Mariner's Green Residential Care

Type of visit: Required - 1 Year

On October 3, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual visit. LPA met with Caregiver, Mely Garland and Andres Cortez and explained the purpose of the visit. Administrator, Carlito Guevarra joined shortly thereafter. LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. LPA observed living room and dining room to be clean and free from tripping hazards. During this time, residents were sleeping or lying down. Lighting was sufficient and a comfortable temperature of 70 degrees F was maintained. Water temperature throughout the facility bathrooms measured between 144.8- 152.9 degrees F. Bathrooms were equipped with grab bars and non-skid mats. Carbon monoxide monitors are working properly. LPA toured the facility kitchen. Water temperature measured at 124.7 degrees F. LPA observed there were sufficient two 2 day supply of perishable and seven 7 day supply of non-perishable food present. During the tour LPA observed an expired gallon of milk in the fridge dated 10/1/2023. Chemicals, sharps and medications were observed to be locked an inaccessible to residents. First aid kit was present. Extra linen was observed to be present. Washer and dryer was observed to be in good working condition. During the visit LPA reviewed 6 resident files and 4 staff files. All were observed to be current and up to date. Staff records are complete with training logs. During resident record review, LPA observed Resident 1's (R1's) physician report to indicate that R1 is allergic to dairy. According to staff interviewed, R1 was provided with cereal for breakfast this morning. According to the administrator, he believes R1 is only allergic to yogurt and sour cream and will confirm with R1's physician and DPOA. Deficiency of the Residential Care Elderly California Code of Regulations, Title 22, Division 6 is observed and cited on a LIC 809D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with Administrator and a copy is provided with the appeals rights.the state’s words, verbatim · CDSS document, Oct 3, 2023

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Allegation investigated: Staff administering supplements to resident without the permission of the resident's authorization representative

On July 18, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced complaint visit to deliver the findings for the above allegation. LPA met with Caregiver, Mely Garland and explained the purpose of the visit. Regarding the allegation that staff are administering supplements to resident without the permission of the resident's authorized representative, according to the complainant, it was indicated that the facility serves a "cloudy" like liquid to residents and is unsure if the facility got authorization from residents family members. During the investigation, LPA interviewed staff and the administrator and it was indicated that the facility gives residents a liquid drink to take as a supplement to boost their immune system. According to the Administrator, he got verbal consent from 5 of the resident's responsible parties to administer the liquid drink to residents, however the Administrator admitted to not asking or receiving consent from a resident's (R1's) responsible party prior to administering the liquid drink. Based on the information collected and interviews conducted. It was determined that staff are administering supplements to resident without the permission of the resident's authorization representative. The preponderance of evidence standard has been met, therefore the above allegation is determined to be Substantiated. Deficiency of the Residential Care Elderly California Code of Regulations, Title 22, Division 6 is observed and cited on a LIC 9099D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with Caregiver, Mely Garland and a copy is provided. Substantiatedthe state’s words, verbatim · CDSS document, Jul 18, 2022 · control 14-AS-20220711133013

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(8) · Plan of correction due date: Jul 25, 2022

87468.1 Personal Rights of Residents in All Facilities: (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (8) To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs. Violation of this regulation is not met as evidenced by: Based on the interviews conducted, the Administrator admitted to not asking or receiving consent from a resident's (R1's) responsible party prior to administering a liquid drink to take as a supplement. consent from R1's responsible party which poses a potential health and safety risks to residents in care.the state’s words, verbatim · CDSS document, Jul 18, 2022

Plan of correction: Facility will request both written and verbal consent from resident's responsible party to all facility to administer the liquid drink to resident and put it in resident's files.

Type of visit: Case Management - Deficiencies

On July 18, 2022, Licensing Program Analyst (LPA) conducted an unannounced case management visit. LPA met with Caregiver, Mely Garland and explained the purpose of the visit. During the investigation of complaint control number; 14-AS-20220711133013, interviewed staff indicated that the facility did not consult with the resident’s physician’s prior to administering a fluid that was used as a supplement. According to the administrator, he was not aware that the facility had to consult with the physician prior to administering this liquid drink. Deficiency of the Residential Care Elderly California Code of Regulations, Title 22, Division 6 is observed and cited on a LIC 809D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with Caregiver, Mely Garland and a copy is provided with the appeals rights.the state’s words, verbatim · CDSS document, Jul 18, 2022

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(e) · Plan of correction due date: Jul 25, 2022

87465 Incidental Medical and Dental Care: (e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank, maintained in the residents file... Violation of this regulation is not met as evidenced by: Based on the interviews conducted, the Administrator admitted to administering R1 fluids without a consent from R1's responsible party which poses a potential health and safety risks to residents in care.the state’s words, verbatim · CDSS document, Jul 18, 2022

Plan of correction: Facility to consult with all resident's physician ensuring residents are able to take the liquid drink as a supplement without any complications. Facility will obtain a written order from all physicians and maintain it in resident files.

Type of visit: Required - 1 Year

On March 18, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual infection control inspection. LPA was greeted by Caregiver, Mely Garland and explained the purpose of the visit. LPA was screened at entry point and the Caregiver was able to provide screening log documentation for residents, staff and visitors. Upon arrival, LPA observed COVID signage on the front door but LPA discussed the need to add more reminder signage (masking, COVID symptoms, social distancing, cough etiquette) on the front door. LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. Infection control practices are present: entry procedures, daily monitoring for residents and staff, and 30-day PPE supply. LPA observed the COVID signage posted throughout the facility. This is a single story with 7 bedrooms (6 private rooms for residents and 1 staff room), 2 full and 4 half bathroom. It is noted that the facility floor plan that was received by CCLD on June 28, 2000, shows a staff room (Room #6). LPA observed the staff room to have a built in structure to accommodate two separate private bedrooms. A new fire clearance will be needed. LPA observed the bathrooms to be equipped with liquid hand soap, hand washing signs, and covered trash cans. LPA Charitra indicated that hand-towels and bath-towels should not be present in the bathrooms. LPA toured the kitchen and advised caregiver to switch out hand-towels for paper-towels and disinfectant wipes. LPA observed 2 day perishable and 7 day non-perishable. Medications, toxins and sharps are stored appropriately and inaccessible to residents, and a comfortable temperature is maintained, lighting is sufficient for comfort. First aid kit was observed to be completed. During the visit LPA observed 3 residents maintaining social distancing while watching television in the living room. LPA requests for the following to be sent to CCLD by 3/25/22: LIC308 Designation of Administrative Organization LIC500 Personnel Report Administrator Certificate LIC610D Emergency Disaster Plan New facility floor plan No citations will be issued during this visit. Report reviewed with Caregiver and a copy will be provided.the state’s words, verbatim · CDSS document, Mar 18, 2022