Crystal Garden RCFE

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPA met with Breeana Redwine, Administrator, and discussed the purpose for the visit. The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (10), and a current census of (10). LPA conducted a general inspection of facility, which included, but was not limited to, the following: Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor space for resident activities. The facility is maintained at a comfortable temperature of 73 degrees Fahrenheit. Resident bedrooms were furnished with beds, bed linen, nightstands, chairs, and sufficient lighting. Resident bathrooms were maintained clean and equipped with grab rails. The hot water temperature in resident's bathroom measured 108 degrees Fahrenheit. The facility is equipped with smoke detectors and carbon monoxide alarms, fully charged fire extinguishers, laundry equipment, and telephone service. The facility has posted in a common area Community Care Licensing complaint poster, Ombudsman poster, facility license, evacuation sketch and emergency telephone numbers. Sharps were kept locked and inaccessible to residents in care. The facility has 24 hours/7 days a week staff coverage. Food Service: Kitchen and dining areas were maintained cleaned. Non-perishable and perishable food supply was sufficient for number of residents in care. Cups, plates, and utensils were sufficient for number of residents in care. The facility’s refrigerators and freezers were operating properly. Medications: Resident medications are centrally stored in a locked cabinet. Interviews with staff and review of medication records reveals, that caregivers who are not medically skilled professionals are administering injections to resident #1 (R1) and resident #2 (R2). Review of R1 and R2's physician's report reveals both residents are not able to administer their own injections. Record Review: The Administrator’s certification, facility’s insurance and emergency drill training are up to date. Resident files were reviewed for admissions agreements, physician’s reports, preplacement appraisals, needs and services plans. Review of staff files reveals, Staff#1 (S1) did not have on file a health screening for review. During today's visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where reports (LIC809 & LIC809D) were discussed and copies provided with appeal rights to Administrator Redwine at the conclusion of the visit.the state’s words, verbatim · CDSS document, Apr 30, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPA met with Breeana Redwine, Administrator, and discussed the purpose for the visit. The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (10), and a current census of (10). LPA conducted a general inspection of facility, which included, but was not limited to, the following: Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor space for resident activities. The facility is maintained at a comfortable temperature of 74 degrees. Resident bedrooms were furnished with beds, bed linen, nightstands, chairs, and sufficient lighting. Resident bathrooms were maintained clean and equipped with grab rails. The hot water temperature in one of the resident's private bathroom measured at 126 degrees F. Deficiency cited. The facility is equipped with smoke detectors and carbon monoxide alarms, fully charged fire extinguishers, laundry equipment, and telephone service. The facility has posted in a common area Community Care Licensing complaint poster, Ombudsman poster, facility license, evacuation sketch and emergency telephone numbers. Sharps were kept locked and inaccessible to residents in care. The facility staff schedule reflects 24 hours a day, 7 days a week staff coverage. Food Service: Kitchen and dining areas were maintained cleaned. Non-perishable and perishable food supply was sufficient for number of residents in care. Cups, plates, and utensils were sufficient for number of residents in care. The facility’s refrigerators and freezers were operating properly. Health Related Services: The facility staff centrally store resident's medications in a locked cabinet. LPA observed in Resident #1 (R1's) medication caddy, pills stored in illegible labeled bottle. LPA was not able to determine the name of resident, medication name, dosage, and expiration dates on the bottle. LPA also observed in R1's medication caddy, (3) unlabeled pills in a plastic container. The Administrator stated the pills were R1's afternoon medications which were transferred into the container. Deficiency cited. ***continued on next page*** Record Review: Resident files reviewed had admissions agreements, physician’s reports, appraisals, needs and services plans. Staff files reviewed had First Aid/CPR certifications, criminal record clearances, training, and health screenings. The Administrator’s certification, facility’s insurance and emergency drill training are up to date. During today's visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where reports (LIC809 & LIC809D) were discussed and copies provided with appeal rights to Administrator Redwine at the conclusion of the visit.the state’s words, verbatim · CDSS document, Mar 20, 2025

The state marks this report as 7 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Allegation investigated: Residents are equipped with catheters when not required to be Residents Physician Report's edited by unlicensed physician

Licensing Program Analyst (LPA) Becky Mann conducted an unannounced visit to the facility to initiate a complaint investigation. LPA met with Breeana Redwine, Administrator and discussed the purpose of the visit. The investigation consisted of LPA pertinent record reviews and interviews with staff and residents. The allegation that Residents are equipped with catheters when not required to be. Based on interviews with administrator, staff, and outside hospice agency, all have denied this allegation. The allegation that Residents Physician Report’s edited by unlicensed physician. Based on LPA observations, there were no documentation and/or evidence to corroborate the allegation. Based on evidence obtained during this investigation, the allegations are Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted where this report was discussed and a copy of this report was provided to the Breeana Redwine, Administrator at the conclusion of the visit. Unfounded Based on evidence obtained during this investigation, the allegations above are Unsubstantiated; meaning that 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. An exit interview was conducted where this report was discussed and a copy of this report was provided to the Breeana Redwine, Administrator at the conclusion of the visit.the state’s words, verbatim · CDSS document, Mar 4, 2025 · control 18-AS-20210407133529

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Anna Fannell conducted an unannounced visit to this facility for a required annual inspection. Entry into the facility is unobstructed and LPA met with administrator Breanna Redwine. The facility is approved for a Hospice Waiver for six (6) residents. LPA and ADministrator toured the interior and exterior of the facility. Physical Plant: The facility is operating within capacity and not beyond the conditions of the license. There are no pools or other bodies of water located on the premises. The facility is being maintained at a comfortable temperature for residents. All passageways are kept free of obstruction. Hot water temperature was measured in all bathrooms and measured between 105 and 110 degrees Fahrenheit. Grab bars, textured shower floor, and shower aid equipment are utilized by residents. Fire safety installations such as extinguishers, sprinklers, and alarms are present. Fire extinguishers were observed to be charged and last inspected on 08/04/2023. A hallway smoke detector was tested by facility staff and all other units, including bedrooms, were found to be interconnected and working. Overall the facility is in good condition; it is clean, sanitary and free of foul odors. Kitchen and Food Service: LPA was present during lunch service. The total daily diet provided to residents appears to be of the quality and in the quantity necessary to meet resident needs. There is at least a one week supply of nonperishable foods and two days of perishable food items, which meets regulatory requirements. All readily perishable food or beverages capable of micro-organism growth are being stored in covered containers at appropriate temperatures. Sharps and cleaning agents are kept secured in the kitchen. Medication, Care, and Supervision: The facility has sufficient and competent staff to provide services needed to meet resident needs. Chemicals and items which can constitute a danger are stored inaccessible to residents. LPA inspected medications and found them in their original containers. Medications appear to be dispensed according to the physician's orders. Resident and Staff Files: LPA reviewed all staff and resident files. Resident files had the required documentation including admission's agreement, consent forms, and appraisal and/or needs and services plan. Staff files had the required documentation including mandated reporting, health screening report, CPR certification. LPA Fannell did not observe updated training related to hospice care and dementia care. These pose potential health and safety risks to residents in care. Operations and Administration: Disaster Plan is present and Administrator Redwine will be updating the plan as needed. Administrator is present in the facility a sufficient amount of hours and their administrator certification is up to date. The required ombudsman poster is posted and Administrator posted licensing poster in public view. Residents rights are posted and a copy is kept the resident's file. Refer to LIC809D for deficiencies were cited during this visit. Technical advisories and violations were issued in relation to deficiencies observed. An exit interview was conducted where this report, LIC 809D, and appeal rights were discussed and provided to Administrator Redwine.the state’s words, verbatim · CDSS document, Mar 28, 2024

The state marks this report as 7 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.