties have received written notification of the revocation action. Refer to LIC 809D issued on 4/19/2022 for deficiency cited. Civil Penalties assessed today total $700. An exit interview was conducted where this report, LIC 421A (civil penalty assessment forms) and appeal rights were discussed. A copy of all reports and forms were provided to care provider Maria Alvarado.the state’s words, verbatim · CDSS document, Apr 25, 2022

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Anna Bueno conducted a case management visit to verify compliance with Health & Safety Code Section 1569.38. LPA met with two (2) care providers and phoned Licensee Smita Sanghvi. Administrator Jasbinder Singh arrived during the visit. Health & Safety Code 1569.38 requires the licensee to provide written notification to a resident, the residents' responsible party, if any, and the local long-term care ombudsman within 10 days from the date indicated on the accusation. The licensee is also required to post the accusation in a conspicuous place in the facility. The date the Accusation was delivered was on 4/8/2022. The licensee had 10 days from this date to notify, in writing, the residents, their responsible parties, and the ombudsman. The 10th day was 4/18/2022. During today's tour of the facility, LPA observed that the facility did not post, as required by law, the accusations: #8219211401, #8219211401B, #8219211401C and #8219211401D at the front entrance of the facility. Licensee telephonically stated she has not informed residents, or their responsible parties, or the local ombudsman in writing of the legal proceedings against the facility. During today’s visit, LPA observed and/or Licensee verbally confirmed that: The facility failed to post accusations: #8219211401, #8219211401B, #8219211401C and #8219211401D, as required by law. The facility failed to provide written notification as required by H&S Code 1569.38(b) to the residents/resident's responsible party within the required 10 days. A civil penalty is being assessed for a violation of Health & Safety Code 1569.38. Civil penalties shall be assessed until violation is corrected. Per California Health & Safety Code section 1569.38, you are hereby notified that a $100 civil penalty per day will be assessed until the violation is corrected. This assessment will not exceed $100/day regardless of the number of notices the licensee fails to send. The total civil penalty for a continuous violation shall not exceed $5,000. The civil penalty assessment starts on 04/19/2022 and continues until Licensing has received proof that all required parties have received written notification of the revocation action. Refer to LIC809D for deficiency cited. A civil penalty of $100.000 was assessed on 4/19/2022. An exit interview was conducted where this report was provided to Jasbinder Singh, administrator.the state’s words, verbatim · CDSS document, Apr 19, 2022

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.38 · Plan of correction due date: Apr 20, 2022

POSTING OF LICENSING REPORTS; DISCLOSURE TO NEW RESIDENTS: Requires the licensee of a residential care facility for the elderly to provide written notification to the residents, resident's responsible party (if any) and to the local Long-Term Care Ombudsman within 10 days..: The Department of Social Services commences proceedings to suspend or revoke the license of the facility. This occurs when the accusation is served to the respondent. This requirement was not met as evidenced by: LPA observed that the facility failed to post accusations. Licensee verified that they have not provided written notification as required by H&S Code 1569.38(b) to the residents/resident's responsible party Ombudsman.the state’s words, verbatim · CDSS document, Apr 19, 2022

Plan of correction: Licensee shall post accusations: 8219211401, 8219211401B, 8219211401C and 8219211401D in a conspicuous place and provide written notification to the residents/resident's responsible party and Ombudsman. The facility was issued a civil penalty of $100 a day which is imposed until the facility complies with a maximum of $5000..

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced after completing a COVID-19 Risk Assessment Screening for the facility via phone call. LPA Colvin met with Administrator Jasbindar Singh and advised of the purpose of the visit, and that the Annual Inspection will be limited to Infection Control only. Below is a summary of what was observed: Infection Control: LPA Colvin went over COVID-19 best practices for infection control and prevention with Administrator Jasbindar Singh, who LPA Colvin found to be successfully incorporating the several aspects of the facility's Mitigation Plan. Residents have hand sanitizer available to them, and the bathrooms were stocked with hand soap and paper towels, and there is a hand washing guide posted above the sink in the bathroom for residents to reference. LPA Colvin additionally observed the facility to have multiple postings throughout the facility for cough etiquette, proper hand washing procedure, social distancing, and emergency contact information. The facility's Personal Protective Equipment (PPE) supply is stored in the garage and staff room for easy access to staff. LPA Colvin confirmed that the facility has a 30-day supply of gloves, masks, and sanitizer, and isolation gowns. LPA Colvin went over the various recommended training for facility staff with Administrator Jasbindar Singh in relation to COVID-19 and confirmed that staff have been trained on various aspects of infection control, recognition of symptoms of COVID-19, and donning/doffing PPE. LPA Colvin inquired as to if staff have been fit tested for N95 masks, and Administrator Jasbindar Singh informed LPA Colvin that at this time staff have not been fit tested. LPA Colvin will be issuing a Technical Assistance Advisory Note during today's inspection for staff not being fit tested for N95 masks. LPA Colvin will not be issuing a deficiency for this item due to the facility not currently having any COVID-19 positive residents, and N95 masks only needing to be worn when a resident is COVID-19 positive or under observation while awaiting test results. Additionally, most residents have been vaccinated and are practicing other COVID-19 precautions, which minimize the risk of them contracting COVID-19. LPA Colvin will be providing Administrator Jasbindar Singh with the information for Provider Information Notice (PIN) PIN-21-10-ASC which contains resources for getting staff fit tested for N95 masks. LPA Colvin inquired about if the facility is still conducting COVID-19 surveillance testing of their staff members. Administrator Jasbindar Singh informed LPA Colvin that they have not been testing their staff members anymore, however, the facility's vaccination rate is above 70%. On 6/7/21, Community Care Licensing (CCL) issued a new Provider Information Notice (PIN) with updated guidelines on surveillance testing of staff members for COVID-19. PIN 21-28-ASC states that if at least 70% of all staff and residents in a facility have been fully vaccinated and do not have any symptoms of COVID-19, then the facility is not required to continue to conduct surveillance testing. Since at least 70% of the facility is fully vaccinated, they are not required to continue to test their staff, unless they display symptoms or have close contact with someone who has tested positive for COVID-19. LPA Colvin additionally informed Administrator Jasbindar Singh of the new PIN (PIN 21-32-ASC) which came out today, and advised that as of 8/9/21, the new guidance for facilities will be to resume COVID-19 testing for staff, due to the increase of COVID-19 cases. In addition to going over the facility's policy for testing staff and residents for COVID-19, LPA Colvin also inquired about if the facility is still screening their residents daily for COVID-19 symptoms, which includes checking their temperature. Administrator Jasbindar Singh confirmed that staff are continuing to monitor residents symptoms, and that both staff and visitors are screened for COVID-19 symptoms prior to entering the facility. LPA Colvin additionally observed a sign-in log for visitors, where their temperature is recorded as well as answers to screening questions. An exit interview was conducted with Administrator Jasbindar Singh and a copy of this report and LIC9102 TA Advisory Note was provided.the state’s words, verbatim · CDSS document, Jul 27, 2021

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.