Hope Assisted Living

Allegation investigated: Staff were not present at the facility for an extended period of time.

At 10:00am on 09/22/2023, Licensing Program Analyst (LPA) Jeffries arrived at the facility to conduct the initial investigation to the allegation above to this complaint. LPA met with Licensee Janelyn Castaniaga, announced who he was and the reason for the visit. As to the allegation of, "Staff were not present at the facility for an extended period of time." It was alleged that on 09/20/2023 at approximately 5:00 PM, residents of the facility were discovered be alone in the facility when staff were not present. A reliable witness (W1) reported that upon entering the facility, they searched for staff and staff were not present. W1 searched each room of the facility and discovered that five Residents (R2-R6) were left in their beds when there were no staff present at the facility. On 09/22/2023, at 10:41am, LPA Jeffries interview facility Licensee/Administrator, Licensee stated that Staff 1 (S1) stated that they left the facility to go on a personal errand to Walmart and did not notify other caregivers, resulting in staff not being present at the facility. At 11:08am on 09/22/2023, LPA Jeffries interviewed S1, S1 stated that, in the late afternoon (approximately 5:00pm), S1 left the facility and went to Walmart for personal medical supplies. CONTINUED on LIC9099C Substantiated When S1 returned to the facility there was a Paramedic and R1 at the facility. Paramedic was retuning R1 from the hospital emergency room. LPA reviewed R1-R6 LIC602 (Physician Reports) which indicated that 4 of 6 residents have a diagnosis of Dementia/Alzheimer disease and two residents have mild cognitive impairment. Based on admission, interviews, documentation and a creditable witness, the allegation of, "Staff were not present at the facility for an extended period of time" and is substantiated at this time. Exit interview, citation issued, fine assessed, report read, report and appeal rights provided.the state’s words, verbatim · CDSS document, Sep 22, 2023 · control 29-AS-20230921143833

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(f)(1) · Plan of correction due date: Sep 25, 2023

(f)Basic services shall at a minimum include:(1)Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidenced by: Based on interviews, admission, documentation and creditable witness the licensee did not comply with the regulation above in that 5 residents were left alone without care and supervision for up to an hour which posed an immediate Health, Safety and Personal Rights risk to residents in care.the state’s words, verbatim · CDSS document, Sep 22, 2023

Plan of correction: Licensee agreed to review regulation 87464, write a statement of understanding on how the facility will prevent this from occurring again, provide an LIC 500 for staff, submit an incident report to the CCL and notify all residents responsible parties of the incident. Civil Penalty Assessed.

Type of visit: Case Management - Other

At 10:40am on 07/06/2023, Licensing Program Analyst (LPA) Jeffries arrived at the facility unannounced to conduct a Case Management visit. LPA met with Primary Care Giver, Lizeth Tunac announced who he was and the reason for the visit. On 07/03/2023 and 07/05/2023, LPA called the facilities main number in response to a transfer request that was denied for a new employee, left two voice messages for call back on both numbers CCLD had for the facility. However, no call back was conducted and prompted this visit. LPA arrived today to ensure that denied employee was not working and that the telephone service for the residents is in compliance with regulations (87311). LPA requested LIC 500 and checked the three current employees working at the facility on this visit, they are all cleared and the denied transfer request employee was not present at the facility and S1 stated that the denied transfer request employee has not started working as of this visit. LPA check facility's phone and facilities phone is working for residents use according to regulation 87311. The facility phone number is (805) 296-7930. LPA advised S1 to have Licensee/Administrator to email LPA to change the phone number to the facility officially. LPA is issuing a technical assistance for the phone number change.the state’s words, verbatim · CDSS document, Jul 6, 2023

Type of visit: Required - 1 Year

At 9:00am on 11/10/2022, Licensing Program Analyst (LPA) Jeffries arrived at the facility unannounced to conduct the annual infection control inspection. LPA was properly screen for infection control mitigation upon entrance to the facility. LPA met with House Lead Care Giver Lizeth Tunac (S1) and announced who he was and the reason for the visit. S1 called Licensee Janelyn Castaniaga and acknowledged that S1 could conduct annual infection control visit and sing for the visit. LPA observed that S1 has an Administrators certificate but is not the designated Administrator of this facility. S1 and LPA conducted a cursory tour of the facility. LPA noted that the facility has 6 resident bedrooms and 3 bathrooms on the first floor, 4 rooms are single resident occupancy. There are two large living rooms, kitchen, dining room and and outdoor area in the back. There is a locked laundry room on the first floor where chemicals and medications are locked and stored. LPA observed at least seven days of perishable and at least two days of non-perishable foods on hand at the facility. LPA observed fire extinguisher to be in the green and stamped current. LPA observed a 30 day supply of PPE on hand and 30 days of incontinence supplies on hand at this facility. LPA observed liquid soap and paper towels in all the facility bathrooms. LPA noted that there was no emergency disaster plan posted and no Provider Information Notice (PIN's) that were easily accessible when requested. LPA noted that there were no other visible violations observed during the cursory tour of the facility. LPA issued a Technical Assistance violation for the Emergency disaster plan and the PINs not being accessible. Licensee will print PINs and make them accessible and post Emergency Disaster Plan immediately. S1 and LPA conducted infection control module of the annual inspection. Two violations noted above are cited. Exit interview, two Technical Assistance violation issued, report signed, and report emailed.the state’s words, verbatim · CDSS document, Nov 10, 2022

The state marks this report as 5 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Allegation investigated: Facility is dirty.

Licensing Program Analyst (LPA) Olson conducted an unannounced 10-day complaint investigation visit to the facility above. LPA met with Janelyn Castaniaga, Administrator, and explained the purpose of the visit. LPA toured the facility at 10:20am. On the Allegation: Facility is dirty. A credible witness (W1) stated on 4/25/2022, the kitchen apeared dirty. On 4/28/22 LPA observed resident rooms were clean. LPA observed the range hood to be full of dirt, dust bunnies, and grease; observed cobwebs above the kitchen cupboards up to the ceiling; kitchen cupboards and kitchen refrigerator had spilled food in them. LPA also observed the kitchen floor was dirty. Based on the evidence this allegation is deemed Substantiated at this time. Exit interview, deficiency cited on 9099-D, report emailed, appeal rights given. Substantiated The administrator showed LPA their phone with pictures that are date and timestamped. The photos are from 4/25/2022 at 8:56am, and show at least 24 cans of fruit, and several large cans of vegetables. The receipt the administrator provided is dated 4/25/2022 at 6:47pm and indicates oranges, bananas, apples, watermelon, cabbage, carrots, and apples were purchased. Based on the information obtained, the supply of food was of the quality and variety to meet the dietary needs of the residents daily. Therefore the allegation is deemed unsubstantiated at this time. Exit interview, report emailed.the state’s words, verbatim · CDSS document, Apr 28, 2022 · control 29-AS-20220426121302

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: May 2, 2022

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times...This requirement was not met as evidenced by: Based on Observations the licensee did not comply with the above, Facility was not clean, or sanitary which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 28, 2022

Plan of correction: Administrator agreed to clean and disinfect the entire area and provide a video or photos of the cleaned facility to CCL by 5/2/22.

Type of visit: Required - 1 Year

At 11:01 am, on 1/28/2022, Licensing Program Analyst (LPA) Darlene Chavez conducted an unannounced annual infection control inspection of the facility above. LPA met with Staff #1 (S1) and explained the reason for the visit. LPA and S1 toured the facility. At 11:37 am, Licensee/Administrator Janelyn Castaniaga, arrived at the facility and LPA explained the reason for the visit. LPA’s initial tour of the facility resulted in observations which were immediately corrected. LPA was screened upon entry to the facility by staff. Licensee has agreed to ensure all staff are fit tested for N95 respirators and provide a certification and staff sign-in sheet. At 11:31 am, LPA observed live-in family member not wearing a mask while washing dishes. Upon finishing the dishes, family member placed a mask on. Staff #2 (S2) was observed wearing a mask below the nose. LPA instructed S2 to pull S2’s mask up and explained the importance of having a secure mask while working with residents in care. S2 immediately pulled up the mask. At 11:12 am, the kitchen water temperature was recorded at 136.4 F, and between 11:12 am and 11:27 am, the bathrooms’ water temperatures were recorded at: bathroom #1 at 135.7 F, bathroom #2 at 108 F, bathroom #3 at 107 F, and bathroom #4 at 106.8 F. The facility failed to protect the personal rights of residents in care to be able to receive safe and healthful accommodations in that the facility’s water temperatures were recorded beyond 120 F degrees in the kitchen and one bathroom. This is a violation of CCR regulations. Pursuant to Title 22, California Code of Regulations, the deficiency will be cited on 809-D. At 11:50 am, LPA conducted the Infection Control mitigation module with the licensee. Exit interview conducted, deficiency cited, and report and Appeal Rights emailed to the licensee.the state’s words, verbatim · CDSS document, Jan 28, 2022