Life Pastiche

Type of visit: Required - 1 Year

LPA Hiratsuka, conducted this unannounced annual visit. LPA wore a surgical mask and observed staff wearing them. Sophia Johnson and Christian Fisher arrived at the facility and completed the visit along with Administrator Rhonda Johnson. This facility has five resident rooms; one shared and four private. There are two common bathrooms and one private bathroom. The dining and kitchen area is separate from the sitting area. There is a detached two car garage. Multiple topics were discussed. No deficiencies cited.the state’s words, verbatim · CDSS document, Mar 21, 2023

Allegation investigated: Financial Abuse

On 07/29/2022 Licensing Program Analyst (LPA) Misty Valencia arrive for a visit to deliver findings regarding Financial Abuse as directed by the Department. LPA met with Rhonada Johnson, Administrator and explained the reason for the visit is to deliver complaint findings. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted Administrator and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical masks. Additionally, LPA was screened by staff at the front door. Financial Abuse continued on 9099-C Substantiated Throughout the course of the investigation the department conducted interviews, reviewed documentation, and observed residents in care. Licensing Program Analyst (LPA) Misty Valencia’s review of the Trust Audit Report that was conducted by the Department’s Audits Section, revealed the department was able to substantiate Financial Abuse allegation. On 11/15/2021 the Chico office received a complaint regarding financial abuse of a caregiver, reporting that $8,000 was given to the caregiver, (S1). On 12/28/2021 LPA received a phone call from S1, perpetrator of financial abuse asking LPA if she could go back to work at the facility. LPA interviewed S1 and S1 reported that she has received about seven (7) checks from resident totaling around $2,000. Audit section received a trust audit request from Sacramento North Adult and Senior Care Regional Office. The licensee is Rhonda Johnson. LPA, Dawn Keane received the SOC 341 via email. Report states that S1 is a caregiver in the facility where resident, (R1) lives. Over a period of two years, S1 has accepted money from R1. The situation was without R1’s daughter’s knowledge and when R1’s daughter asked S1 about it, S1 said she has turned down money on multiple occasions, but upon R1’s insistence S1 accepted R1’s money multiple times over the years. R1 has lived at Life Pastiche since 2017, and for the last three years S1 has been one of his caregivers. On 12/28/2021, S1 called LPA and asked if she could go back to work at the facility. LPA asked S1 to explain the situation. S1 stated that R1 has offered her money for her bills for several years. S1 reported that about a year ago she started accepting money from R1 in the form of checks. S1 stated that she received approximately seven (7) checks totaling around $2,000. S1 also reported that she tried to pay the money back to R1, but R1 refused, and R1 didn’t want to press charges. R1, 88 years old, was admitted to Life Pastiche on 6/22/2017. The monthly private pay rate for basic service is $4,000 and an additional service charge $75 for transport to the appointments. R1 does not have a diagnosis of mild cognitive impairment or dementia, but has motor impairment and used a walker. R1 is responsible for himself, handles his own financial affairs and pays his rent every month with a check. When admitted R1 was able to manage his own cash resources but by 4/13/2018 his daughter became the Power of Attorney (POA). R1’s wife, was admitted to Life Pastiche at the same time and passed away on 4/3/2018 at the facility. The cause of death was kidney failure. R1’s POA, described in an email dated 2/9/22 that R1 has a checking account. The account is a joint account with R1’s POA’s name on it. On 11/5/2021, R1’s POA and R1 went to the bank and saw a lot of Door Dash Charges, ATM withdrawals, checks and unusual charges on R1’s checking account printout for the months of September & October/2021. R1 did not know anything about these charges. R1’s POA questioned the care worker if R1 received door dash food. They said no. There were multiple checks made out to S1. R1’s POA didn’t think that R1 should be giving S1 checks and immediately requested the bank cancel R1’s debit card. The Department obtained copies of R1’s monthly bank statements, cancelled checks and video surveillance for ATM cash withdraws for the period from January 2019 up to current. Based on bank records reviewed, the following information was obtained: Bank Statements The bank statements showed there were multiple check transactions, ATM withdrawals and numerous food delivery charges for different restaurants. The cancelled checks were reviewed and showed that there were seventeen (17) checks made out to S1, totaling $10,100 for the period from March 2020 to October 2021. The memo line noted the payments were for loan, X-Mas or help. ATM Cash Withdraw Bank video surveillance captured three (3) images for ATM cash withdraws. -On 9/28/2021 at 8:24 p.m. a woman and a man used R1’s debit card to pull out cash for $400 via ATM machine located in Redding, CA. The Licensee was able to identify the individuals using the ATM machine, as shown in the video surveillance, as S1’s daughter and her boyfriend. -On 9/30/2021 at 7:26 p.m. a woman used R1’s debit card to pull out cash for $500 via ATM machine located in Redding CA. The Licensee was able to identify the individual using the ATM machine, as shown in the video surveillance, as S1’s daughter -On 10/28/2021 at 6:38 p.m. a woman drove-up to an ATM located in Redding, CA and pulled out $500. S1 not only obtained and used R1’s debit card to pull out cash for herself but also let her daughter, use R1’s debit card to pull out cash as well. Food Delivery Charges There were numerous food delivery charges from an outside food delivery company totaling $3,512.81 as shown on the R1’s bank statement, with multiple food order charges on the same day. The Department obtained records identifying customer information, including the name of the person who ordered the food and the address where the food was delivered. These records confirmed that S1’s daughter had ordered food deliveries to her home address in Redding, CA 96002 and that S1 gave her daughter R1’s debit card and allowed her to use it make various online food purchases. The Department reviewed R1’s bank statements, cancelled checks, bank video surveillance and food delivery charges information. There were multiple checks made out to S1 totaling $10,100. Both S1 and S1’s daughter used R1’s debit card to withdraw cash via ATM for their personal financial gain. The Department reviewed R1’s admission agreement, physician’s report, cancelled checks, bank statements, bank surveillance, and an outside food delivery service account information, which confirmed S1 received $10,100 from R1 by checks for the period from March 2020 to October 2021. S1 and S1’s daughter not only obtained R1’s debit card, but also used R1’s debit card to pull out cash via ATM for their personal financial gain. S1’s daughter linked R1’s debit card to her personal outside food delivery service account making numerous online food purchases, totaling $3,512.81 for the period from December 2020 to November 2021, and food was delivered to S1’s daughter’s home address. Due to the Licensee’s failure to exercise administrator’s duty and lack of internal supervision resulting in R1’s financial loss, the allegation that “Staff (S1) financially abused resident (R1)” is substantiated. Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D. Plan of correction (POC) were discussed. Appeal rights were provided and exit interview conducted Exit interview conducted, report and appeal rights emailed to Administrator.the state’s words, verbatim · CDSS document, Jul 29, 2022 · control 25-AS-20211115125538

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87205(a) · Plan of correction due date: Aug 1, 2022

Accountability of Licensee Governing Body (a)The licensee, whether an individual or other entity, shall exercise general supervision over the affairs of the licensed facility and establish policies concerning its operation in conformance with these regulations... This requirement is not met as evidenced by: based on The licensee did not exercise internal supervision over the affairs of the facility which lead to staff financially abusing a resident for a year and a half. This poses an immediate Health, Safety and Personal Rights risk to clients in carethe state’s words, verbatim · CDSS document, Jul 29, 2022

Plan of correction: Licensee agree to reimburse R1, for $13,612.81 ($10,100 + $3,512.81) Licensee is to provide the Regional Office proof of payment made to R1’s or a payment plan by 08/01/2022.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(a)(8) · Plan of correction due date: Aug 2, 2022

Additional Personal Rights of Residents in Privately Operated Facilities (a)(8) To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement is not met as evidenced by: based on The licensee did not protect R1 from S1's financial abuse for over a year. This poses an immediate Health, Safety and Personal Rights risk to clients in care.the state’s words, verbatim · CDSS document, Jul 29, 2022

Plan of correction: POC already completed. licensee has new hires sign a policy regarding taking gifts from residents in care.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87405(h)(5) · Plan of correction due date: Aug 1, 2022

Administrator - Qualifications and Duties (h)(5) Provide or ensure the provision of services to the residents with appropriate regard for the residents' physical and mental well-being and needs This requirement is not met as evidenced by: based on Adminitrator did not provide supervision and security regarding one of one (1 of 1) residents financial property. This poses an immediate Health, Safety and Personal Rights risk to clients in carethe state’s words, verbatim · CDSS document, Jul 29, 2022

Plan of correction: Licensee agrees to read Regulation 87405(h)(5) and sign a statement that it is understood and provide that statement to the department by 08/01/2022.

Type of visit: Case Management - Other

On 4/21/22 at 10:45 a.m., Dawn Keane, Licensing Program Analyst (LPA) and Jacqueline Juarez, Audit Manager (AM) arrived at the facility unannounced to conduct a case management visit to copy facility files for an ongoing investigation. LPA Keane met with care giver Care Giver (CG), Joann Jetton who was not wearing a mask. LPA informed CG that masks are required for all staff at this time. LPA informed CG that when LPA last visited, staff was not wearing masks. Technical advice has been given twice to facility for not wearing masks as required. LPA Keane completed the required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID 19 infection to affirm no COVID-19 related symptoms. The administrator was contacted to complete a facility risk assessment, but the phone's voice mail was full LPA Keane and AM ensured that hand sanitizer was applied before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA Keane was screened at the front door by staff. During today’s inspection, the Administrator was not available to come to the facility. It has been noted during other on site inspections that the Administrator is not present and/or available. LPM L. Munoz contacted the Administrator today, 4/21/22, who stated her daughter is the designated substitute however is also not available. At this time, the facility does not have a designated substitute Administrator as required. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. An exit interview was conducted, and a copy of the report was given to CG.the state’s words, verbatim · CDSS document, Apr 21, 2022

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87505(a) · Plan of correction due date: Apr 21, 2022

87405(a) (a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications .......the state’s words, verbatim · CDSS document, Apr 21, 2022

Plan of correction: The Licensee shall submit an updated LIC500 as well as LIC308 with the Administrator designated substitute within seven (7) days.

Type of visit: Required - 1 Year

On 03/16/2022 Licensing Program Analyst (LPA) Misty Valencia arrived at the facility unannounced to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with Joann Jetton, Caregiver and explained the purpose of the visit. The administrator was not available for the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical masks. Additionally, LPA was screened by care staff at the front door before entering facility. . LPA Valencia and Ms. Jetton toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, bathrooms, kitchen, storage areas and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Ms. Jetton completed the infection control domain and facility was found to be in substantial compliance at this time. No deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report was emailed to administrator Rhonda Johnson.the state’s words, verbatim · CDSS document, Mar 16, 2022

Type of visit: Required - 1 Year

12/16/2021 10:30 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with care staff Zoey Bishop and explained the purpose of the visit. The administrator was not available for the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Mask, gloves. Additionally, LPA Knight was screened by care staff Zoey Bishop. LPA Knight and Ms. Bishop toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, bathrooms, kitchen, storage areas and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA Knight and Ms. Bishop completed the infection control domain and facility was found to be in substantial compliance at this time. No deficiencies are being cited as a result of todays inspection. Technical assistance was provided. Exit interview conducted and copy of report was emailed to administrator Rhonda Johnson.the state’s words, verbatim · CDSS document, Dec 17, 2021

The state marks this report as 7 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.