Joy & Jay Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection visit. The LPA introduced himself and discussed the purpose of the visit to Caregivers Melisande Bauzon and Julius Sevilla. The facility was licensed for a capacity of six (6) non-ambulatory residents and a hospice waiver of four (4). At the time of the visit, the facility had a census of four (4) residents. The LPA, accompanied by caregiver Bauzon, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. 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 client activities. There was at least 2 days of perishable food, and at least 7 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 areas. No pools, nor bodies of water were witnessed on the premises. Per Staff Bauzon, no firearms nor ammunition were kept at the facility. Fire extinguisher along with smoke alarms were present. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and reviewed multiple staff and client records/files. No deficiencies were observed nor cited during today's annual inspection. An exit interview was conducted with Caregivers Bauzon and Sevilla, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058), were provided.the state’s words, verbatim · CDSS document, Oct 30, 2023

Allegation investigated: Staff did not provide resident's authorized representative with a refund

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced visit to initiate a complaint investigation regarding the above allegation. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Melisande Bauzon. Administrator Ana Osborne arrived during the visit and assisted the LPA. Throughout the investigation, the Department secured pertinent records and conducted interviews with internal and external sources. It was alleged the facility did not provide a resident's authorized representative with a refund. It was reported to the Department Resident #1 (R1) had moved into the facility on 8/16/23, passed away on 8/21/23, and R1’s belongings were removed from the facility on 8/26/23. Review of R1’s admission agreement, along with interviews with internal and external sources, revealed a pre-admission fee of Fifteen hundred dollars ($1,500) and a monthly fee of Seven thousand dollars ($7,000). Substantiated Interviews also corroborated the agreement indicated pre-admission fees were non-refundable, monthly fees were non-refundable upon a resident’s death, and that a refund was not provided to R1’s authorized representative. Based on the evidence obtained, a refund was not provided as indicated in California Code of Regulations Title 22, nor in the Health and Safety Code. The allegation was substantiated and cited in an LIC 9099D. A plan of correction was jointly formulated with Administrator Osborne. An exit interview was conducted with Osborne, to whom a copy of this report, LIC 9099D, and Licensee/Appeals Rights (LIC 9058) were provided.the state’s words, verbatim · CDSS document, Sep 20, 2023 · control 08-AS-20230919120951

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.652(c) · Plan of correction due date: Sep 20, 2023

§1569.652 Termination of admission agreement upon death of resident; removal of resident’s property; refund of fees paid; notice of contract termination and refunds (c) A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual, individuals, or entity contractually responsible for the fees or, if the deceased resident paid the fees, to the resident’s estate, within 15 days after the personal property is removed. This Requirement was not met as evidenced by: Based on interviews and review of records, the licensee did not ensure a refund was provided to R1's authorized representative, which posed a potential health, safety and personal rights risk to 1 of 6 residents in care.the state’s words, verbatim · CDSS document, Sep 20, 2023

Plan of correction: Administrator agree to refund R1's authorized representative $6,016.12, by 9/29/23. Administrator agreed to provided proof of refund by 9/29/23.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced Required - 1 Year visit. The LPA was granted entry after introducing himself, and disclosing the purpose of the visit to Caregiver, Agus Sinoman. Administrator, Anna Osborne, and House Manager, Dearme Doverte, arrived during the visit. On today's visit, the LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff, residents and visitors; a sign-in policy enacted for all visitors; signs throughout the facility to promote hand hygiene; face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of Personal Protective Equipment (PPE). Additionally, Cleaning supplies and medications were observed to be locked in different locations and inaccessible to residents in care. No deficiencies were cited on today's date. An exit interview was conducted with House Manager, Dearme Doverte, to whom a copy of this report along with Applicant/Appeal Rights (LIC9058 01/16) were provided via electronic mail. An electronic mail read receipt confirms the documents were received by the house manager.the state’s words, verbatim · CDSS document, Oct 25, 2022

Type of visit: POC

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced case management visit to follow-up on a Plan of Correction for a deficiency cited on 8/24/22. The LPA was greeted by Staff Kenneth Doverte and was allowed entry, after identifying himself and disclosing the purpose of the visit. House Manager, Dearme Doverte, arrived during the visit. Deficiency cited under 87211 Reporting Requirements (c): On August 24th, 2022. On 8/25/22, House Manager provided a tentative schedule of staff, topics, and a date of when the training would be conducted. On today's date, House Manager provided the LPA copies of staff certificates indicating the training was completed on 8/30/22 and 8/31/22. The training was conducted by an outside vendor, as agreed in the Plan of Correction. An exit interview was conducted with House Manager, Dearme Doverte, to whom a copy of this report, Letter of Deficiencies Cleared, and Licensee Rights (LIC 9058/16) were provided to via electronic mail. An electronic mail read receipt confirms these documents were received by the House Manager.the state’s words, verbatim · CDSS document, Sep 29, 2022

Allegation investigated: Neglect resulting in bruises.

Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to the facility to deliver findings on the above-mentioned allegation. LPA gained access to the facility, identified herself, and met with Dearme Doverte to discuss the purpose of the visit. LPA’s visit consisted of delivering findings on the above-mentioned allegation. LPA conducted the initial investigation visit on August 24, 2022, and was able to interview residents, facility staff, and outside sources. LPA also reviewed records, and conducted a physical inspection of the facility. It was alleged that facility neglect resulted in bruises. Interviews revealed that Resident 1 (R1) had brusies on their body over two years ago. Interviews revealed staff denied any neglect towards R1 and the other residents. Unsubstantiated Staff interviews denied residents having bruising. Interviews revealed that staff have been trained on resident rights. Interviews with outside sources and residents did not produce any evidence to verify that neglect resulted in bruises occurred. Based on the evidence obtained from interviews, and record review, the complaint allegation is found to be unsubstantiated; as there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted with Dearme Doverte and a copy of this report along with Licensee/Appeal Rights (LIC 9058 01/16) was provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Sep 16, 2022 · control 08-AS-20220818162523

Allegation investigated: Sexual abuse to resident by unknown staff member Staff speak to residents inappropriately Facility does not meet resident's dietary needs

Licensing Program Analyst (LPA), Sabel Martinez, completed an unannounced complaint visit to conduct additional interviews and deliver findings regarding the above mentioned allegations. The LPA was granted entry to the facility by Caregiver, Kenneth Doverte, after identifying himself and disclosing the purpose of the visit. Administrator, Ana Osborne, and House Manager, Dearme Doverte, arrived during the visit. Throughout the investigation, the LPA toured the facility, reviewed staff records, resident records, and conducted interviews with residents, staff, and outside sources. It was alleged a resident was sexually abused by an unknown staff member. While conducting an interview, Resident # 1 (R1) was witnessed to be oriented to person, time, place, and situation. R1 reported that on multiple occasions an unknown male, or males had entered R1’s room at night and raped R1. R1 did not know if the suspected abuser, or abusers were facility employees, or outside persons entering the facility at night. Unsubstantiated When asked how R1 knew R1 was raped, R1 pointed to R1’s genitals and stated it did not feel normal when R1 would wake up. R1 was not able to explain what normal and not normal felt like. R1 disclosed this to an outside source and believed the outside source had not addressed it, because the outside source did not want R1 to move back home. R1 confirmed it was R1’s desire to move back home. Interviews with outside sources revealed R1 had fabricated allegations in the past in order to control certain situations. An outside source recalled previously being at R1’s home, R1 becoming upset and adamant something had occurred the way R1 recalled it. The outside source was present and confirmed it did not happen the way R1 was describing the incident. R1 had expressed a desire to move back to R1’s home, and outside sources believed this allegation was fabricated as an attempt for R1 to be moved back home. When outside sources had attempted to corroborate R1 allegation, R1 had said R1 knew R1 was raped only after waking up and stating R1’s genitals did not feel normal. R1 had not disclosed any staff names, and only described the suspected abuser as big, tall, and male. Outside sources had not witnessed any signs of physical trauma on R1’s body. Interviews with staff revealed R1 required assistance with multiple Activities of Daily Living (ADLs), including showering and toileting. Since moving into the facility, R1 had refused assistance from male and female staff, on multiple occasions. Management had maintained R1’s assistance with ADLs, while addressing R1’s need for independence. Management was aware of the sexual abuse allegation, and description of the abuser as big, tall, and male. Obtained facility schedules, interviews, and observations did not corroborate any staff to match the description provided by the R1. It was alleged staff speak to residents inappropriately. Interviews with outside sources revealed staff had addressed residents in a respectful manner. Interviews with staff revealed there is one resident with a hearing impairment requiring staff to raise their voice to properly communicate. This has caused another resident to become upset and believe the staff are mistreating the resident. Observation and records review confirmed the resident in question did have a hearing impairment and required auditory devices. It was alleged facility did not meet resident's dietary needs. Interviews with outside sources revealed the facility provided and had an appropriate amount of food for the residents in care. Interviews with residents and observation corroborated the facility had an ample amount of food and residents are able to request additional servings, if it is the resident’s desire. Interviews with residents and observation corroborated the facility had an ample amount of food and residents were able to request additional servings, if it is the resident’s desire. Based on the evidence gathered throughout the investigation, there is not a preponderance of evidence to prove the alleged violations occurred, therefore, the allegations are unsubstantiated. An exit interview was conducted with, Ana Osborne, to whom a copy of this report along with the licensee Rights (LIC 9058 01/16 ) were provided tothe state’s words, verbatim · CDSS document, Aug 24, 2022 · control 08-AS-20220429095237

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA), Sabel Martinez, conducted a case management visit to cite for a deficiency that was observed during a complaint investigation. The LPA was granted entry into the facility by Caregiver, Kenneth Doverte, after identifying himself and disclosing the purpose of the visit. Administrator, Ana Osborne, House Manager, Dearme Doverte, arrived during the visit During a complaint investigation, the LPA discovered the facility Administrator, Ana Osborne, who is a mandated reporter, had knowledge of possible abuse requiring reporting to the local ombudsman, the Department, and local law enforcement. Based on interviews, and records reviewed, it was determined the facility did not meet the required reporting requirements. Per California Code of Regulations, Title 22, this deficiency was cited on an LIC 809D. A Plan of Correction was jointly formulated with the facility administrator. An exit interview was conducted with Administrator, Ana Osborne, to whom a copy of the report and Licensee/Appeal Rights (LIC 9058 01/16) were provided to.the state’s words, verbatim · CDSS document, Aug 24, 2022

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87211(c) · Plan of correction due date: Aug 24, 2022

87211 Reporting Requirements (c) Any suspected physical abuse that does not result in serious bodily injury of an elder or dependent adult shall be reported to the local ombudsman, the corresponding licensing agency, and the local law enforcement agency within twenty-four (24) hours as required by Welfare and Institutions Code Section 15630(b)(1). This requirement was not met as evidenced by: Based on interviews and records reviewed, the Licensee did not report physical abuse of an elder or dependent adult to the local ombudsman, Lincensing, nor local law enforecement. This posed an immediate health, safety, and personal rights risk to 6 of 6 residents in care.the state’s words, verbatim · CDSS document, Aug 24, 2022

Plan of correction: The administrator agreed to provide all staff mandated reporting training from an outside vendor. Administrator agreed to submit proof of scheduled training by 8/25/22. Administrator agreed to provide the LPA records of the completed training and staff who completed the training by 9/21/22.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Adam Hamer conducted an unannounced annual required licensing inspection on today's date. LPA was greeted at the front door and was granted entry after identifying himself and disclosing the purpose of the visit. An overall tour of the facility was conducted inside and out. The inspection included, but was not limited to, verifying compliance with statutes, regulations and other written requirements that are most relevant to protecting the health of residents in care and staff, including in the area of infection control practices. LPA reviewed with Administrator Ana Osborne and House Manager Dearme Doverte the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report (LIC 808) including the following sections: Persons in Care, Staff, Visitors, Facilities without COVID-19, Residents, Facility has Plans for Infection Control, and Physical Distancing. LPA assessed the strategies that the facility is employing for the prevention, containment and mitigation of COVID-19, implementation of infection control guidance, staff retention and essential health and safety. LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff and visitors; a sign-in policy enacted for all visitors; signs posted at facility entrance with the facility’s visitor policy, and signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of PPE. The facility is in compliance with and has implemented infection control practices as outlined in its LIC 808. No deficiencies were observed during today's visit. An exit interview was conducted with Ms. Osborne and a copy of this report along with Licensee/Appeal Rights (LIC 9058 FAS 01/16) was provided to her via email; she expressed that she would send LPA a confirmation email upon receipt of these documents.the state’s words, verbatim · CDSS document, Sep 21, 2021

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Adam Hamer conducted an unannounced annual required licensing inspection on today's date. LPA was greeted at the front door and was granted entry after identifying himself and disclosing the purpose of the visit. An overall tour of the facility was conducted inside and out. The inspection included, but was not limited to, verifying compliance with statutes, regulations and other written requirements that are most relevant to protecting the health of residents in care and staff, including in the area of infection control practices. LPA reviewed with Administrator Ana Osborne and House Manager Dearme Doverte the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report (LIC 808) including the following sections: Persons in Care, Staff, Visitors, Facilities without COVID-19, Residents, Facility has Plans for Infection Control, and Physical Distancing. LPA assessed the strategies that the facility is employing for the prevention, containment and mitigation of COVID-19, implementation of infection control guidance, staff retention and essential health and safety. LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff and visitors; a sign-in policy enacted for all visitors; signs posted at facility entrance with the facility’s visitor policy, and signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of PPE. The facility is in compliance with and has implemented infection control practices as outlined in its LIC 808. No deficiencies were observed during today's visit. An exit interview was conducted with Ms. Osborne and a copy of this report along with Licensee/Appeal Rights (LIC 9058 FAS 01/16) was provided to her via email; she expressed that she would send LPA a confirmation email upon receipt of these documents.the state’s words, verbatim · CDSS document, Sep 21, 2021