Bayview Senior Assisted Living

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced case management visit. LPA was greeted and allowed entry into the facility by Alma Saenz, Med Tech. LPA stated the purpose of the visit was to conduct a health and safety check and collect records. During today's visit, LPA conducted a brief facility tour, interacted with residents and staff and obtained facility records. No deficiencies were observed or cited during this visit. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC9058 03/22) were provided to Ms. Saenz whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, May 26, 2023

Allegation investigated: Resident sustained unexplained weight loss Resident is not provided adequate meals

Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced complaint investigation visit to deliver findings regarding the above-mentioned allegations. LPA identified herself to, was greeted by, and explained the purpose of the visit to House Manager Maria Flores. The Department’s investigation consisted of interviews with residents, staff, and outside sources, review of records, LPA observations, and a tour of the facility. It was alleged that a resident sustained unexplained weight loss and a resident was not provided with adequate meals. Interviews with residents revealed that residents did not have any complaints regarding the food being served. Residents stated that the facility served eggs, toast, and bacon for breakfast, served food like salads or sandwiches for lunch, and served food like hamburgers and chicken for dinner. During the initial visit on 8/23/2021, LPA Ruiz observed staff cooking scrambled eggs for breakfast. Unsubstantiated Interviews revealed that the facility employed a dietitian who reviewed and created the food menu on a quarterly basis and staff would take resident preferences and family feedback into consideration when preparing meals. The staff also used a standing scale to weigh residents who were able to stand every month and would document any refusal of meals. Staff would notify residents’ physicians and responsible parties whenever a significant weight loss or gain was observed. Staff stated that a weight loss or gain requiring purchasing all new clothing would be considered a significant weight loss. Interviews revealed that around September 2021, resident 1’s (R1) spouse passed away at another assisted living facility. On September 8, 2021, staff observed that R1 had decreased food and liquid intake and they notified R1’s physician that R1 was refusing meals. On September 9, 2021, R1’s physician increased R1’s medication and noted that R1’s change in behavior could be connected to the passing of R1’s spouse. Review of R1’s needs and services plan dated September 10, 2021 revealed that staff were told to monitor R1 for changes in condition, ensure that a water cup was within R1’s reach, and redirect R1 as needed. Review of hospital records dated December 24, 2021 revealed that R1 had a weight loss of around 25 pounds in the last year and noted that it could have been attributed to R1’s history of cancer, diagnosis of dementia, medication prescribed for behaviors, and depression related to the death of R1’s spouse. The Department has investigated the above-mentioned allegations and based on interviews, record review, and LPA observations, the preponderance of the evidence has not been met, therefore, these allegations are deemed unsubstantiated. An exit interview was conducted with House Manager Maria Flores, to whom a copy of this report and the Licensee Appeal Rights (LIC9058 01/16) were provided via hard copy.the state’s words, verbatim · CDSS document, Nov 22, 2022 · control 08-AS-20210813161627

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced annual required licensing inspection. LPA was greeted at the entrance to the facility by Caregiver, Anna Sanchez. After identifying himself and stating the reason for the visit, LPA was permitted entry into the facility. LPA was later met by Administrator, Maria Flores to verify 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 conducted a tour of the facility and observed the residents in care. In accordance with the Department’s Infection Control, LPA provided consultation, observed, and evaluated the facility's implementation of their Infection Control Plan, to include disinfection, testing, vaccination, screening protocols, and the use of personal protective equipment. No deficiencies were observed during today’s visit. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Administrator, Flores whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Jul 8, 2022

Allegation investigated: Licensee did not meet the needs of the resident, resulting in severe dehydration Licensee did not meet the needs of the resident, resulting in severe malnutrition Facility staff did not treat scabies

Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced complaint investigation visit to deliver findings regarding the above-mentioned allegations. LPA identified herself to, was greeted by, and explained the purpose of the visit to Administrator Maria Flores. The Department’s investigation consisted of interviews with staff, residents, and outside sources, review of records, and a tour of the facility. It was alleged that the Licensee did not meet the needs of the resident, resulting in severe dehydration and malnutrition. Record review and investigative interviews revealed that on 6/28/2021, Resident 1 (R1) was observed by facility staff to be weak and fainted during breakfast. R1 was admitted to the hospital and diagnosed with severe dehydration, severe malnutrition, a urinary tract infection, and scabies. Interviews with outside sources revealed that R1's spouse had passed away in April 2021 and R1 attended the funeral for their spouse in early June 2021. Continued on LIC9099-C... Unsubstantiated After the funeral, R1 was observed by staff and outside sources to be sleeping more and eating and drinking less. R1’s sibling also passed away in June 2021. Staff stated that in response to this behavior change, they gave R1 milk shakes and R1's choice of fast food and facility food. Record review revealed that starting in April 2021, facility staff were working with R1’s physician and home health services regarding R1’s decreased food intake and scheduled multiple medical appointments in May 2021. Interviews with staff also revealed that facility staff offered R1 water whenever staff interacted with R1 and R1 was able to drink unassisted. Onsite visits and interviews revealed R1 did not have any issues with the care R1 received at the facility and was offered drinks throughout the day and with meals. During onsite visits, R1 was observed with drinks and snacks. Review of medical documents from R1's hospitalization on 6/28/21 revealed that R1's weight was recorded on 6/28/2021 at 9:04am at 120 pounds and 5.9 ounces. On the same day at 9:31pm, R1's weight was recorded at 70 pounds and 12.3 ounces. Interviews with R1's primary physician stated that it appeared that R1's weight was entered in error due to the vast discrepancy in weight history. Interviews with facility staff and Licensee revealed that between late 2020 and April 2021, R1 lost approximately 40 pounds while living at another community care facility. The Department’s investigation consisted of interviews with staff, residents, and outside sources, review of records, and a tour of the facility. It was alleged that facility staff did not treat the resident’s scabies. Review of fax documents between the facility and R1’s primary physician revealed that the facility was in communication with R1’s primary physician regarding R1’s skin conditions between 3/3/2020 and 7/2/2021. Interviews with outside sources revealed that R1 had a history of heat rashes. The facility contacted R1’s primary physician on 5/18/2020, 5/19/2020, and 5/23/2020 regarding R1’s shingles diagnosis and the care plans for treatment. On 5/20/2021, R1 attended a medical appointment where R1 was diagnosed with scabies and prescribed a topical cream and topical ointment. On the same day as the medical appointment, the facility contacted R1’s primary physician to notify them of R1’s scabies diagnosis. Facility staff applied a topical medication to treat the scabies, disinfected R1’s belongings, and increased the frequency of R1’s showers. On 6/28/2021, R1 was diagnosed with scabies at the hospital. The facility contacted R1’s primary physician, moved R1 to a new room, and cleaned and sanitized R1’s belongings and furniture. On or about 7/2/2021, R1 was not showing any improvement with the skin condition and the facility contacted R1’s physician to request updated care plans. Continued on LIC9099-C Page... Investigative interviews revealed that R1 was treated for scabies and the facility’s physician had determined that R1’s scabies was not active and that scarring from the scabies could last for months. Interviews with outside sources and R1’s physician revealed that R1 was undergoing treatment for the scabies. R1’s physician also did not have any concerns about the care being provided at the facility. The Department has investigated the above-mentioned allegations and based on observation, interviews, and record review, the preponderance of the evidence has not been met, therefore, these allegations are deemed unsubstantiated. An exit interview was conducted with Administrator Maria Flores, to whom a copy of this report and the Licensee Appeal Rights (LIC9058 01/16) were provided via hard copy.the state’s words, verbatim · CDSS document, Jun 30, 2022 · control 08-AS-20210709083731

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced case management visit to deliver an amended report for a visit conducted on 7/14/2021. LPA was greeted by, identified herself to, and explained the purpose of the visit to Administrator Maria Flores. During the visit, LPA obtained Maria Flores' signature on the amended complaint investigation report - LIC 9099. An exit interview was conducted with Administrator Maria Flores, to whom a copy of this report and the Licensee's Rights (LIC9058 01/16) were provided via hard copy.the state’s words, verbatim · CDSS document, Jun 30, 2022

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Dang Nguyen and Rebecca Ruiz conducted an unannounced Required 1 - Year Visit. The facility file was reviewed prior to the visit. LPAs were greeted by, identified themselves to, and explained the purpose of the visit to House Manager Maria Flores. Administrator Jeffrey Settineri arrived later during the visit. All staff present have a current criminal record clearance. LPAs conducted a brief tour of the facility, both inside and outside, and observed the clients in care. In accordance with the Department’s Infection Control, LPAs provided technical assistance and 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 Administrator Jeffrey Settineri, to whom a copy of this report and the licensee appeal rights (LIC9058 01/16) were provided via E-mail.the state’s words, verbatim · CDSS document, Jul 26, 2021