Tender Loving Care Home for Elderly

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA Lopez identified herself, was granted entry by Administrator Lauretta Bordon. LPA discussed the purpose of the visit with Administrator Bordon. According to the facility’s license, there may be a maximum of four (4) non-ambulatory residents at any given time at the facility site. During today’s inspection, the facility’s current census is three (3) residents living at the facility; one (1) client was present at the facility site during the inspection. The facility is undergoing a change of facility status to change residents served to clients. LPA, accompanied by the Administrator, 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. Residents bedrooms contained the required furnishings. Doors, windows, 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 activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present. Cooking, dining equipment and utensils were present and safely stored. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in a locked cabinet. No pools or bodies of water on the premises. Per licensee, 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. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] LPA reviewed staff and client records/files. During today’s visit, all clients were off-site at a day program but there was one resident who was interviewed. LPA observations of the facility and records did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in locked areas. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Administrator Lauretta Bordon to whom a copy of this report along with the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. The signature below confirms the documents were received. LPA requested Administrator Bordon to submit a current Designation of Administrative Responsibility LIC 308, Personnel Report LIC 500 and Emergency Disaster Plan LIC 610-E to the licensing office within 10 business days. Forms available at www.ccld.ca.gov.the state’s words, verbatim · CDSS document, Oct 16, 2023

Allegation investigated: - Licensee did not allow resident to wear their own clothes - Licensee did not allow resident to retain their personal belongings

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to open a complaint investigation. While at the facility LPA investigated and delivered findings regarding the above-mentioned allegations. LPA identified herself and was granted entry by Lauretta Bordon, Licensee. LPA stated the purpose of the visit and reviewed the findings of the complaint with Licensee Bordon. The Department’s investigation consisted of interviews with staff, resident, and an outside source, records review of relevant documents pertinent to this investigation, and LPA observations. On July 31, 2023, it was alleged that the Licensee did not allow resident to wear their own clothing; and they did not allow resident to retain their personal belongings. It was specifically alleged that the licensee did not want to have the resident wear their own personal clothing and opted to donate old clothing and purchase new clothing for resident without their consent. Interview with Licensee said that they have accepted three new admissions under an emergency placement from a third-party agency. Unsubstantiated When they accepted the new residents, each resident was able to retrieve at least two weeks of clothing from their former facility to take with them. If they did not have a needed item, the Licensee was able to purchase the items needed until the residents retrieved their clothing. According to the Licensee, they had two trash bags with donation items that had a few clothing items but disclosed that Resident #1 (R1) and Resident #2 (R2) did not have any items to donate. All the items being donated belonged to another resident, resident #3 (R3). A brief interview with resident #1 (R1) said that they were happy with their attire. Interview with an outside source did not have any immediate concerns as the residents had just arrived at the facility. A review of records revealed that R1 is excellent at advocating their wants and has the ability to speak full sentences and has no problem with communicating. On August 08, 2023, LPA toured the facility and observed that each of the residents’ clothing items were organized in their closet or drawers. The residents clothing items varied in appearance from newer to older items. It was specifically alleged that the resident’s personal belongings were not allowed into the facility when the resident transitioned into the facility. Interview with Licensee said that as it was an immediate move the residents were unable to take all of their belongings with them, but they were able to take some personal items with them prior to departing from their former facility. A resident’s family member was able move the last of the residents’ belongings from the former facility and take it to the new facility on August 5, 2023. From their move, the residents had two bags of donation items with books, purses, shoes, etc., that R3 opted to donate. R1 and R2 opted to keep all their belongings and had no items for donation. According to Licensee, R1 stored kept items in their closet. Interview with R1 regarding belongings was attempted, but R1 did not want to respond. Interview with an outside source had no immediate concerns. A review of records revealed that R1 is excellent at advocating their wants and has no problem with communicating their needs. On August 08, 2023, LPA toured the facility and observed that the residents’ personal belongings were organized in their room area or stored in their closet with their name labeling their bins. Based on the Department’s investigation of the above-mentioned allegations and the evidence obtained during staff and outside source interviews, records reviewed, and LPA observations, there is insufficient evidence to meet the preponderance of evidence standard. Therefore, the above allegations are deemed to be unsubstantiated. The report was discussed, and an exit interview was conducted with Licensee Lauretta Bordon. A copy of this report along with Licensee/Appeal Rights (LIC9058 3/22) were provided to Licensee Bordon at the conclusion of the visit. The signature below confirms the receipt of these documents.the state’s words, verbatim · CDSS document, Aug 8, 2023 · control 08-AS-20230731112119

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Carmen Lopez made an unannounced visit to the facility to conduct an annual required licensing inspection. LPA identified herself and was granted entry by Lauretta Bordon, Licensee, and discussed the purpose of today’s visit. A tour of the facility was conducted inside and out. LPA accompanied by Licensee Bordon conducted a general overall inspection, with specific focus on infection control protocols. During today's inspection LPA observations include the following: Symptom screening procedures for staff, residents and visitors; posted signs regarding visitor policy, promoting hand washing/hand hygiene practices, cough and sneeze etiquette and other infection control procedures; testing plan and procedures for staff and clients; plans for containing infections, PPE supplies procedures and training; and disinfection procedures. LPA provided updated guidance with current PINs for Resident Cohorting, Isolation and Quarantine, Staffing and Use of Personal Protective Equipment Based on Resident Coronavirus Disease 2019 (COVID-19) Status; Best Practices for Visitation Related to Coronavirus Disease 2019 (COVID-19) and the Recession of the Statewide Visitation Waiver; Updated Adult and Senior Care Facility Worker Coronavirus Disease 2019 (COVID-19) Vaccination, Booster, and Testing Information; and California Department of Public Health (CDPH) Recommendations for Coronavirus 2019 (COVID-19) Vaccines and Updated Booster Doses. Based on today’s inspection, no deficiencies were observed. An exit interview was conducted with Licensee Bordon, and Administrator Collen Bordon. A copy of this report, along with the Licensee Rights (3/22) was provided to Licensee Bordon at the conclusion of the visit. The signature below serves as confirmation of receipt of these documents. LPA requested for Licensee and Administrator Bordon to submit a current Designation of Administrative Responsibility LIC 308, Personnel Report LIC 500 and Emergency Disaster Plan LIC 610-E to the licensing office within 10 business days. Forms available at www.ccld.ca.gov.the state’s words, verbatim · CDSS document, Oct 12, 2022

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Carmen Lopez made an unannounced visit to the facility to conduct an annual required licensing inspection and in conjunction conducted a case management visit to and gave the facility additional guidance. LPA identified herself and was granted entry by Licensee Lauretta Bordon. LPA met Lauretta Bordon, and discussed the purpose of today’s visit. During today’s visit LPA went over Title 22, Division 6, Chapter 8, Section 87211 Reporting Requirements; and Chapter 3.2 Health and Safety (H&S) Code Regulations Section 1507.15 Absentee notification plan for missing residents or participants; and H&S code Section 1569.317 Absentee notification plan for missing residents with Licensee Bordon and Administrator Colleen Bordon. LPA additionally provided Licensee Bordon guidance on Records to be Maintained at the Facility – Residential Care Facility for the Elderly (LIC311F) and provided a copy of the LIC311F. Based on today’s inspection no deficiencies were cited. An exit interview was conducted with Licensee Bordon and Administrator Colleen Bordon. A copy of this report, along with the Licensee Rights (03/22) was provided to Licensee Bordon at the conclusion of the visit. The signature below serves as confirmation of receipt of these documents.the state’s words, verbatim · CDSS document, Oct 12, 2022

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Carmen Lopez and County of San Diego Nurse Contractor, Robert Montillano with the HAI Program, conducted an on-site HAI assessment visit. LPA and team identified themselves and discussed the purpose of the visit with Licensee Lauretta Bordon, and Melanie Miranda, volunteer care staff. The Department conducted an on-site visit to provide technical assistance and to evaluate the facility's mitigation plan on the COVID-19 protocols and procedures to include cleaning and disinfection, testing, isolation and quarantine, hand hygiene and screening protocols as well as the use of personal protective equipment (PPE). During today's visit, the team interviewed the Licensee and conducted a walk-though of the facility. A debriefing was conducted with the Licensee at the conclusion of the visit. During today's visit, no deficiencies were cited. An exit interview was conducted with Melanie Miranda, volunteer care staff and Licensee Lauretta Bordon to whom a copy of this report, along with Licensee Rights (LIC 9058 01/16), were provided at the conclusion of the visit. The signature below serves as confirmation of receipt of the documents.the state’s words, verbatim · CDSS document, Jul 1, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Lizzette Tellez visited the facility to conduct an annual required licensing inspection. LPA met with Licensee/Administrator, Lauretta Bordon, and discussed the purpose of the visit. During today's visit, LPA toured the facility, and verified compliance with infection control practices. LPA and Ms. Bordon reviewed the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report. 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 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 cleaning products and PPE. No deficiencies were cited during today’s visit. An exit interview was conducted with Ms. Bordon, and a copy of this report, along with the Licensee Rights (LIC 9058 FAS 01/16) were provided to them via email. An electronic receipt of confirmation was requested to be sent by the Administrator upon receipt of the documents.the state’s words, verbatim · CDSS document, Oct 25, 2021