Carewell at Pistachio

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced at Carewell at Pistachio LLC for the purpose of conducting a Case Management- Incident inspection. LPA was granted access to the facility by carestaff. LPA spoke with Administrator via phone. Department learned via a Special Incident Report (SIR) that on 07/16/2023 resident (R1) left the facility unassisted at 04:16 PM and was found by Local Law Enforcement nearby at 4:45 PM and returned to the facility unharmed. Resident's physician's report dated on 06/23/2022 states that resident has a diagnosis of dementia and not allowed to leave facility unassisted. Resident had been at the facility for one year with no history of wandering. LPA discussed re-training staff regarding wandering behaviors and safe practices for caring for residents with Dementia with Administrator. Administrator agreed to conduct a review with staff. No citations were issued. Exit interview conducted with care staff, Sonia Jones.the state’s words, verbatim · CDSS document, Aug 17, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jill Nakagawa conducted an unannounced 1 year required inspection and met with Benjamin Pulan, Caregiver. Administrator and Licensee were informed of inspection via phone and text message. The inspection is focused on the Infection Control procedures and practices of this facility. All visitors, essential visitors, and staff are screened upon entry. Temperatures are taken, and screening questions are to be answered before being allowed to remain in the facility; all information is logged. Residents are screened and observed for any changes, all information is logged. Facility was found to be clean, orderly, and at a comfortable temperature of 70 F with all exits free from obstruction. Toxins are stored in locked cabinets and in the locked laundry room. There was a sufficient supply of hygiene products, cleaners, and paper products for use as needed. Medications were stored in locked cabinets in the kitchen making them inaccessible to residents. Residents able to administer own medications have locked cabinets in their rooms for storage of medications. All exit alarms were on exit doors and working properly. All bathrooms had grab bars, and non-slip mat/flooring for bathing as needed. There is a visitation area outside in the backyard, with a view of pool, which is fenced and inaccessible. All postings were up and visible to all as required. Facility has a sufficient supply of personal protective equipment (PPE). Administrator and all staff and 1 visitor had a mask on during the LPA's inspection. There is an approved Fire Clearance and hospice waiver for six (6) residents. Mitigation plan was approved by the Department on 04/22/21. The Licensee has also submitted an Infection Control Plan. There were six (6) residents in care at the facility during this inspection. No deficiencies during today's inspection. No citations issued. Exit interview conducted with Benjamin Pulan, Caregiver.the state’s words, verbatim · CDSS document, Feb 7, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jill Nakagawa conducted an unannounced 1 year required inspection and met with Administrator Paulin Pantig and Benjamin Pulan, Caregiver. The inspection is focused on the Infection Control procedures and practices of this facility. All visitors, essential visitors, and staff are screened upon entry. Temperatures are taken, and screening questions are to be answered before being allowed to remain in the facility; all information is logged. Residents are screened and observed for any changes, all information is logged. Facility was found to be clean, orderly, and at a comfortable temperature of 74 F with all exits free from obstruction. Toxins are stored in locked cabinets and in the locked laundry room. There was a sufficient supply of hygiene products, cleaners, and paper products for use as needed. Medications were stored in locked cabinets in the kitchen making them inaccessible to residents and staff that do not handle medications. All exit alarms were on exit doors and working properly. All bathrooms had grab bars, and non-slip mat/flooring for bathing as needed. All postings were up and visible to all as required. Facility has a sufficient supply of personal protective equipment (PPE). Administrator and all staff and 1 visitor had a mask on during the LPA's inspection. There is an approved Fire Clearance and hospice waiver for six (6) residents. Mitigation plan was approved by the Department on 04/22/21. There were six (6) residents in care at the facility during this inspection. No deficiencies during today's inspection. No citations issued. Exit interview conducted with Benjamin Pulan, Caregiver.the state’s words, verbatim · CDSS document, Feb 1, 2022

Allegation investigated: Facility did not meet resident's nutritional needs

Licensing Program Analyst (LPA) Jill Nakagawa conducted a complaint investigation regarding the allegation listed above. LPA arrived unannounced on this day for the purpose of delivering findings of the above allegation and met with Benjie Pulan, Care Staff with Paulin Pantig, Administrator (via phone). It is alleged facility is not meeting the resident’s nutritional needs. During the investigation LPA reviewed records, made observations at the facility on 3 separate occasions (10/21/2021, 10/29/2021, 11/03/2021) and conducted interviews and obtained photos. At today’s inspection, LPA observed that the facility was well-stocked and had a two day supply of perishable foods (including watermelon, pineapple, apaplesauce, juices) and a seven day supply of non-perishable foods as required in regulation Title 22, Division 6, Chapter 8, Article 10, Food Services. LPA observed food stores on several visits on different days of the week, and found supplies were within regulation. Although the allegation may have happened, or is true, there is not a preponderance of evidence to prove the allegation is true or did, or did not, happen. Therefore, the allegation is UNSUBSTANTIATED. Unsubstantiatedthe state’s words, verbatim · CDSS document, Dec 23, 2021 · control 21-AS-20211019122728

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.

Allegation investigated: Untrained staff

At approximately 9:30AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to deliver findings for the above allegation. LPA was met by Staff 1, and was asked Covid-19 screening questions and temperature was taken. LPA received copies of training records on 08/05/2021 that documented the required training hours for staff. At approximately 9:45AM, LPA reviewed additional training records at the facility. Staff are trained using a computerized training system as well as in person trainings that are conducted with a Vendorized instructor. Administrator Paulin Pantig arrived at approximately 10:25AM, and provided LPA with additional training records. This agency has investigated the above allegation. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. No Citations issued during today's visit. Unfoundedthe state’s words, verbatim · CDSS document, Aug 6, 2021 · control 21-AS-20210317161820

Allegation investigated: Neglect/Lack of Supervision staff failed to seek timely medical attention for resident in care.

At approximately 12:30PM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility to deliver findings from an investigation conducted by the department into the above allegation. LPA was met by caregiver and screened upon entry. Based on interviews conducted and a review of records the above allegation is found to be Substantiated. Licensee did not ensure medical attention was sought in a timely manner. A fall occurred between approximately 7:30AM and 8AM on 3/16/2021, resulting in an injury to a resident. Emergency medical personnel were not contacted until 9:41AM, approximately 2 hours after the fall occurred. Based on the Departments investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Appeal rights were given. Due to technical issues, a paper copy was not provided. A copy of this report was emailed to Licensee. Substantiated LPA observed the records contained the required documentation. Physician reports were current for residents with Dementia and were within regulation. LPA found resident appraisals that were 3 months past due in 3 resident files. Admission agreements were all signed by responsible parties and facility representative. LPA reviewed medication records and found centrally stored medication records matched physician orders. Facility utilizes a computerized medication administration record (MAR), and the record indicated the medications were given as ordered. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated. Due to technical issues, a paper copy was not provided. A copy of this report was emailed to Licensee.the state’s words, verbatim · CDSS document, Aug 4, 2021 · control 21-AS-20210317161820

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(g) · Plan of correction due date: Aug 5, 2021

Incidental Medical and Dental Care Services. 9-1-1 shall be telephoned immediately if an injury or other circumstance has resulted in an imminent threat to a resident’s health... apparent life-threatening medical crisis. This requirement is not met as evividenced by: Based on interviews conducted, Licensee did not seek emergency medical care in a timely manner. This poses an Immediate risk to residents in care.the state’s words, verbatim · CDSS document, Aug 4, 2021

Plan of correction: Licensee agrees to submit updated procedures for medical emergencies stating how they will ensure the health and safety of residents in the case of an imminent health risk by POC due date of 08/05/2021.

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.