Silver House Assisted Living

Type of visit: Required - 1 Year

On 8/7/23 at 9:34 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection and was granted entry by staff. LPA met with Licensee/Administrator (LIC) Rachael Gardiner. LPA toured inside and outside the facility. Facility set at comfortable temperature. Smoke and carbon monoxide detectors tested and operational. All bedrooms observed with sufficient furnishings and lighting. Non-skid mats observed in showers. Grab bars observed for each toilet and shower. Smoke and carbon monoxide detectors tested and operational. Sharps observed locked. Centrally stored medication observed locked. Staff and resident records reviewed. Administrator certificate valid. The following deficiencies were observed: 1. Fire extinguisher last serviced on 6/3/21. 2. A bottle of toilet cleaner observed accessible in bathrooms 1 and 3; cabinet where all chemicals and cleaners are stored was accessible and stored in accessible laundry room; and various paint can sizes observed accessible in open cabinet in accessible garage. 3. S1 did not have a completed transfer of criminal record clearance and has been working in the facility since 6/28/21. 4. Bathroom #2 observed with curtain in doorway and door missing. 5. R2 does not have TB results and was admitted to the facility on 7/24/23. 6. Residents' medications were observed prepared in advance of five days in a separate week pill box located in the inaccessible kitchen drawer where sharps are stored. Continue on LIC809-C. Continued from LIC809. Deficiencies are being cited based on LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22, see LIC809Ds. A civil penalty is being assessed in the amount of $100 per day, for a maximum of 5 days, for a total of $500. See LIC421BG for more details. An exit interview was conducted and Plans of Corrections were reviewed and developed with the Licensee. A copy of this report and appeal rights were discussed and left with Licensee, whose signature on this form confirms receipt of these documents. The following updated forms are to be submitted to CCL within two weeks: LIC308, LIC500the state’s words, verbatim · CDSS document, Aug 7, 2023

The state marks this report as 14 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst LPA Shawna Doucette and Vadim Gorban conducted an Annual Infection Inspection on this date. LPA was met by Staff Becki Winters and discussed the purpose of the visit. Administrator Rachael Gardiner responded to the facility to assist with the inspection. LPA and Administrator Rachael Gardiner began the tour at the front entrance/office of the facility. Visitor log-in/temperature check, masks, and disinfection station was observed upon entry. Facility has one entrance/exit point. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common areas. Covid-19 related signs were observed in the common areas. Cleaning supplies were observed locked in cabinet in the laundry room. LPA observed the following personal protective equipment in office; gowns, gloves, face shields, hand sanitizer and masks. LPA observed all facility staff to be wearing masks upon arrival. Resident’s files have updated emergency contact information. LPA's reviewed staff training for Covid. Exit interview was conducted and a copy of this report was providedthe state’s words, verbatim · CDSS document, Aug 9, 2022

Type of visit: Office

An informal meeting was held on 07/20/2022 at the Fresno Regional Office. The purpose of the informal meeting was to discuss recently identified issues/concerns associated with the operation of the facility. The informal meeting process was explained during this meeting. The following were in attendance: Rachael Gardiner, Licensee/Administrator Becki Winter, Staff (Via Telephone) Sergiy Pidgirny, Licensing Program Manager Shawna Doucette, Licensing Program Analyst Licensee was provided with copies of all applicable regulations and/or Health and Safety Code.the state’s words, verbatim · CDSS document, Jul 20, 2022

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(g) · Plan of correction due date: Jul 21, 2022

87465 Incidental Medical and Dental Care (g) The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis except as specified in Sections 87469(c)(2), (c)(3), or (c)(4). This requirement was not met as evidenced by LIcensee did not call 911 once R1 had a change in condition. Licensee did not call 911 once resident passed and called another staff to respond to the facility prior to calling 911 which poses an immediate health, safety and/or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jul 20, 2022

Plan of correction: Plan of Correction POC Licensee agrees to come up with a written plan and understanding of this regulation.

Type of visit: Case Management - Incident

Licensing Program Analyst LPA conducted a Case Management to follow up on an incident report that occurred on 3/25/22. LPA was met by Staff Becki Winters and discussed the purpose of the visit. Administrator Rachael Gardiner responded to the facility to assist with the visit. LPA took resident's file to copy and will return by the end of the day. LPA's interviewed staff. An exit interview was conducted with the Administrator Rachael Gardiner.the state’s words, verbatim · CDSS document, May 27, 2022

Type of visit: Case Management - Incident

Licensing Program Analyst LPA conducted a Case Management to follow up on an incident report that occurred on 3/25/22 and return R1's file. LPA was met by Administrator Rachael Gardiner and discussed the purpose of the visit. An exit interview was conducted with the Administrator Rachael Gardiner.the state’s words, verbatim · CDSS document, May 27, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst LPA Shawna Doucette conducted an Annual Inspection on this date. LPA was met by Staff Mary Jane Ibnos and discussed the purpose of the visit. LPA and Medication Technician Becki Winters began the tour at the front entrance/office of the facility. Medication Technician Becki Winters responded to the facility to assist with the inspection. Visitor log-in/temperature check, masks, and disinfection station was observed upon entry. Facility has one entrance/exit point. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common areas. Hand washing and other various Covid-19 related signs were observed in the common areas. LPA observed a two day supply of perishable food and seven day supply of non-perishable food. Cleaning supplies were observed behind a locked door in garage. LPA observed the following personal protective equipment in a storage cabinet in garage; gowns, face shield, gloves, and masks. Staff records were reviewed for infection control training. LPA observed all facility staff wearing masks. Resident’s files have updated emergency contact information. No deficiencies were observed. Exit interview was conducted and a copy of this report was providedthe state’s words, verbatim · CDSS document, Jul 21, 2021

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.