Abraham Rest Home

Type of visit: Case Management - Deficiencies

On 05/17/2023 at 9:30 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct a Case Management visit regarding the deficiencies he identified during his 05/16/2023 complaint inspection. The LPA met with Administrator (ADM) Annette Sanchez. During the visit, the LPA toured the facility inside and outside with the ADM, reviewed documents, and interviewed staff members. During visit, LPA issued 2 Type B citations (refer to LIC809-D for details) and Civil Penalties for missing Caregiver Background checks (refer to LIC421BG for details). Exit interview conducted. Copy of this report provided via email.the state’s words, verbatim · CDSS document, May 17, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(g) · Plan of correction due date: May 24, 2023

87411 Personnel Requirements - General (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall This requirement was not met as evidenced by: Criminal record transfer for Claudia de la Cruz and initial DOJ certification for Dania Calderon had not been completed before working at the facility.the state’s words, verbatim · CDSS document, May 17, 2023

Plan of correction: During inspection, Administrator provided proof of transfer for Ms. de la Cruz, Ms. Calderon vacated the facility, and proof of the initiation of fingerprinting process for Ms. Calderon was provided.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87305(a) · Plan of correction due date: May 24, 2023

87208 PLAN OF OPERATION (a) Each facility shall have and maintain a current, written definitive plan of operation . . . on file in the facility . . . (7) Sketches, showing . . . (A) Building . . . uses intended and a designation of the rooms . . . for nonambulatory . . . and for bedridden residents . . . (B) The grounds showing buildings, driveways, fences . . . recreation area and other space used by the residents. This requirement was not met as evidenced by: Inaccurate and/or missing sketches of the building and the yard.the state’s words, verbatim · CDSS document, May 17, 2023

Plan of correction: On or before due date, Administrator shall send to LPA accurate and fully completed sketches in LIC999 and LIC200.

Allegation investigated: Facility front door is equipped with a inappropriate lock

On 05/15/2023 at 8:20 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct an initial 10-day investigation regarding the above allegation. LPA explained the purpose of the visit to staff. Administrator Sara Abraham arrived at 10:45 AM. LPA confirmed inappropriate lock on front upon entering facility. During a tour of the facility, 3 other sliding glass exit doors were "locked" in place with poles blocking movement of the glass door, thereby blocking exit. When asked, Caregiver Claudia de la Cruz confirmed what had been stated by Complainant that it was used to block residents' exit. Based on the data collected by observation and interview, the preponderance of evidence standard has been met; therefore, the above allegation has been found to be SUBSTANTIATED. Deficiency cited per Title 22 California Code of Regulations is listed on the LIC9099-D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report provided via email. Substantiatedthe state’s words, verbatim · CDSS document, May 16, 2023 · control 15-AS-20230515133330

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(2) · Plan of correction due date: May 17, 2023

Personal Rights of Residents in all Facilities: (a) Residents in all residential care facilities for the elderly shall ... (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by locking the front exit door from the inside, which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, May 16, 2023

Plan of correction: Licensee removed front door lock during visit.

Type of visit: Required - 1 Year

On 11/07/2022, Licensing Program Analyst (LPA) J. Sampair conducted an infection control annual inspection. LPA explained the purpose of the visit with Administrator Annette Sanchez. Facility toured inside and out. Facility has an infection control plan in place that they are following. The designated infection control leader is the administrator. They have one central entry point that has been designated for universal entry screening with the station located near the front entrance with visitor's log, hand sanitizer, face masks, and no touch thermometer. Facility follows daily cleaning, sanitation of frequently touched common surfaces with disinfectants. COVID-19 signs were posted to promote hand washing, cough/sneeze etiquette and physical distancing. No obstructions inside. Temperature inside facility was 69.4 and hot water was 118 degrees, Functioning carbon monoxide and smoke alarms. Fire extinguisher checked within a year. An administrator is on site more than the required 20 hour minimum each week to oversee business operations. . No citations were issued. Exit interview conducted, copy of Appeal Rights, and a copy of this report provided via email.the state’s words, verbatim · CDSS document, Nov 7, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) James Sampair conducted an infection control annual inspection. Upon arrival, LPA explained the purpose of the visit to staff members. LPA then began his tour of the facility inside and out after which he met with Licensee Sara Abraham who had arrived. The facility has a completed COVID-19 mitigation plan (LIC 808) and the LPA observed that staff are following all of the Department and Public Health Covid-19 infection control guidelines, including screening of all visitors and staff, all staff wearing face masks, and Covuid-19 signs at the entry point for visitors and throughout the facility to promote hand washing, cough and sneeze etiquette, physical distancing, and mask wearing. High level of care was provided to the residents. There were sufficient supplies of food and PPE. The temperature within the facility was maintained at a comfortable level. A certified administrator is on site more than the minimum of 20 hours a week to oversee proper business operation. The facility was cited for two deficiencies: Type A: hot water temperature measured at 135 degrees F Type B: repairing and cleaning in the outside and inside of the facility An exit interview conducted and a copy of this report was provided to the Licensee.the state’s words, verbatim · CDSS document, Dec 10, 2021