Mission Home III

Type of visit: Required - 1 Year

On 10/19/2023, at about 10:00 AM, Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced Required Annual Inspection. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Susana Baragan, Caregiver. According to the facility’s license, the facility serves six (6) non-ambulatory elderly residents, age 60 and above. The facility had an Infection Control Plan which LPA reviewed and noted no concerns. LPA Pena toured the interior and exterior of the facility and inspected each resident’s room. The facility was organized, kempt, in good repair and contained no offensive odors. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Bathroom had grab bars at toilet and shower used by residents. Non-skid mat was observed in shower. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There was at least two days of perishable food, and at least seven days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in locked cabinet. No pools or bodies of water were observed on the premises. Per Caregiver, Baragan, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. Hot water temperatures measured in the resident restroom and kitchen were within Title 22 Regulations. LPA interviewed staff and residents and reviewed staff and resident records/files. LPA interviews did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in locked areas. [CONTINUED FROM LIC 809] No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Caregiver, Baragan to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Oct 19, 2023

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.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Riza Alvarez and Renita Hall, conducted an unannounced Required 1 - Year Visit. The facility file was reviewed prior to the visit. LPAs were let into the facility by Maria Barragan, Caregiver. LPAs discussed the purpose of the visit with Administrator Ceren Curmak. All staff present have a current criminal record clearance. LPAs conducted a tour of the facility, both inside and outside and observed the residents in care. In accordance with the Department’s Infection Control, LPA Alvarez provided technical assistance, evaluated, and observed the facility's implementation of their mitigation plan to include disinfection, testing surveillance, and screening protocols as well as the use of personal protective equipment. No deficiencies were cited or observed on this date. Mr. Curmak was provided a copy of their appeal rights (LIC9058 03/22). An exit interview was conducted and a copy of this report was given to Mr. Curmak.the state’s words, verbatim · CDSS document, Oct 21, 2022

Allegation investigated: Facility staff neglected resident resulting in an unexplained injury. Facility staff neglected resident resulting in a pressure injury. Facility staff neglected resident resulting in scabies. Facility staff neglected resident resulting in a urinary tract infection.

Licensing Program Analyst (LPA) Elizabeth Hamilton conducted an unannounced complaint investigation visit at the facility. LPA was greeted at the front entrance by Maria Susana Barragan and granted entry after identifying herself. LPA explained the purpose of the visit was to deliver findings for the above allegations. The Department’s investigation consisted of records reviewed, interviews with residents, staff and outside sources. On May 27, 2020, it was alleged that on May 19, 2020, facility staff neglected Resident 1 (R1) resulting in an unexplained injury. Interviews with staff revealed that R1 was observed with a red (bloodshot) right eye but no visible head injuries or complaints of pain a few days before a May 19, 2020 hospital visit for a Urinary Tract Infection (UTI). Interviews and records reported R1 was non-ambulatory and needed a two-person assist transitioning in and out of bed with a Hoyer lift. R1 was observed every two hours and staff were not aware of any falls at the facility. Unsubstantiated Interviews with outside sources revealed that after R1 was admitted to the hospital on May 19, 2020, they were diagnosed with a small right frontal hemorrhage (“brain bleed”). Although R1 was diagnosed with this condition, interviews with outside sources confirmed they never observed any visible injuries on R1’s head that would indicate they suffered some sort of head injury while at the facility. Interviews with outside sources confirmed R1 had no known falls at the facility. Interview statements from R1 were consistent in that they never had a fall at the facility. Records reviewed confirmed R1’s diagnosis and showed R1 received services from a home health agency one to two times per week. They had treated a pressure injury to the scalp on or about April 08, 2020, that was observed as “healed” on April 20, 2020; however, no head injuries were notated. Hospital records further indicated there were no visible signs of head injury to account for the brain bleed, which was assessed as stable and did not require surgery. There was insufficient evidence to support the allegation that staff neglect resulted in an unexplained injury to R1. It was also alleged that on May 19, 2020, facility staff neglected R1 resulting in a pressure injury. Interviews with staff revealed R1 was repositioned every two hours, as they were non-ambulatory and spending most of their time in bed. Any skin tears observed were reported to the home health agency. Interviews with outside sources confirmed R1 had chronic skin issues, including rashes and minor pressure injuries, that were evaluated as either Stage one or Stage two. Interviews with outside sources corroborated facility staff would constantly reposition R1 while in their bed or sitting in their wheelchair to avoid pressure injuries and would report any observed skin issues immediately to the home health agency and to R1’s primary physician. Records reviewed revealed R1 was initially observed with a possible sacral ulcer stage 1-2 upon hospital admission, with a pending wound care consult. The wound consult determined no signs of stage 1 sacral pressure ulcer, and the wound was treated during hospitalization with frequent turning and wound care. Additional records confirmed R1 had a toe wound that was treated March 19, 2020; a wound to middle of back closed and healed on April 7, 2020; wound care treated to the back of scalp on April 09, 2020; and a coccyx pressure injury that healed on April 20, 2020. R1 received outside agency home health visits 1-2 times a week with ongoing skin assessments during this time. There was insufficient evidence to support the allegation that staff neglect resulted in a pressure injury to R1. It was further alleged that on May 19, 2020, facility staff neglected R1 resulting in scabies. Interviews with staff revealed that R1 had an ongoing rash that was reported to the home health agency and was reported to their primary physician. Interviews with outside sources confirmed R1 had on-going skin issues that included recurring scabies episodes. Records reviewed confirmed R1 had a rash to the back, neck and buttocks that were treated with Clotrimazole. Records further revealed that on May 19, 2020, the rash was thought to be yeast and new medication was prescribed for additional treatment while R1 was hospitalized. There is insufficient evidence to support the allegation that staff neglect resulted in R1’s scabies. It was also alleged that on May 19, 2020, facility staff neglected R1 resulting in a urinary tract infection (UTI). Interviews with staff revealed that R1 had a catheter that was changed monthly by a home health nurse. R1 had a history of chronic UTIs and was last diagnosed with a UTI in early May of 2020, after a change of condition. Home health was notified, and they were sent to the hospital on May 19, 2020 for evaluation. Interviews with outside sources confirmed R1 had on-going issues with UTIs due to their need for a catheter and that staff would immediately notify the home health agency of any changes to their health. Records reviewed confirmed R1 had a history of UTIs and they had been treated and monitored for UTIs by the home health agency from March 05, 2020 until they were sent to the hospital on May 19, 2020. There was insufficient evidence to support the allegation that staff neglect resulted in R1 developing a UTI. The Department has investigated the allegations listed above. Based on evidence obtained, including interviews and records reviewed, the above allegations are determined to be unsubstantiated as the Department could not meet the preponderance of the evidence standard. An exit interview was conducted with Ms. Barragan and a copy of this report and Licensee/Appeals Rights (LIC 9058 01/16) was provided to the Licensee via email. An electronic receipt of confirmation was requested to be sent by the Licensee upon receipt of the documents.the state’s words, verbatim · CDSS document, Dec 15, 2021 · control 08-AS-20200527110327

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced Required 1 - Year Visit. The facility file was reviewed prior to the visit. LPA was allowed entry by, identified herself to, and explained the purpose of the visit to Caregivers Abril Meneses Aguilar and Lidia Leo. Administrator Ceren Curmak was briefly at the facility during the visit. LPA conducted a brief tour of the facility and observed the clients in care. In accordance with the Department’s Infection Control, LPA provided technical assistance, observed, and evaluated the facility's implementation of their COVID-19 Mitigation Plan, to include disinfection, testing surveillance, screening protocols, and the use of personal protective equipment. No deficiencies were cited or observed on this date. An exit interview was conducted with Caregiver Lidia Leo. A copy of this report and the licensee appeal rights (LIC9058 01/16) were provided to Administrator Ceren Curmak via E-mail.the state’s words, verbatim · CDSS document, Oct 19, 2021