Huntington Chateau

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced case management - annual continuation visit. LPA was greeted by, identified herself to, and explained the purpose of the visit to Licensee Philip Butzen. During today's visit, LPA observed residents in care and toured the facility LPA reviewed multiple resident and staff records. Each resident record was complete and contained a signed admission agreement, updated physician’s report and medical assessment, documents regarding safeguarding personal property, and personal rights. Each staff file was complete and contained a personnel record, first aid certificate, fingerprint clearance and association, and a health screening. The facility’s water temperature was measured at 105.3 degrees Fahrenheit in non-private bathroom and 106.5 degrees Fahrenheit in a private resident bathroom. LPA provided the Licensee with technical assistance regarding the facility's emergency disaster plan and the Infection Control plan. The Licensee will submit a copy of their current liability insurance to the Department. No deficiencies were cited on today’s date. An exit interview was conducted with Licensee Philip Butzen, whose signature below confirms receipt of a copy of this report, two LIC9102TA forms, and the Licensee Appeal Rights (LIC9058 01/16).the state’s words, verbatim · CDSS document, Oct 27, 2023

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 greeted by, identified herself to, and explained the purpose of the visit with Licensee Philip Butzen. The facility is licensed for a maximum capacity of 6 residents, all of which may be bedridden. The facility has a waiver for 6 hospice residents. During today’s visit, the facility had a census of 4 residents, 2 of which were bedridden and receiving hospice services, 1 was non-ambulatory, and 1 was ambulatory. The facility does not have a clearance for delayed egress or secured perimeter and LPA did not observe any aspects of delayed egress or secured perimeter. The Administrator for the facility is Lyndon Derafera and their certificate was valid and current. During today’s visit, LPA toured the facility and inspected each room of the facility, including resident rooms, bathrooms for resident and staff use, kitchen, garage, common areas, and outside space. The facility has a swimming pool on the premises that is located down a flight of stairs. During today's visit, LPA observed two sections of the fence surrounding the pool had been removed, resulting in the swimming pool being unsecured. Per the Licensee, the fence had been removed approximately 3 months ago. A deficiency and an immediate civil penalty of $500 was assessed during today's visit. According to the Licensee, no firearms or weapons are stored on the premises. The facility was found to be clean, safe, and in good repair with no pathway obstructions. LPA observed locked storage for all hazardous and/or toxic chemicals and were stored separately from food supplies. Continued on LIC809-C page... LPA observed a 2-day supply of perishable food and a 7-day supply of non-perishable food present at the facility. LPA observed linens and hygiene products provided to the residents that are in good repair and sufficient to meet their needs. Staff present at the facility during the time of the inspection had a criminal background clearance. Due to time constraints, the LPA was unable to complete the Required-1 year inspection during today's visit and an annual continuation will be conducted at a later date. The following deficiency is cited per CA Code of Regulations Title 22 and noted on the attached LIC809-D page. The $500 civil penalty was noted on the LIC421IM form. An exit interview was conducted with Licensee Philip Butzen, whose signature below confirms receipt of a copy of this report, the LIC421IM, and the Licensee Appeal Rights (LIC9058 01/16).the state’s words, verbatim · CDSS document, Oct 19, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Esther Miller conducted an unannounced annual required inspection on today's date. LPA was greeted at the front door and granted entry by Nick Delacruz, caregiver, after identifying herself and disclosing the purpose of the visit. An overall tour of the facility was conducted. The inspection included, but was not limited to, verifying compliance with statutes, regulations and other requirements most relevant to protecting the health of residents in care and staff, including in the area of infection control practices. Administrator Lyndon Derafera arrived after the tour. LPA reviewed with Administrator the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report (LIC808) including the following sections: Persons in Care, Staff, Visitors, Facilities without COVID-19, Residents, Facility 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 most staff; hand sanitizer/hand washing stations readily available; a designated visitation area; and an adequate supply of PPE (Personal Protective Equipment). Based on observations, the facility is in compliance with and has implemented infection control practices as outlined in its LIC808. A technical assistance was given during today's visit for mask wearing. An exit interview was conducted with Administrator and a copy of this report along with Licensee/Appeal Rights (LIC9058) were provided.the state’s words, verbatim · CDSS document, Oct 11, 2022

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Dawn Segura visited the facility to conduct an annual required licensing inspection. LPA was granted entry into the facility and met with Lyndon Derafera, Administrator, with whom she discussed the purpose of the visit. During today's visit, LPA toured the facility and verified compliance with infection control practices. LPA and Administrator reviewed the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation. 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 in the facility to promote hand hygiene and cough/sneeze etiquette; hand sanitizer/hand washing stations readily available; available visitation areas; emergency agencies’ contact information visible to staff; and an adequate supply of cleaning products and PPE. Upon arrival, LPA observed that staff were not wearing face coverings; however, later during the visit, staff were observed wearing appropriate face coverings. No deficiencies were cited during today’s visit. An exit interview was conducted with Lyndon Derafera, Administrator, and a copy of this report and Licensee Rights (LIC 9058 FAS 01/16) were provided to the administrator via email following the visit. An electronic receipt of confirmation was requested to be sent to LPA upon receipt of the documents.the state’s words, verbatim · CDSS document, Aug 16, 2021