Graceful Living at Riverbank

Type of visit: Required - 1 Year

On 8/1/23 at approximately 1:00pm Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a required 1 year annual visit. LPA Jensen met with care provider Rosalinda Ortega and LPA spoke to Licensee Voica Matis by phone. The Administrator, Voica Matis, holds current Administrator's certificate # 6008538740 which is good through 12/16/23. LPA Jensen toured the grounds and physical plant. The grounds were observed to be well maintained and all paths were clear of obstruction. There is outdoor furniture so that residents may enjoy leisure activities outdoors. There are no bodies of water on the property. There are 3 bedrooms of which 2 are single occupancy and 1 is double occupancy. There are currently 4 residents. The front entrance is equipped with sign in logs and sanitizer. The entrance way also has postings that include infection control measures, Resident Council, Long Term Care Ombudsman, Personal Rights, Emergency Disaster Plan and facility sketch. The carbon monoxide detector and smoke detector was tested and determined to be in good working order. The fire extinguisher was last serviced in June of 2023 and is in compliance. The first aid kits were observed to be complete. The facility maintains emergency lighting and supplies on site. LPA Jensen toured the kitchen and observed all knives and sharp objects to be locked and inaccessible to residents in care. Chemicals, cleaning supplies and toxins are stored locked in the garage. The facility maintains in excess of a 2 day supply of perishable food and 7 day supply of non-perishable food. All food is labeled with the expiration date. There was fresh vegetables and fruit available for residents. The medication is stored in a locked cabinet and was observed to be inaccessible to residents in care. LPA Jensen conducted a random count of controlled medications and found the record keeping to be accurate. The effectiveness of all PRN medication is documented. LPA Jensen reviewed the Medication Administration Records (MARs) and found them to be accurate. LPA Jensen observed 3 of 3 bedrooms and determined all to be equipped with the required furniture. 1 of 4 residents has an exception authorized by his physician for the use of wheel chair instead of a bed. There is an adequate supply of linens maintained. The bathrooms were observed to be sanitary and equipped with grab bars at the toilet and in the shower. There were no toxins observed to be accessible in the 2 bathrooms. LPA Jensen measured the bathroom water temperature at 107 degrees Fahrenheit which falls within the required range of 105-150 degrees Fahrenheit. The thermostat was set at 75 degrees Fahrenheit for the comfort of the residents. LPA Jensen interviewed 2 of 2 staff members and 2 of 4 residents. The remaining 2 residents were not available for interviews. During the course of the staff interviews, activities were stressed as a key component of care. The resident roster was last updated in June of 2023 and accurately reflects the facility resident population. LPA Jensen reviewed 4 of 4 resident files and 2 staff files. LPA Jensen verified that the facility has scheduled some interior renovations including replacing the flooring and interior paint for later this month, mid to late August 2023. The Licensee does not anticipate any disruption of care for the residents but will notify the Department if any disruption or relocation is required. The facility was determined to be in substantial compliance and no deficiencies were cited as a result of this inspection. The facility was determined to be in substantial compliance and no deficiencies were issued as a result of this visit. An exit interview was conducted and a copy of this report and appeal rights were given to Rosalinda Ortega.the state’s words, verbatim · CDSS document, Aug 1, 2023

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 9/9/22 at 9:50am Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a required 1 year annual visit. LPA Jensen met with care provider Rosalinda Ortega. Licensee Voica Matis arrived at the facility shortly after. LPA Jensen explained the purpose of today's visit to Rosalinda Ortega and Voica Matis. The facility is a single story structure with a single designated entry point. The entry point has a sign in sheet and is equipped for COVID screening. The facility has 3 bedrooms, one of which is double occupancy and 2 single occupancy rooms. The bedrooms were observed to be adequately furnished. There was an adequate supply of linen on hand. The lighting throughout the facility was adequate. The thermostat was set at 76 degrees for the comfort of the residents. There is emergency lighting on hand. There are two 1st aid kits at the facility complete with scissors, tweezers, thermometer, various wound dressings and 1st aid manual. The bathrooms were observed to be sanitary and contained cleaning supplies that are locked in a cabinet under the sink. The temperature of the water in the bathroom measured at 124 degrees. There is a Caution-hot water sign posted. The fire extinguishers were last serviced in June of 2022 and are in compliance. The carbon monoxide and fire detectors were tested and are in good repair. The kitchen was observed to be sanitary. There was a 2 day supply of perishable food and 7 day supply of non-perishable food on hand. There was no expired food observed and items were labeled with expiration dates. Knives are stored in the kitchen in a locked drawer and are inaccessible to residents. Medications are stored in the kitchen in a locked cabinet and inaccessible to residents. Two sets of scissors were observed in an unlocked drawer in the kitchen under the microwave. A locked safe is stored in the refrigerator for medications that are temperature controlled. Continued on LIC 809C... Continued from LIC 809... The facility was free of odor and free of clutter. The carpeting in the bedrooms was observed to be stained in high traffic areas. The corners of the walls and walls in bathrooms were observed to be scraped from friction. The window screens were observed to be in good repair. The dining room and living room were sanitary and furnished sufficiently to accommodate the residents needs. The front and back yards are landscaped and well maintained. The backyard has a large concrete patio with outdoor furniture to accommodate all residents. The backyard patio also serves as the activity area. There are grapes growing along the backyard fence that are in season which the residents may consume if they choose. The exit path in the backyard was observed to be obstructed with an inoperable microwave, mattress, a glass shower door and frame and other debris. 4 of 4 resident files were reviewed. 1 staff file was reviewed. All staff present at the facility had criminal background clearance and were associated to the facility. The LIC 610 was reviewed and determined to be in compliance. The facility had the postings throughout including but not limited Resident Rights, COVID prevention, Ombudsman and See Something, Say Something. Deficiencies are being cited from the California Code of Regulations, Title 22, Division 6. An exit interview was conducted with staff member Rosalinda Ortega with permission of the licensee. A copy of this report along with appeal rights were given to Rosalinda Ortega.the state’s words, verbatim · CDSS document, Sep 9, 2022

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(f)(1) · Plan of correction due date: Sep 10, 2022

(f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement was not met as evidenced by: Based on LPA's observation of two sets of scissors in an unlocked drawer located in the kitchen under the microwave. This poses an immediate risk to the health, safety and personal rights of residents in care.the state’s words, verbatim · CDSS document, Sep 9, 2022

Plan of correction: The scissors were immediately relocated to a locked cabinet in the presence of the LPA. No further plan of correction is required at this time.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87303(a) · Plan of correction due date: Oct 7, 2022

(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by: Based on LPA's observation of the stained carpets and obstruction in teh backyard pathway including inoperable appliances, a mattress and shower glass door and frame plus various debris. This poses a potential health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Sep 9, 2022

Plan of correction: The licensee agrees to have the carpets cleaned and the debris removed from the backyard pathway to the exit by the POC due date. The licensee will email photos as proof of correction to maja.jensen@dss.ca.gov. The wall scuffs will addressed at a later date during an anticipated remodel.

Type of visit: Required - 1 Year

On 9/13/21 at 12:34pm, Licensing Program Analyst (LPA) Michael Bilger arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the lead caregiver Ma Emelina Cabangal and explained the purpose of the visit. Administrator Voica Matis was not present and gave permission for Ma Emelina Cabangal to sign in her absence. LPA Bilger inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, common TV area, and outside backyard of the facility to ensure compliance with Title 22 regulations. Facility is a 4 bed residential care facility for the elderly with a current census of 4. There are 3 bedrooms. Two are private, one room is shared. There are 2 bathrooms for resident use. There is a separate living room/TV area and laundry room which leads out to the emergency exit path. No obstructions to emergency exits noted. LPA also conducted the infection control domain tool. The facility submitted a LIC 808 mitigation plan, which was approved. The facility has central entry point and has implemented screening and sign in procedures at the front door area. The facility conducts routine symptom screening for employees, residents, and visitors. LPA observed the facility to have hand washing, COVID - 19 informational, and social distancing signs posted throughout the facility, on the front door, and back yard. The facility has a designated infection control lead. The facility is able to designate and dedicated a Covid-19 room/bathroom if needed. Common touch surfaces are cleaned after each use. Water temperature reads 113.5*F in the bathroom and room temperature reads 75*F. LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguisher was checked 6/17/2021. Facility has an emergency food and water kit. Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a report was given to lead caregiver Ma Emelina Cabangal.the state’s words, verbatim · CDSS document, Sep 13, 2021

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.