Cloverdale Better Living Senior Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Victoria Bertozzi arrived unannounced to conduct an Annual Required inspection and was greeted by Licensee/Administrator, Melissa Genet. LPA initiated a tour of the facility around 9:35am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in bathrooms used by residents measured at 110 and 1118 degrees F which are within the range of 105 to 120 degrees F allowed per regulation. Extra hygiene products and linens were available. Cabinet containing cleaning supplies was locked. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality and stored per regulation. Medications were centrally stored and locked. Emergency food and water supplies are stored in the pantry. Fire extinguishers were last serviced May 2023. Facility has a fire system that LPA is unable to test but us monitored and serviced by a vendor. Facility's most recent fire/disaster drill was conducted October, 2023. Three staff files and six resident files were reviewed. Staff have required First Aid and CPR certificates. Administrator Certificate for Administrator, Melissa Genet expires December 1, 2023.. Medications and medication records were reviewed. Training records were also reviewed. Licensee/Administrator to submit updates of the following documents by 12/09/2022: LIC 308 Designated Administrator (if applicable) LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan (review and update if changes) Infection Control Plan (if changes) Liability Insurance No deficiencies cited during this inspection.the state’s words, verbatim · CDSS document, Nov 9, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Victoria Bertozzi arrived unannounced to conduct an Annual Required inspection and met with Licensee/Administrator, Melissa Genet. The inspection is focused on the Infection Control procedures and practices of this facility. Upon arrival, LPA was screened by staff for Covid-19 which included a temperature check. LPA initiated a walk-through of the facility around 9:25 am and observed the following: Facility has COVID-19 posters throughout that include hand washing signs in bathrooms. Facility was a comfortable temperature and exits were free from obstructions. Hand sanitizer is located throughout common areas of the facility. Observed staff had masks on during this visit. Commonly touched surfaces are disinfected twice per day. Facility maintains documentation of staff and resident daily temperatures. Facility has multiple visitation areas outside and is allowing for visitation in resident rooms per CCL guidance. Staff continue to receive training on infection control and donning and doffing of Personal Protective Equipment (PPE) and have been N95 fit tested. LPA and Licensee discussed visitation and activities. Facility has submitted and CCL has reviewed their Covid Mitigation Plan. Facility has more than a 30 day supply of PPE including but not limited to masks, gowns, and hand sanitizer. Facility maintains a 30 day supply of medication. Fire extinguishers were last serviced November 2021. Facility has a centralized fire system that is maintained and serviced by a vendor. Per tag on fire panel, the most recent service was conducted October 2021 but per conversation with Licensee, the system was tested December 2021. LPA is unable to test system so reminded Licensee to have system tested and serviced. Carbon Monoxide detector was tested and operational. Continued on LIC809C Continued from LIC809C Licensee and LPA discussed their Emergency Disaster Plan and Infection Control Plan. Licensee/Administrator to submit updates of the following documents by 11/11/2022: LIC 308 Designated Administrator LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan (review and update if changes) Liability Insurance No deficiencies cited during this inspection.the state’s words, verbatim · CDSS document, Oct 11, 2022

Type of visit: Post Licensing

Licensing Program Analyst Willis arrived unannounced to conduct a Post Licensing Inspection. and met with Licensee, Melissa Genet. The inspection is focused on the Infection Control procedures and practices of this facility but LPA made additional observations. Upon arrival, Licensee checked LPA's temperature and documented in the visitor log. Facility has visitors sign in and asks them standard Covid-19 screening questions. Facility also conducts vaccination verification of visitors per CCL guidance. LPA conducted a walk-through of the facility and observed the following: Facility has COVID-19 posters throughout the facility that includes hand-washing signs located in bathrooms. Facility was a comfortable temperature and exits were free from obstruction. Previous physical plant issues have been corrected including replacement of a window in a resident room, replacing vanities in seven resident rooms, fixing the HVAC system, replacing and painting deck boards and filling in gaps on concrete sidewalk. Additionally, the Licensee has turned a previous area used as an office and storage area into a common area for residents that includes tables for activities. Facility has been painted in the interior and all rooms are set up per regulation. Hand sanitizer was available in common areas. LPAs observed staff wearing masks during this visit. Commonly touched surfaces are disinfected at least once per day. Staff are screened prior to each shift and residents are screened daily. LPAs and Licensee discussed resident activities and visitation. LPA confirmed that Licensee has created new Admission Agreements and Assessments due to retaining residents from the previous facility at this location. Continued on LIC809 Continued from LIC809 Facility has at least a 30 day supply of Personal Protective Equipment (PPE) including surgical masks, gloves, gowns, and hand sanitizer. Staff have been N-95 fit tested and trained regarding proper use of PPE. Fire Extinguisher was last serviced November 2021. Carbon monoxide detector was tested and operational. Facility has had a recent servicing of their fire system and a recent inspection from the fire department as part of the Change of Ownership. No deficiencies cited during this inspection.the state’s words, verbatim · CDSS document, Mar 2, 2022

Type of visit: Case Management - Other

Licensing Program Analysts Victoria Willis and Caitlynn Felias arrived unannounced to conduct a Case Management Inspection and met with current and former Licensees Vilma Richardson, Melissa Genet and William Lacayo. Facility received a provisional license effective 12/29/2021. Previous Licensee and live-in staff plans to be completely vacated from facility no later than 12/31/2021. LPAs and current Licensee discussed fingerprinting staff via the Guardian. Also discussed was the provisional license that is effective for one month. All physical plant issues must be remedied within that month. Licensee is in discussion with the landlord and has agreed to contact them via email notifying them that the facility is licensed and they must move forward in making repairs in order for the license to be permanently approved. Per discussion, the Licensee has contacted their insurance broker regarding their liability insurance. Once received, Licensee will submit proof of insurance to LPA. Licensee and former Licensee understand that the former facility, Clearwater Lodge is closed as of 12/29/2021. No deficiencies cited during inspection.the state’s words, verbatim · CDSS document, Dec 29, 2021

Type of visit: Prelicensing

Licensing Program Analysts Victoria Willis and Caitlynn Felias arrived unannounced to conduct a Pre-licensing inspection and met with Applicant, Melissa Genet. LPAs conducted a walk through of the facility with Applicant to discuss their plans for the facility once the current Licensee has vacated. Facility currently has three residents and each of their rooms are furnished per regulation. Vacant rooms are not fully furnished but according to Applicant, they have furniture in storage and will furnish rooms once they take over the facility. Additional physical plant issues are currently being discussed/addressed including painting, heating and air conditioning and replacement of a window in a vacant resident room. Facility is currently having heating issues on one wing of the facility that is currently not occupied by residents. Areas occupied and used by residents were a comfortable temperature. Applicant is currently discussing next steps with the landlord. Additionally, a sink in a vacant resident room is loose at the wall. LPA and Applicant discussed options including removing the sink. Personal items belonging to the current Licensee and live-in staff will be removed once Applicant takes over facility. Applicant's Administrator Certificate has been renewed until 12/1/2023. Per conversation with Applicant, the fire clearance approval should be sent to CCL within the next day. No deficiencies cited during this inspection.the state’s words, verbatim · CDSS document, Dec 22, 2021

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 10 Census (if any clients in care): 3 Method: Telephone call with CAB COMP II Participants: Melissa Genet, Applicant/Administrator Applicant/administrator participated in COMP II via telephone call with the analyst at CAB. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, Dec 7, 2021